2023, Número 1
<< Anterior Siguiente >>
Rev cubana med 2023; 62 (1)
Celiaquía: Aprovechar el poder diagnóstico de los anticuerpos
Kokuina E
Idioma: Español
Referencias bibliográficas: 36
Paginas: 1-9
Archivo PDF: 408.59 Kb.
RESUMEN
La celiaquía es un trastorno mediado por la respuesta inmune al gluten ingerido en individuos genéticamente susceptibles. La enfermedad celíaca afecta al 1 % de la población mundial, y su incidencia se ha incrementado sustancialmente en las últimas décadas. Sin embargo, aún la enfermedad celíaca es pobremente reconocida por la comunidad médica y por la población, tanto a nivel internacional, como nacional, muchos casos permanecen subdiagnosticados. Para mejorar el diagnóstico y manejo del paciente celíaco se recomienda el uso oportuno de la serología específica de la enfermedad celíaca. De los distintos anticuerpos asociados con la enfermedad celíaca, los anticuerpos anti-transglutaminasa tisular (anti-TGt IgA) representan la primera opción diagnóstica por su elevada sensibilidad y especificidad. La prueba de anti-TGt IgA no solo permite descartar de modo confiable la celiaquía, sino funciona como filtro para la selección de pacientes tributarios de biopsia intestinal para la confirmación diagnóstica. El desarrollo de la serología ha posibilitado la aplicación de nuevas estrategias diagnósticas que obvian la biopsia intestinal al menos en algunos grupos de pacientes.
REFERENCIAS (EN ESTE ARTÍCULO)
Singh P, Arora A, Strand TA, Leffler DA, Catassi C, Green PH, et al. Global prevalence of celiac disease: systematic review and meta- analysis. Clin. Gastroenterol Hepatol. 2018;(16):823-36.e2. DOI: https://doi.org/10.1016/j.cgh.2017.06.0371..
Rubin JE, Crowe SE. Celiac Disease. Ann Intern Med 2020; 172:ITC1-ITC16. DOI: https://doi.org/10.7326/AITC2020010702.
King JA, Jeong J, Underwood FE, Quan J, Panaccione N, Windsor JW, et al. Incidence of celiac disease is increasing over time: a systematic review and meta-analysis. Am J Gastroenterol. 2020;115:507-25. DOI: https://doi.org/10.14309/ajg.00000000000005233..
Lebwohl B, Green PHR, Söderling J, Roelstraete B, Ludvigsson JF. Association between celiac disease and mortality risk in a Swedish population. JAMA. 2020;323:1277-85. DOI: https://doi.org/10.1001/jama.2020.19434.
Castañeda C. Enfermedad celíaca en Cuba y sus cuarenta años de experiencias y realidades para su diagnóstico. Rev. Cuban Pediatr. 2016;88:483-97. ISSN digital: 1561-3119.
Husby S, Murray JA, Katzka DA. AGA Clinical practice update on diagnosis and monitoring of celiac disease: changing utility of serology and histologic measures: expert review. Gastroenterol. 2019;156:885-89. DOI: https://doi.org/10.1053/j.gastro.2018.12.0106.
Hujoel IA, Reilly NR, Rubio-Tapia A. Celiac disease: Clinical features and diagnosis. Gastroenterol Clin North Am. 2019;48:19-37. DOI: https://doi.org/10.1016/j.gtc.2018.09.0017.
Di Sabatino A, Vanoli A, Giuffrida P, Luinetti O, Solcia E, Corazza GR. The function of tissue transglutaminase in celiac disease. Rev. Autoimmun. 2012;11:746-53. DOI: https://doi.org/10.1016/j.autrev.2012.01.0078.
Jabri B, Sollid LM. T cells in celiac disease. J. Immunol. 2017;198:3005-14. DOI: https://doi.org/10.4049/jimmunol.16016939.
Di Niro R, Mesin L, Zheng NY, Stamnaes J, Morrissey M, Lee JH, et al. High abundance of plasma cells secreting transglutaminase 2-specific IgA autoantibodies with limited somatic hypermutation in celiac disease intestinal lesions. Nat. Med. 2012;18:441-45. DOI: https://doi.org/10.1038/nm.265610.
Rubio-Tapia A, Hill ID, Kelly CP, Calderwood AH, Murray JA, American College of Gastroenterology. ACG clinical guidelines: diagnosis and management of celiac disease. Am J Gastroenterol 2013;108:656-76. DOI: https://doi.org/10.1038/ajg.2013.7911.
Li M, Yu L, Tiberti C, Bonamico M, Taki I, Miao D, et al. Autoantibody Workshop for Celiac Disease. Am J Gastroenterol 2009;104:154-63.DOI: https://doi.org/10.1038/ajg.2008.812.
Losurdo G, Di Leo M, Santamato E, Arena M, Rendina M, Luigiano C, et al. Serologic diagnosis of celiac disease: May it be suitable for adults? World. J. Gastroenterol. 2021;27:7233-39. DOI: https://dx.doi.org/10.3748/wjg.v27.i42.723313..
Ludvigsson JF, Bai JC, Biagi F, Card TR, Ciacci C, Ciclitira PJ, for the BSG Coeliac Disease Guidelines Development Group, British Society of Gastroenterology. Diagnosis and management of adult coeliac disease: guidelines from the British Society of Gastroenterology. Gut. 2014;63:1210-28. DOI: https://doi.org/10.1136/gutjnl-2013-30657814..
Halfdanarson TR, Litzow MR, Murray JA. Hematologic manifestations of celiac disease. Blood. 2007;109:412-21. DOI: https://doi.org/10.1182/blood-2006-07-03110415.
Hoerter NA, Shannahan SE, Suarez J, Lewis SK, Green PHR, Leffler DA, et al. Diagnostic yield of isolated deamidated gliadin peptide antibody elevation for celiac disease. Dig Dis Sci. 2017;62:1272-76. DOI: https://doi.org/10.1007/s10620-017-4474-516.
Recognition, management, and assessment of coeliac disease. (Clinical Guideline NG 20): National Institute for Health and Care Excellence, 2015. [acceso: 30/01/2017]. https://www.nice.org.uk/guidance/ng20/chapter/Recommendations17..
Silvester JA, Kurada S, Szwajcer A, Kelly CP, Leffler DA, Duerksen DR. Tests for serum transglutaminase and endomysial antibodies do not detect most patients with celiac disease and persistent villous atrophy on gluten-free diets: a meta-analysis. Gastroenterology. 2017;153:689-701. DOI: https://doi.org/10.1053/j.gastro.2017.05.01518.
Arencibia I, Castañeda C, Fragoso T, de Armas A, Blanco E. Ensayo inmunoenzimático para determinar anticuerpos anti-gliadina en pacientes celíacos. Rev. Cuban Pediatr. 1992;64:38-42. ISSN digital: 1561-3119..
Caio G, Riegler G, Patturelli M, Facchiano A, Magistris LDE, Sapone A.. Pathophysiology of non-celiac gluten sensitivity: where are we now? Minerva Gastroenterol Dietol. 2017;63:16-21. DOI: https://doi.org/10.23736/S1121-421X.16.02346-120.
Leonard MM, Lebwohl B, Rubio-Tapia A, Biagi F. AGA Clinical practice update on the evaluation and management of seronegative enteropathies: expert review. Gastroenterol. 2021;160:437-44. DOI: https://doi.org/10.1053/j.gastro.2020.08.06121.
Lebwohl B, Rubio-Tapia A. Epidemiology, presentation, and diagnosis of celiac disease. Gastroenterol. 2021;160:63-75. DOI: https://doi.org/10.1053/j.gastro.2020.06.09822.
Sarna VK, Lundin KEA, Mørkrid L, Qiao S-W, Sollid LM, Christophersen A. HLA-DQ gluten tetramer blood test accurately identifies patients with and without celiac disease in absence of gluten consumption. Gastroenterol. 2018;154:886-96.e6. DOI: https://doi.org/10.1053/j.gastro.2017.11.00623.
Sorell L, Garrote JA, Acevedo B, Arranz E. One-step immune- chromatographic assay for screening of coeliac disease. Lancet 2002;359:945-46. DOI: https://doi.org/10.1016/S0140-6736(02)08046-724.
Lebwohl B, Sanders DS, Green PHR. Coeliac disease. Lancet. 2018;391:70-81. https://doi.org/doi.org/10.1016/S0140-6736(17)31796-825.
Raiteri A, Granito A, Giamperoli A, Catenaro T, Negrini G, Tovoli F. Current guidelines for the management of celiac disease: A systematic review with comparative analysis. World J Gastroenterol 2022;28:154-75. DOI: https://dx.doi.org/10.3748/wjg.v28.i1.15426..
García Menéndez G, Andrade Ruiseco M, Valbuena Rodríguez M, Alfonso González B, Hernández Acea B, Kokuina E, et al. Insuficiencias metodológicas lastran el diagnóstico de la enfermedad celíaca. Rev Cuban Pediatr. 2019 [acceso: 30/01/2020](91):898:1-13. Disponible en: http://scielo.sld.cu27..
Goldstein NS. Non-gluten sensitivity-related small bowel villous flattening with increased intraepithelial lymphocytes: not all that flattens is celiac sprue. Am J Clin Pathol. 2004;121:546-50. DOI: https://doi.org/10.1309/10FC-NCTC-56NM-N0YE28.
Husby S, Koletzko S, Korponay-Szabo IR, Mearin ML, Phillips A, Shamir R, et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease. J Pediatr Gastroenterol Nutr. 2012;54:136-60. DOI: https://doi.org/10.1097/MPG.0b013e31821a23d029..
Fuchs V, Kurppa K, Huhtala H, Laurila K, Mäki M, Collin P, et al. Serology-based criteria for adult coeliac disease have excellent accuracy across the range of pre-test probabilities. Aliment Pharmacol Ther. 2019;49:277-84. DOI: https://doi.org/doi/10.1111/apt.1510930.
Robert ME, Crowe SE, Burgart L, Yantiss RK, Lebwohl B, Greenson JK, et al. Statement on best practices in the use of pathology as a diagnostic tool for celiac disease: a guide for clinicians and pathologists. Am J Surg. Pathol. 2018;42:e44-e58. DOI: https://doi.org/10.1097/PAS.000000000000110731.
Sollid LM, Markussen G, Ek J, Gjerde H,Vartdal F, Thorsby E. Evidence for a primary association of celiac disease to a particular HLA-DQ alpha/beta heterodimer. J Exp Med. 1989;169:345-50. DOI: https://doi.org/10.1084/jem.169.1.34532..
Lau MS, Sanders DS. Optimizing the diagnosis of celiac disease. Curr Opin Gastroenterol. 2017,33:173-80. DOI: https://doi.org/10.1097/MOG.000000000000034333..
Werkstetter KJ, Korponay-Szabo IR, Popp A, Villanacci V, Salemme M, Heilig G, et al. Accuracy in Diagnosis of Celiac Disease Without Biopsies in Clinical Practice. Gastroenterology 2017;153:924-35. DOI: https://doi.org/10.1053/j.gastro.2017.06.00234.
Van Wanrooij RL, Bouma G, Bontkes HJ, Neefjes-Borst A, Van Grieken NC, Von Blomberg BM, et al. Outcome of referrals for non-responsive celiac disease in a tertiary center: low incidence of refractory celiac disease in the Netherlands. Clin Transl Gastroenterol 2017;8:e218. DOI: https://doi.org/10.1038/ctg.2016.7035.
Rubio-Tapia A, Rahim MW, See JA, Lahr BD, Wu TT, Murray JA, et al. Mucosal recovery and mortality in adults with celiac disease after treatment with a gluten-free diet. Am J Gastroenterol. 2010;105:1412-20. DOI: https://doi.org/10.1038/ajg.2010.1036.