Plasma IgG anti-tissue transglutaminase antibodies in the diagnosis of
necrotizing enterocolitis
Abstract
Background: Necrotizing enterocolitis (NEC) is a severe
inflammatory gastrointestinal disease that affects premature neonates
with high morbidity and mortality. We aimed to evaluate the potential of
IgG anti-tissue transglutaminase antibodies (IgG tTG) as biomarkers for
NEC and to explore their applicability in the early diagnosis,
monitoring prognosis. Method: We conducted a prospective
observational study on 60 neonates with abdominal distension, dividing
into the NEC(n=30) and the control(n=30) groups according to the
follow-up results. We collected plasma samples within 48 h of the onset
of abdominal distension, and used the autoantigen microarray to screen
for NEC-associated autoantibodies. Additionally, an Enzyme-linked
immunosorbent assay (ELISA) was utilized to measure the levels of IgG
tTG in a validation study that included 43 neonates with NEC and 20
gestational age- and weight-matched controls. Results: The
autoantibody microarray analysis indicated that plasma levels of IgG tTG
were significantly higher in neonates with NEC compared to controls (
P< 0.001). ELISA confirmed the significant elevation of
plasma IgG tTG in neonates with NEC ( P<0.001). Plasma
IgG tTG were able to distinguish NEC from the control group, with an
area under the curve (AUC) of 0.8674 (95% confidence interval (CI):
0.7794 - 0.9555, sensitivity of 72.09% and specificity of 95%).
Encouragingly, IgG tTG levels were significantly higher in NEC stage I
than in the controls ( P < 0.001). Furthermore, as
neonates with NEC showed clinical improvement, the levels of IgG tTG
decreased ( P=0.0159). Conclusion: IgG tTG may serve as
a biomarker for diagnosis early NEC and predict its prognosis.