Front. Med., 02 May 2014 |

Beyond the intestinal celiac mucosa: diagnostic role of anti-TG2 deposits, a systematic review

  • 1Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy
  • 2Department of Surgical Pathology, Università Politecnica delle Marche, Ancona, Italy
  • 3Department of Pediatric Surgery, Università Politecnica delle Marche, Ancona, Italy

Aim: To review the existing literature on the role and significance of intestinal transglutaminase 2 immunoglobulin A deposits (TG2 deposits) in patients with overt celiac disease (CD), potential celiac disease (PCD), and other autoimmune or gluten-related conditions.

Methods: We conducted a systematic review of studies published in English, evaluating presence and characteristics of TG2 deposits in subjects with overt CD, PCD, gluten-related diseases [dermatitis herpetiformis (DH), gluten-ataxia (GA)], autoimmune disorders (type-1 diabetes), and other conditions. Studies were identified through a MEDLINE search (1950–2013).

Results: Twenty-three studies were included in the review. Eleven studies were performed in children. Overall TG2 deposits were present in 100% of adults with overt CD, while in children prevalence ranged from 73.2 to 100%. Six studies with an established definition of PCD were considered, prevalence of deposits ranging from 64.7 to 100%. A single study followed-up PCD patients with repeated biopsies and identified presence of intestinal deposits as the best marker to reveal progression toward villous atrophy. Two studies investigated presence of deposits in DH, reporting prevalence between 63 and 79%. A single study documented TG2 deposits in 100% of patients with GA. In children with type-1 diabetes (T1D), positivity of intestinal TG2 deposits ranged from 25 to 78%.

Conclusion: Transglutaminase 2 IgA deposits seem to be a constant feature in overt CD patients and are frequently detectable in other gluten-related conditions (DH and GA). The vast majority of PCD patients express TG2 deposits at the intestinal level, but no sufficient data are available to exactly define their prognostic role as a marker of evolution toward overt CD. The frequent finding of TG2 deposits in the intestinal mucosa of patients with T1D is an interesting observation deserving further evaluation.

Keywords: intestinal deposits, anti-tissue transglutaminase 2, celiac disease, potential celiac disease, dermatitis herpetiformis, immunofluorescence

Citation: Gatti S, Rossi M, Alfonsi S, Mandolesi A, Cobellis G and Catassi C (2014) Beyond the intestinal celiac mucosa: diagnostic role of anti-TG2 deposits, a systematic review. Front. Med. 1:9. doi: 10.3389/fmed.2014.00009

Received: 27 February 2014; Accepted: 06 April 2014;
Published online: 02 May 2014.

Edited by:

Yeong Yeh Lee, University of Glasgow, UK

Reviewed by:

Govind K. Makharia, All India Institute of Medical Sciences, India
Ruggiero Francavilla, University of Bari, Italy

Copyright: © 2014 Gatti, Rossi, Alfonsi, Mandolesi, Cobellis and Catassi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Carlo Catassi, Department of Pediatrics, Università Politecnica delle Marche, Via Corridoni 11, Ancona 60123, Italy e-mail: