Clinical Significance

Celiac disease is characterized by gluten intolerance leading to a chronic malabsorptive disorder due to inflammation of the intestinal mucosa and flattening of the epithelium. The revised criteria for the diagnosis of celiac disease, according to The European Society for Pediatric Gastroenterology and Nutrition (ESPGAN) 1990, requires the identification of a single positive gut biopsy together with the demonstration of at least two of the three following IgA antibodies: IgA anti-endomysial antibodies, IgG and IgA anti-gliadin antibodies and anti-reticulin antibodies. Several studies have demonstrated that IgA anti-endomysial tests have a greater than 99% specificity for celiac disease with a greater sensitivity than anti-gliadin and anti-reticulin assays. The target endomysial antigen has recently been identified as the calcium dependent, protein cross-linking, enzyme tissue transglutaminase. The

ELISA assay for IgA anti-tTG provides a suitable alternative to immunofluorescent assays (IFA) and is ideal for small and large-scale screening.