<<Disclaimer: Verify this information before applying it to your situation.>>
A new study shows that anti-tTG antibodies are present in inflammatory
bowel disease (IBD), and, thus, an anti-endomysial antibody test is
necessary for known or suspected IBD patients when testing for celiac
disease.
Another new study answers a question frequently asked on this List: If a
GF diet has been started before getting a serum test for celiac disease,
for how long after starting a GF diet will enough antibodies remain to
reliably serum test for celiac disease? After 30 days on a GF diet, it may
already be too late.
----------
Clin Chem Lab Med. 2004;42(10):1092-7
Anti-tissue transglutaminase antibodies in inflammatory bowel disease: new
evidence.
Di Tola M, Sabbatella L, Anania MC, Viscido A, Caprilli R, Pica R, Paoluzi
P, Picarelli A.
Department of Clinical Sciences, University La Sapienza, Rome, Italy.
Anti-tissue transglutaminase, previously held to be identical to anti-
endomysial antibodies in celiac sprue, has been reported in inflammatory
bowel disease patients. To investigate these data further, we evaluated
serum and intestinal anti-tissue transglutaminase in inflammatory bowel
disease patients, with respect to the Crohn's disease activity index and
the integrated disease activity index. Study population comprised: 49
patients with Crohn's disease and 29 patients with ulcerative colitis; 45
patients with celiac sprue and 85 autoimmune patients as disease controls;
and 58 volunteers as healthy controls. Immunoglobulin A (IgA) anti-
recombinant human tissue transglutaminase and anti-endomysial antibody
detection in sera and fecal supernatants were performed. Adsorption of
positive sera with recombinant human tissue transglutaminase were also
performed. Marked increased anti-tissue transglutaminase concentrations
were found in celiac sprue, while low-positive values were also found in
Crohn's disease and ulcerative colitis. Anti-endomysial antibodies were
detectable only in celiac sprue. Antigen adsorption resulted in a
significant reduction of the anti-tissue transglutaminase either in celiac
sprue or inflammatory bowel disease sera. A significant correlation between
anti-tissue transglutaminase and Crohn's disease activity index or
integrated disease activity index scores was found. Anti-tissue
transglutaminase was also detectable in fecal supernatants from
inflammatory bowel disease patients. Data highlight that both circulating
and intestinal anti-tissue transglutaminases are detectable in inflammatory
bowel disease, and that they are related to disease activity. These
features underline that, in addition to anti-tissue transglutaminase, an
anti-endomysial antibody test is necessary in the diagnostic work-up of
celiac sprue, especially in patients with known inflammatory bowel disease.
PMID: 15552265 [PubMed - in process]
----------
J Intern Med. 2004 Dec;256(6):519-24
Antibody levels in adult patients with coeliac disease during gluten-free
diet: a rapid initial decrease of clinical importance.
Midhagen G, Aberg AK, Olcen P, Jarnerot G, Valdimarsson T, Dahlbom I,
Hansson T, Strom M.
Department of Medicine, KSS, Skovde, Sweden.
Abstract. Midhagen G, Aberg A-K, Olcen P, Jarnerot G, Valdimarsson T,
Dahlbom I, Hansson T, Strom M (KSS, Skovde; Orebro University Hospital;
Linkoping University Hospital; Pharmacia Diagnostics; and Karolinska
Institutet, Stockholm, Sweden). Antibody levels in adult patients with
coeliac disease during gluten-free diet: a rapid initial decrease of
clinical importance. J Intern Med 2004; 256: 519-524.Objective. Analysis of
antibodies against tissue transglutaminase (tTG) has been shown valuable in
the diagnosis of coeliac disease (CD) but how quickly serum titres decrease
after introduction of a gluten-free diet (GFD) is not known in adults. CD
is a well-recognized disorder amongst the general population and many
persons try a GFD for fairly vague symptoms before they seek medical
advice. Therefore, it is important to determine the time that the serologic
tests remain predictive of the disease after the introduction of a GFD.
Methods. Sera were taken from 22 consecutively biopsy-proven adult patients
with CD in connection with the diagnostic biopsy. The patients were
followed for 1 year and sera were taken after 1, 3, 6 and 12 months after
start of a GFD. Sera were stored at -20 degrees C and analysed for IgA
antibodies against gliadin, endomysium and two different commercial tTG
assays based on recombinant human tTG (tTGrh) and guinea-pig liver (tTGgp).
Results. Twenty patients could be followed during GFD and all antibody
titres fell sharply within 1 month after introduction of a GFD and
continued to decline during the survey interval. Thirty days after
beginning the diet only 58, 84, 74 and 53% of all patients had positive
antibody levels of tTGrh, tTGgp, EmA and AGA respectively. Conclusions. As
the antibodies used to confirm the diagnosis of CD fall rapidly and
continue to decline following the introduction of a GFD, it is important
that health care providers carefully inquire about the possibility of self-
prescribed diets before patients sought medical attention.
PMID: 15554953 [PubMed - in process]
* * *
*Support summarization of posts, reply to the SENDER not the CELIAC List*
|
