Salivary antigliadin and antiendomysium antibodies in coeliac disease

The definitive diagnosis of coeliac disease is based on typical changes in the small intestine biopsy specimens. To screen individuals for coeliac dis ease serum IgA and IgG antigliadin (AGA), IgA antireticulin (ARA) and IgA a ntiendomysium (EmA) antibodies are used. The aim of this study was to inves tigate whether these antibodies can also be detected in saliva as diagnosti c markers of coeliac disease. The study population comprised 30 patients wi th coeliac disease treated with a gluten-free diet, 14 patients with untrea ted coeliac disease and 13 healthy control subjects. Sera and saliva were t ested simultaneously for the presence of IgA and IgG AGA and IgA EmA. None of patients studied had a selective IgA deficiency. There was no significan t difference in salivary IgA AGA levels between the three groups tested and there was no correlation between the individual serum and salivary values of IgA AGA. Salivary IgG AGA levels were very low or undetectable. Serum Ig A AGA showed a low sensitivity (36.4%) to detect an untreated patient with coeliac disease. All salivary samples, regardless of the study group were n egative for IgA EmA. Serum IgA EmAs were universally detected in the sera o f patients with newly diagnosed coeliac disease and also in the sera of fiv e of 30 patients with treated coeliac disease. No IgA EmA was detected in t he sera of controls. None of the patients studied had a selective IgA. defi ciency either. Serum IgA EmA is the most sensitive, and IgA and IgG AGA are good indicators for coeliac disease, but salivary IgA or IgG AGA and saliv ary IgA EmA are not helpful for the diagnosis or follow-up of coeliac disea se patients.