Deamidated Gliadin Peptide Antibodies in Celiac Disease: A Diagnostic Driver or just along for the Ride?

Abstract

Anti deamidated gliadin peptides antibodies are considered as celiac disease associated diagnostic antibodies. They are in clinical use for almost the last two decades. In the first decade they were preferentially used in early childhood, in face of IgA deficiency and occasionally recommended as the prime serological marker, outperforming the anti-tissue transglutaminase autoantibody. Notably, they were recommended in combination with the tissue transglutaminase as enhancer of the diagnostic performances. No more, the circle turned over. In the second decade (2012-2019), most of the studies limited and criticized their past published advantages. They suggested that deamidated gliadin peptides antibodies do not have any advantage over anti-tissue transglutaminase autoantibodies in terms of early childhood, IgA deficiency, diagnostic performances and when both antibodies are combined. It seems that the deamidated gliadin peptide are losing their place in the celiac disease algorithmic diagnostic flow chart.