850 Anti-Tissue Transglutaminase Autoantibody Levels Predict Histology in Celiac Disease: A Prospective Application of the ESPGHAN Guidelines in a Symptomatic Adult Population

2015 ◽  
Vol 148 (4) ◽  
pp. S-170
Author(s):  
Konstantinos Efthymakis ◽  
Angelo Milano ◽  
Francesco Laterza ◽  
Mariaelena Serio ◽  
Matteo Neri
Keyword(s):  
Celiac Disease ◽  
Tissue Transglutaminase ◽  
Adult Population ◽  
Prospective Application ◽  
Espghan Guidelines

scholarly journals Antibodies against Synthetic Deamidated Gliadin Peptides as Predictors of Celiac Disease: Prospective Assessment in an Adult Population with a High Pretest Probability of Disease

2007 ◽  
Vol 53 (12) ◽  
pp. 2186-2192 ◽  
Author(s):  
Sonia Niveloni ◽  
Emilia Sugai ◽  
Ana Cabanne ◽  
Horacio Vazquez ◽  
Julio Argonz ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Small Bowel ◽  
Diagnostic Accuracy ◽  
Tissue Transglutaminase ◽  
Adult Population ◽  
Pretest Probability ◽  
Intestinal Biopsy ◽  
Predictive Values ◽  
Marsh Type ◽  
High Pretest Probability

Abstract Background: Noninvasive serologic tests have shown high diagnostic accuracy for celiac disease (CD) in selected populations. Our aim was to determine prospectively the performance of CD-related serology in individuals undergoing intestinal biopsy because of clinical suspicion of small-bowel disorders. Methods: We enrolled 141 unselected consecutive adult patients attending a small-bowel disease clinic. Patients underwent endoscopy and biopsy; serum samples were obtained at that time for measurements of anti–tissue transglutaminase (a-tTG), IgA and IgG anti–deamidated gliadin-related peptide (a-DGP), and IgA antiactin antibodies (AAAs). Characterization of patients was based on histological criteria (Marsh type II lesion or greater). Results: The prevalence of CD was 42.5%. Sensitivity, specificity, and positive and negative predictive values were >90% for most assays. Diagnostic accuracy based on ROC curve analysis was similar for all assays [area under the curve (95% CI): 0.996 (0.967–0.998) for a-tTG, 0.995 (0.964–0.998) for IgA a-DGP, 0.989 (0.954–0.999) for IgG a-DGP, 0.996 (0.966–0.998) for blended conjugated of IgA + IgG a-DGP in a single assay, and 0.967 (0.922–0.990) for AAA]. The combinations of 2 tests, IgG a-DGP plus IgA a-tTG or the single blended conjugate detecting IgA + IgG a-DGP plus IgA a-tTG had 100% positive and negative predictive values if concentrations of both tests in either combination were above or below the cutoff. Conclusions: In a population with high pretest probability, the newly developed a-DGP tests have diagnostic accuracy that is at least equivalent to that of established assays.

scholarly journals IMPROVED ADHERENCE TO THE ESPGHAN GUIDELINES IS NECESSARY FOR DIAGNOSING CELIAC DISEASE IN CHILDREN: A SINGLE-CENTER EXPERIENCE

2021 ◽  
Author(s):  
Wing-Yu Siobhan LAU ◽  
Paul Anthony HEATON ◽  
Siba Prosad PAUL
Keyword(s):  
Celiac Disease ◽  
Tissue Transglutaminase ◽  
Retrospective Case ◽  
Single Center Experience ◽  
Resource Limited ◽  
Immune Mediated ◽  
Biopsy Confirmation ◽  
Systemic Disorder ◽  
Espghan Guidelines ◽  
Diagnostic Pathways

ABSTRACT BACKGROUND: Celiac disease (CD) is an immune-mediated systemic disorder elicited by the ingestion of gluten. The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) guidelines published in 2012 suggested a no-biopsy pathway (NBP) for symptomatic children with IgA tissue transglutaminase (TGA-IgA) ≥10x upper limit of normal (ULN). Biopsy confirmation remained mandatory for other cases. OBJECTIVE: This retrospective case note study was aimed at evaluating the adherence to the ESPGHAN 2012 guidelines for diagnosing CD in our unit. METHODS: Forty-three cases with positive TGA-IgA were identified by a laboratory database search from January 2013 to December 2019. 6 of 43 patients were not referred for a confirmation of CD diagnosis. Data was collected on the diagnostic pathways followed, and appropriateness of adherence was compared with the existing ESPGHAN guidelines. RESULTS: A total of 37 cases were included with 35 children diagnosed with CD. 29/35 (83%) were diagnosed via the NBP;15/29 (52%) children did not meet all the criteria required for NBP, but were diagnosed and managed as having CD. 20/35 (57%) children were diagnosed with CD in adherence to the 2012 guidelines. CONCLUSION: The recommended diagnostic guidelines were frequently not implemented; adherence to the guidelines may improve following regular educational sessions. The revised 2020 ESPGHAN guidelines which exclude HLA-DQ2/DQ8 testing would address the issue of diagnosis for the 10/15 NBP cases (with TGA-IgA >10xULN) in our study who did not have HLA testing and were therefore non-adherent to the 2012 diagnostic guidelines. NBP, with the reduced need for endoscopy may be beneficial in resource limited settings.

P.08.14 A PROSPECTIVE APPLICATION OF THE ESPGHAN GUIDELINES IN A SYMPTOMATIC ADULT POPULATION

2016 ◽  
Vol 48 ◽  
pp. e170
Author(s):  
K. Efthymakis ◽  
M. Serio ◽  
D. D'Amato ◽  
A. Milano ◽  
F. Laterza ◽  
...  
Keyword(s):  
Adult Population ◽  
Prospective Application ◽  
Espghan Guidelines

Tissue transglutaminase, the celiac disease autoantigen, preferentially generates antigenic neoepitopes in γ and γ but not in α gliadins

2001 ◽  
Vol 120 (5) ◽  
pp. A684-A684
Author(s):  
D TRAPP ◽  
W DIETERICH ◽  
H WIESER ◽  
M LEIDENBERGER ◽  
D SEILMEIER ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Tissue Transglutaminase

scholarly journals Efficient implementation of the ‘non-biopsy approach’ for the diagnosis of childhood celiac disease in the Netherlands: a national prospective evaluation 2010–2013

2021 ◽  
Author(s):  
Caroline R. Meijer ◽  
Joachim J. Schweizer ◽  
Anne Peeters ◽  
Hein Putter ◽  
M. Luisa Mearin
Keyword(s):  
Celiac Disease ◽  
The Netherlands ◽  
Clinical Presentation ◽  
Paediatric Population ◽  
Hla Typing ◽  
Newly Diagnosed ◽  
Prospective Evaluation ◽  
Espghan Guidelines ◽  
Intestinal Symptoms ◽  
Nationwide Implementation

AbstractThe aim of this study was (1) to prospectively evaluate the nationwide implementation of the ESPGHAN-guidelines for the diagnosis of celiac disease (CD), (2) to investigate the incidence and clinical presentation of diagnosed childhood CD (0–14 years) in the Netherlands, and (3) to compare the findings with national survey data from 1975 to 1990 and 1993 to 2000 using the same approach. From 2010 to 2013, all practicing paediatricians were invited to report new celiac diagnoses to the Dutch Pediatric Surveillance Unit. Data were collected via questionnaires. A total of 1107 children with newly diagnosed CD were reported (mean age, 5.8 years; range, 10 months–14.9 years; 60.5% female). After the introduction of the non-biopsy approach in 2012, 75% of the diagnoses were made according to the guideline with a significant decrease of 46.3% in biopsies. The use of EMA and HLA-typing significantly increased with 25.8% and 62.1%, respectively. The overall incidence rate of childhood CD was 8.8-fold higher than in 1975–1990 and 2.0-fold higher than in 1993–2000. During the study period, the prevalence of diagnosed CD was 0.14%, far below 0.7% of CD identified via screening in the general Dutch paediatric population. Clinical presentation has shifted towards less severe and extra-intestinal symptoms.Conclusion: ESPGHAN guidelines for CD diagnosis in children were effectively and rapidly implemented in the Netherlands. Incidence of diagnosed CD among children is still significantly rising with a continuous changing clinical presentation. Despite the increasing incidence of diagnoses, significant underdiagnosis still remains. What is Known:• Since 2000 the incidence of diagnosed childhood CD in the Netherlands has shown a steady rise.• The rise in incidence has been accompanied by a changing clinical presentation at diagnosis. What is New:• The ESPGHAN guidelines 2012 for CD diagnosis were effectively and rapidly implemented in the Netherlands.• The incidence of diagnosed childhood CD in the Netherlands has continued to rise significantly during the reported period.

scholarly journals Gliadin Sequestration as a Novel Therapy for Celiac Disease: A Prospective Application for Polyphenols

2021 ◽  
Vol 22 (2) ◽  
pp. 595
Author(s):  
Charlene B. Van Buiten ◽  
Ryan J. Elias
Keyword(s):  
Immune Response ◽  
Celiac Disease ◽  
Gastrointestinal Symptoms ◽  
Autoimmune Disorder ◽  
Treatment Method ◽  
Mucosal Damage ◽  
Protective Effects ◽  
Novel Therapy ◽  
Gluten Proteins ◽  
Prospective Application

Celiac disease is an autoimmune disorder characterized by a heightened immune response to gluten proteins in the diet, leading to gastrointestinal symptoms and mucosal damage localized to the small intestine. Despite its prevalence, the only treatment currently available for celiac disease is complete avoidance of gluten proteins in the diet. Ongoing clinical trials have focused on targeting the immune response or gluten proteins through methods such as immunosuppression, enhanced protein degradation and protein sequestration. Recent studies suggest that polyphenols may elicit protective effects within the celiac disease milieu by disrupting the enzymatic hydrolysis of gluten proteins, sequestering gluten proteins from recognition by critical receptors in pathogenesis and exerting anti-inflammatory effects on the system as a whole. This review highlights mechanisms by which polyphenols can protect against celiac disease, takes a critical look at recent works and outlines future applications for this potential treatment method.

245 THE ORAL TISSUE TRANSGLUTAMINASE INHIBITOR ZED1227 PREVENTS GLUTEN-INDUCED ENTEROPATHY IN A TRANSGENIC MOUSE MODEL OF CELIAC DISEASE

2021 ◽  
Vol 160 (6) ◽  
pp. S-53-S-54
Author(s):  
Manuel A. Encalada Ventura ◽  
Martin Hils ◽  
Bernhard Tewes ◽  
Ralf Pasternack ◽  
Roland Greinwald ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Mouse Model ◽  
Transgenic Mouse ◽  
Tissue Transglutaminase ◽  
Transgenic Mouse Model ◽  
Oral Tissue

Tu1386 Susceptibility for Celiac Disease Based on Tissue Transglutaminase Seroprevalence and HLA Genotype in a Community Study

2016 ◽  
Vol 150 (4) ◽  
pp. S891
Author(s):  
Michael D. Potter ◽  
Gregory Brogan ◽  
Marjorie M. Walker ◽  
Mark McEvoy ◽  
Elizabeth Holliday ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Tissue Transglutaminase ◽  
Community Study ◽  
Hla Genotype

scholarly journals Effect of Rothia mucilaginosa enzymes on gliadin (gluten) structure, deamidation, and immunogenic epitopes relevant to celiac disease

2014 ◽  
Vol 307 (8) ◽  
pp. G769-G776 ◽  
Author(s):  
Na Tian ◽  
Guoxian Wei ◽  
Detlef Schuppan ◽  
Eva J. Helmerhorst
Keyword(s):  
Celiac Disease ◽  
Tissue Transglutaminase ◽  
Mass Difference ◽  
Cross Linking ◽  
Esi Ms ◽  
Rp Hplc ◽  
Complementary Approach ◽  
Sds Page ◽  
Rothia Mucilaginosa ◽  
Immunogenic Properties

Rothia mucilaginosa, a natural microbial inhabitant of the oral cavity, cleaves gluten (gliadin) proteins at regions that are resistant to degradation by mammalian enzymes. The aim of this study was to investigate to what extent the R. mucilaginosa cell-associated enzymes abolish gliadin immunogenic properties. Degradation of total gliadins and highly immunogenic gliadin 33-mer or 26-mer peptides was monitored by SDS-PAGE and RP-HPLC, and fragments were sequenced by liquid chromatography and electrospray ionization tandem mass spectrometer (LC-ESI-MS/MS). Peptide deamidation by tissue transglutaminase (TG2), a critical step in rendering the fragments more immunogenic, was assessed by TG2-mediated cross-linking to monodansyl cadaverine (MDC), and by a +1-Da mass difference by LC-ESI-MS. Survival of potential immunogenic gliadin epitopes was determined by use of the R5 antibody-based ELISA. R. mucilaginosa-associated enzymes cleaved gliadins, 33-mer and 26-mer peptides into smaller fragments. TG2-mediated cross-linking showed a perfect inverse relationship with intact 33-mer and 26-mer peptide levels, and major degradation fragments showed a slow rate of MDC cross-linking of 6.18 ± 2.20 AU/min compared with 97.75 ± 10.72 and 84.17 ± 3.25 AU/min for the intact 33-mer and 26-mer, respectively, which was confirmed by reduced TG2-mediated deamidation of the fragments in mass spectrometry. Incubation of gliadins with Rothia cells reduced R5 antibody binding by 20, 82, and 97% after 30 min, 2 h, and 5 h, respectively, which was paralleled by reduced reactivity of enzyme-treated 33-mer and 26-mer peptides in the R5 competitive ELISA. Our broad complementary approach to validate gluten degrading activities qualifies R. mucilaginosa-associated enzymes as promising tools to neutralize T cell immunogenic properties for treatment of celiac disease.

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