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The endomysium contains a form of transglutaminase called "tissue transglutaminase" or "tTG" for short, and antibodies that bind to this form of transglutaminase are called endomysial autoantibodies (EmA). [6] The antiendomysial antibody test is a histological assay for patient serum binding to esophageal tissue from primate.
Antibodies associated with coeliac disease were reported in around 11% of cases. [1] These IgA endomysial antibodies and anti-transglutaminase antibodies are very sensitive and specific for coeliac disease implying that this proportion of duodenal lymphocytosis cases has definite coeliac disease.
Anti-transglutaminase antibodies result in a form of gluten sensitivity in which a cellular response to Triticeae glutens that are crosslinked to tTG are able to stimulate transglutaminase specific B-cell responses that eventually result in the production of anti-transglutaminase antibodies IgA and IgG.
Anti-GBM antibodies Confirmed 1 per million people [46] IgA nephropathy: Kidneys: IgA autoantibodies Confirmed 3.5 per 100,000 [47] Membranous nephropathy: Kidneys: Anti-PLA2R antibodies Confirmed 10 per 100,000 [48] Lupus nephritis: Kidneys: Anti-dsDNA, Anti-Sm, Anti-nuclear antibodies Confirmed Up to 60% of those with Lupus [49] Interstitial ...
Tests for the antibodies in the blood can be used clinically to help screen for celiac disease, IgA blood tests for both tTG and endomysial tTG can be effective ways to determine whether someone has Celiac disease, especially in more severe cases, although for more common, mild forms of Celiac, these tests are less effective.
People who present with minor damage to the small intestine may have seronegative findings so many patients with coeliac disease often are missed. In patients with villous atrophy, anti-endomysial (EMA) antibodies of the immunoglobulin A (IgA) type can detect coeliac disease with a sensitivity and specificity of 90% and 99%, respectively. [90]
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The IgG antibody is similar to AGA IgA, but is found at higher levels in patients with the IgA-less phenotype. It is also associated with coeliac disease and non-celiac gluten sensitivity. [5] [6] [7] Anti-gliadin antibodies are frequently found with anti-transglutaminase antibodies.