IgA anti-endomysial antibodies on human umbilical cord tissue for celiac disease screening

Abstract

Since celiac disease screening by traditional IgA anti-endomysial antibody test is limited by high costs of monkey esophagus commercial kits as well as by rising ethical problems related to the endangered species, the identification of an inexpensive and commonly available substrate for this antibody determination is urgently required. To achieve this goal, we compared the prevalence of IgA anti-endomysial antibodies detected on monkey esophagus with that on human umbilical cord. Fifty-seven (95%) of 60 untreated adult celiacs were positive for these antibodies on monkey esophagus as well as on human umbilical cord. IgA anti-endomysial antibodies, detected on both tissues, were negative in all 200 disease and healthy controls tested, displaying a 100% specificity for gluten-sensitive enteropathy. These data suggest that human umbilical cord can replace monkey esophagus for IgA anti-endomysial antibodies test. Human umbilical cord allows unlimited testing for celiac disease screening on wide series of high-risk subjects, permitting identification of greater numbers of asymptomatic celiac patients with a remarkable saving of money and bypassing the ethical problems related to killing monkeys.

Antiendomysium antibodies in brazilian patients with celiac disease and their first-degree relatives

“…In 1995, VOLTA et al (71) , using human umbilical cord instead of monkey's esophagus as substrate, showed the same specificity and sensitivity of EmA IgA in both techniques. These data were then confirmed by BAGNASCO et al (6) in relatives of patients with CD.…”

“…Monkey's esophagus is ethically questionable for large scale screening (71) . The endomysial antibody has been found to have a greater specificity and sensitivity (15,33) .…”

Screening of celiac disease in patients with autoimmune thyroid disease from Southern Brazil

“…All subjects were screened for IgA-EmA according to Volta and cols. (15), using indirect immunofluorescence with cryostatic sections of human umbilical cord as substrate, with initial dilution 1/2.5. Secondary anti-human IgA conjugate antibodies (GMK, Porto Alegre, Brazil) were used in the reactions.…”

“…Positive samples were tittered up to the end point; positive and negative controls were used for each bath. This test was used due its high sensitivity (95%) and specificity (100%) for the diagnosis of CD (15).…”

Celiac disease diagnosis and gluten-free food analytical control

“…EMA association with CD was first described in 1984 [49] and its detection rapidly became the serological test of choice, due to its specificity of almost 100%. The use of human umbilical cord as substrate has been proposed as a valid alternative to the monkey esophagus [50][51][52].…”