Antibodies to Gliadin in Children with Coeliac Disease

Abstract

We have measured antibodies to gliadin (AGA), bovine beta-lactoglobulin, and chicken egg ovalbumin with a four-layer solid phase radioimmunoassay (RIA) in 62 children and adolescents with coeliac disease and in 36 healthy controls. The geometric mean titre of IgG AGA in patients at initial diagnosis was more than 100-fold that of controls (p less than 0.0001). Even patients on gluten-free diet had significantly higher IgG AGA titres than the controls (p = 0.0001), the difference being more than 5-fold. All the 42 patients with active disease (30 at initial diagnosis and 12 after gluten challenge) had their IgG AGA titre above 1,000, as compared with 2 (5.7%) of the 35 controls (p less than 0.0001). Both IgG and IgA AGA were quite sensitive and specific in identifying children with coeliac disease; the sensitivities for IgG and IgA AGA were 100% and 95.2%, the specificities 94.3% and 97.2%, respectively. We conclude that determination of IgG and IgA AGA with RIA is suitable for monitoring dietary compliance in children with coeliac disease, and the method is sensitive and specific for screening for coeliac disease in children.

Serum Food Antibodies Analyzed by Enzyme‐Linked Immunosorbent Assay (ELISA) and Diffusion‐in‐Gel (DIG)‐ELISA Methods in Children with and without Celiac Disease

“…As expected, we found that celiac children at presentation have significantly higher levels of IgA and IgG antibodies to gliadin than reference children (1). We also confirmed previous observations (11,13,15,16) that they have elevated levels of other food antibodies as well. Unlike other reports describing no elevation of antigliadin IgM (8), or elevated levels in IgA-deficient individuals only (4), we found significant differences in the IgM isotype against gliadin as well.…”

“…Both solid-phase ELISA (4), such as diffusion-in-gel (DIG)-ELISA (5)(6)(7), and conventional ELISA (8-10) have been used. Other methods include fluorescent immunosorbent (11), dot immunobinding assay (12), and solid-phase radioimmunoassay (13). 56 combined information from IgA and IgG antigliadin antibodies gave the highest specificity (94%) and sensitivity (89%).…”

“…Analyses of antibodies to other food constituents have also been performed in celiac disease (13)(14)(15)(16). The antibody levels have been found to be elevated in untreated patients (13)(14)(15)(16) and fall in response to mucosal healing (13,15,16).…”

Follow-up of patients with celiac disease: Achieving compliance with treatment

“…Studies from Australia, Brazil, Finland, Italy, and the United Kingdom all correlated AGA titers to dietary adherence. [7][8][9][10][11][12] In Italy, it was reported that patients with poor to moderate compliance with the GFD had high levels of both AGA IgA and IgG 75% and 40% of the time, respectively. 11 However, AGA were elevated in 24% of those reporting good compliance, indicating perhaps a fictitious patient account, inadvertent gluten contamination of the diet, or a poor positive predictive value of AGA for villous damage.…”

Peripheral γδ T Cell Receptor‐Bearing Lymphocytes Are Increased in Children with Celiac Disease

“…(In active celiac disease, eight samples were taken before treatment and five samples after a gluten challenge.) DISCUSSION Some of the immune abnormalities in celiac disease may be due to loss of oral tolerance to gluten ; patients have strikingly high titers of IgG and IgA antibodies to gliadin (12), which are produced even before the appearance of dam age to the jejunal structure (13). In mice, oral tolerance to thymusdependent antigen can be abolished by transferring intraepithelial ''is TCR + lymphocytes (14).…”