Journal
CLINICA CHIMICA ACTA
Volume 403, Issue 1-2, Pages 37-41Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/j.cca.2009.01.006
Keywords
Anti-tissue transglutaminase antibodies; ELISA; Fibronectin; Celiac disease
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Funding
- Estonian Science Foundation [6514]
- Skane Council Foundation for Research and Development
- European Union Marie Curie grant [MTKD-CT-2004-517176]
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Background: Serum IgA antibodies against tissue transglutaminase (tTG) are reliable markers for celiac disease (CD), still the diagnostic performance of anti-tTG immunoassays can be improved. A novel ELISA, using fibronectin (FN) as tTG binding protein, was evaluated for the detection of anti-tTG antibodies in CD. Methods: Sera from 173 children with untreated CD and 97 controls were analyzed for IgA, IgG, and IgM anti-tTG antibodies with ELISA using human recombinant tTG with or without FN. Results: The areas under the ROC (receiver operating characteristic) curves were significantly higher for FN/tTG ELISA compared to tTG ELISA for IgG (0.930 versus 0.809; p < 0.001) and IgM (0.850 versus 0.811; p = 0.019), but not for IgA (0.977 versus 0.970; p = 0.356), respectively. At the fixed diagnostic specificity (100% for IgA and IgM, 99% for IgG), the sensitivity of all three FN/tTG ELISA (92.5% for IgA, 60.7% for IgG, 50.3% for IgM) exceeded those obtained in tTG ELISA (89.0% for IgA, 48.6% for IgG, 38.7% for IgM; p < 0.05). The combined use of IgA- and IgG-FN/tTG ELISA resulted in 95.4% sensitivity and 99.0% specificity for CD. Conclusions: Using FN to bind tTG improves the diagnostic performance of solid phase anti-tTG antibody assays for childhood CD. (C) 2009 Elsevier B.V. All rights reserved.
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