Epidemiological study of Celiac Disease in Chivilcoy, Buenos Aires

CERNY N; MARIA INES TAMBORENEA; CANEPA A; CIMARELLI M; TOLOSA GABRIEL; ZUNINO SEBASTIAN; GHIGLIERI R; HIDALGO G; MALCHIODI E; IACONO R; DE MARZI M

IV International Congress in Translational Medicine

Congreso; International Congress in Translational Medicine; 2018

Celiac disease (CD) is a serious, genetic autoimmune disorder triggered by the intake a protein called gluten, which is found in wheat, barley and rye. When susceptible individuals eats gluten, the protein interferes with the absorption of nutrients from food by damaging a part of the small intestine. . The immune reaction is triggered by gliadin, a protected fraction of wheat gluten, oats, barley and rye. Damaged villi make it nearly impossible for the body to absorb nutrients into the bloodstream, leading to malnourishment and a host of other problems including some cancers, thyroid disease, osteoporosis, infertility and the onset of other autoimmune diseases. Once the CD is diagnosed, the clinical picture refers to the patient submitted to a gluten-free diet.Currently, it is estimated that the CD affects between 0.6 to 1.0% of the world population, with very important regional differences, for reasons not yet established. In our country, it will be estimated that more than 400000 person has the disease. However, despite the fact that a more precise and rational diagnostic evaluation is now possible, in Argentina we do not have national statistics and the CD remains an underdiagnosed entity.The discovery of transglutaminase (Tg) as the main autoantigen of the endomysium led to the development of a test for the detection of autoantibodies of the IgA and IgG anti-Tg type, which represents an important tool for the diagnosis and monitoring of the disease. Given the high cost of imported diagnostic kits, we developed an enzyme-linked immunosorbent assay (ELISA) for the detection of anti-Tg antibodies to replace the imported ones, currently used in our country. To carry out the ELISA kit in our laboratory, the tissue transglutaminase protein type 2 (rTg), was first cloned and expressed in bacteria E. coli, from where it was purified with affinity columns. Then the immunoassay was set up, evaluating different concentrations and incubation times. The results of anti-Transglutaminase antibodies (IgA and IgG) that were obtained with the proprietary kit (CELISAR) were compared with the commercial ELISA kit (Orgentec).To date, it has been possible to obtain samples of 508 volunteers from the city of Chivilcoy, Province of Buenos Aires. Each person summoned had to sign consent along with a survey in which he/she is asked for information related to their clinical and dietary backgrounds, which were uploaded in the software developed for this purpose, by the computer center of the University of Luján (CIDETIC). This system allows an association between environmental and clinical data and the appearance of symptoms compatible with celiac disease.The analytical performance of the CELISAR method was evaluated taking the Orgentec commercial method as a reference. For this, 352 samples were processed simultaneously by both methodologies, obtaining a sensitivity value of 0.7273% and specificity of 0.944%; assuming the positive results for the commercial kit as true positives and taking 200 negative samples to determine the CutOff. So far we obtained an incidence of 7.62% in the evaluated population, with a homogeneous distribution in the city of Chivilcoy, and with a strong association to other related pathologies.In this way it is intended that the diagnosis by CELISAR be of lower cost and can be presented as benchmarks in the market. This savings in inputs will allow a greater number of patients to access an early diagnosis, improving their quality of life and also, allow monitoring during gluten-free treatment, thus obtaining accurate epidemiological data of reference in our country.