Poor Sensitivity of Fecal Gluten Immunogenic Peptides and Serum Antibodies to Detect Duodenal Mucosal Damage in Celiac Disease Monitoring

A lifelong gluten-free diet (GFD) is the only current treatment for celiac disease (CD), but strict compliance is complicated. Duodenal biopsies are the “gold standard” method for diagnosing CD, but they are not generally recommended for disease monitoring. We evaluated the sensitivity and specifici...

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Main Authors: Emilio J. Laserna-Mendieta, María José Casanova, Ángel Arias, Laura Arias-González, Pedro Majano, Luis Alberto Mate, Carlos Humberto Gordillo-Vélez, Mirella Jiménez, Teresa Angueira, Emilia Tébar-Romero, María Jesús Carrillo-Ramos, María Ángeles Tejero-Bustos, Javier P. Gisbert, Cecilio Santander, Alfredo J. Lucendo
Format: Article
Language:English
Published: MDPI AG 2021-12-01
Series:Nutrients
Subjects:
Online Access:https://www.mdpi.com/2072-6643/13/1/98
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spelling doaj-712824f6f969441ba37ec21ba3eaf4072020-12-31T00:02:20ZengMDPI AGNutrients2072-66432021-12-0113989810.3390/nu13010098Poor Sensitivity of Fecal Gluten Immunogenic Peptides and Serum Antibodies to Detect Duodenal Mucosal Damage in Celiac Disease MonitoringEmilio J. Laserna-Mendieta0María José Casanova1Ángel Arias2Laura Arias-González3Pedro Majano4Luis Alberto Mate5Carlos Humberto Gordillo-Vélez6Mirella Jiménez7Teresa Angueira8Emilia Tébar-Romero9María Jesús Carrillo-Ramos10María Ángeles Tejero-Bustos11Javier P. Gisbert12Cecilio Santander13Alfredo J. Lucendo14Department of Gastroenterology, Hospital General de Tomelloso, 13700 Tomelloso, SpainDepartment of Gastroenterology, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), 28006 Madrid, SpainInstituto de Investigación Sanitaria Princesa, 28006 Madrid, SpainDepartment of Gastroenterology, Hospital General de Tomelloso, 13700 Tomelloso, SpainInstituto de Investigación Sanitaria Princesa, 28006 Madrid, SpainPathology Department, Hospital General Mancha Centro, 13600 Alcázar de San Juan, SpainInstituto de Investigación Sanitaria Princesa, 28006 Madrid, SpainDepartment of Gastroenterology, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), 28006 Madrid, SpainDepartment of Gastroenterology, Hospital General de Tomelloso, 13700 Tomelloso, SpainDepartment of Gastroenterology, Hospital General de Tomelloso, 13700 Tomelloso, SpainDepartment of Gastroenterology, Hospital General de Tomelloso, 13700 Tomelloso, SpainDepartment of Gastroenterology, Hospital General de Tomelloso, 13700 Tomelloso, SpainDepartment of Gastroenterology, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), 28006 Madrid, SpainDepartment of Gastroenterology, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), 28006 Madrid, SpainDepartment of Gastroenterology, Hospital General de Tomelloso, 13700 Tomelloso, SpainA lifelong gluten-free diet (GFD) is the only current treatment for celiac disease (CD), but strict compliance is complicated. Duodenal biopsies are the “gold standard” method for diagnosing CD, but they are not generally recommended for disease monitoring. We evaluated the sensitivity and specificity of fecal gluten immunogenic peptides (GIPs) to detect duodenal lesions in CD patients on a GFD and compared them with serum anti-tissue transglutaminase (tTG) IgA antibodies. A prospective study was conducted at two tertiary centers in Spain on a consecutive series of adolescents and adults with CD who maintained a long-lasting GFD. Adherence to a GFD and health-related quality of life were scored with validated questionnaires. Mucosal damage graded according to the Marsh–Oberhüber classification (Marsh 1/2/3) was used as the reference standard. Of the 97 patients included, 27 presented duodenal mucosal damage and 70 had normal biopsies (Marsh 0). The sensitivity (33%) and specificity (81%) of GIPs were similar to those provided by the two assays used to measure anti-tTG antibodies. Scores in questionnaires showed no association with GIP, but an association between GIPs and patients’ self-reported gluten consumption was found (<i>p</i> = 0.003). GIP displayed low sensitivity but acceptable specificity for the detection of mucosal damage in CD.https://www.mdpi.com/2072-6643/13/1/98celiac diseasegluten-free diet monitoringMarsh–Oberhüber typegluten immunogenic peptidesanti-tissue transglutaminase antibodiesdiagnostic accuracy
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language English
format Article
sources DOAJ
author Emilio J. Laserna-Mendieta
María José Casanova
Ángel Arias
Laura Arias-González
Pedro Majano
Luis Alberto Mate
Carlos Humberto Gordillo-Vélez
Mirella Jiménez
Teresa Angueira
Emilia Tébar-Romero
María Jesús Carrillo-Ramos
María Ángeles Tejero-Bustos
Javier P. Gisbert
Cecilio Santander
Alfredo J. Lucendo
spellingShingle Emilio J. Laserna-Mendieta
María José Casanova
Ángel Arias
Laura Arias-González
Pedro Majano
Luis Alberto Mate
Carlos Humberto Gordillo-Vélez
Mirella Jiménez
Teresa Angueira
Emilia Tébar-Romero
María Jesús Carrillo-Ramos
María Ángeles Tejero-Bustos
Javier P. Gisbert
Cecilio Santander
Alfredo J. Lucendo
Poor Sensitivity of Fecal Gluten Immunogenic Peptides and Serum Antibodies to Detect Duodenal Mucosal Damage in Celiac Disease Monitoring
Nutrients
celiac disease
gluten-free diet monitoring
Marsh–Oberhüber type
gluten immunogenic peptides
anti-tissue transglutaminase antibodies
diagnostic accuracy
author_facet Emilio J. Laserna-Mendieta
María José Casanova
Ángel Arias
Laura Arias-González
Pedro Majano
Luis Alberto Mate
Carlos Humberto Gordillo-Vélez
Mirella Jiménez
Teresa Angueira
Emilia Tébar-Romero
María Jesús Carrillo-Ramos
María Ángeles Tejero-Bustos
Javier P. Gisbert
Cecilio Santander
Alfredo J. Lucendo
author_sort Emilio J. Laserna-Mendieta
title Poor Sensitivity of Fecal Gluten Immunogenic Peptides and Serum Antibodies to Detect Duodenal Mucosal Damage in Celiac Disease Monitoring
title_short Poor Sensitivity of Fecal Gluten Immunogenic Peptides and Serum Antibodies to Detect Duodenal Mucosal Damage in Celiac Disease Monitoring
title_full Poor Sensitivity of Fecal Gluten Immunogenic Peptides and Serum Antibodies to Detect Duodenal Mucosal Damage in Celiac Disease Monitoring
title_fullStr Poor Sensitivity of Fecal Gluten Immunogenic Peptides and Serum Antibodies to Detect Duodenal Mucosal Damage in Celiac Disease Monitoring
title_full_unstemmed Poor Sensitivity of Fecal Gluten Immunogenic Peptides and Serum Antibodies to Detect Duodenal Mucosal Damage in Celiac Disease Monitoring
title_sort poor sensitivity of fecal gluten immunogenic peptides and serum antibodies to detect duodenal mucosal damage in celiac disease monitoring
publisher MDPI AG
series Nutrients
issn 2072-6643
publishDate 2021-12-01
description A lifelong gluten-free diet (GFD) is the only current treatment for celiac disease (CD), but strict compliance is complicated. Duodenal biopsies are the “gold standard” method for diagnosing CD, but they are not generally recommended for disease monitoring. We evaluated the sensitivity and specificity of fecal gluten immunogenic peptides (GIPs) to detect duodenal lesions in CD patients on a GFD and compared them with serum anti-tissue transglutaminase (tTG) IgA antibodies. A prospective study was conducted at two tertiary centers in Spain on a consecutive series of adolescents and adults with CD who maintained a long-lasting GFD. Adherence to a GFD and health-related quality of life were scored with validated questionnaires. Mucosal damage graded according to the Marsh–Oberhüber classification (Marsh 1/2/3) was used as the reference standard. Of the 97 patients included, 27 presented duodenal mucosal damage and 70 had normal biopsies (Marsh 0). The sensitivity (33%) and specificity (81%) of GIPs were similar to those provided by the two assays used to measure anti-tTG antibodies. Scores in questionnaires showed no association with GIP, but an association between GIPs and patients’ self-reported gluten consumption was found (<i>p</i> = 0.003). GIP displayed low sensitivity but acceptable specificity for the detection of mucosal damage in CD.
topic celiac disease
gluten-free diet monitoring
Marsh–Oberhüber type
gluten immunogenic peptides
anti-tissue transglutaminase antibodies
diagnostic accuracy
url https://www.mdpi.com/2072-6643/13/1/98
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