Together with anti-endomysium antibodies (EMA), tTg represent the most specific serological marker for the diagnosis of celiac disease.
Anti-transglutaminase antibodies are directed against a tissue protein (called transglutaminase antigen), located in the mucosa of the small intestine; this protein interacts with gliadin, playing a fundamental role in the pathogenesis of celiac disease.
CELIAC is an autoimmune disease triggered, in genetically predisposed people, by the ingestion of gluten (protein contained in wheat and other cereals). This results in malabsorption and morphological alterations of the intestinal mucosa (atrophy of the villi, hypertrophy of the crypts, thinning intestinal wall and mucosal infiltration by inflammatory cells).
In the organism affected by celiac disease there is also an altered response of the immune system, which determines the formation of auto-antibodies against gluten (called anti-gliadin antibodies) and against the intestinal mucosa (EMA or tTG).
Celiac disease therapy is a gluten-free diet. Failure to adhere to this diet is the main cause of persistent or recurring symptoms.
Currently, the existence of at least 8 different types of transglutaminases (TGs) has been recognized:
- plasma transglutaminase (coagulation factor XII);
- tissue translutaminase (liver, erythrocytes or endothelium);
- keratinocytic transglutaminase;
- epidermal transglutaminase;
- prostatic transglutaminase;
- transglutaminase X and others.
