title: Anti-transglutaminase immunoreactivity and histological lesions of the duodenum in coeliac patients.
abstract: Coeliac disease (CD) is characterized by several markers, including anti-transglutaminase auto-antibodies (tTGAb) directed against multiple epitopes of the gliadin protein. We aimed to investigate the correlation among CD duodenal lesions, tTGAb titres and the immunoreactivity against tTG constructs. A total of 345 CD patients (209 females, 136 males, overall median age: 7.3 years) were tested for full-length (fl) tTGAb with a fluid-phase radioimmunoassay. Out of the total, 231 patients were also tested for immunoreactivity against tTG fragments (F1: a.a. 227-687 and F2: a.a. 473-687). Patients were classified according to diffuse (D), patchy (P) or bulb (B) histological lesions. All sera were found fltTGAb positive. Patients with D, P and B lesions had a mean Ab index of 0.84±0.39, 0.57±0.39 and 0.45±0.24, respectively. Mean tTGAb titre varied between D and localized (P+B) patients (0.84±0.39 versus 0.52±0.34, P < 0.0001). Overall, 86.1% of patients were F1 auto-antibody (F1Ab) positive (D: 89%, P: 75%, B: 40%; D versus P+B: P = 0.004) and 49% of patients were F2 auto-antibody (F2Ab) positive (D: 53%, P: 19%, B: 10%; D versus P+B: P = 0.0006). Of the D patients 50.7% showed combined F1Ab-F2Ab (D versus P+B: P = 0.001), whereas 60% of B patients were negative for both F1Ab and F2Ab (B versus D: P < 0.0001). Coeliac-specific tTGAb immunoreactivity correlates with the grading and extension of histological duodenal lesions in CD patients at diagnosis. The immunoreactivity against single and combined tTG fragments is significantly higher in patients with D lesions. This is the first evidence of a distinct coeliac-specific immunoreactivity in patients with different duodenal involvement.
authors: Department of Paediatrics, Sapienza University of Rome, Rome, Italy. raffaella.nenna@uniroma1.it
authors: Raffaella
authors: R
authors: Nenna
authors: Claudio
authors: C
authors: Tiberti
authors: Laura
authors: L
authors: Petrarca
authors: Maurizio
authors: M
authors: Mennini
authors: Gerarda
authors: G
authors: Mastrogiorgio
authors: Federica
authors: F
authors: Lucantoni
authors: Francesca
authors: F
authors: Panimolle
authors: Stefano
authors: S
authors: Pontone
authors: Maria
authors: M
authors: Bavastrelli
authors: Fabio Massimo
authors: FM
authors: Magliocca
authors: Margherita
authors: M
authors: Bonamico
mesh_terms: D000293:Adolescent; D000328:Adult; D002446:Celiac Disease / Q000201:enzymology / Q000276:immunology* / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D004386:Duodenum / Q000201:enzymology / Q000276:immunology* / Q000473:pathology*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D011503:Transglutaminases / Q000276:immunology*; D055815:Young Adult
chemical_list: D011503:Transglutaminases
keywords: anti-transglutaminase antibodies; coeliac disease; histological lesions; tTG target domains