Intestinal transglutaminase (TG2) IgA deposits represent early marker of coeliac disease (CeD) and can predict the evolution towards intestinal atrophy.
To validate a double immunohistochemistry method for the determination of intestinal TG2 IgA deposits on formalin-fixed paraffin-embedded biopsies.
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).
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.
Our results indicate double immunohistochemistry as promising diagnostic tool to improve diagnosis of CeD.
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Published online: November 26, 2021
Accepted: November 8, 2021
Received: October 6, 2021
Financial support: Associazione Serena Talarico per i giovani nel mondo onlus (to CG).
Financial disclosure: The Authors declare no competing interests for the present study.
© 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
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- IgA deposits in celiac disease. Their immunohistochemistry value in early diagnosisDigestive and Liver DiseaseVol. 54Issue 2
- PreviewCeliac disease (CD) is an immune-mediated enteropathy that arises in genetically susceptible individuals carrying the human leucocyte antigen (HLA) DQ2 or DQ8 haplotypes. It is characterized, histologically, by an increased number of intraepithelial T lymphocyte (> 25/100 epithelial cells) with or without crypt hyperplasia, and variable villous atrophy. These histological features are not pathognomonic of CD and integration with clinical, genetical and serological data is required to diagnose CD. High serum levels of IgA anti-tissue transglutaminase type 2 (anti-TG2) and anti-endomysium (EMA) are typical features of untreated CD.