Antibodies to deamidated gliadin peptide in diagnosis of celiac disease in children

J Pediatr Gastroenterol Nutr. 2015 May;60(5):626-31. doi: 10.1097/MPG.0000000000000666.

Abstract

Objectives: Determination of antibodies to synthetic deamidated gliadin peptides (anti-DGPs) may work as an alternative or complement the commonly used test for tissue transglutaminase antibodies (TGA) in the diagnosis of celiac disease (CD). We analyzed the performance of a time-resolved immunofluorometric anti-DGP assay (TR-IFMA) in the diagnosis of CD in children and also retrospectively analyzed the appearance of anti-DGP antibodies before TGA seroconversion.

Methods: The study included 92 children with biopsy-confirmed CD. Serum samples were taken at the time or just before the clinical diagnosis. The control group comprised 82 TGA-negative children who were positive for human leucocyte antigen-DQ2 or -DQ8.

Results: Based on receiver operating characteristic curves, the optimal cutoff value for immunoglobulin (Ig) A anti-DGP positivity was 153 arbitrary units (AUs) with a sensitivity of 92.4% and specificity of 97.6% and that for IgG anti-DGP 119 AU, with a sensitivity of 97.8% and specificity of 97.6%. All 92 children with CD were either IgA or IgG anti-DGP positive at the time of diagnosis. Sera from 48 children with CD were also analyzed retrospectively before the diagnosis. Anti-DGP antibodies preceded TGA positivity in 35 of the 48 children with CD and appeared a median of 1 year earlier.

Conclusions: The TR-IFMA assay for detecting anti-DGP antibodies shows high sensitivity and specificity for the diagnosis of CD in children. In a majority of our study population, anti-DGP seropositivity preceded TGA positivity, indicating that earlier detection of CD may be possible by monitoring anti-DGP antibodies frequently in genetically susceptible children.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Celiac Disease / blood*
  • Celiac Disease / diagnosis*
  • Celiac Disease / genetics
  • Child
  • Child, Preschool
  • Early Diagnosis
  • Female
  • Fluoroimmunoassay
  • GTP-Binding Proteins / immunology
  • Glutens / immunology*
  • HLA-DQ alpha-Chains / genetics
  • HLA-DQ beta-Chains / genetics
  • Humans
  • Immunoglobulin A / blood*
  • Immunoglobulin G / blood*
  • Infant
  • Male
  • ROC Curve
  • Retrospective Studies
  • Serologic Tests
  • Time Factors
  • Transglutaminases / immunology

Substances

  • HLA-DQ alpha-Chains
  • HLA-DQ beta-Chains
  • HLA-DQA1 antigen
  • HLA-DQB1 antigen
  • Immunoglobulin A
  • Immunoglobulin G
  • Glutens
  • transglutaminase 2
  • Transglutaminases
  • GTP-Binding Proteins