Abstract
Aim: To review the existing literature on the role and significance of intestinal transglutaminase 2 immunoglobulin A deposits (TG2 deposits) in patients with overt celiac disease (CD), potential celiac disease (PCD), and other autoimmune or gluten-related conditions.Methods: We conducted a systematic review of studies published in English, evaluating presence and characteristics of TG2 deposits in subjects with overt CD, PCD, gluten-related diseases [dermatitis herpetiformis (DH), gluten-ataxia (GA)], autoimmune disorders (type-1 diabetes), and other conditions. Studies were identified through a MEDLINE search (1950–2013).Results: Twenty-three studies were included in the review. Eleven studies were performed in children. Overall TG2 deposits were present in 100% of adults with overt CD, while in children prevalence ranged from 73.2 to 100%. Six studies with an established definition of PCD were considered, prevalence of deposits ranging from 64.7 to 100%. A single study followed-up PCD patients with repeated biopsies and identified presence of intestinal deposits as the best marker to reveal progression toward villous atrophy. Two studies investigated presence of deposits in DH, reporting prevalence between 63 and 79%. A single study documented TG2 deposits in 100% of patients with GA. In children with type-1 diabetes (T1D), positivity of intestinal TG2 deposits ranged from 25 to 78%.Conclusion: Transglutaminase 2 IgA deposits seem to be a constant feature in overt CD patients and are frequently detectable in other gluten-related conditions (DH and GA). The vast majority of PCD patients express TG2 deposits at the intestinal level, but no sufficient data are available to exactly define their prognostic role as a marker of evolution toward overt CD. The frequent finding of TG2 deposits in the intestinal mucosa of patients with T1D is an interesting observation deserving further evaluation.
Highlights
Celiac disease (CD) is a chronic, immune-mediated enteropathy triggered by the ingestion of gluten containing grains in genetically susceptible individuals, expressing the HLA-class 2 molecules DQ2 or DQ8 (1)
Overall transglutaminase 2 (TG2) deposits were present in 100% of adults with overt CD, while in children prevalence ranged from 73.2 to 100%
Transglutaminase 2 immunoglobulin A (IgA) deposits seem to be a constant feature in overt CD patients and are frequently detectable in other gluten-related conditions (DH and GA)
Summary
Celiac disease (CD) is a chronic, immune-mediated enteropathy triggered by the ingestion of gluten containing grains in genetically susceptible individuals, expressing the HLA-class 2 molecules DQ2 or DQ8 (1). Gluten-induced small-bowel (SB) mucosal histological damage develops gradually, from lymphocytic infiltration of the epithelium to crypt hyperplasia and further to villous atrophy (2). Potential celiac disease (PCD) is a well-known condition, characterized by a positive serology for CD with an architecturally normal intestinal mucosa. Timing of progression toward classical CD has not clearly been established in PCD, a recent study indicates that 30% of children with PCD left on a normal diet develop villous atrophy within 4 years (5). In another study performed in an at-risk population (first-degree relatives), 5% of children with PCD developed overt CD within 2 years (6). In this context, the search for a specific marker with a high prognostic value is extremely appealing
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
