ANTIBODIES TO DESAMINATED GLYADIN PEPTIDES, TISSUE TRANSGLUTAMINASE AND ENDOMYSIUM IN HLA-DQ 2/8 GENOTYPE CARRIERS

DOI: https://doi.org/10.29296/24999490-2019-01-08

A.M. Malkova(1), A.I. Budkova(2), A.V. Mazing(2), T.V. Blinova(2), S.V. Lapin(2) 1-Saint Petersburg State University, 7–9, Universitetskaya Emb., Saint Petersburg, 199034, Russian Federation; 2-Saint Petersburg I.P. Pavlov State Medical University, L’va Tolstogo str., 6–8, Saint Petersburg, 197022, Russian Federation E-mail: anya.malkova.95@mail.ru

Introduction. The laboratory diagnosis of celiac disease is based on the detection of antibodies against deamidated gliadin peptides (anti-DGP), autoantibodies to tissue transglutaminase (anti-tTG) and endomysium (AEA), as well as genotyping of HLA-DQ2/8 loci. All these biomarkers represent the pathological immune process and have high specificity. Concordance of the results is very important for the diagnosis of celiac disease. The aim of the study. To identify the interrelation between the detection of antibodies (anti-tTG, AEA, anti-DGP) and HLA-DQ2/DQ8 genotypes among 697 patients with the suspected celiac disease. Methods. There were analyzed the results of HLA-DQ-genotyping and the determination of celiac-specific antibodies in 697 patients enrolled in research in the diagnostic laboratory of autoimmune disease of the Pavlov State Medical University during the period of 2014 to 2017. Results. HLA-DQ2/DQ8 genotypes were found in 49,5% (345/697) of patients, among whom the HLA-DQ2.5 genotype was most prevalent in 23,3% (162/697). Only in 9,7% (3/31) of genetically predisposed patients there were found celiac disease-specific antibodies. Among patients with the HLA-DQ2.2 genotype, the high level of anti-DPG and autoantibodies was most often detected. The combination of AEA, anti-tTG, anti-DPG was found only among predisposed patients. Anti-DGP antibodies were determined regardless of the genotype, but high levels of anti-DGP (more than 100 U/ml) were observed only in the presence of HLA-DQ2/DQ8 genotypes (the authenticity р=0,038). Conclusion. Our results confirm the presence of HLA-DQ2/DQ8 loci to be a predisposing factor for the formation of an autoimmune response in celiac disease. Among patients with HLA-DQ2.2 genotypes, the development of an autoimmune reaction was more often detected. anti-tTG and AEA were confirmed to be found only with the genotype of the risk of celiac disease, and therefore the determination of the level of these autoantibodies has a diagnostic significance in the diagnosis of celiac disease, while the anti-DPG was not a specific index of the disease.
Keywords: 
celiac disease, laboratory diagnosis, genotype, concordance, autoantibodies

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