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首页> 外文期刊>APMIS: Acta Pathologica, Microbiologica et Immunologica Scandinavica >Serologic screening for celiac disease in children: a comparison between established assays and tests with deamidated gliadin-derived peptides plus conjugates for both IgA and IgG antibodies.
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Serologic screening for celiac disease in children: a comparison between established assays and tests with deamidated gliadin-derived peptides plus conjugates for both IgA and IgG antibodies.

机译：儿童乳糜泻的血清学筛查：既定的测定与使用脱酰胺的麦醇溶蛋白衍生的肽加结合物的IgA和IgG抗体之间的比较。

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摘要

Selection of patients for diagnostic biopsy concerning celiac disease (CD) is mainly guided by the results with serological screening tests like anti-tissue-transglutaminase (tTG), anti-endomysium (EmA) and anti-gliadin (AGA) IgA. New tests using deamidated gliadin-derived peptides (DGP) including both IgA and IgG antibodies have been developed, to cover the IgA-deficient sera. In addition, a combined IgA and IgG DGP test, with or without human erythrocyte-derived tTG, offers possible advantages. In order to explore the screening accuracy of the new combination tests sera from 167 children below 3 years of age were assayed. Biopsy had been taken in connection with serology in 32 of these children, 24 with histopathological CD. The results with the DGP and the combined test were congruent with the IgA antibody tests for tTG, EmA and AGA, all identifying 21 of 24 of the CD cases. Two of the CD patients were AGA-IgA positive only (2/24), while 2 of 24 sera were AGA-IgA negative but positive in all the other tests. These results raises the question whether the modifications of the gliadin antigen not only decrease false positivity but also give more false-negative results, a major drawback for a screening test for an important disease. Further studies have to be undertaken to explore this. Our results also stress that serologic screening of CD in children cannot be based on one test only.
机译：有关乳糜泻（CD）的诊断性活检患者的选择主要取决于血清筛查试验的结果，如抗组织转谷氨酰胺酶（tTG），抗内膜肌瘤（EmA）和抗麦胶蛋白（AGA）IgA。已经开发出使用包括IgA和IgG抗体在内的脱酰胺基麦醇溶蛋白衍生肽（DGP）的新测试，以涵盖IgA缺陷血清。此外，结合IgA和IgG DGP测试（有或没有人红细胞衍生的tTG）都可能具有优势。为了探索新的组合测试的筛查准确性，分析了167名3岁以下儿童的血清。在这些儿童中，有32名与组织病理学CD进行了与血清学有关的活检。 DGP和联合检测的结果与tTG，EmA和AGA的IgA抗体检测结果完全一致，均鉴定出24例CD病例中的21例。 2名CD患者仅AGA-IgA阳性（2/24），而24个血清中有2名AGA-IgA阴性，但在所有其他检查中均为阳性。这些结果提出了以下问题：麦醇溶蛋白抗原的修饰是否不仅降低了假阳性，而且给出了更多的假阴性结果，这是对重要疾病进行筛查的主要缺点。必须对此进行进一步的研究。我们的结果还强调，儿童CD的血清学筛查不能仅基于一项测试。

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