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. 2023 Oct;23(6):2829-2838.
doi: 10.1007/s10238-023-01040-1. Epub 2023 Mar 13.

Study of the immune response in celiac patients with selective IgA deficiency who start a gluten-free diet

Lola Giner-Pérez  1 , Ester Donat  2   3 , Paula Sinisterra-Sebastián  4 , Etna Masip  2   3 , Verónica Ballester  2   3 , Begoña Polo  2   3 , Carmen Ribes-Koninckx  2   3 , María Roca  2
Affiliations

Study of the immune response in celiac patients with selective IgA deficiency who start a gluten-free diet

Lola Giner-Pérez et al. Clin Exp Med. 2023 Oct.

Abstract

Studies are scarce regarding IgG anti-tissue transglutaminase 2 (tTG) normalization in selective IgA deficient (SIgAD) celiac disease (CD) patients after beginning a gluten free diet (GFD). The aim of this study is to analyse the decreasing dynamics of IgG anti-tTG in patients diagnosed with CD who start a GFD. To achieve this objective, IgG and IgA anti-tTG levels at diagnosis and during follow-up in 11 SIgAD CD patients and in 20 IgA competent CD patients were retrospectively evaluated. At diagnosis, statistical differences were not found when comparing IgA anti-tTG levels of IgA competent subjects with IgG anti-tTG levels of SIgAD subjects. Regarding the decreasing dynamics, even though no statistical differences were found (p = 0.06), normalization rates were slower for SIgAD CD patients. After 1 and 2 years on GFD, respectively, only 18.2% and 36.3% of the SIgAD CD patients normalized IgG anti-tTG levels; otherwise, IgA anti-tTG reached values under the reference values in 30% and 80% of the IgA competent patients in the same time-points. Although IgG anti-tTG has demonstrated a high diagnostic efficiency in SIgAD CD pediatric patients, this test does not appear to be as precise for long-term GFD response monitoring as IgA anti-tTG levels in IgA sufficient patients.

Keywords: Anti-endomysium antibodies; Celiac disease; Children; Follow-up; Selective IgA deficiency; Tissue transglutaminase.

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Figures

Fig. 1
Fig. 1
Anti- tTG levels at CD diagnosis. Statistical differences in the median IgA/IgG anti- tTG levels between the patients’ groups are represented. Ns Not significant; ****p-value < 0.0001
Fig. 2
Fig. 2
The correlation between IgA and IgG anti-tissue transglutaminase (tTG) levels in IgA competent children with untreated CD (n = 20)
Fig. 3
Fig. 3
IgG and IgA antibodies against tissue transglutaminase (anti- tTG) serum levels in IgA competent celiac disease pediatric patients since the start of a gluten-free diet
Fig. 4
Fig. 4
Serum levels of IgG antibodies against tissue transglutaminase (anti- tTG) expressed as logarithm in CD children with Selective IgA Deficiency (SIgAD) and IgA competent children (IgA comp) since starting a gluten-free diet
Fig. 5
Fig. 5
Serum levels expressed as logarithm of IgG antibodies against tissue transglutaminase (anti- tTG) in children with Selective IgA Deficiency (SIgAD) and serum levels of IgA anti- tTG in IgA competent children (IgA comp) since the start of a gluten-free diet
See this image and copyright information in PMC

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Supplementary concepts