A modified ELISA for improved detection of IgA, IgG, and IgM anti-tissue transglutaminase antibodies in celiac disease

• Published in: Clinica chimica acta Vol. 403; no. 1; pp. 37 - 41
• Main Authors: Teesalu, Kaupo, Agardh, Daniel, Panarina, Marina, Utt, Meeme, Uibo, Oivi, Uibo, Raivo
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01-05-2009
• Subjects: Anti-tissue transglutaminase antibodies; Blood Chemical Analysis - methods; Celiac; Celiac disease; Celiac Disease - blood; Celiac Disease - diagnosis; Celiac Disease - immunology; Child; Child, Preschool; Clinical Laboratory Medicine; Clinical Medicine; disease; ELISA; Enzyme-Linked Immunosorbent Assay - methods; Female; Fibronectin; Fibronectins - metabolism; Humans; Immunoglobulin A - blood; Immunoglobulin A - immunology; Immunoglobulin G - blood; Immunoglobulin G - immunology; Immunoglobulin Isotypes - blood; Immunoglobulin Isotypes - immunology; Immunoglobulin M - blood; Immunoglobulin M - immunology; Klinisk laboratoriemedicin; Klinisk medicin; Male; Medical and Health Sciences; Medicin och hälsovetenskap; Transglutaminases - immunology; Transglutaminases - metabolism; Celiac disease; Anti-tissue transglutaminase antibodies; Fibronectin; ELISA
• ISSN: 0009-8981; 1873-3492
• DOI: 10.1016/j.cca.2009.01.006

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.
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.
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.
Using FN to bind tTG improves the diagnostic performance of solid phase anti-tTG antibody assays for childhood CD.