ABSTRACT
Introducción: El diagnóstico precoz y seguimiento de la condición celíaca ha sido objeto de importantes cambios, y según la guía ESPGHAN (2012) la serología es ahora una herramienta fundamental. Los principales son los anticuerpos anti-gliadina IgG/IgA, anti-transglutaminasa IgG/IgA, anti-endomisiales (EMA), y los recientemente descritos anti-péptidos deaminados de gliadina (anti-DGPs). El propósito del estudio fue determinar la sensibilidad y especificidad de estos marcadores en 308 individuos con y sin patología. Materiales y métodos: A cada individuo se le realizaron determinaciones de: TTGG y TTGA Qual (AESKU Diagnostics ®, Germany), TgTG, TgTA, AAGG y AAGA por ENEASYSTEM III® (Byogenetix, Italia), Neoep. IgG/A (AESKU Diagnostics®, Germany), EMA IgG e IGA y GAF3X IgG e IgA (Euroimmun, Germany ®). Resultados: Los valores de sensibilidad (S) y especificidad (E) fueron: Para anti-IgA Celicheck: S: 44.44%, E: 97.59%; anti-TTG Qual: S: 14.28%, E: 97.61%; anti-neoepítopes IgG/IgA: S: 54.44%, E: 91.59%; AAG IgG: S: 89.11%, E: 63.19%; AAG IgA: S: 79.11%, E: 68.16%; anti-DGPs IgA: S: 86.67%, E: 96.21% (p<0,05). Conclusiones: Los ATgT IgG e IgA solo son superados por los anti-DGPs. Se debe ampliar las investigaciones para estandarizar este nuevo método de valoración.
Introduction: The diagnosis and management of celiac disease has undergone significant changes, according to the ESPGHAN guide (2012) serology is now an essential tool. The main ones are the anti-gliadin IgG/IgA anti-transglutaminase IgG/IgA, anti-endomysial and the recently described anti-deaminated gliadin peptides (anti-DGPs). The purpose of the study was to determine the sensitivity and specificity of these markers in 308 individuals with and without pathology. Materials and Methods: Each individual is simultaneously made the following determinations: TTGG and TTGA Qual (AESKU Diagnostics®, Germany), TgTG, TgTA, AAGG and AAGA ENEASYSTEM III® (Byogenetix, Italia), Neoep. IgG/A (AESKU Diagnostics®, Germany), EMA IgG, IGA and GAF3X IgG-IgA (Euroimmun, Germany®). Results: The sensitivity (S) and specificity (Sp) were: anti-IgA To Celicheck: S: 44.44%, E: 97.59% anti-TTG Qual: S: 14.28%, E: 97.61% anti-neoepitopes IgG/IgA: S: 54.44%, E: 91.59%; AAG IgG: S: 89.11%, E: 63.19%; AAG IgA: S: 79.11%, E: 68.16% IgA anti-DGPs: S: 86.67% E: 96.21% (p<0.05). Conclusions: IgG and IgA ATGT are surpassed only by anti-DGPs However, it is important to extend the research to standardize this new method of assessment.
ABSTRACT
Aim: The aim of this study was to assess the immunological and histological profiles of adult coeliac patients after commencing Nigella sativa (NS) oil with gluten free diet (GFD) for a period of 1 year ± 1month to prove its validity in treatment of refractory coeliac disease (CD). Methodology: Thirty two adult coeliac patients who all accepted to do endoscopy and duodenal biopsy in addition to serological assessment before and after treatment of GFD alone or with NS oil capsules for a period of 1 year ± 1 month. Duodenal biopsies were interpreted histologically according to modified Marsh criteria and the sera were tested for antigliadin antibody (AGA), anti tissue transglutaminase antibody (tTG) and endomysium antibody (EMA). Results: The response to gluten withdrawal with NS oil for a period of 1 year ± 1 month in CD patients was better than GFD alone with significant response to serological markers. Conclusion: The administration of NS oil with GFD to CD patients leads to a significant decreases more than GFD alone in the levels of all immunological parameters with histological improvement and stop the disease process (P=0.001). Ultimately, the results emerging from this study may substantially improve the immunotherapeutic application of NS in clinical management of refractory CD cases.