Article

Journal of Clinical Immunology

, Volume 31, Issue 3, pp 436-442

First online:

Serodiagnostic Assays for Celiac Disease Based on the Open or Closed Conformation of the Autoantigen, Transglutaminase 2

  • Katri LindforsAffiliated withPediatric Research Center, University of Tampere and Tampere University Hospital
  • , Outi KoskinenAffiliated withPediatric Research Center, University of Tampere and Tampere University Hospital
  • , Kalle KurppaAffiliated withPediatric Research Center, University of Tampere and Tampere University Hospital
  • , Kaija LaurilaAffiliated withPediatric Research Center, University of Tampere and Tampere University Hospital
  • , Pekka CollinAffiliated withDepartment of Gastroenterology and Alimentary Tract Surgery, Tampere University HospitalSchool of Medicine, University of Tampere
  • , Katri HaimilaAffiliated withFinnish Red Cross Blood Service
  • , Jukka PartanenAffiliated withFinnish Red Cross Blood Service
  • , Päivi SaavalainenAffiliated withDepartment of Medical Genetics and Research Program for Molecular Medicine, Biomedicum Helsinki, University of Helsinki
  • , Markku MäkiAffiliated withPediatric Research Center, University of Tampere and Tampere University Hospital
    • , Katri KaukinenAffiliated withDepartment of Gastroenterology and Alimentary Tract Surgery, Tampere University HospitalSchool of Medicine, University of Tampere Email author 

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Abstract

The autoantigen of celiac disease, transglutaminase 2 (TG2), adopts an open conformation during enzymatic activation. We studied diagnostic accuracy of serodiagnostic assays using TG2 in its open and closed conformation as antigens in patients with diagnostic difficulties. The open TG2 antibody (TG2ab) test identified 93% of untreated celiac patients in contrast to 44%, 27%, and 68% detected by closed and conventional TG2ab and endomysial antibody (EmA) tests, respectively. The assay was able to detect 60% of non-responding celiac patients seronegative for conventional TG2ab and EmA. The titers of the openTG2abs were higher than those of the closed TG2abs. The serological test utilizing TG2 in an open conformation was more accurate than the other assays in finding active celiac disease even in patients having negative or borderline conventional celiac autoantibodies and in revealing poor dietary response non-invasively. It thus offers a promising tool in the diagnostics and follow-up of celiac disease.

Keywords

Celiac disease gluten transglutaminase 2 open conformation diagnostic accuracy