Deamidated gliadin antibodies

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It was the discovery in 1997 that tissue transglutaminase (tTG) is the target autoantigen for anti-endomysial antibodies that triggered off significant progress both in the understanding of coeliac disease (CD) and in the serological assay available to assist in the diagnosis. The realisation that tTG is important in unmasking of B and T lymphocyte neo-epitopes by de-amidating glutamine residues to the more negatively charged glutamic acid was critical knowledge in this progress. Epitope mapping of de-amidated wheat gliadins and glutenins has uncovered some dominant linear B cell epitopes that have been employed in a number of novel assays now in routine use in diagnostic laboratories. These assays appear to have a similar diagnostic performance to the IgA anti-tTG/EMA assays with potential advantages in certain groups including those with IgA deficiency, young children and the elderly. How to best utilise de-amidated gliadin peptide (DGP) antibody assays remains an area of active debate and ongoing research. Given the complexity of wheat and other toxic CD proteins, research into B cell epitope mapping continues. This research has the potential discover more B cell epitopes and to further increase the sensitivity of DGP antibody assays without affecting specificity. This may make it the assay of choice for both screening and assisting in the diagnosis of CD in the future. It was the discovery in 1997 that tissue transglutaminase (tTG) is the target autoantigen for anti-endomysial antibodies that triggered off significant progress both in the understanding of coeliac disease (CD) and in the serological assay available to assist in the diagnosis. The realisation that tTG is important in unmasking of B and T lymphocyte neo-epitopes by de-amidating glutamine residues to the more negatively charged glutamic acid was critical knowledge in this progress. Epitope mapping of de-amidated wheat gliadins and glutenins has uncovered some dominant linear B cell epitopes that have been employed in a number of novel assays now in routine use in diagnostic laboratories. These assays appear to have a similar diagnostic performance to the IgA anti-tTG/EMA assays with potential advantages in certain groups including those with IgA deficiency, young children and the elderly. How to best utilise de-amidated gliadin peptide (DGP) antibody assays remains an area of active debate and ongoing research. Given the complexity of wheat and other toxic CD proteins, research into B cell epitope mapping continues. This research has the potential discover more B cell epitopes and to further increase the sensitivity of DGP antibody assays without affecting specificity. This may make it the assay of choice for both screening and assisting in the diagnosis of CD in the future.