Screening for celiac disease using anti-tissue transglutaminase antibody assays in healthy students individuals

This study was aimed to determine the prevalence of seropositivity of celiac disease among apparently healthy individuals. Between December / 2014 to March / 2015, eighty four apparently healthy students (42 males and 42 females) of the Technical College/Kirkuk with mean age ± standard deviation of 22.25 ± 2.85 years where participated in the study. All subjects were serologically screened for the presence of immunoglobulin A and G of antitissue transglutaminase antibodies (IgA-tTG and IgG-tTG) by using Enzyme-Linked Immunosorbent Assay (ELISA). In total, 84 students (42 males and 42 females). There was only five students (5.9%) who had a seropositive for celiac disease, including 4 females and 1 male, among them only one female showed positive results of both IgA and IgG anti-tissue transglutaminase antibodies (IgA-tTG and IgG-tTG), while the remaining students (3 females and 1 male) revealed negative results of IgA anti-tissue transglutaminase antibodies and positive results of IgG anti-tissue transglutaminase antibodies. The Computerized Microsoft Excel program was performed by using proportions and mean ± standard deviation. In conclusions, positive celiac screening is existent at a high prevalence rate in our healthy individuals, in which the individuals' IgA deficiency are detected with the positivity of IgG anti-tissue transglutaminase antibodies. Females are more affected than males. A study widely is needed to estimate the real prevalence by substantiation of positive cases with histological examination.


Introduction
Celiac Disease (CD) is an immune-mediated disorder initiated in genetically predispose individuals by ingestion of gluten, which progresses to destroy the small intestine [1].It has been identified throughout the world, and its prevalence is approximately 1% in the general population, but there are emerging data to suggest that its prevalence might be increased in recent years [2].The disorder originates from the interaction of environmental and genetic agents [3].The essential environmental elicit is gluten, which is a mixture of gliadin and related prolamines present in cereals such as wheat, rye and barley [4], while the genetic predisposition depends on some HLA-related class II genes, most celiac patients about 90-95% express HLA DQ2, while, the remaining 5-10 of the patients are positive for DQ8 [5] The disease onsets at any age and with many possible presentations, and the identification of CD is challenging because it could be completely symptomless, or it can begin not only with gastrointestinal symptoms but also with a typical gastrointestinal and extra-intestinal symptoms (recurrent abdominal pain, constipation, anemia, osteoporosis, aphthous stomatitis, raised transaminases and associated autoimmune disorders) [6].
Tissue transglutaminase (tTG) and antiendomysial (EMAs) are a highly reliable serological assays for the diagnosis of celiac disease [6].However, tTG have similar sensitivity and specificity to EMAs test but it represents an improvement over the antiendomysial antibody assay because it is inexpensive, rapid and easy to perform by using enzyme-linked immunesorbent assay (ELISA) technique [7].This study was aimed to estimate the prevalence of seropositivity of celiac disease among apparently healthy student individuals.

Subjects and Methods
The

Discussion
Celiac disease is a throughout life disorder caused by ingested cereal-derived gluten in predisposed individuals [3].Since celiac disease is common but difficult to detect because of the heterogeneous clinical picture, a wide scale screening of the whole population with

Vol: 13
No:3 , July 2017 DOI : http://dx.doi.org/10.24237/djps.1303.236AP-ISSN: 2222-8373 E-ISSN: 2518-9255 Screening for celiac disease using anti-tissue transglutaminase antibody assays in healthy students individualsBraihanHamdi Hameed 164 Vol: 13 No:3 , July 2017 DOI : http://dx.doi.org/10.24237/djps.1303.236AP-ISSN: 2222-8373 E-ISSN: 2518-9255 study was carried out on healthy individuals during the period between December / 2014 to March / 2015.This study included eighty four apparently healthy students (42 males and 42 females) from Technical College/Kirkuk and their ages ranged between (19 -25 years).All subjects were subjected to personal interview using specially designed questionnaire format gathered information concerning name, age, gender, knowledge about the CD, if each subject has a family history of CD or formerly diagnosed as celiac patient, clinical history of: vomiting, diarrhea, abdominal pain, anemia and other associated autoimmune diseases.Venous blood samples were also obtained from each subject included in this study.Sera were detached and frozen at (-20 C) until performing the tests.The immunoglobulin A and G of anti-tissue transglutaminase antibodies were determined by using enzyme-linked immunesorbent assay (ELISA) (AESKU.DIAGNOSTICS.MIKROFORUM RING 2.55234 Vol: 13 No:3 , July 2017 DOI : http://dx.doi.org/10.24237/djps.1303.236AP-ISSN: 2222-8373 E-ISSN: 2518-9255 WENDELSHEIM.GERMANY) in conformity with the manufacturer's directive.Sera of all subjects were examined at a dilution (1:101); a 6-point calibrator curve (0, 3, 10, 30, 100, 300 U/ml) were used to calculate the antibody level and expressed as (U/ml).Values more than 18 U/ml were considered positive.The Computerized Microsoft excel program was performed by using proportions and mean ± standard deviation [8].ResultsA total of 84 apparently healthy students, positive result of IgA-tTG was found in one individual 1 female (1.2%).While, IgG-tTG antibody test results showed that 5 individuals tested positive 1 male & 4 females (5.9%), one of these females also showed positive result of IgA-tTG.Based on the screening questionnaire, no individual was found to have features to suggest CD.One individual tested positive for IgG-tTG revealing family history of CD.The properties of individuals with the positive result of IgA-tTG and IgG-tTG or both are presented in the table(1).