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Autoantibodies Against Soluble and Immobilized Human Recombinant Tissue Transglutaminase in Children with Celiac Disease.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för genetik och patologi.
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2005 (Engelska)Ingår i: J Pediatr Gastroenterol Nutr., Vol. 41, nr 3, s. 322-327Artikel i tidskrift (Refereegranskat) Published
Ort, förlag, år, upplaga, sidor
2005. Vol. 41, nr 3, s. 322-327
Nationell ämneskategori
Immunologi inom det medicinska området
Identifikatorer
URN: urn:nbn:se:uu:diva-96689OAI: oai:DiVA.org:uu-96689DiVA, id: diva2:171346
Tillgänglig från: 2008-02-06 Skapad: 2008-02-06 Senast uppdaterad: 2018-01-13
Ingår i avhandling
1. The Significance of IgG Antibodies against Tissue Transglutaminase in Coeliac Disease
Öppna denna publikation i ny flik eller fönster >>The Significance of IgG Antibodies against Tissue Transglutaminase in Coeliac Disease
2008 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Coeliac disease (CD) is a multifactorial disease of the small intestine. In genetically predisposed individuals the, ingestion of cereals leads to a remodulation of the mucosal architecture, and the production of autoantibodies against tissue transglutaminase (tTG). The treatment is a lifelong gluten-free diet.

The diagnostic procedure relies on the examination of a small-bowel biopsy that displays villous atrophy. A spectrum of clinical manifestations is associated with CD, ranging from overt enteropathy to atypical and silent symptoms. Approximately 1% of the general population has CD, and the majority is undiagnosed. Although most patients with active CD can be detected by the assessment of elevated IgA-tTG, some patients lack these antibodies. Moreover, individuals with IgA-deficiency cannot be identified by means of IgA serology.

The aim of this thesis was to investigate the clinical utility of IgG-tTG for the detection and follow-up of subjects with active CD. The included studies showed that IgG-tTG was highly prevalent in IgA-deficient and IgA-competent patients with CD, whereas non-CD patients rarely had these antibodies. During a gluten-free diet, IgG-tTG decreased, demonstrating that IgG-tTG can be used to follow the patient’s adherence such a diet. Furthermore, 10% of healthy IgA deficient blood donors had elevated IgG-tTG, indicating that they had silent CD.

In IgA-competent subjects, high IgG-tTG levels correlated with a severe mode of CD and profound mucosal deterioration, suggesting that IgG-tTG might be involved in the disease progression. Moreover, we found that although a considerable percentage of IgA-competent patients lack IgG-tTG, the presence of these antibodies in conjunction with high levels of IgA-tTG was highly predictive of a severe small-intestine villous atrophy. It was also demonstrated that IgG-tTG normalisation coincided with clinical remission in IgA-competent CD patients on a gluten-free diet.

Ort, förlag, år, upplaga, sidor
Uppsala: Acta Universitatis Upsaliensis, 2008. s. 56
Serie
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 307
Nyckelord
Immunology, Coeliac disease, Tissue transglutaminase, Endomysium, IgG antibodies, Immunologi
Identifikatorer
urn:nbn:se:uu:diva-8424 (URN)978-91-554-7078-4 (ISBN)
Disputation
2008-02-27, Rudbecksalen, Rudbeck Laboratory, Dag Hammarskjölds väg 20, Uppsala, 13:15
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Handledare
Tillgänglig från: 2008-02-06 Skapad: 2008-02-06Bibliografiskt granskad

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