Abstract
Immune responses to tissue transglutaminase (tTG) and nonapeptides of gliadin (npG) are associated with dermatitis herpetiformis (DH), a gluten-related dermatosis. Recently, a bi-analyte immunoblot (b-aIB) was introduced to detect IgA antibodies in response to tTG and npG. We compared the utility of ELISA and b-aIB with tTG in serological diagnoses of DH and their agreement with direct immunofluorescence (DIF). In total, 55 sera (27 DIF-positive DH patients, 4 DIF-negative DH patients and 24 healthy controls) were examined. ELISA for anti-tTG IgA, b-aIB for anti-npG and anti-tTG IgA, and statistical analysis were performed. The b-aIB with tTG showed 78% sensitivity, 100% specificity, 100% positive predictive value, and 82% negative predictive value in relation to ELISA. A better rate of agreement (Cohen’s kappa values) in IgA detection was observed in the pair tTG ELISA and b-aIB with npG (0.85) than in pairs tTG ELISA and b-aIB with tTG (0.78) or b-aIB with tTG and b-aIB with npG (0.78). No degree of agreement was found between serological tests and DIF. Both serological tests may be used to detect the anti-tTG IgA in DH patients. Still, DH diagnosing requires careful consideration of clinical data as well as results of tissue imaging (crucial DIF) and immunoserological techniques detecting DH-type features.
Highlights
In humans, nine members of the transglutaminase (TG) family have been identified [1,2], most of which catalyze post-translational protein-modifying reactions and are able to alter their function [2,3]
In the control group, there were no positive results of anti-tissue transglutaminase (tTG) IgA with ELISA
Anti-TG antibodies seem to play an important role in the histopathogenesis of dermatitis herpetiformis (DH) [37,38,39,40,41], and the presence of circulating anti-tTG is often used to aid in the diagnosis and follow-up of these patients
Summary
Nine members of the transglutaminase (TG) family have been identified [1,2], most of which catalyze post-translational protein-modifying reactions and are able to alter their function [2,3]. The TG family is probably implicated in many diseases, such as type 2 diabetes, essential hypertension, neurodegenerative diseases, and dermatological disorders [3,4,5]. Some data have indicated anti-TG6 IgA in sera from schizophrenia patients [6]. DH is a chronic IgA-mediated blistering dermatosis related to dietary gluten, where both autoimmunity and autoinflammation are implicated in its development [8,9,10,11,12]. The clinical picture presents an intense itching and polymorphic eruption, with a predilection for the external surfaces of the knees, elbows, buttocks, and shoulders, undergoing the spatial-temporal evolution
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