International Journal of Celiac Disease
ISSN (Print): 2334-3427 ISSN (Online): 2334-3486 Website: Editor-in-chief: Samasca Gabriel
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International Journal of Celiac Disease. 2019, 7(2), 42-45
DOI: 10.12691/ijcd-7-2-6
Open AccessArticle

Deamidated Gliadin Peptide Antibodies in Celiac Disease: A Diagnostic Driver or just along for the Ride?

Lerner Aaron1, , Haimi Motti2 and Matthias Torsten1

1AESKU.KIPP Institute, Wendelsheim, Germany

2Clalit Health Services, Children’s Health Center, Haifa, Israel

Pub. Date: August 13, 2019

Cite this paper:
Lerner Aaron, Haimi Motti and Matthias Torsten. Deamidated Gliadin Peptide Antibodies in Celiac Disease: A Diagnostic Driver or just along for the Ride?. International Journal of Celiac Disease. 2019; 7(2):42-45. doi: 10.12691/ijcd-7-2-6


Anti deamidated gliadin peptides antibodies are considered as celiac disease associated diagnostic antibodies. They are in clinical use for almost the last two decades. In the first decade they were preferentially used in early childhood, in face of IgA deficiency and occasionally recommended as the prime serological marker, outperforming the anti-tissue transglutaminase autoantibody. Notably, they were recommended in combination with the tissue transglutaminase as enhancer of the diagnostic performances. No more, the circle turned over. In the second decade (2012-2019), most of the studies limited and criticized their past published advantages. They suggested that deamidated gliadin peptides antibodies do not have any advantage over anti-tissue transglutaminase autoantibodies in terms of early childhood, IgA deficiency, diagnostic performances and when both antibodies are combined. It seems that the deamidated gliadin peptide are losing their place in the celiac disease algorithmic diagnostic flow chart.

celiac disease deamidated gliadin peptide tissue transglutaminase diagnosis serology serological marker antibodies

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[1]  Lerner A, Jeremias P, Matthias T. The world incidence and prevalence of autoimmune diseases is increasing: A review. Internat J Celiac Disease. 2015; 3: 151-155.
[2]  Lerner A, Jeremias P, Matthias T. The world incidence of celiac disease is increasing: a review. Internat. J. Of Recent Scient. Res. 2015; 7: 5491-5496.
[3]  Lerner A, Matthias T. Extraintestinal manifestations of CD: Common pathways in the gut-remote organs’ axes. Internat J Celiac Dis. 2017; 5: 24-27.
[4]  Lerner A, Matthias T, Wusterhausen P. Autoimmunity in celiac disease: extra-intestinal manifestations. Autoimm. Rev. 2019; 18: 241-246.
[5]  Lerner A, Matthias T. GUT-the Trojan horse in remote organs’ autoimmunity. Journal of Clinical & Cellular Immunology, 2016; 7: 401.
[6]  Eliyah Livshits O, Shauol R, Reifen R, Matthias T, Lerner A. Can Celiac Disease Present Along With Childhood Obesity? International Journal of Celiac Disease. 2017; 5: 19-23.
[7]  Lerner A, Matthias T. Increased knowledge and awareness of celiac disease will benefit the elderly. Intern. J of Celiac Dis. 2015; 3: 112-114.
[8]  Lerner A, Matthias T. A Silent or Hypo-symptomatic Disease Can Erupt: Acute Presentations of Celiac Disease. Internat J Celiac Dis 2017; 5: 129-132.
[9]  Samasca G, Ramesh A, Sur D, Cornel A, Sur L, Flocaa E, SurG, Lupand L, Matthias T, Lerner A. Polyautoimmunity - The missing ingredient. Autoimmun Rev. 2018: 17: 840-841.
[10]  Lerner A, Makhoul BF, Eliakim R. Neurological manifestations of celiac disease in children and adults. Europ Neurolog J. 2012; 4: 15-20.
[11]  Lerner A, Matthias T. Gluten and autoimmunogenesis. In: Musaic of Autoimmunity, The novel factors of autoimmune diseases revisited. 2nd edition, Eds: Shoenfield Y, Perricone C. Pub; Elsevier. 2019 pp:315-321.
[12]  Lerner A, Ramesh A, Matthias T. Serological diagnosis of celiac disease: new biomarkers. Gastroenterol Clin North Amer 2019; 48: 307-317.
[13]  Arguelles-Grande C, Tennyson C.A, Lewis, S.K, Green PH, Bhagat, G. Variability in small bowel histopathology reporting between different pathology practice settings: impact on the diagnosis of coeliac disease. J. Clin. Pathol. 2012; 65: 242-7.
[14]  Picarelli A, Borghini R, Donato G, Di Tola M, Boccabella C, et al. Weaknesses of histological analysis in celiac disease diagnosis: new possible scenarios. Scand. J. Gastroenterol. 2014; 12: 1-7.
[15]  Lerner A, Matthias T. Intraepithelial Lymphocyte Normal Cut-off Level in Celiac Disease: The Debate Continues. Internat. J. of Celiac Dis. 2016; 4: 4-6.
[16]  Lerner A. Serological Diagnosis of Celiac Disease –Moving Beyond the Tip of the Iceberg. International Journal of Celiac Disease. 2014; 2: 64-66.
[17]  Lerner A, Jeremias P, Neidhöfer S, Matthias T. Comparison of the reliability of 17 celiac disease associated bio-markers to reflect intestinal damage J of Clin & Cell Immunology. 2017; 8: 686.
[18]  Husby S, Koletzko S, Korponay-Szabó IR, Mearin ML, Phillips A, et al. (2012) European Society for Pediatric Gastroenterology Hepatology and Nutrition guidelines for the diagnosis of coeliac disease. J. Pediatr. Gastroenterol. Nutr. 54: 136-60.
[19]  Lerner A, Aminov R, Matthias T. Dysbiosis may trigger autoimmune diseases via inappropriate posttranslational modification of host proteins. Frontiers in Microbiology. 2016; 7: Article 84.
[20]  Lerner A, Aminov R, Matthias T. Intestinal dysbiotic transglutaminases are potential environmental drivers of systemic autoimmunogenesis. Frontiers in Microbiology, 2017; 8; article 66.
[21]  Quarsten H, Molberg O, Fugger L, McAdam SN, Sollid LM. HLA binding and T cell recognition of a tissue transglutaminase-modified gliadin epitope. Eur J Immunol. 1999; 29: 2506-14.
[22]  Aleanzi M, Demonte AM, Esper C, Garcilazo S, Waggener M. Celiac disease: antibody recognition against native and selectively deamidated gliadin peptides. Clin Chem. 2001; 47: 2023-8.
[23]  Aleanzi M, Demonte AM, Esper C, Garcilazo S, Waggener M. Celiac disease: antibody recognition against native and selectively deamidated gliadin peptides. Clin Chem. 2001; 47: 2023-8.
[24]  Mozo L, Gómez J, Escanlar E, Bousoño C, Gutiérrez C. Diagnostic value of anti-deamidated gliadin peptide IgG antibodies for celiac disease in children and IgA-deficient patients. J Pediatr Gastroenterol Nutr. 2012; 55: 50-5.
[25]  Villalta D, Tonutti E, Prause C, Koletzko S, Uhlig HH, Vermeersch P, et al. IgG antibodies against deamidated gliadin peptides for diagnosis of celiac disease in patients with IgA deficiency. Clin Chem. 2010; 56: 464-8.
[26]  Vermeersch P, Geboes K, Mariën G, Hoffman I, Hiele M, Bossuyt X. Diagnostic performance of IgG anti-deamidated gliadin peptide antibody assays is comparable to IgA anti-tTG in celiac disease. Clin Chim Acta. 2010; 411: 931-5.
[27]  Niveloni S, Sugai E, Cabanne A, Vazquez H, Argonz J, Smecuol E, et al. Antibodies against synthetic deamidated gliadin peptides as predictors of celiac disease: prospective assessment in an adult population with a high pretest probability of disease. Clin Chem. 2007; 53: 2186-92.
[28]  Sayed SK, Imam HM, Mahran AM, Refaiy AM. Diagnostic utility of deamidated gliadin peptide antibody in celiac disease compared to anti-tissue transglutaminase and IgA- endomysium antibodies. Egypt J Immunol. 2012; 19: 41-52.
[29]  Agardh D. Antibodies against synthetic deamidated gliadin peptides and tissue transglutaminase for the identification of childhood celiac disease. Clin Gastroenterol Hepatol. 2007; 5: 1276-81.
[30]  Volta U, Granito A, Parisi C, Fabbri A, Fiorini E, Piscaglia M, et al. Deamidated gliadin peptide antibodies as a routine test for celiac disease: a prospective analysis. J Clin Gastroenterol. 2010; 44: 186-90.
[31]  Kaukinen K, Collin P, Laurila K, Kaartinen T, Partanen J, Mäki M. Resurrection of gliadin antibodies in coeliac disease. Deamidated gliadin peptide antibody test provides additional diagnostic benefit. Scand J Gastroenterol. 2007; 42: 1428-33.
[32]  Sakly W, Mankaï A, Ghdess A, Achour A, Thabet Y, Ghedira I.Performance of anti-deamidated gliadin peptides antibodies in celiac disease diagnosis. Clin Res Hepatol Gastroenterol. 2012; 36: 598-603.
[33]  Gould MJ, Brill H, Marcon MA, Munn NJ, Walsh CM.In Screening for Celiac Disease, Deamidated Gliadin Rarely Predicts Disease When Tissue Transglutaminase Is Normal. J Pediatr Gastroenterol Nutr. 2019; 68: 20-25.
[34]  Ermarth A, Bryce M, Woodward S, Stoddard G, Book L, Jensen MK. Identification of Pediatric Patients With Celiac Disease Based on Serology and a Classification and Regression Tree Analysis. Clin Gastroenterol Hepatol. 2017; 15: 396-402.
[35]  Maglione MA, Okunogbe A, Ewing B, Grant S, Newberry SJ, Motala A, Shanman R, Mejia N, Arifkhanova A, Shekelle P, Harmon G. Diagnosis of Celiac Disease [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2016 Jan.
[36]  Dahlbom I, Nyberg BI, Berntson L, Hansson T. Simultaneous detection of IgA and IgG antibodies against tissue transglutaminase: The preferred pre-biopsy test in childhood celiac disease. Scand J Clin Lab Invest. 2016; 76: 208-16.
[37]  Giersiepen K, Lelgemann M, Stuhldreher N, Ronfani L, Husby S, Koletzko S, et al.Accuracy of diagnostic antibody tests for coeliac disease in children: summary of an evidence report. J Pediatr Gastroenterol Nutr. 2012; 54: 229-41.
[38]  Dickerson JA, Lee D, Pacheco MC. Deamidated gliadin peptide in pediatric patients with moderately increased tissue transglutaminase; does it help? Clin Chim Acta. 2019; 492: 20-22.
[39]  Hojsak I, Mozer-Glassberg Y, Segal Gilboa N, Weinberger R, Hartman C, Shamir R. Celiac disease screening assays for children younger than 3 years of age: the performance of three serological tests. Dig Dis Sci. 2012; 57: 127-32.
[40]  Olen O, Gudjónsdóttir AH, Browaldh L, Hessami M, Elvin K, Liedberg AS, et al. Antibodies against deamidated gliadin peptides and tissue transglutaminase for diagnosis of pediatric celiac disease. J Pediatr Gastroenterol Nutr. 2012; 55: 695-700.
[41]  Wolf J, Hasenclever D, Petroff D, Richter T, Uhlig HH, Laaß MW, et al. Antibodies in the diagnosis of coeliac disease: a biopsy-controlled, international, multicentre study of 376 children with coeliac disease and 695 controls. PLoS One. 2014; 9: e97853.
[42]  Frulio G, Polimeno A, Palmieri D, Fumi M, Auricchio R, Piccolo E, et al. Evaluating diagnostic accuracy of anti-tissue Transglutaminase IgA antibodies as first screening for Celiac Disease in very young children. Clin Chim Acta. 2015; 446: 237-40.
[43]  Wang N, Truedsson L, Elvin K, Andersson BA, Rönnelid J, Mincheva-Nilsson L, wet al. Serological assessment for celiac disease in IgA deficient adults. PLoS One. 2014; 9: e93180.
[44]  Husby S, Murray JA, Katzka DA. AGA Clinical Practice Update on Diagnosis and Monitoring of Celiac Disease-Changing Utility of Serology and Histologic Measures: Expert Review. Gastroenterology. 2019; 156:885-889.
[45]  Lewandowska K, Ciepiela O, Szypowska A, Wyhowski J, Głodkowska-Mrówka E, Popko K, et al. Celiac antibodies in children with type 1 diabetes - A diagnostic validation study. Autoimmunity. 2018; 51:81-88.
[46]  Bufler P, Heilig G, Ossiander G, Freudenberg F, Grote V, Koletzko S. Diagnostic performance of three serologic tests in childhood celiac disease. Z Gastroenterol. 2015; 53:108-14.
[47]  Zucchini L, Giusti D, Gatouillat G, Servettaz A, Tabary T, Barbe C, et al.Interpretation of serological tests in the diagnosis of celiac disease: Anti-deamidated gliadin peptide antibodies revisited. Autoimmunity. 2016; 49:414-420.