title: Primate liver tissue as an alternative substrate for endomysium antibody immunofluorescence testing in diagnostics of paediatric coeliac disease.
abstract: BACKGROUND
  Immunofluorescence assays of antibodies against endomysium (EmA) on primate oesophagus sections represent the gold standard in serological testing for coeliac disease (CD). As alternative immunofluorescence technique, staining of primate liver tissue is in use. We compared performance and predictive power of IgA- and IgG-EmA on primate oesophagus and primate liver sections.
  
  
  METHODS
  Sera of 298 paediatric biopsy-proven CD patients under gluten-containing diet and 574 disease controls were investigated. Samples were collected between 2004 and 2013 in six children's hospitals. The antibodies were assayed blinded to diagnoses and histological data. Sensitivity, specificity, and positive (PPV) and negative predictive values (NPV) were calculated for different assays.
  
  
  RESULTS
  (Oesophagus vs liver): For IgA-EmA, sensitivity (0.953 vs 0.956) and specificity (0.981 vs 0.972) as well as PPV (0.963 vs 0.947) and NPV (0.976 vs 0.979) were comparable on both tissues. IgG-EmA on liver showed significantly higher sensitivity (0.520 vs 0.631; p=0.006) but significantly lower specificity (0.995 vs 0.963; p=0.002) and PPV (0.981 vs 0.899; p=0.0002) than on oesophagus. NPV on liver was higher than NPV on oesophagus, however, the difference was not statistically significant (0.799 vs 0.834; p=0.099).
  
  
  CONCLUSIONS
  Primate liver can be used as alternative, equally well functioning substrate for IgA-EmA testing.
authors.affiliation: Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Medical Faculty of the University and University Hospital, Leipzig, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Wolf
authors.affiliation: EUROIMMUN Medizinische Labordiagnostika AG Lübeck, Germany.
authors.forename: Annika
authors.initials: A
authors.lastname: Jahnke
authors.affiliation: EUROIMMUN Medizinische Labordiagnostika AG Lübeck, Germany.
authors.forename: Kai
authors.initials: K
authors.lastname: Fechner
authors.affiliation: Children's Hospital of the Clinical Centre "Sankt Georg" Leipzig, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Richter
authors.affiliation: University Children's Hospital, Technische Universität Dresden, Germany.
authors.forename: Martin W
authors.initials: MW
authors.lastname: Laass
authors.affiliation: University Children's Hospital Graz, Austria.
authors.forename: Almuthe
authors.initials: A
authors.lastname: Hauer
authors.affiliation: University Children's Hospital Tübingen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Stern
authors.affiliation: Children's Hospital, Justus Liebig University Giessen, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: de Laffolie
authors.affiliation: University Children's Hospital Leipzig, Germany.
authors.forename: Gunter
authors.initials: G
authors.lastname: Flemming
authors.affiliation: Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Medical Faculty of the University and University Hospital, Leipzig, Germany. Electronic address: mothes@medizin.uni-leipzig.de.
authors.forename: Thomas
authors.initials: T
authors.lastname: Mothes
mesh_terms: D000818:Animals; D001323:Autoantibodies / Q000032:analysis*; D016022:Case-Control Studies; D002446:Celiac Disease / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D003238:Connective Tissue / Q000276:immunology*; D004947:Esophagus / Q000276:immunology; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D008099:Liver / Q000276:immunology*; D009130:Muscle, Smooth / Q000276:immunology; D011323:Primates; D012680:Sensitivity and Specificity
chemical_list: D001323:Autoantibodies; D007070:Immunoglobulin A; D007074:Immunoglobulin G
keywords: Coeliac disease; Endomysium antibodies; Liver; Oesophagus; Serology