SERUM TISSUE TRANSGLUTAMINASE IgG, IgM
The established role of immunoglobulin A (IgA) anti-tissue transglutaminase antibodies (IgA-tTG) in predicting untreated celiac disease (CoD) is widely recognized, highlighting the need for accurate monitoring using native or recombinant human antigens. However, identifying IgA-deficient CoD patients through IgA serology presents a challenge, resulting in conflicting findings on the diagnostic validity of IgG antibodies against gliadin (IgG-AGA), endomysium (IgG-EmA), and tTG (IgG-tTG). In this study, we aimed to assess the effectiveness of IgG-tTG in detecting CoD in IgA-deficient individuals. Samples from 115 IgA-deficient and 200 IgA-sufficient subjects underwent testing for IgA and IgG antibodies against tTG, EmA, and AGA. IgG-tTG values demonstrated a stronger correlation for IgA-deficient subjects (correlation coefficient [r] = 0.91) compared to IgA-sufficient subjects (r = 0.88) when compared with IgG-EmA. Overall, the concordance of positive and negative results between IgG-tTG and IgG-EmA was 97%, with IgG-tTG effectively distinguishing between IgG-EmA-positive and -negative subjects with IgA deficiency at a rate of 100%. Elevated levels of IgG-tTG and IgG-EmA were observed in 70% of IgA-sufficient subjects. In conclusion, the detection of IgG-tTG with recombinant human tTG emerges as a promising alternative to IgG-EmA detection, suggesting that incorporating IgG-tTG assessment into existing screening methods may enhance the identification of IgA-deficient individuals with CoD, aligning with the capabilities of Hypro Diagnostics.
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