Using radioligand-binding assays to measure tissue transglutaminase autoantibodies in young children

被引:11
|
作者
Agardh, D [1 ]
Carlsson, A
Lynch, K
Axelsson, I
Lernmark, Å
Ivarsson, SA
机构
[1] Lund Univ, Malmo Univ Hosp, Dept Paediat, SE-20502 Malmo, Sweden
[2] Univ Lund Hosp, Dept Paediat, S-22185 Lund, Sweden
[3] Univ Washington, Sch Publ Hlth & Community Med, Dept Biostat, Seattle, WA 98195 USA
[4] Lund Univ, Malmo Univ Hosp, Wallenberg Lab, SE-20502 Malmo, Sweden
[5] Univ Washington, Dept Med, RH Williams Lab, Seattle, WA USA
关键词
children; coeliac disease; EMA; screening; tissue transglutaminase;
D O I
10.1111/j.1651-2227.2004.tb02716.x
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Aim: To measure autoantibodies against tissue transglutaminase (tTG) in young children prospectively screened for coeliac disease (CD). Methods: In total, 652 children aged 2.9 (2.5-4.2) y were analysed for IgA-tTG and IgG-tTG with radioligand-binding assays and IgA endomysial antibodies (EMA) by indirect immunofluorescence. Antibody-positive children were retested after 1.2 (range 0.2-1.9) y. Intestinal biopsy was performed on children with persistently high antibody levels. Results: In total, 3.2% (95% CI: 1.9-4.6%) of the 652 children were positive for at least one antibody at baseline: 2.5% (95% CI: 1.3-3.7%) for IgA-tTG, 1.7% (95% CI: 0.7-2.7%) for IgG-tTG and 2.9% (95% CI: 1.6-4.2%) for IgA-EMA, respectively. Ten children were positive for all three antibodies, five for both IgA-tTG and EMA, four for EMA only, one for IgA-tTG and another for IgG-tTG. IgA-EMA titres correlated with IgA-tTG levels (r = 0.73, p = 0.0003). At follow-up, seven of 20 children remained positive for all three antibodies, three for IgA-tTG only, one for both IgA-tTG and EMA, one for IgA-tTG and IgG-tTG, and the remaining child refused further participation. Three biopsies showed villous atrophy, two increased intraepithelial lymphocytes and two normal findings. Biopsy was not performed in four children with low or declining tTG antibody levels at follow-up and in one child who declined. CD was evident in 0.5% (95% CI: 0.0-1.0%) (3/652). Conclusion: This study revealed a high number of young children positive for tTG antibodies as well as EMA, but the majority showed declining levels in both antibodies over time. We suggest using radioligand-binding assays for quantitative measurement of tTG antibodies when change in antibody levels is studied in young children.
引用
收藏
页码:1046 / 1051
页数:6
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