Background/Purpose: Microbial transglutaminase (mTg) and human tissue Tg (tTg) complexed to gliadin peptides present neo-epitopes. Antibodies against these complexes are called tTg neo-epitope and mTg neo-epitope. Reliability of antibodies against the non-complexed and complexed forms of both transglutaminases to reflect intestinal damage and to diagnose the pediatric Celiac Disease (PCD) was compared.

Methods: 95 PCD patients, 99 normal children (NC) and 79 normal adults (NA) were tested using the following ELISAs detecting IgA, IgG or both IgA+IgG combined: AESKULISA® tTg (tTg, RUO), AESKULISA® tTg New Generation (tTg neo-epitope (tTg-neo)), AESKULISA® mTg (RUO) and AESKULISA® mTg neo-epitope (mTg-neo, RUO). Marsh criteria were used for the degree of intestinal injury.

Results: All anti-mTg-neo and anti-tTg-neo levels were higher (p<0.001) compared to the single antigens. tTg-neo IgA and IgG+IgA were higher than mTg-neo IgA and IgA+IgG (p<0.0001). The antibody activities reflecting best the increased intestinal damage were: mTg-neo IgA> mTg-neo IgA+IgG > tTg-neo IgG ≥ mTg-neo IgG > tTg-neo IgA> tTg-neo IgA+IgG. Taken together, mTg-neo IgG and tTg-neo IgA & IgA+IgG correlated best with intestinal pathology (r=0.5633, r=0.6165 & r= 0.6492; p<0.0001, p<0.0001 & p<0.0001 respectively).

Conclusion: The complexed forms of both transglutaminases exhibited a higher OD activity and better reflected intestinal damage in PCD, compared to the non-complexed forms. mTg is immunogenic in children with CD and by complexing to gliadin its immunogenicity and pathology reflection is enhanced.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/new-markers-for-celiac-disease-anti-neo-epitope-human-and-microbial-transglutaminases/