Antibody concentrations decrease 14-fold in children with celiac disease on a gluten-free diet but remain high at 3 months
<strong>Background & Aims</strong> Celiac disease can be identified by a serologic test for IgA against tissue transglutaminase (IgA-TTG) in a large proportion of children. However, the increased concentrations of antibody rarely normalize within the months after children are pla...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
AGA Institute
2018
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| _version_ | 1826273382493061120 |
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| author | Petroff, D Wolf, J Richter, T Auth, M Uhlig, H Laass, M Lauenstein, P Krahl, A Händel, N de Laffolie, J Hauer, A Heiduk, M Flemming, G Schmidt, A Hasenclever, D Mothes, T |
| author_facet | Petroff, D Wolf, J Richter, T Auth, M Uhlig, H Laass, M Lauenstein, P Krahl, A Händel, N de Laffolie, J Hauer, A Heiduk, M Flemming, G Schmidt, A Hasenclever, D Mothes, T |
| author_sort | Petroff, D |
| collection | OXFORD |
| description | <strong>Background & Aims</strong> Celiac disease can be identified by a serologic test for IgA against tissue transglutaminase (IgA-TTG) in a large proportion of children. However, the increased concentrations of antibody rarely normalize within the months after children are placed on a gluten-free diet (GFD). Early serologic predictors of sufficient adherence to gluten-free diet are required for optimal treatment. <strong>Methods</strong> In a prospective study, we observed the response to a GFD in 345 pediatric patients (67% girls; mean age, 8.4 y) who underwent duodenal biopsy to confirm or refute celiac disease from October 2012 through December 2015. Baseline serum samples were tested centrally for IgA-TTG and IgG against deamidated gliadin. Follow-up serologic analyses of children on a GFD were performed about 3 months later. <strong>Results</strong> The geometric mean concentration of IgA-TTG decreased from 72.4-fold to 5.2-fold the upper limit of normal (ULN), or by a factor of 14.0 (95% CI, 12.0–16.4). A substantial response (defined as a larger change than the typical variation in patients not on a GFD) was observed in 80.6% of the children. Only 28.1% of patients had a substantial response in the concentration of IgG against deamidated gliadin. Concentration of IgA-TTG remained above 1-fold the ULN in 83.8% of patients, and above 10-fold the ULN in 26.6% of patients with a substantial response. <strong>Conclusions</strong> Serum concentration of IgA-TTG decreases substantially in most children with celiac disease within 3 months after they are placed on a GFD, but does not normalize in most. This information on changes in antibody concentrations can be used to assess patient response to the diet at short-term follow-up evaluations. Patients with a substantial response to a GFD often still have high antibody levels after 3 months. German Clinical Trials Registry no. DRKS00003854. |
| first_indexed | 2024-03-06T22:27:20Z |
| format | Journal article |
| id | oxford-uuid:5718153d-3d31-419c-8dc4-506909ee4eed |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T22:27:20Z |
| publishDate | 2018 |
| publisher | AGA Institute |
| record_format | dspace |
| spelling | oxford-uuid:5718153d-3d31-419c-8dc4-506909ee4eed2022-03-26T16:54:36ZAntibody concentrations decrease 14-fold in children with celiac disease on a gluten-free diet but remain high at 3 monthsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:5718153d-3d31-419c-8dc4-506909ee4eedEnglishSymplectic Elements at OxfordAGA Institute2018Petroff, DWolf, JRichter, TAuth, MUhlig, HLaass, MLauenstein, PKrahl, AHändel, Nde Laffolie, JHauer, AHeiduk, MFlemming, GSchmidt, AHasenclever, DMothes, T<strong>Background & Aims</strong> Celiac disease can be identified by a serologic test for IgA against tissue transglutaminase (IgA-TTG) in a large proportion of children. However, the increased concentrations of antibody rarely normalize within the months after children are placed on a gluten-free diet (GFD). Early serologic predictors of sufficient adherence to gluten-free diet are required for optimal treatment. <strong>Methods</strong> In a prospective study, we observed the response to a GFD in 345 pediatric patients (67% girls; mean age, 8.4 y) who underwent duodenal biopsy to confirm or refute celiac disease from October 2012 through December 2015. Baseline serum samples were tested centrally for IgA-TTG and IgG against deamidated gliadin. Follow-up serologic analyses of children on a GFD were performed about 3 months later. <strong>Results</strong> The geometric mean concentration of IgA-TTG decreased from 72.4-fold to 5.2-fold the upper limit of normal (ULN), or by a factor of 14.0 (95% CI, 12.0–16.4). A substantial response (defined as a larger change than the typical variation in patients not on a GFD) was observed in 80.6% of the children. Only 28.1% of patients had a substantial response in the concentration of IgG against deamidated gliadin. Concentration of IgA-TTG remained above 1-fold the ULN in 83.8% of patients, and above 10-fold the ULN in 26.6% of patients with a substantial response. <strong>Conclusions</strong> Serum concentration of IgA-TTG decreases substantially in most children with celiac disease within 3 months after they are placed on a GFD, but does not normalize in most. This information on changes in antibody concentrations can be used to assess patient response to the diet at short-term follow-up evaluations. Patients with a substantial response to a GFD often still have high antibody levels after 3 months. German Clinical Trials Registry no. DRKS00003854. |
| spellingShingle | Petroff, D Wolf, J Richter, T Auth, M Uhlig, H Laass, M Lauenstein, P Krahl, A Händel, N de Laffolie, J Hauer, A Heiduk, M Flemming, G Schmidt, A Hasenclever, D Mothes, T Antibody concentrations decrease 14-fold in children with celiac disease on a gluten-free diet but remain high at 3 months |
| title | Antibody concentrations decrease 14-fold in children with celiac disease on a gluten-free diet but remain high at 3 months |
| title_full | Antibody concentrations decrease 14-fold in children with celiac disease on a gluten-free diet but remain high at 3 months |
| title_fullStr | Antibody concentrations decrease 14-fold in children with celiac disease on a gluten-free diet but remain high at 3 months |
| title_full_unstemmed | Antibody concentrations decrease 14-fold in children with celiac disease on a gluten-free diet but remain high at 3 months |
| title_short | Antibody concentrations decrease 14-fold in children with celiac disease on a gluten-free diet but remain high at 3 months |
| title_sort | antibody concentrations decrease 14 fold in children with celiac disease on a gluten free diet but remain high at 3 months |
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