Coeliac disease

Clinical information

Coeliac disease (also gluten-sensitive enteropathy, GSE) is a systemic autoimmune disease in which genetic predisposition play a pronounced role. Coeliac disease may affect different organ systems. Its prevalence is estimated to be around 1 %, with experts assuming a large number of undiagnosed cases due to atypical or mild symptoms. Coeliac disease mostly manifests as a severe inflammation and damage of the mucosa of the small intestine (enteropathy). In conjunction with the resulting disruption of the nutrient absorption, a wide range of clinical gastrointestinal and non-gastrointestinal symptoms (among others chronic diarrhoea, abdominal pain, weight loss), can be observed. The clinical picture of coeliac disease may also include a chronic rash in the form of Duhring’s dermatitis.

Coeliac disease is caused by an overreaction of the immune system following ingestion of gluten, especially of the so-called gliadin, which accounts for around 90 % of the protein content of many grains. Gliadin can be only partially digested in the small intestine. If the intestinal epithelium presents gaps, as typically occurs in patients with coeliac disease, gliadin fragments may pass the intestinal barrier and reach the underlying connective tissue. There, the enzyme tissue transglutaminase (tTG) deamidates the amino acid glutamine into glutamic acid at specific loci of the gliadin peptides. Given a genetic predisposition, this modification causes the peptides to have an immunological effect. Activation of the B cells leads to the formation of antibodies against the deamidated gliadin peptides (DGP) and the body-own tTG. Furthermore, T-cells secrete proinflammatory cytokines, which cause inflammatory reactions in the tissue.

Diagnostics

Monkey liver: Aab against endomysiumAccording to the guidelines of the European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) (Husby et al., 2020), patients with corresponding symptoms should be first investigated for anti-tTG antibodies (IgA) and total IgA antibodies. In the case of a positive test result, this should be confirmed by determination of EmA (IgA). Moreover, the guidelines point out the additional use of coeliac-specific IgG-based tests, e.g. tests for detection of antibodies against DGP. If there is a general IgA deficiency – a state often observed in coeliac disease patients – anti-DGP antibodies (IgG) are considered an important indicator of coeliac disease. EmA can be detected by IIFT on tissue sections of primate liver, primate oesophagus or primate intestine. The target antigen of EmA is tTG. Anti-tTG antibodies can be detected by ChLIA, ELISA or EUROLINE tests. In addition, anti-DGP antibodies can be detected using ChLIA, ELISA, EUROLINE and the monospecific EUROPLUS substrate.

Selected Products

Method
Parameter
Substrate
Species
EUROLINE
Autoimmune Gastrointestinal Diseases IgA
(tissue transglutaminase (endomysium), gliadin-analogue
fusion peptide (GAF-3X), mannan (ASCA))
EUROLINE
EUROLINE
Autoimmune Gastrointestinal Diseases IgG
(tissue transglutaminase (endomysium),
gliadin-analogue fusion peptide (GAF-3X),
parietal cell antigen (PCA) separately
Intrinsic factor, mannan (ASCA))
EUROLINE
IIFT
antibodies against endomysium
(EMA IgA control)
IIFT
antibodies against endomysium
(EMA IgG control)
EUROLINE
positive control serum: IgA, human, 100x concentrated
for DL 1910 A
EUROLINE
positive control serum: IgG, human, 100x concentrated
for DL 1910 G
EUROLINE
Coeliac Disease Profile
(tissue transglutaminase (endomysium),
gliadin-analogue fusion peptide (GAF-3X) separately)
EUROLINE
ELISA
tissue transglutaminase
(endomysium)
antigen-coated
microplate wells
ELISA
tissue transglutaminase
(endomysium)
antigen-coated
microplate wells
IIFT
endomysium
oesophagus
monkey
IIFT
Coeliac Disease Screen (EM) EUROPattern
endomysium

oesophagus

monkey
IIFT
EUROPLUS
endomysium
gliadin (GAF-3X)
2 BIOCHIPs per field:
oesophagus
gliadin (GAF-3X) BIOCHIPs

monkey
IIFT
Coeliac Disease Screen 9B
endomysium
tissue transglutaminase (tTG)
3 BIOCHIPs per field:
oesophagus
transfected cells
control transfection

monkey
EU 90
EU 90
IIFT
antibodies against endomysium plus gliadin (GAF-3X)
(EMA plus gliadin GAF-3X IgA control)
IIFT
antibodies against endomysium plus gliadin (GAF-3X)
(EMA plus gliadin GAF-3X IgG control)
IIFT
endomysium
small intestine
monkey
IIFT
EUROPLUS
endomysium
gliadin (GAF-3X)
2 BIOCHIPs per field:
small intestine
gliadin (GAF-3X) BIOCHIPs

monkey
IIFT
endomysium
endomysium
small intestine
oesophagus
(2 BIOCHIPs per field)
monkey
monkey
IIFT
EUROPLUS
endomysium
gliadin (GAF-3X)
endomysium
endomysium
4 BIOCHIPs per field:
small intestine
gliadin (GAF-3X) BIOCHIPs
oesophagus
liver

monkey

monkey
monkey
IIFT
endomysium
endomysium
endomysium
small intestine
oesophagus
liver
(3 BIOCHIPs per field)
monkey
monkey
monkey
IIFT
endomysium
liver
monkey
IIFT
Coeliac Disease Screen (LM) EUROPattern
endomysium
liver
monkey
IIFT
EUROPLUS
endomysium
gliadin (GAF-3X)
2 BIOCHIPs per field:
liver
gliadin (GAF-3X) BIOCHIPs

monkey
IIFT
endomysium
endomysium
liver
small intestine
(2 BIOCHIPs per field)
monkey
monkey
IIFT
EUROPLUS
endomysium
endomysium
gliadin (GAF-3X)
3 BIOCHIPs per field:
liver
small intestine
gliadin (GAF-3X) BIOCHIPs

monkey
monkey
IIFT
endomysium
umbilical cord
human
IIFT
antibodies against gliadin (GAF-3X)
(gliadin GAF-3X IgA control)
IIFT
antibodies against gliadin (GAF-3X)
(gliadin GAF-3X IgG control)
ELISA
gliadin (GAF-3X)
antigen-coated
microplate wells
IIFT
gliadin (GAF-3X)
gliadin (GAF-3X)
BIOCHIPs
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