264 The Role of Salivary Anti-Transglutaminase Autoantibodies at the Diagnosis and Follow-Up of Coeliac Disease

Abstract

Aim: We have demonstrated that saliva can be used to screen coeliac disease (CD) children (J Pediatr 2004). The aim of this study was to evaluate salivary tTGAb presence on a large series of CD patients at diagnosis and during the follow-up.

Methods: 77 coeliacs at the first biopsy (Group 1a: 25m; 1.9–28 yrs), 35 of them on a gluten-free diet (GFD) from at least 6 months (Group 1b: 10m, 2.3–26.6 yrs), 74 gastroenterological controls (Group 2: 35m; 1.3–18 yrs) and 40 healthy controls (Group 3: 11m; 21.9–41.5 yrs) were enrolled in this study. IgA-tTGAb presence on serum and saliva of each subject were detected with a fluid-phase radioimmunoprecipitation method. The ROC analysis was used to detect the limit of positivity of tTGAb method. IgA-EMA were tested by the indirect immunofluorescence.

Results: The percentages of salivary and serum tTGAb and EMA positivity were in Group 1a 96.1%, 98.7% and 90.9% respectively, and in Group 1b 60%, 65.7% and 36.7% respectively. Mean salivary or serum tTGAb indexes ±SD were significantly lower in Group 1b (0.12±0.16 and 0.21±0.29 respectively) than in Group 1a (0.40±0.40 and 0.77±0.33 respectively) with a p<0.0001. All control subjects were found tTGAb and EMA negative, both in saliva and serum.

Conclusion: This study confirms the possibility of salivary tTGAb detection in CD patients with a high sensitivity also during follow-up. The sensitivity of the salivary and serum Ab detection in patients on a GFD appears to be comparable. Salivary tTGAb presence in these subjects could reveal a non strict adherence to the diet with possible nutritional and immunological implications.

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