Accuracy Of Testing For Antibodies To Synthetic Gliadin-related Peptides In Celiac Disease.

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Clin Gastroenterol Hepatol. 2006 Jul 20;

Accuracy of Testing for Antibodies to Synthetic Gliadin-Related Peptides in Celiac Disease.

Sugai E, Vazquez H, Nachman F, Moreno ML, Mazure R, Smecuol E, Niveloni S, Cabanne A, Kogan Z, Gomez JC, Maurino E, Bai JC.

Small Bowel Diseases Clinic, Division of Pathology, Department of Medicine, Dr. Carlos Bonorino Udaondo Hospital of Gastroenterology, Buenos Aires, Argentina; Department of Gastroenterology, School of Medicine, University of Salvador, Buenos Aires, Argentina.

BACKGROUND & AIMS: Our aim was to explore the diagnostic value of a newly developed synthetic peptide antibody assay addressing specific synthetic gliadin-derived deamidated peptides (AGA II) for the diagnosis of celiac disease (celiac disease). METHODS: We assayed serum samples obtained prospectively at diagnosis from a population of 92 consecutive adult patients with celiac disease and 113 non-celiac disease controls. Patients were reevaluated after 6 months (n = 56) and 1 year (n = 20) of treatment. All patients and controls underwent intestinal biopsy and a set of celiac disease-related serology tests. A newly developed enzyme-linked immunosorbent assay (ELISA) for detecting IgA and IgG antibodies against synthetic deamidated gliadin epitopes was used. RESULTS: At diagnosis, sensitivity and specificity were 94.6% and 99.1% for AGA II IgA and 92.4% and 100% for AGA II IgG. Absolute values and the proportion of positive samples for both antibodies were significantly reduced at 6 months (P < .0000) and 1 year (P < .001) after initation of a gluten-free diet. Compared with conventional AGA, the peptide antibodies had greater sensitivity, specificity, positive and negative predictive values, accuracy, and likelihood ratios. Compared with antitissue transglutaminase antibodies, AGA II had similar sensitivity but greater specificity and predictive values, better likelihood ratios, and an excellent agreement (kappa statistic = .92). CONCLUSIONS: This study assessed the value of an ELISA assay in detecting antibodies to gliadin-related peptides. This assay appears to be a reliable tool for diagnosing celiac disease and suggests promising accuracy that may be very useful in clinical practice.