title: Neo-epitope tissue transglutaminase autoantibodies as a biomarker of the gluten sensitive skin disease--dermatitis herpetiformis.
abstract: BACKGROUND
  The deamidated gliadin peptides (DGP) cross linked to human tissue transglutaminase (tTg) comprises a novel neo-epitope structure (Neo-tTg) for serological screening of celiac disease (CD). Our aim is to verify anti-Neo-tTg IgA and IgG in adults with dermatitis herpetiformis (DH).
  
  
  METHODS
  Multi-centric retrospective evaluation of the IgA/G autoantibodies in sera of DH patients on a regular diet (n=40) and a gluten restricted diet (GRD, n=53) and control adults with autoimmune skin diseases (n=107) by ELISA.
  
  
  RESULTS
  The sensitivities of Celicheck Neo IgA/G (76%, 95% CI 67-84%) and the Neo tTg-A (85%, 95% CI 70-97%) ELISA were significantly greater than that of tTg-A (56%, 95% CI 46-67%), eTg-A (62%, 95% CI 52-72%), DGP-A (55%, 95% CI 55-65%), DGP-G (61%, 95% CI 51-71%), Glia-A (55%, 95% CI 45-65%) and Glia-G (56%, 95% CI 46-66%) ELISA. The specificities of all 8 ELISA were in the range of 90-100%. The area under the curve (AUC) of receiver operator characteristic curve (ROC) for the two Neo-tTg ELISA (0.863 and 0.949) were higher than the AUCs for ROCs of tTg, DGP and eTG ELISA (range between 0.657 and 0.783). The autoantibody levels of DH patients on a normal diet were significantly higher than those on GRD in the Celicheck Neo IgA/IgG, NeotTg-A; tTg-A and the eTg-A; ELISA (p<0.01) and of no significance in the DGP and Gliadin ELISA.
  
  
  CONCLUSIONS
  Neo-epitope IgA autoantibodies represent a new and sensitive serological marker of DH.
authors.affiliation: SeraDiaLogistics, München, Germany. Simon.lytton@t-online.de
authors.forename: Simon D
authors.initials: SD
authors.lastname: Lytton
authors.forename: Emiliano
authors.initials: E
authors.lastname: Antiga
authors.forename: Sascha
authors.initials: S
authors.lastname: Pfeiffer
authors.forename: Torsten
authors.initials: T
authors.lastname: Matthias
authors.forename: Anna
authors.initials: A
authors.lastname: Szaflarska-Poplawska
authors.forename: Vijay K
authors.initials: VK
authors.lastname: Ulaganathan
authors.forename: Waldemar
authors.initials: W
authors.lastname: Placek
authors.forename: Paolo
authors.initials: P
authors.lastname: Fabbri
authors.forename: Russell
authors.initials: R
authors.lastname: Hall
authors.forename: Marzia
authors.initials: M
authors.lastname: Caproni
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001323:Autoantibodies / Q000032:analysis* / Q000276:immunology; D015551:Autoimmunity; D015415:Biomarkers / Q000378:metabolism; D003874:Dermatitis Herpetiformis / Q000175:diagnosis* / Q000276:immunology* / Q000473:pathology; D055050:Diet, Gluten-Free; D004797:Enzyme-Linked Immunosorbent Assay; D000939:Epitopes / Q000276:immunology; D005903:Gliadin / Q000276:immunology*; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis* / Q000276:immunology; D007074:Immunoglobulin G / Q000032:analysis* / Q000276:immunology; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D012867:Skin / Q000276:immunology / Q000473:pathology; D011503:Transglutaminases / Q000276:immunology* / Q000378:metabolism
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D000939:Epitopes; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D005903:Gliadin; D011503:Transglutaminases