gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLC10.22416/1382-4376-2022-32-1-34-40gastro-j-719Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL ARTICLESОценка корреляции между титром антител к тканевой трансглутаминазе и выраженностью атрофии ворсин тонкой кишки при целиакии в сирийской популяцииEvaluating the Correlation between High Titers of Tissue-Transglutaminase Antibody with the Grade of Severity of Villous Atrophy in Syrian Patients with Celiac Diseasehttps://orcid.org/0000-0002-5541-6412АльхаббалА.AlhabbalA.

Адель Альхаббал — доктор, кафедра биохимии и микробиологии Фармацевтического факультета Университета Дамаска.

Damascus — Almazzah — 17th April — Damascus University — Faculty of Pharmacy.

Adel Alhabbal — Dr, member of teaching staff, Department of Biochemistry & Microbiology, Faculty of pharmacy, Damascus University.

Damascus, Almazzah, 17th April, Damascus University, Faculty of Pharmacy.

Dr.a.habbal@gmail.comАбу КамизИ.Abou KhamisI.

Имад Абу Камиз — доктор, профессор, заслуженный профессор, кафедра биохимии и микробиологии Фармацевтического факультета Университета Дамаска.

Damascus — Almazzah — 17th April — Damascus University — Faculty of Pharmacy.

Imad Abou Khamis — Dr., Professor, Distinguished Professor, Department of Biochemistry & Microbiology, Faculty of pharmacy, Damascus University.

Damascus, Almazzah, 17th April, Damascus University, Faculty of Pharmacy.

imad.aboukhamis@gmail.comУниверситет ДамаскаСирияUniversity of DamascusSyrian Arab Republic2022240520223213440Copyright © Альхаббал А., Абу Камиз И., 20222022Альхаббал А., Абу Камиз И.Alhabbal A., Abou Khamis I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gastro-j.ru/jour/article/view/719Введение

Введение. Диагноз целиакии заподозривают на основании анализа клинической картины заболевания и серологических тестов и подтверждают данными биопсии двенадцатиперстной кишки. Однако при высоком титре антител против тканевой трансглутаминазы верификацию данного диагноза возможно провести и без выполнения биопсии.

Цель

Цель. Целью данного исследования является оценка корреляции между титром антител против тканевой трансглутаминазы (анти-tTG) IgA и степенью выраженности гистологических изменений при целиакии в сирийской популяции, а также установление диагностического титра данных антител для верификации диагноза «целиакия» у детей и взрослых без проведения биопсии.

Материалы и методы

Материалы и методы. В проспективном когортном исследовании приняли участие 100 больных с целиакией в возрасте от 6 до 65 лет. Всем им была выполнена эзофагогастродуоденоскопия с проведением биопсии слизистой оболочки двенадцатиперстной кишки (взято 2 биоптата) и определение титра анти-tTG IgA. Оценка гистологических изменений в биоптатах была проведена в соответствии со шкалой Марша патоморфологом-экспертом.

Результаты

Результаты. Средний возраст пациентов составил 18,55 ± 12,92 года. Анемия была выявлена у 35% из них и оказалась самым частым внекишечным проявлением целиакии. При этом не было значимой корреляции между стадией гистологических изменений по Маршу и уровнем гемоглобина в крови (r = 0,36, p > 0,05). Однако уровень анти-tTG IgA значимо позитивно коррелировал со стадией гистологический изменений по Маршу (r = 0,718, p < 0,001). ROC-анализ установил, что использование 270 МЕ/мл в качестве точки отсечения значения содержания анти-tTG IgA в крови позволяет предсказать выявление атрофии ворсин при проведении биопсии двенадцатиперстной кишки с чувствительностью 100% и специфичностью 89%.

Выводы

Выводы. Диагноз целиакии может быть поставлен без проведения биопсии слизистой оболочки двенадцатиперстной кишки на основании высоких титров антител против тканевой трансглутаминазы.

Background

Background. Diagnosis of celiac disease depends on the patient’s history and serological tests, and is confirmed by biopsies from the duodenum. Biopsies from the small intestine could be dispensable regarding the verification of celiac disease with the presence of high levels of atissue-transglutaminase antibody.

Aim

Aim. The objective of this investigation is to substantiate the correlation between titers of anti-tissue transglutaminase type IgA (anti-tTG IgA) and the severity of histological alterations in Syrian patients with celiac disease and to determine the diagnostic level of anti-tTG to previse celiac disease in adults and children without the necessity of a biopsy sampling.

Materials and methods

Materials and methods. The study was conducted as a prospective cohort study with the participation of 100 symptomatic patients between the age group of 6–65 years. All participants underwent upper gastrointestinal endoscopy. Two samples were taken from the duodenum and were evaluated by an expert pathologist according to Marsh grading. Serum anti-tTG IgA levels were measured as well to determine any association between the levels of serum anti-tTG IgA and Marsh grading.

Results

Results. The mean age of the patients was (18.55 ± 12.92). Anemia was the most frequent non-gastrointestinal finding as it was found among 35% of the participant, but no remarkable association was found between Marsh grading and hemoglobin levels (r = 0.36, p > 0.05). However, serum tTGA levels were positively correlated with Marsh grading (r = 0.718, p < 0.001). Receiver-operator curve (ROC) analysis cut-off value of serum anti-tTGA for speculating villous atrophy was 270 IU/ml of cut-off value with a sensitivity of 100% and a specificity of 89%.

Conclusion

Conclusion. Duodenal biopsies could be foregone during the diagnosis of susceptible patients for celiac diseasewith high anti-tTG IgA.

целиакиябиопсия двенадцатиперстной кишкиантитела против тканевой трансглутаминазыгистологияшкала Маршаceliac diseaseduodenal biopsyanti-tissue transglutaminase IgAhistologyMarch gradingМы хотели бы поблагодарить доктора Талла Алмелли, фармацевтический факультет Арабского частного университета науки и технологии. Это исследование было поддержано фармацевтическим факультетом Дамасского университета.We would like to thank Dr. Tallah Almelli, Faculty of pharmacy, Arab private University for science and technology. This study was supported by Damascus University, Faculty of Pharmacy.ReferencesLudvigsson J., Murray J. Epidemiology of Celiac Disease. Gastroenterol Clin North Am. 2019;48(1):1–18. DOI: 10.1016/j.gtc.2018.09.004Ludvigsson J., Murray J. Epidemiology of Celiac Disease. Gastroenterol Clin North Am. 2019;48(1):1–18. DOI: 10.1016/j.gtc.2018.09.004Lebwohl B., Sanders D., Green P. Coeliac disease. Lancet. 2018;391(10115):70–81. 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The authors declare that there are no conflicts of interest present.