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. 2020 May 29;7:73. doi: 10.3389/fnut.2020.00073

Table 1.

Tools employed to detect intestinal production of anti-TG2 autoantibodies.

Tool Technique Strengths Weaknesses References
Detection of anti-reticulin antibodies in jejunal juice Indirect immunofluorescence on frozen sections of kidney rat – Low sensitivity
– Difficulty in getting the samples
– Requires frozen samples of kidney rat and highly experienced operators
– Unreliable as diagnostic test
(80)
Detection of EMA in fecal supernatants Indirect immunofluorescence on frozen sections of monkey esophagus – High sensitivity
– Easy to get fecal samples
– Requires frozen monkey esophagus samples and highly experienced operators
– Culture system technology requires experienced operators
(81)
Measurement of EMA in supernatants from cultured biopsy experiments Indirect immunofluorescence on frozen sections of monkey esophagus High sensitivity – Requires frozen monkey esophagus samples and highly experienced operators
– Culture system technology requires experienced operators
(56, 82, 88, 89)
Measurement of anti-TG2 IgA antibodies in fecal supernatants ELISA – Easy to get fecal samples Sensitivity lower than serum tests (81)
Measurement of anti-TG2 IgA antibodies in supernatants from cultured biopsy experiments ELISA – High sensitivity and specificity
– ELISA Test is not dependent on operator skill
– Quantitative test
Culture system technology requires experienced operators and equipped laboratories (8385, 88, 90, 91)
Detection of mucosal IgA anti-TG2 deposits Double immunofluorescence on frozen duodenal sections – High sensitivity
– High specificity
– Requires frozen duodenal sections, highly experienced operators and equipped laboratories
– Semiquantitative test
(8487, 89, 9193, 98)
Detection of synthesized IgA anti-TG2 from intestinal B lymphocytes Phage display libraries – High sensitivity
– High specificity
– Tested in small patient groups and by only one group of researchers
– Highly complex test that requires experienced operators and equipped laboratories
– It cannot be proposed for routine use
(57, 94)
Detection of anti-TG2-specific plasma cells Double immunofluorescence on frozen duodenal sections – High sensitivity
– High specificity
Requires frozen duodenal sections, highly experienced operators and equipped laboratories (58, 59, 61)
Sorting TG2-specific plasma cells Flow cytometry Requires freshly picked duodenal samples, highly experienced operators and equipped laboratories (58, 61, 64, 65)

Anti-TG2, anti-tissue transglutaminase2 antibodies; EMA, anti-endomysium antibodies.