Transglutaminase 6 antibodies in the diagnosis of gluten ataxia
Transglutaminase 6 antibodies in the diagnosis of gluten ataxia
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DOI：
10.1212/wnl.0b013e3182919070
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发表时间：
2013-05-01
期刊：
影响因子：
9.9
通讯作者：
Aeschlimann, Daniel P.
中科院分区：
文献类型：
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作者：
Hadjivassiliou, Marios;Aeschlimann, Pascale;Aeschlimann, Daniel P.
目的：先前发现的免疫反应主要针对谷蛋白共济失调（GA）患者的转氨酶（TG）6导致我们调查的作用，TG 6抗体在诊断GA。方法：这是一项前瞻性队列研究。我们从皇家哈勒姆郡医院（谢菲尔德，英国）的共济失调、麸质/神经病学、乳糜泻（CD）和运动障碍诊所以及坦佩雷大学医院（坦佩雷，芬兰）的CD诊所招募患者。这些组包括特发性散发性共济失调、GA和CD患者，以及神经病学和健康对照组。所有人都进行了TG 6抗体检测。血清学阳性的患者进行十二指肠活检。此外，分析了连续15例特发性散发性共济失调和谷蛋白相关疾病血清学阴性患者的活检组织中抗TG的免疫球蛋白A沉积。TG 6抗体的患病率在特发性散发性共济失调中为21/65（32%），在GA中为35/48（73%），在CD中为16/50（32%），神经病学对照组中82例中的4例（5%），健康对照组中57例中的2例（4%）。42%的GA患者有肠病，51%的共济失调和TG 6抗体患者也有肠病。连续15例特发性散发性共济失调患者中有5例有抗TG 2的免疫球蛋白A沉积，其中4例随后检测为TG 6抗体阳性。经过1年的无麸质饮食，TG 6抗体滴度显着降低或undetected.Conclusions：TG 6抗体是麸质依赖性的，似乎是一个敏感和特异性的GA标记。神经病学（R）2013;80：1740-1745
Objectives: The previous finding of an immunologic response primarily directed against transglutaminase (TG) 6 in patients with gluten ataxia (GA) led us to investigate the role of TG6 antibodies in diagnosing GA.Methods: This was a prospective cohort study. We recruited patients from the ataxia, gluten/neurology, celiac disease (CD), and movement disorder clinics based at Royal Hallamshire Hospital (Sheffield, UK) and the CD clinic, Tampere University Hospital (Tampere, Finland). The groups included patients with idiopathic sporadic ataxia, GA, and CD, and neurology and healthy controls. All were tested for TG6 antibodies. Duodenal biopsies were performed in patients with positive serology. In addition, biopsies from 15 consecutive patients with idiopathic sporadic ataxia and negative serology for gluten-related disorders were analyzed for immunoglobulin A deposits against TG.Results: The prevalence of TG6 antibodies was 21 of 65 (32%) in idiopathic sporadic ataxia, 35 of 48 (73%) in GA, 16 of 50 (32%) in CD, 4 of 82 (5%) in neurology controls, and 2 of 57 (4%) in healthy controls. Forty-two percent of patients with GA had enteropathy as did 51% of patients with ataxia and TG6 antibodies. Five of 15 consecutive patients with idiopathic sporadic ataxia had immunoglobulin A deposits against TG2, 4 of which subsequently tested positive for TG6 antibodies. After 1 year of gluten-free diet, TG6 antibody titers were significantly reduced or undetectable.Conclusions: Antibodies against TG6 are gluten-dependent and appear to be a sensitive and specific marker of GA. Neurology (R) 2013;80:1740-1745