Diagnostic efficacy of the ELISA test for the detection of deamidated anti‐gliadin peptide antibodies in the diagnosis and monitoring of celiac disease

Tonutti, Elio; Visentini, Daniela; Picierno, Alessia; Bizzaro, Nicola; Villalta, Danilo; Tozzoli, Renato; Kodermaz, Graziano; Carroccio, Antonio; Iacono, Giuseppe; Teresi, S.; Chiusa, Stella Maria La; Brusca, Ignazio

doi:10.1002/jcla.20313

Cited by 37 publications

(28 citation statements)

References 31 publications

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“…The high diagnostic sensitivity obtained with the IgG-anti-dGli assay is comparable with results of previous smaller studies on IgA-deficient CD patients (9,19 ) and with reports on individual IgA-deficient cases (17,18 ) applying another test based on dGli as the antigen.…”

supporting

confidence: 87%

“…Recently, 8 IgA-deficient CD children were described (11,17,18 ) who all had low concentrations of IgA-anti-tTG and IgA-anti-dGli but high concentrations of IgG-anti-dGli. Two further studies, each including 20 IgA-deficient CD patients, revealed higher accuracy of IgG-anti-dGli detection compared with antibodies against native gliadin (9,19 ). However, IgG-anti-dGli did not achieve as high a diagnostic accuracy as IgG-anti-tTG.…”

mentioning

confidence: 93%

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IgG Antibodies against Deamidated Gliadin Peptides for Diagnosis of Celiac Disease in Patients with IgA Deficiency

et al. 2010

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Background: Assays for IgG antibodies against deamidated gliadin (IgG-anti-dGli) are comparable in performance with tests detecting IgA antibodies against tissue transglutaminase (IgA-anti-tTG) in diagnosing celiac disease (CD). IgA-anti-tTG are absent in IgA deficiency, a condition often associated with CD. In IgA deficiency, IgG-anti-tTG, which have a lower overall diagnostic accuracy, are routinely measured. We examined whether IgG-anti-dGli would be useful for diagnosing CD in patients with IgA deficiency.Methods: We studied 34 IgA-deficient CD patients, 185 IgA-competent newly diagnosed children with CD, 316 children without CD, 400 adult blood donors, and 6 control IgA-deficient individuals without CD. Anti-dGli and anti-tTG were measured by ELISA, and endomysium antibodies (EmA) were measured by immunofluorescence on monkey esophagus (IgA as well as IgG class for all antibodies). We calculated diagnostic sensitivity (percentage of patients above cutoff with 95% CIs) according to age-specific cutoffs for 95% diagnostic specificity and according to cutoffs proposed by the manufacturer of the assays.Results: No IgA-deficient CD patients were positive for any IgA-based antibody assay. Diagnostic sensitivity of IgG-anti-tTG was 91.2% (95% CI 76.3%–97.7%) according to age-specific cutoffs and 82.4% (66.1%–92.0%) according to manufacturer cutoffs. The diagnostic sensitivity of IgG-EmA was 75.8% (58.8%–87.4%) and the sensitivity of IgG-anti-dGli was 88.2% (72.8%–95.9%) according to both cutoffs.Conclusions: IgG-anti-dGli and IgG-anti-tTG have comparable diagnostic sensitivities for IgA-deficient celiac patients. IgG-anti-dGli may be useful for diagnosing CD in IgA-deficient patients.

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confidence: 93%

IgG Antibodies against Deamidated Gliadin Peptides for Diagnosis of Celiac Disease in Patients with IgA Deficiency

et al. 2010

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“…These data were subsequently confirmed by Sugai et al (39). A clinical study by Tonutti et al (40) involving a large group of children with CD, some of whom were anti-tTG negative, showed that anti-DGP antibodies have very high sensitivity and specificity.…”

Section: Introductionmentioning

confidence: 71%

“…In recent years it has been shown that the new anti-DGP ELISA tests using deamidated gliadin peptides as antigen have a high sensitivity and a specificity comparable to those of anti-tTG and EMA and higher than AGA (25,(38)(39)(40).…”

Section: Discussionmentioning

confidence: 99%

The old and new tests for celiac disease: which is the best test combination to diagnose celiac disease in pediatric patients?

Brusca

Carroccio²,

Tonutti³

et al. 2012

Clinical Chemistry and Laboratory Medicine

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Background: In the diagnosis of celiac disease (CD), serum assays for anti-endomysium (EMA) and anti-transglutaminase (anti-tTG) antibodies have excellent diagnostic accuracy. However, these assays are less sensitive in young pediatric patients. Recently, a new ELISA test using deamidated gliadin peptides (DGP) as antigen has proved to be very sensitive and specific even in pediatric patients. In addition, anti-actin IgA antibodies (AAA) is another test that can be used in CD patients because antibody concentrations correlate with the degree of villous atrophy. This study evaluated the clinical accuracy of anti-tTG, EMA, AGA, anti-DGP and AAA and the effectiveness of these in different combinations for diagnosing CD in a large cohort of pediatric patients. Methods: Sera of 150 children under 6 years of age were tested: 95 patients had a diagnosis of CD, while 55 patients who did not suffer from CD were used as controls. Anti-DGP IgA/IgG and AAA were assayed with ELISA kits, while anti-tTG IgA/IgG and AGA IgG/IgA were assayed using a quantitative fluoroimmunoassay. The EMA test was conducted by indirect immunofluorescence.

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“…These criteria were met by the studies listed in Table 1. 10,11,[17][18][19][20][21][22][23][24] Sensitivities, specificities, study prevalences together with positive predictive values (PPV) and negative predictive values (NPV) are shown whenever these where reported (definition of the terms according to Jørgensen et al, 25 Table 2). Because information of normal distribution of data was rarely given, it was decided to use nonparametric median and ranges.…”

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confidence: 99%

Serological testing for celiac disease in adults

Schyum

Rumessen

2013

UEG Journal

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Background and aim: We present a systematic review on the performance of currently available methods for serological diagnosis of celiac disease (CD) and the role of human leukocyte antigen (HLA) typing. Objective: A literature survey was conducted using PubMed, MeSH database, Web of Science as well as manual searches. Results: Tissue transglutaminase antibodies (tTG) (IgA) (tested in nine studies) show sensitivities and specificities in the range of 0.76-0.968 and 0.909-0.98, and deamidated gliadin peptide (DGP) (IgA and IgG) (tested in eight studies) show sensitivities and specificities in the range of 0.69-0.984 and 0.903-1. Endomysial antibodies (EMA) (tested in five studies) show sensitivities and specificities in the range of 0.61-0.937 and 0.98-1, respectively. Combination assays (tested in three studies) using DGP þ tTG and DGP (IgA þ IgG) show sensitivities and specificities in the range of 0.87-1 and 0.8-1, respectively. HLA DQ2/DQ8 may be necessary for the development of CD-HLA DQ2 in particular. A possible close correlation may also exist between CD and HLA-G. Conclusion: DGP and tTG for serological testing for CD show equivalent diagnostic performance. More studies with, in particular, DGP alone and in combination with tTG are necessary before a firm recommendation can be made. HLA typing to exclude CD may still be controversial. It still seems premature to diagnose celiac disease in adults based on serology alone.

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Diagnostic efficacy of the ELISA test for the detection of deamidated anti‐gliadin peptide antibodies in the diagnosis and monitoring of celiac disease

Cited by 37 publications

References 31 publications

IgG Antibodies against Deamidated Gliadin Peptides for Diagnosis of Celiac Disease in Patients with IgA Deficiency

IgG Antibodies against Deamidated Gliadin Peptides for Diagnosis of Celiac Disease in Patients with IgA Deficiency

The old and new tests for celiac disease: which is the best test combination to diagnose celiac disease in pediatric patients?

Serological testing for celiac disease in adults

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