Evaluation of a Microsphere‐Based Flow Cytometric Assay for Diagnosis of Celiac Disease

Abstract

The multiplexed particle-based flow cytometric technology proposes a new approach for the diagnosis of autoimmune diseases combining the advantages of conventional methods with the ability to quantitatively determine multiple autoantibodies in the same sample, simultaneously and rapidly. Recently, a commercial kit (FIDIS Celiac, Biomedical Diagnostics, Mane la Vallé, France) was introduced for the simultaneous detection of IgA anti-tissue transglutaminase (anti-tTG), IgG, and IgA anti-gliadin antibodies (AGA). This study was undertaken to evaluate and compare the FIDIS Celiac kit with standardized commercial ELISAs (QUANTA Lite, INOVA Diagnostics Inc., San Diego, CA). A disease group consisted of 21 samples from untreated patients with biopsy confirmed celiac disease (CD), and two control groups of historical sera (207 from regular blood donors and 181 from chronically infected hepatitis patients) were studied. All control sera were negative for IgA anti-endomysial antibodies (EmA) and had an IgA concentration above the lower normal limit. Concerning the reproducibility, intra- and inter-assay coefficients of variation (CVs) ranging between 2% and 12%, and between 3% and 21%, respectively, were observed. Regarding the diagnostic quality, each assay was compared to the disease diagnosis using the McNemar test and the kappa (K) parameter, while ROC analysis was applied. Generally, the performance of FIDIS assay was proved almost equally adequate to that of ELISA in the detection of IgA anti-tTG antibodies, IgA and IgG AGA. However, the performance of FIDIS assay was found surmounting that of ELISA among hepatitis patients, possibly due to the avoidance of debris and unbound cross contaminants and, hence, the "noise" of such materials in samples under analysis. Taking our results together with the simplicity and the high throughput of FIDIS assay, its overall performance in the diagnosis of CD seems better than that of ELISA.

Prevalence and Clinical Significance of Immunoglobulin A Antibodies against Tissue Transglutaminase in Patients with Diverse Chronic Liver Diseases

“…It is worth mentioning that our cutoff values were substantially higher than those proposed by the manufacturers. More precisely, the cutoff values that we used for ELISA and MFC assay were 25.4 and 69.5 arbitrary units (AU)/ml in controls and 26.2 and 74 AU/ml in hepatitis patients, respectively (49). Specimens with anti-tTG antibody concentrations above these cutoff values by either of the methods used were deemed positive.…”

Performance of Antibodies against Tissue Transglutaminase for the Diagnosis of Celiac Disease: Meta-Analysis

“…Although sensitivity estimates differ across studies in terms of absolute values, the studies do not show significant heterogeneity in terms of diagnostic power. The SROC curve analysis showed that the diagnostic performance of the various studies closely follows a satisfactory defined path of trade-off between sensitivity and specificity (7,16,21,28,33,37). The independent estimates of sensitivity and specificity can be reliable estimates (perhaps not for the rh-tTG studies using the most popular assay), since they are relatively close to the SROC curve.…”

Autoantibody Detection Using Multiplex Technologies

“…A FIDIS kit has been reported for this determination. 89 Twenty-one samples from patients with untreated, biopsy confirmed celiac disease were tested, as well as sera from 207 blood donors and 181 patients with chronic hepatitis. The results for the celiac markers showed good agreement with ELISA; the multiplexed assay generated fewer positive results for the hepatitis controls.…”