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Clinical symptoms and basis of diagnostics

Coeliac disease (CD) and Dermatitis Herpetiformis (DH) are autoimmune diseases with known environmental trigger and a strong genetic component. The external trigger is ingested wheat gluten or related proteins from rye, barley and possibly oats. CD is a multigenic disorder with a strong HLA association. HLA-DQ2 and DQ8 confer susceptibility together with as yet unidentified gene loci. Expression of HLA-DQ2 and DQ8 molecules that present gliadin-derived peptides to CD4 T cells is necessary but not sufficient to develop CD.

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NA1000Biofons Anti-Gliadin IgA
The Biofons Anti-gliadin IgA kit is intended for the determination of human anti-gliadin IgA in serum. The Biofons Anti-gliadin IgA and IgG kits have been designed to be used as sensitive screening tests for jejunal biopsy in patients with suspected celiac disease. The monitoring of the disappearance of gliadin antibodies during gluten-free diet can be used to indicate successful elimination of gluten from the diet. These tests are also useful in the screening of dermatitis herpetiformis. The used protocol is same as with Anti-Gliadin IgG ELISA and all other Biofons Celiac Disease Panel ELISA kits which makes these tests easy to perform at the same time. Package insert

NG1000Biofons Anti-Gliadin IgG
The Biofons Anti-gliadin IgG kit is intended for the determination of human anti-gliadin IgG in serum. The Biofons Anti-gliadin IgA and IgG kits have been designed to be used as sensitive screening tests for jejunal biopsy in patients with suspected celiac disease. The monitoring of the disappearance of gliadin antibodies during gluten-free diet can be used to indicate successful elimination of gluten from the diet. These tests are also useful in the screening of dermatitis herpetiformis. Since gliadin antibodies are formed also in some other conditions leading to increased absorption of macromolecules in the intestine, e.g. cow's milk allergy, Crohn's disease or other inflammatory intestinal diseases, the diagnosis of celiac disease cannot be based solely on gliadin antibodies, but an intestinal biopsy must always be taken to confirm the diagnosis. Since IgA deficient subjects have 10 times higher incidence of celiac disease, and the prevalence of serum IgA deficiency is 1:400, it is highly recommended that in addition to IgA antibodies also IgG antibodies to gliadin should be screened in patients with suspected celiac disease. The used protocol is same as with Anti-Gliadin IgG ELISA and all other Biofons Celiac Disease Panel ELISA kits which makes these tests easy to perform at the same time. Package insert

RTA4000Biofons Anti-Transglutaminase IgA
The Biofons Anti-Transglutaminase IgA kit is intended for the determination of human anti-tissue transglutaminase IgA in serum. The kit has been designed to be used as a sensitive screening test for jejunal biopsy in patients with suspected celiac disease. This test is also useful in the screening of dermatitis herpetiformis. The used protocol is same as with Anti-Gliadin IgA and IgG ELISA tests which makes these tests easy to perform at the same time as a complete celiac panel. Package insert

RTG4000Biofons Anti-Transglutaminase IgG
Biofons tTG IgG kit is an enzyme-linked immunosorbent assay (ELISA) for the qualitative/semi quantitative detection of IgG class anti-tissue transglutaminase antibodies (tTG IgG) in human serum. The test is intended to be used as a screening test for jejunal biopsy in IgA deficient patients suspected for celiac disease. Since IgA deficient subjects have 10 times higher incidence of celiac disease, and the prevalence of serum IgA deficiency is 1:400, it is highly recommended that in addition to IgA antibodies also IgG antibodies to tTG should be screened in patients with suspected celiac disease. Package Insert

SC3000Biofons Anti-Endomysial (hUC) IgA (available also as Monkey)
Indirect fluorescent assay (IFA) for anti-endomysial antibodies has proven to be a good method to screen for Celiac disease. Endomysial antibodies of the IgA subclass (IgA EmA) react with the reticulin component of the endomysium of the smooth muscle in primate esophagus tissue. These antibodies can be found in 60-70% of patients with Dermatitis herpetiformis (DH) on a non-restricted diet and in almost 100% of patients with Celiac disease (CD) and gluten-sensitivity enteropathy with partial or subtotalling villous atrophy. There is a small percentage of IgG EmA that will be negative IgA when screened. A negative result exhibited by a patient with overt clinical symptoms may need to be considered for IgG testing.

It is recommended to perform an anti-Gliadin test in order to reach the maximum specificity of the test. It has been demonstrated that serum IgA endomysial antibodies were found in the majority (87%) of patients with untreated Celiac disease and approximately 70% of anti-Gliadin (IgA AGA) positive patients. The R1 anti-Reticulin (R1-ARA) appears to be a less reliable marker with less than 50% being positive. These findings were based on the same patient population. It should be noted that a strict adherence to a gluten-free diet will greatly effect the antibody results in most patients. IgA AGA and R1-ARA will normally disappear after one year while IgA EmA may persist at a lower titer. In this way the test may have prognostic value in monitoring strict adherence to diet. Package Insert
Last Updated ( Thursday, 10 July 2008 07:27 )