Abstract
The diagnostic value of the fluorescent immunosorbent test for IgG gliadin antibodies (FIST) has been investigated in comparison with the LIF test—the competence of the gluten subfractions B2 and B3 in releasing lymphokines from peripheral lymphocytes in vitro—in 96 patients with coeliac disease (CD) under various dietary conditions. In untreated children with CD during their first 2 years of life, the FIST showed 100% sensitivity with 95% specificity, whilst the LIF test showed only 70% sensitivity and 73% specificity. Therefore it can be concluded that the FIST as a screening test is superior to the LIF. In older children with a proved recurrence of the mucosal abnormality after reintroduction of a normal diet, only 44% showed increased IgG gliadin antibody titres whereas 70% proved to be positive in the LIF test.
Under a controlled gluten challenge all six patients reacted with a distinct increase in gliadin antibody titres whereas the LIF test changed from positive to negative and vice versa without following any clear principle. These results emphasize the inadequacy of the LIF test as a diagnostic method, both in untreated CD and under controlled gluten challenge.
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Abbreviations
- FIST:
-
fluorescent immunosorbent test
- CD:
-
coeliac disease
- LIF:
-
leucocyte migration inhibition factor
- GFD:
-
gluten free diet
References
Ashkenazi A, Idar D, Handzel ZT, Ofarim M, Levin S (1978) An in-vitro immunological assay for diagnosis of coeliac disease. Lancet I:627–629
Ashkenazi A, Levin S, Idar D, Or A, Rosenberg J, Handzel ZT (1980) Immunological assay for the diagnosis of coeliac disease: Interaction between purified gluten fractions. Pediatr Res 14: 776–778
Ashkenazi A, Levin S, Idar D, Or A, Barzilai N, Handzel ZT (1981) Effect of gluten free diet on an immunological assay for coeliac disease. Lancet I:914–916
Axen R, Porath J, Ernbach S (1967) Chemical coupling of peptides and proteins to polysaccharides by means of cyanogen halides. Nature 214:1302–1305
Boyum A (1968) Separation of leucocytes from blood and bone marrow. J Clin Lab Invest 21:31–50
Bullen AW, Losowsky MS (1978) Cell-mediated immunity to gluten fraction III in adult coeliac disease. Gut 19:126–131
Bürgin-Wolff A, Hernandez R, Just M, Signer E (1976) Immuno-fluorescent antibodies against gliadin: a screening test for coeliac disease. Helv Paediatr Acta 31:375–380
Dahlquist A (1968) Assay of intestinal disaccharidases. Anal Biochem 22:99–107
Falchuk ZM, Gebhard RL, Strober W (1974) In: Hekkens WThJM, Pena AS (eds) Coeliac disease. HE Stenfert Kroese BV, Leiden, p 107
Ferguson A, MacDonald TT, McClure JP, Holdern RJ (1975) Cell-mediated immunity to gliadin within the small-intestinal mucosa in coeliac disease. Lancet I:895–897
Haeney MR, Asquith P (1977) Inhibition of leucocyte migration by α-gliadin in patients with gastrointestinal disease: its specificity with respect to α-gliadin and coeliac disease. In: McNicholl B, McCarthy CF, Fottrell PF (eds) Perspectives in coeliac disease. Galway MTP Press Ltd, Lancaster, U.K., pp 229–241
McNeish AS, Rolles CJ, Arthur LJH (1976) Criteria for the diagnosis of temporary gluten intolerance. Arch Dis Child 51:275–278
McNeish AS, Harms HK, Rey J, Shmerling DH, Visakorpi JK, Walker-Smith JA (1979) The diagnosis of coeliac disease. A commentary on the current practice of members of the European Society for Paediatric Gastroenterology and Nutrition (ESPGAN). Arch Dis Child 54:783–786
Savilahti E, Viander M, Perkkiö M, Vainio E, Kalimo K, Reunala T (1983) IgA Antigliadin antibodies: A marker of mucosal damage in childhood coeliac disease. Lancet I:320–322
Signer E, Bürgin-Wolff A, Berger R, Birnbaumer A, Just M (1979) Antibodies to gliadin as a screening test for coeliac disease. Helv Paediatr Acta 34:41–52
Sikora K, Anad BS, Truelove SC, Ciclitiria PJ, Offord RE (1976) Stimulation of lymphocytes from patients with coeliac disease by a subfraction of gluten. Lancet II:389–391
Stern M, Fischer K, Grüttner R (1979) Immunofluorescent serum gliadin antibodies in children with coeliac disease and various malabsorptive disorders. Eur J Pediatr 130:155–164
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Bertele, R.M., Bürgin-Wolff, A., Berger, R. et al. The fluorescent immunosorbent test for IgG gliadin antibodies and the leucocyte migration inhibition test in coeliac disease; comparison of diagnostic value. Eur J Pediatr 144, 58–62 (1985). https://doi.org/10.1007/BF00491928
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DOI: https://doi.org/10.1007/BF00491928