Abstract
Purpose: Non-invasive tests used in the screening and follow-up of celiac disease (CD) are currently below expectations because they show false negatives/positives and are not always correlated with duodenal histology. We aimed to investigate the predictive value of intestinal free fatty acid binding protein (FABP-I) which can easily be released into the circulation in the presence of enterocyte damage in a short time in CD.
Methods: This study included 59 patients with CD who were not on gluten free diet (GFD)(n=24) and who were on GFD(n=35) and 52 healthy controls. Demographic variables, complete blood count, ferritin, vitamin D, calcium, phosphorus, vitamin B12, prothrombin time, INR, and serum FABP-I levels were recorded for all groups.
Results: There was no difference between the groups in terms of complete blood count, ferritin, calcium, phosphorus, vitamin B12, prothrombin time and INR (all p>0.05). Mean serum FABP-I was determined as 499.2±33.3 ng/L for patients with CD who were not on GFD and as 487.7±48.0 ng/L for who were on GFD, and these values were significantly higher when compared to the healthy controls 432.2±63.8 ng/L(p<0.001). The sensitivity, specificity, positive predictive value, and negative predictive value of FABP-I for a cut-off value of 456.8 ng/L were 84.7%, 69.2%, 10.2% and 61.5%, respectively(AUC=0.785).
Conclusion: This study has shown that FABP-I can serve as a non-invasive predictive marker for CD diagnosis. Overlooked diagnosis in serology-negative patients and false serology positivity for reasons other than CD will be prevented with its use in clinical practice since FABP-I directly reflects intestinal damage.
Keywords
Celiac disease enterocyte damage FABP2 FABP-I gluten-free diet intestinal free fatty acid binding protein
Supporting Institution
This work is supported by the Scientific Research Project Fund of Cumhuriyet University
Project Number
T-762.
References
- 1. Vreugdenhil AC, Wolters VM, Adriaanse MP, et al. Additional value of serum I-FABP levels for evaluating celiac disease activity inchildren. Scand J Gastroenterol. 2011;46:1435-41. DOI:10.3109/00365521.2011.627447
- 2. Adriaanse MP, Tack GJ, Passos VL, et al. Serum I-FABP as marker for enterocyte damage in coeliac disease and its relation to villous atrophy and circulating autoantibodies. Aliment Pharmacol Ther. 2013;37:482-90. DOI:10.1111/apt.12194
- 3. Oberhuber G, Granditsch G, Vogelsang H. The histopathology of coeliac disease: time for a standardized report scheme for pathologists. Eur J Gastroenterol Hepatol. 1999;11:1185-94. DOI: 10.1097/00042737-199910000-00019
- 4. Rubio TA, Hill ID, Kelly CP, et al. ACG clinical guidelines: Diagnosis and management of celiac disease. Am J Gastroenterol. 2013;108:656-76. DOI: 10.1038/ajg.2013.79
- 5. Volta U, Fabbri A, Parisi C, et al. Old and new serological test for celiac disease screening. Expert Rev Gastroenterol Hepatol. 2010;4:31-5. DOI: 10.1586/egh.09.66
- 6. Lewis NR, Scott BB. Meta-analysis: deamidated gliadin peptide antibody and tissue transglutaminase antibody compared as screening tests for coeliac disease. Aliment Pharmacol Ther. 2010;31:73-81. DOI: 10.1111/j.1365-2036.2009.04110.x
- 7. Adriaanse MPM, Mubarak A, Riedl RG, et al. Progress towards non-invasive diagnosis and follow-up of celiac disease in children; a prospective multicentre study to the usefulness of plasma I-FABP. Sci Rep. 2017;7:8671. DOI: 10.1038/s41598-017-07242-4
- 8. Ho SSC, Keenan JI, Day AS. The Role of Gastrointestinal-Related Fatty Acid-Binding Proteins as Biomarkers in Gastrointestinal Diseases. Dig Dis Sci. 2020;65:376-90. DOI: 10.1007/s10620-019-05841-x
- 9. Not T, Ziberna F, Vatta S, et al. Cryptic genetic gluten intolerance revealed by intestinal antitransglutaminase antibodies and response to gluten-free diet. Gut. 2011;6011:1487-93. DOI: 10.1136/gut.2010.232900
- 10. Salardi S, Volta U, Zucchini S, et al. Prevalence of celiac disease in children with type 1 diabetes mellitus increased in the mid-1990s: an 18-year longitudinal study based on anti-endomysial antibodies. J Pediatr Gastroenterol Nutr. 2008;46:612-4. DOI: 10.1097/MPG.0b013e31815d697e
- 11. Shamaly H, Hartman C, Pollack S, et al. Tissue transglutaminase antibodies are a useful serological marker for the diagnosis of celiac disease in patients with Down syndrome. J Pediatr Gastroenterol Nutr. 2007;44:583-6. DOI: 10.1097/MPG.0b013e3180320679
- 12. Sardy M, Csikos M, Geisen C, et al. Tissue transglutaminase ELISA positivity in autoimmune disease independent of gluten-sensitive disease. Clin Chim Acta. 2007;376:126-35. DOI: 10.1016/j.cca.2006.08.006
- 13. Sood A, Khurana MS, Mahajan R, et al. Prevalence and clinical significance of IgA anti-tissue transglutaminase antibodies in patients with chronic liver disease. J Gastroenterol Hepatol. 2017;32:446-50. DOI: 10.1111/jgh.13474
- 14. Oldenburger IB, Wolters VM, Kardol-Hoefnagel T, et al. Serum intestinal fatty acid-binding protein in the noninvasive diagnosis of celiac disease. APMIS. 2018;126:186-90. DOI: 10.1111/apm.12800
- 15. Dipper CR, Maitra S, Thomas R, et al. Anti-tissue transglutaminase antibodies in the follow-up of adult coeliac disease. Aliment Parmacol Ther. 2009;30:236-244. DOI: 10.1111/j.1365-2036.2009.04039.x
- 16. Gidrewicz D, Trevenen CL, Lyon M, et al. Normalization time of celiac serology in children on a gluten-free diet. J Pediatr Gastroenterol Nutr. 2017;64:362-7. DOI: 10.1097/MPG.0000000000001270
- 17. Al-Toma A, Volta U, Auricchio R, et al. European Society for the Study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten-related disorders. United European Gastroenterol J. 2019;7:583-613. DOI: 10.1177/2050640619844125
Abstract
Project Number
T-762.
References
- 1. Vreugdenhil AC, Wolters VM, Adriaanse MP, et al. Additional value of serum I-FABP levels for evaluating celiac disease activity inchildren. Scand J Gastroenterol. 2011;46:1435-41. DOI:10.3109/00365521.2011.627447
- 2. Adriaanse MP, Tack GJ, Passos VL, et al. Serum I-FABP as marker for enterocyte damage in coeliac disease and its relation to villous atrophy and circulating autoantibodies. Aliment Pharmacol Ther. 2013;37:482-90. DOI:10.1111/apt.12194
- 3. Oberhuber G, Granditsch G, Vogelsang H. The histopathology of coeliac disease: time for a standardized report scheme for pathologists. Eur J Gastroenterol Hepatol. 1999;11:1185-94. DOI: 10.1097/00042737-199910000-00019
- 4. Rubio TA, Hill ID, Kelly CP, et al. ACG clinical guidelines: Diagnosis and management of celiac disease. Am J Gastroenterol. 2013;108:656-76. DOI: 10.1038/ajg.2013.79
- 5. Volta U, Fabbri A, Parisi C, et al. Old and new serological test for celiac disease screening. Expert Rev Gastroenterol Hepatol. 2010;4:31-5. DOI: 10.1586/egh.09.66
- 6. Lewis NR, Scott BB. Meta-analysis: deamidated gliadin peptide antibody and tissue transglutaminase antibody compared as screening tests for coeliac disease. Aliment Pharmacol Ther. 2010;31:73-81. DOI: 10.1111/j.1365-2036.2009.04110.x
- 7. Adriaanse MPM, Mubarak A, Riedl RG, et al. Progress towards non-invasive diagnosis and follow-up of celiac disease in children; a prospective multicentre study to the usefulness of plasma I-FABP. Sci Rep. 2017;7:8671. DOI: 10.1038/s41598-017-07242-4
- 8. Ho SSC, Keenan JI, Day AS. The Role of Gastrointestinal-Related Fatty Acid-Binding Proteins as Biomarkers in Gastrointestinal Diseases. Dig Dis Sci. 2020;65:376-90. DOI: 10.1007/s10620-019-05841-x
- 9. Not T, Ziberna F, Vatta S, et al. Cryptic genetic gluten intolerance revealed by intestinal antitransglutaminase antibodies and response to gluten-free diet. Gut. 2011;6011:1487-93. DOI: 10.1136/gut.2010.232900
- 10. Salardi S, Volta U, Zucchini S, et al. Prevalence of celiac disease in children with type 1 diabetes mellitus increased in the mid-1990s: an 18-year longitudinal study based on anti-endomysial antibodies. J Pediatr Gastroenterol Nutr. 2008;46:612-4. DOI: 10.1097/MPG.0b013e31815d697e
- 11. Shamaly H, Hartman C, Pollack S, et al. Tissue transglutaminase antibodies are a useful serological marker for the diagnosis of celiac disease in patients with Down syndrome. J Pediatr Gastroenterol Nutr. 2007;44:583-6. DOI: 10.1097/MPG.0b013e3180320679
- 12. Sardy M, Csikos M, Geisen C, et al. Tissue transglutaminase ELISA positivity in autoimmune disease independent of gluten-sensitive disease. Clin Chim Acta. 2007;376:126-35. DOI: 10.1016/j.cca.2006.08.006
- 13. Sood A, Khurana MS, Mahajan R, et al. Prevalence and clinical significance of IgA anti-tissue transglutaminase antibodies in patients with chronic liver disease. J Gastroenterol Hepatol. 2017;32:446-50. DOI: 10.1111/jgh.13474
- 14. Oldenburger IB, Wolters VM, Kardol-Hoefnagel T, et al. Serum intestinal fatty acid-binding protein in the noninvasive diagnosis of celiac disease. APMIS. 2018;126:186-90. DOI: 10.1111/apm.12800
- 15. Dipper CR, Maitra S, Thomas R, et al. Anti-tissue transglutaminase antibodies in the follow-up of adult coeliac disease. Aliment Parmacol Ther. 2009;30:236-244. DOI: 10.1111/j.1365-2036.2009.04039.x
- 16. Gidrewicz D, Trevenen CL, Lyon M, et al. Normalization time of celiac serology in children on a gluten-free diet. J Pediatr Gastroenterol Nutr. 2017;64:362-7. DOI: 10.1097/MPG.0000000000001270
- 17. Al-Toma A, Volta U, Auricchio R, et al. European Society for the Study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten-related disorders. United European Gastroenterol J. 2019;7:583-613. DOI: 10.1177/2050640619844125
Details
| Primary Language | English |
|---|---|
| Subjects | Gastroenterology and Hepatology |
| Journal Section | Research Article |
| Authors | |
| Project Number | T-762. |
| Publication Date | January 1, 2022 |
| Submission Date | August 6, 2021 |
| Published in Issue | Year 2022 |