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lüll Performance of antibodies against tissue transglutaminase for the diagnosis of celiac disease: meta-analysis Zintzaras E; Germenis AEClin Vaccine Immunol 2006[Feb]; 13 (2): 187-92A meta-analysis of studies investigating the diagnostic accuracy of enzyme-linked immunosorbent assays (ELISA) for antibodies against tissue transglutaminases (tTG) of various origins in celiac disease (CD) diagnosis was carried out. Twenty-one studies, with untreated CD patients and healthy/CD-free controls, were included in the meta-analysis. The diagnostic accuracy was estimated using a summary receiver operating characteristic (SROC) curve and pooled sensitivity (Se) and specificity (Sp). Multiple assays within a study were treated by considering all the assays within a study and by analyzing the most popular assay (i.e., the commercial anti-tTTG ELISA most frequently utilized in the papers in which multiple assays were included). The SROC curve indicated the absence of heterogeneity, and the superiority of recombinant human tTG (rh-tTG) and purified human tTG (ph-tTG) compared to guinea pig-tTG (gp-tTG). The sensitivities (most popular assay) for rh-tTG, ph-tTG, and gp-tTG were 94%, 90%, and 92%, respectively, and the specificities were 97%, 92%, and 96%, respectively. A sensitivity analysis (exclusion of studies with bias) altered the results of ph-tTG: Se, 95%; Sp, 98%. The sensitivities (all individual assays) for rh-tTG, ph-tTG, and gp-tTG were 94%, 94%, and 91%, respectively, and the specificities were 95%, 94%, and 89%, respectively. Human tTG ELISA is sensitive and specific, and it can be used for mass screening. Sensitivity analysis showed that ph-tTG might perform better.|Animals[MESH]|Case-Control Studies[MESH]|Celiac Disease/*diagnosis/enzymology/*immunology[MESH]|Enzyme-Linked Immunosorbent Assay/methods/statistics & numerical data[MESH]|Guinea Pigs[MESH]|Humans[MESH]|Immunoglobulin A/*blood[MESH]|Recombinant Proteins/immunology[MESH]|Sensitivity and Specificity[MESH]|Serologic Tests[MESH]|Transglutaminases/*immunology[MESH] |