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  • Title: Clinical Value of Tissue Transglutaminase Antibodies in Celiac Patients over a Long Term Follow-Up.
    Author: Farina E, Roncoroni L, Lombardo V, Scricciolo A, Vecchi M, Doneda L, Elli L.
    Journal: Nutrients; 2021 Aug 31; 13(9):. PubMed ID: 34578935.
    Abstract:
    INTRODUCTION & AIM: Anti-tissue transglutaminase antibody (tTGA) titer is used during the follow-up of celiac patients to evaluate gluten-free diet (GFD) responsiveness. However, no clear data are available on this issue. The aim of this study was to evaluate tTGA significance during celiac disease (CD) monitoring. METHODS: From January 2017 to January 2020, consecutive CD patients on a GFD with persistent positive tTGA were enrolled. Antibody titres were evaluated on a yearly basis from CD diagnosis to the last follow-up. Urinary gluten detection tests, duodenal histology and capsule enteroscopy (CE) were performed. A tTGA-positive cohort was compared with a control group composed of 212 treated CD patients with negative tTGA. RESULTS: 65 patients (12% males, median age at enrollment and CD diagnosis, 37 (14-86) and 31 (1-76), respectively, median follow up 4 (1-26) years) presented with positive tTGA during follow-up. Overall, the tTGA titres were 3 (1-79) fold increased (ULN). Three different tTGA trends were recognized: (I) 36 (55%) patients with a progressive titres decrease; (II) 16 (25%) patients with a fluctuating behavior; (III) 13 (20%) patients with a steady state or increased titres. tTGA+ patients did not present with different clinical and demographic parameters. Duodenal atrophy was present in 10% vs. 36% of the tTGA positive vs. negative group (p < 0.005), respectively. Gluten detection results were positive in 3 (8%) cases, all in the III group. In tTGA+ patients, CE did not identify any CD-related complications. CONCLUSIONS: tTGA positivity during CD follow up did not present a relevant clinical significance without association with autoimmune comorbidities and mucosal damage.
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