BACKGROUND Intestinal coeliac auto-antibodies are the marker of coeliac disease (CD). Since the determination of these antibodies is still not widely available, we used immunoassays to identify the most suitable technology for revealing intestinal auto-antibodies in the wide clinical spectrum of CD. METHODS Intestinal auto-antibodies have been prospectively investigated in CD suspected children using two immunoassays: intestinal-deposits of IgA anti-tissue transglutaminase antibodies (anti-tTG) and biopsy-culture IgA anti-endomysium (AEA). Intestinal IgM antibodies have been determined in IgA-deficient subjects. FINDINGS Two-hundred and twenty-one suspected CD patients were enrolled. Intestinal antibodies were tested positive for both assays in classical CD patients (n = 178) with villous atrophy and positive serum-CD antibodies, potential CD patients (n = 16) with normal intestinal mucosa and positive serum-CD antibodies, and pre-potential CD patients (n = 14) with normal intestinal mucosa and negative serum-CD antibodies. In 13/221 with normal intestinal mucosa, negative CD-serum antibodies and negative intestinal antibodies CD has been excluded. All classical, 14/16 potential and 11/14 pre-potential CD patients on gluten-free diet (GFD) improved their symptoms. In 9/11 pre-potential patients intestinal antibodies disappeared on GFD. Both assays were negative in 69/71 control subjects. The two assays showed high diagnostic sensitivity (100%) and specificity (99%). INTERPRETATION Intestinal CD-antibodies make prompt diagnosis in the wide clinical spectrum of CD reducing the delay in diagnosis and treatment, especially in pre-potential CD patients. The easy handling biopsy culture assay is an effective diagnostic tool which should be carried out by any gastroenterology unit to recognize all CD clinical manifestations. FUNDING Interreg Central-Europe, IRCCS "Burlo Garofolo".

中文翻译：

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肠道自身抗体在乳糜泻广泛临床范围内的诊断准确性和适用性。


背景肠道乳糜泻自身抗体是乳糜泻（CD）的标志物。由于这些抗体的测定尚未广泛应用，我们使用免疫测定法来确定最合适的技术，以揭示广泛的 CD 临床谱中的肠道自身抗体。方法 使用两种免疫测定法对疑似克罗恩病儿童的肠道自身抗体进行了前瞻性研究：IgA 抗组织转谷氨酰胺酶抗体（抗 tTG）肠道沉积物和活检培养 IgA 抗肌内膜抗体（AEA）。已在 IgA 缺陷受试者中测定了肠道 IgM 抗体。结果 纳入了 221 名疑似 CD 患者。在具有绒毛萎缩和血清 CD 抗体阳性的经典 CD 患者 (n = 178)、具有正常肠粘膜和阳性血清 CD 抗体的潜在 CD 患者 (n = 16) 和预电位患者中，两项检测的肠道抗体均呈阳性CD 患者 (n = 14) 肠粘膜正常且血清 CD 抗体呈阴性。在肠粘膜正常的13/221中，阴性CD血清抗体和阴性肠抗体CD已被排除。所有接受无麸质饮食 (GFD) 的经典型、14/16 潜在型和 11/14 潜在型 CD 患者的症状均得到改善。在 9/11 预潜能患者中，GFD 后肠道抗体消失。 69/71 的对照受试者的两项检测均呈阴性。两种检测显示出较高的诊断敏感性（100%）和特异性（99%）。解释 肠道 CD 抗体可在广泛的 CD 临床谱中做出及时诊断，减少诊断和治疗的延误，特别是在潜在 CD 患者中。 易于操作的活检培养测定是一种有效的诊断工具，任何胃肠病学单位都应该进行这种分析，以识别所有 CD 临床表现。资助中欧Interreg，IRCCS“Burlo Garofolo”。