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Intestinal-mucosa anti-transglutaminase antibody assays to test for genetic gluten intolerance

Cellular & Molecular Immunology volume 11, pages 617–620 (2014)Cite this article

Celiac disease (CD) is an autoimmune enteropathy characterized by gluten-triggered intestinal mucosa lesions in genetically susceptible individuals carrying the HLA DQ2 or DQ8. CD diagnosis is based on the concentration of IgA serum anti-transglutaminase (anti-tTG) antibodies together with mucosal damage at intestinal biopsy.1 However, it is now known that in subjects with genetic gluten intolerance, gastrointestinal and extra-intestinal symptoms may be present even when both mucosal morphology and serum anti-tTGs are normal.2,3 In this context, the anti-tTG in the intestinal mucosal seem to be the specific CD immunological marker that is detectable before the development of intestinal atrophy and the appearance of serum anti-tTG.4 This prospective study investigates the presence of intestinal anti-tTG antibodies in patients with differing clinical spectrums of genetic gluten intolerance by using two immunoassays: double immunofluorescence test for anti-tTG on the intestinal mucosa and flow cytometry assay to measure acid-eluted intestinal anti-tTG. In selected cases, the immunological data were compared with the corresponding mucosal phage-display assays in order to clone the anti-tTG derived from the IGHV5-51 gene. Results were correlated with the patients' clinical condition and the effects of a 24-months gluten-free diet (GFD) or gluten-containing diet (GCD).

This study was conducted at the Institute of Child Health IRCCS ‘Burlo Garofolo’ from June 2011 to June 2013 (ClinicalTrials.gov NCT00677495) and it was approved by the Independent Ethical Committee of our Institute. In the course of gastro-intestinal endoscopy, six biopsies were obtained from each patient. All patients were tested for the presence of HLA DQ2 or DQ8 haplotypes, and measured for the concentration of serum IgA anti-tTGs. The biopsies of patients testing positive for intestinal anti-tTG antibodies but with both normal mucosa and serum anti-tTG, were analysed by phage display technology. All patients diagnosed as having CD markers were followed for their clinical condition, the concentration of serum anti-tTGs and the effects of a 24-month GFD or GCD.

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Acknowledgements

This study was supported by the grants from Italian Ministry of Health (RF2010-2318081) to SQ from Institute of Child Health Burlo Garofolo (RC27/11) to TN, and from Trans2care project (http://www.trans2care.eu) to LDL.

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Author notes

  1. Sara Quaglia and Luigina De Leo: These two authors contributed equally to the study.

Authors and Affiliations

  1. Institute for Maternal and Child Health - IRCCS “Burlo Garofolo”, Trieste, Italy

    Sara Quaglia, Luigina De Leo, Fabiana Ziberna, Serena Vatta, Marilena Granzotto, Vincenzo Petix, Stefano Martelossi, Grazia Di Leo & Tarcisio Not

  2. Department of Pathology, Spedali Civili, University of Brescia, Brescia, Italy

    Vincenzo Villanacci

  3. University of Trieste, Trieste, Italy

    Lucio Torelli & Tarcisio Not

Authors
  1. Sara Quaglia
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  2. Luigina De Leo
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  3. Fabiana Ziberna
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  4. Serena Vatta
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  5. Vincenzo Villanacci
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  6. Marilena Granzotto
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  7. Vincenzo Petix
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  8. Stefano Martelossi
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  9. Grazia Di Leo
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  10. Lucio Torelli
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  11. Tarcisio Not
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Correspondence to Tarcisio Not.

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Quaglia, S., De Leo, L., Ziberna, F. et al. Intestinal-mucosa anti-transglutaminase antibody assays to test for genetic gluten intolerance. Cell Mol Immunol 11, 617–620 (2014). https://doi.org/10.1038/cmi.2014.32

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