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Plasma IgG anti-tissue transglutaminase antibodies in the diagnosis of necrotizing enterocolitis
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  • Hua Li,
  • Chaoting Lan,
  • Shuo Chen,
  • Bowen Tian,
  • Lin Li,
  • Yide Mu,
  • Shenwei Huang,
  • Junjian Lv,
  • Yufeng Liu,
  • Yan Tian
Hua Li
Guangzhou Women and Children's Medical Center
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Chaoting Lan
Guangzhou Women and Children's Medical Center
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Shuo Chen
Nanchang University Jiangxi Medical College
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Bowen Tian
Guangzhou Women and Children's Medical Center
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Lin Li
Guangzhou Women and Children's Medical Center
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Yide Mu
Guangzhou Women and Children's Medical Center
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Shenwei Huang
Guangzhou Women and Children's Medical Center
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Junjian Lv
Guangzhou Women and Children's Medical Center
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Yufeng Liu
Guangzhou First People's Hospital
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Yan Tian
Nanchang University Jiangxi Provincial Children's Hospital

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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.
Submitted to Pediatric Allergy and Immunology
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02 Jul 2024Review(s) Completed, Editorial Evaluation Pending