Clinical utility of quantitative multi-antibody Polycheck immunoassays in the diagnosis of coeliac disease

AIM:To evaluate the clinical utility of multi-antibody strategies in the diagnosis of coeliac disease(CD),the new quantitative Polycheck immunoassays were analysed.METHODS:Polycheck Celiac Panels(PCPs)are immunoenzyme screening assays for the quantitative measurement of coeliac-specific immunoglobulin class G(Ig G)or class A(Ig A)in serum.Lines of relevant antigens are coated together with five Ig G or Ig A standard lines used for the standard curve as positive control.PCP IgA consists of human recombinant human tissue transglutaminase(t TG)and deamidated gliadin peptides(DGP)as targets to detect Ig A antibodies.PCP IgG consists of t TG,DGP and IF(intrinsic factor)antigens to detect antibodies in Ig G class.PCPs were performed on 50 CD patients,including 6 cases with selective Ig A deficiency,and 50 non-coeliac controls.CD diagnosis was performed according to the ESPGHAN recommendations:The presence of specific anti-t TG-Ig A or anti-DGP-Ig G(in the case of Ig A deficiency)antibodies,typical histopathological changes in duodenal mucosa described in Marsh-Oberhüber classification as at least grade 2.The diagnosis of the majority of the control subjects was functional gastrointestinal disorders.The PCP results were compared with reference EliA Celikey.RESULTS:The usage of PCPs led to the correct identification of all CD patients.In our study,PCPs showed 100%agreement with the histopathological results.PCP IgA test showed a 98%concordance and correlated positively(R=0.651,P=0.0014)with Eli A Celikey test.The highest specificity and positive predictive value(both 100%)were observed for the detection of Polycheck anti-t TG-Ig A antibodies.The highest sensitivity and negative predictive value(both 100%)were achieved by Polycheck anti-DGPIg G antibody detection.The best performance(98%sensitivity and negative predictive value,100%specificity and positive predictive value,diagnostic accuracy-AU ROC 99%)was observed for the strategy of using both PCP IgA and IgG and determining positive outcomes of the test with two or more coeliac-specific antibodies detected.The majority of coeliac patients had multiple antibodies.All four antibodies were detected in 7(14%)cases,19 children(38%)were positive for three antibodies and 23(46%)were positive for two antibodies.CONCLUSION:The present study showed that detection of coeliac-specific antibodies with multi-antibody PCPs is effective and efficacious in the diagnosis of CD.

Leukocyte cell-derived chemotaxin-2 and fibroblast growth factor 21 in alcohol-induced liver cirrhosis

BACKGROUND The importance of early diagnosis of alcoholic liver disease underscores the need to seek better and especially non-invasive diagnostic procedures.Leukocyte cellderived chemotaxin-2(LECT2)has been widely studied to determine its usefulness in monitoring the course of non-alcoholic fatty liver disease but not for alcoholic liver cirrhosis(ALC).AIM To determine the concentration of LECT2 in the blood serum of patients in relation to progressive stages of ALC,its relation to fibroblast growth factor 1(FGF-1)and FGF-21,and to examine the possible wider use of LECT2 in diagnosing ALC.METHODS A retrospective case-control study was conducted with 69 ALC cases and 17 controls with no ALC.Subjects were recruited from the region of Lublin(eastern Poland).Liver cirrhosis was diagnosed based on clinical features,history of heavy alcohol consumption,laboratory tests,and abdominal ultrasonography.The degree of ALC was evaluated according to Pugh-Child criteria(the Pugh-Child score).Blood was drawn and,after centrifugation,serum was collected for analysis.LECT2,FGF-1,and FGF-21 were determined using enzyme-linked immunosorbent assay kits.RESULTS The LECT2 Levels in the control group were 18.99±5.36 ng/mL.In the study groups,they declined with the progression of cirrhosis to 11.06±6.47 ng/mL in one group and to 8.06±5.74 ng/mL in the other(P<0.0001).Multiple comparison tests confirmed the statistically significant differences in LECT2 Levels between the control group and both test groups(P=0.006 and P<0.0001).FGF-21 Levels were 44.27±64.19 pg/mL in the first test group,45.4±51.69 pg/mL in the second(P=0.008),and 13.52±7.51 pg/mL in the control group.The difference between the control group and the second test group was statistically significant(P=0.007).CONCLUSION We suggest that LECT2 may be a non-invasive diagnostic factor for alcoholinduced liver cirrhosis.The usefulness of LECT2 for non-invasive monitoring of alcohol-induced liver cirrhosis was indirectly confirmed by the multiple regression model developed on the basis of our statistical analysis.