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Clinical and Vaccine Immunology, February 2006, p. 187-192, Vol. 13, No. 2
1071-412X/06/$08.00+0     doi:10.1128/CVI.13.2.187-192.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Performance of Antibodies against Tissue Transglutaminase for the Diagnosis of Celiac Disease: Meta-Analysis

Elias Zintzaras1* and Anastasios E. Germenis2

Department of Biomathematics, University of Thessaly School of Medicine, Papakyriazi 22, GR-41222 Larissa, Greece,1 Department of Immunology and Histocompatibility, University Hospital of Larissa, University of Thessaly School of Medicine, GR-41110 Larissa, Greece2

Received 9 August 2005/ Returned for modification 20 September 2005/ Accepted 15 November 2005

A meta-analysis of studies investigating the diagnostic accuracy of enzyme-linked immunosorbent assays (ELISA) for antibodies against tissue transglutaminases (tTG) of various origins in celiac disease (CD) diagnosis was carried out. Twenty-one studies, with untreated CD patients and healthy/CD-free controls, were included in the meta-analysis. The diagnostic accuracy was estimated using a summary receiver operating characteristic (SROC) curve and pooled sensitivity (Se) and specificity (Sp). Multiple assays within a study were treated by considering all the assays within a study and by analyzing the most popular assay (i.e., the commercial anti-tTTG ELISA most frequently utilized in the papers in which multiple assays were included). The SROC curve indicated the absence of heterogeneity, and the superiority of recombinant human tTG (rh-tTG) and purified human tTG (ph-tTG) compared to guinea pig-tTG (gp-tTG). The sensitivities (most popular assay) for rh-tTG, ph-tTG, and gp-tTG were 94%, 90%, and 92%, respectively, and the specificities were 97%, 92%, and 96%, respectively. A sensitivity analysis (exclusion of studies with bias) altered the results of ph-tTG: Se, 95%; Sp, 98%. The sensitivities (all individual assays) for rh-tTG, ph-tTG, and gp-tTG were 94%, 94%, and 91%, respectively, and the specificities were 95%, 94%, and 89%, respectively. Human tTG ELISA is sensitive and specific, and it can be used for mass screening. Sensitivity analysis showed that ph-tTG might perform better.

* Corresponding author. Mailing address: Department of Biomathematics, University of Thessaly School of Medicine, Papakyriazi 22, GR-41222 Larissa, Greece. Phone and fax: 30 2410 565270. E-mail: zintza{at}med.uth.gr.

Clinical and Vaccine Immunology, February 2006, p. 187-192, Vol. 13, No. 2
1071-412X/06/$08.00+0     doi:10.1128/CVI.13.2.187-192.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.



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