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  • Title: IgA isotyping of antigliadin antibodies. A possible clue for a less invasive diagnosis of coeliac disease.
    Author: Elewaut A, Dacremont G, Robberecht E, Leroy J, De Baets MH.
    Journal: Clin Chim Acta; 1989 Aug 31; 183(3):285-94. PubMed ID: 2805354.
    Abstract:
    An enzyme-linked immunosorbent assay was used to measure serum antigliadin antibodies (AGA) of IgG and IgA classes. The assay was modified to measure IgA1 and IgA2 subclasses with monoclonal anti-IgA subclass antibodies. Serum IgG- and IgA-AGA levels were elevated in patients with coeliac disease (CD) but an overlap was seen with control sera. IgA-AGA isotyping using monoclonal anti-human IgA1 and IgA2 antibodies increased the sensitivity and specificity of the assay to almost 100%. All patients with active untreated CD and none of the control groups had elevated IgA1-AGA and IgA2-AGA. In order to measure the relative distribution of IgA1-AGA versus IgA2-AGA an IgA1/IgA2 ratio was calculated. In patients with active untreated CD a ratio of 2.8 was found, declining to 2.2 during treatment. A gluten challenge increased the ratio to 3.4. These findings suggest that IgA1-AGA subclass measurements are a useful screening test before small bowel biopsies are performed. This method can also be used to assess the results of a gluten free diet.
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