A new double immunohistochemistry method to detect mucosal anti-transglutaminase IgA deposits in coeliac children

Chiara Maria Trovato; Salvatore Oliva; Nicoletta Pietropaoli; Maria Gemma Pignataro; Silvia Berni; Andrea Tancredi; Salvatore Cucchiara; Carla Giordano; Monica Montuori

doi:10.1016/j.dld.2021.11.006

A new double immunohistochemistry method to detect mucosal anti-transglutaminase IgA deposits in coeliac children

Dig Liver Dis. 2022 Feb;54(2):200-206. doi: 10.1016/j.dld.2021.11.006. Epub 2021 Nov 26.

Authors

Chiara Maria Trovato¹, Salvatore Oliva², Nicoletta Pietropaoli², Maria Gemma Pignataro³, Silvia Berni³, Andrea Tancredi⁴, Salvatore Cucchiara², Carla Giordano⁵, Monica Montuori⁶

Affiliations

¹ Maternal and Child Health Department, Sapienza - University of Rome, Rome, Italy; Hepatology Gastroenterology and Nutrition Unit, "Bambino Gesù" Children Hospital, 00165 Rome, Italy.
² Maternal and Child Health Department, Sapienza - University of Rome, Rome, Italy.
³ Department of Radiology, Oncology and Pathology, Sapienza, University of Rome, Rome, Italy.
⁴ Department of Methods and Models for Economy, Territory and Finance, Sapienza, University of Rome, Rome, Italy.
⁵ Department of Radiology, Oncology and Pathology, Sapienza, University of Rome, Rome, Italy. Electronic address: carla.giordano@uniroma1.it.
⁶ Maternal and Child Health Department, Sapienza - University of Rome, Rome, Italy. Electronic address: m.montuori@policlinicoumberto1.it.

PMID: 34844876
DOI: 10.1016/j.dld.2021.11.006

Abstract

Background: Intestinal transglutaminase (TG2) IgA deposits represent early marker of coeliac disease (CeD) and can predict the evolution towards intestinal atrophy.

Aims: To validate a double immunohistochemistry method for the determination of intestinal TG2 IgA deposits on formalin-fixed paraffin-embedded biopsies.

Methods: Immunohistochemistry was tested on: 1) children with overt CeD [persistently positive serum IgA anti-tissue transglutaminase type 2 (TGA-IgA) with moderate or low titer, and histological findings of CeD]; 2) potential CeD (persistently positive serum TGA-IgA and normal intestinal mucosa) and 3) controls (negative serum TGA-IgA and normal intestinal mucosa).

Results: Samples from 61 children were analyzed (32 overt CeD, 14 potential CeD, and 15 controls). Deposits appeared as focal, multifocal, or confluent extracellular foci of red and brown staining colocalization in the sub-epithelium and around mucosal vessels. Deposits were present in all 32 children with overt CeD and in 9/14 potential CeD. Deposits were never observed in the 15 controls. Patients with higher serum level of TGA-IgA and with mucosal atrophy showed mostly a multifocal/diffuse pattern of deposits distribution. The bulb appeared most severely involved. In potential CeD deposits showed mainly a focal distribution.

Conclusion: Our results indicate double immunohistochemistry as promising diagnostic tool to improve diagnosis of CeD.

Keywords: Anti-transglutaminase; Coeliac disease diagnosis; Immunohistochemistry; Mucosal IgA transglutaminase deposits.

Publication types

Validation Study

MeSH terms

Atrophy
Autoantibodies / analysis*
Autoantibodies / blood
Biomarkers / analysis
Biopsy
Celiac Disease / diagnosis*
Child
Child, Preschool
Female
Humans
Immunohistochemistry / methods*
Intestinal Mucosa / metabolism
Intestinal Mucosa / pathology*
Male
Predictive Value of Tests
Reproducibility of Results

Substances

Autoantibodies
Biomarkers
anti-transglutaminase autoantibody