Trend of Antitissue Transglutaminase Antibody Normalization in Children With Celiac Disease Started on Gluten‐free Diet: A Comparative Study Between Chemiluminescence and ELISA Serum Assays
Abstract
Background: The aim of this study is to compare the performance of antitissue transglutaminase (atTG) chemiluminescence immunoassay (CLIA) with the standard enzyme‐linked immunosorbent assay (ELISA) methods in monitoring celiac children after the start of gluten‐free diet (GFD). Methods: Celiac children diagnosed between 2005 and 2016 at our centre were classified into 2 groups based on serum assay (ELISA vs CLIA) used for atTG monitoring, and were compared on percentage of decrease and time to normalization of atTG on GFD. Results: Among 260 included children, the rate of normalization of atTG levels at 30 months’ follow‐up was 86% and 70% in ELISA and CLIA group, respectively ( P < 0.01). Median time to normalization was 11.7 and 14.7 months in ELISA and CLIA group respectively ( P = 0.003). Marsh score at diagnosis was not associated with time to atTG normalization ( P = 0.770), whereas older age at diagnosis and higher baseline atTG predicted longer time to atTG normalization ( P = 0.01, P < 0.01). Conclusions: The percentage and the time of the atTG normalization in celiac children on GFD should be interpreted according to the utilized assay: at 30 months’ follow‐up children tested by CLIA are less likely to normalize atTG levels compared to those tested by ELISA. Younger age at diagnosis and lower baseline atTG are predictors of earlier atTG normalization, regardless of the adopted assay.
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Full normalization of both TGA levels and histopathology may take over two years, particularly in those with severe small bowel lesions and high TGA levels at diagnosis.
“Full normalization of both TGA levels and histopathology may take over two years, particularly in those with severe small bowel lesions and high TGA levels at diagnosis (25-27).”
From ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease. (2022) · cites this paper as [26]
Cites
Husby, S., Koletzko, S., Korponay‐Szabó, I. R., Mearin, M. L., Phillips, A., Shamir, R., Troncone, R., Giersiepen, K., Branski, D., Catassi, C., et al. (2012) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0b013e31821a23d0 · Cited by 2,683 · see citing works
Marsh, M. N. (1992) · PubMed · Cited by 2,000 · see citing works
Gluten, major histocompatibility complex, and the small intestine
Marsh, M. N. (1992) · Gastroenterology · doi:10.1016/0016-5085(92)91819-p · Cited by 1,715 · see citing works
ACG Clinical Guidelines: Diagnosis and Management of Celiac Disease
Rubio‐Tapia, A., Hill, I. D., Kelly, C. P., Calderwood, A. H., & Murray, J. A. (2013) · The American Journal of Gastroenterology · doi:10.1038/ajg.2013.79 · Cited by 1,681 · see citing works
Hill, I. D., Dirks, M., Liptak, G. S., Colletti, R. B., Fasano, A., Guandalini, S., Hoffenberg, E. J., Horváth, K., Murray, J. A., Pivor, M., et al. (2004) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/00005176-200501000-00001 · Cited by 1,187 · see citing works
Autoantibodies to tissue transglutaminase as predictors of celiac disease
Dieterich, W., Laag, E., Schöpper, H., Volta, U., Ferguson, A., Gillett, H. R., Riecken, E. O., & Schuppan, D. (1998) · Gastroenterology · doi:10.1016/s0016-5085(98)70007-1 · Cited by 586 · see citing works
Mucosal Recovery and Mortality in Adults With Celiac Disease After Treatment With a Gluten-Free Diet
Rubio‐Tapia, A., Rahim, M. W., See, J. A., Lahr, B. D., Wu, T., & Murray, J. A. (2010) · The American Journal of Gastroenterology · doi:10.1038/ajg.2010.10 · Cited by 403 · see citing works
Histopathology of celiac disease
Oberhuber, G. (2000) · Biomedicine & Pharmacotherapy · doi:10.1016/s0753-3322(01)80003-2 · Cited by 289 · see citing works
Systematic review: the evidence base for long‐term management of coeliac disease
Haines, M. L., Anderson, R. P., & Gibson, P. R. (2008) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2008.03820.x · Cited by 203 · see citing works
Hopper, A. D., Hadjivassiliou, M., Hurlstone, D. P., Lobo, A., McAlindon, M. E., Egner, W., Wild, G., & Sanders, D. S. (2008) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2007.12.008 · Cited by 185 · see citing works
A comparison of 13 guinea pig and human anti-tissue transglutaminase antibody ELISA kits
Wong, R. C. W., Wilson, R. J., Steele, R. H., Radford‐Smith, G. L., & Adelstein, S. (2002) · Journal of Clinical Pathology · doi:10.1136/jcp.55.7.488 · Cited by 144 · see citing works
Normalization Time of Celiac Serology in Children on a Gluten‐free Diet
Gidrewicz, D., Trevenen, C. L., Lyon, M., & Butzner, J. D. (2017) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0000000000001270 · Cited by 66 · see citing works
Specific Celiac Disease Antibodies in Children on a Gluten-Free Diet
Esch, C. E. H., Wolters, V. M., Gerritsen, S. A. M., Putter, H., von Blomberg, B. M., van Hoogstraten, I. M. W., Houwen, R. H. J., van der Lely, N., & Mearin, M. L. (2011) · Pediatrics · doi:10.1542/peds.2010-3762 · Cited by 49 · see citing works
Szakács, Z., Mátrai, P., Hegyi, P., Szabó, I., Vincze, Á., Balaskó, M., Mosdósi, B., Sarlós, P., Simon, M., Márta, K., et al. (2017) · PLOS ONE · doi:10.1371/journal.pone.0187526 · Cited by 35 · see citing works
Antitissue Transglutaminase Normalization Postdiagnosis in Children With Celiac Disease
Isaac, D. M., Rajani, S., Yaskina, M., Huynh, H. Q., & Turner, J. M. (2017) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0000000000001480 · Cited by 33 · see citing works
Lakos, G., Norman, G. L., Mähler, M., Martis, P., Bentow, C., Santora, D., & Fasano, A. (2014) · Journal of Immunology Research · doi:10.1155/2014/371263 · Cited by 28 · see citing works
Celiac Disease Diagnosis Without Biopsy
Previtali, G., Licini, L., D’Antiga, L., Marseglia, A., Ravasio, R., Nembrini, F., Greco, S., Sonzogni, A., Azzarà, G., Ravelli, P., et al. (2017) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0000000000001773 · Cited by 27 · see citing works
Self-citationAita, A., Rossi, E., Basso, D., Guariso, G., Bozzato, D., Pelloso, M., Pescarin, M., Zambon, C., Navaglia, F., Greco, E., et al. (2013) · Clinica Chimica Acta · doi:10.1016/j.cca.2013.03.024 · Cited by 26 · see citing works
A New Indirect Chemiluminescent Immunoassay to Measure Anti–tissue Transglutaminase Antibodies
Basso, D., Guariso, G., Fasolo, M., Pittoni, M., Schiavon, S., Fogar, P., Greco, E., Navaglia, F., Zambon, C., & Plebani, M. (2006) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/01.mpg.0000239739.09983.38 · Cited by 25 · see citing works
Martín‐Pagola, A., Martín‐Pagola, A., Paranza, L. O., Martín‐Pagola, A., Paranza, L. O., Bilbao, J. R., de Nanclares, G. P., Estevez, E. P., Castaño, L. A., & Vitoria, J. C. (2007) · Autoimmunity · doi:10.1080/08916930601119260 · Cited by 24 · see citing works
Daves, M., Cemin, R., Perkmann, V., Bernard, P., Caprioli, G., Platzgummer, S., & Lippi, G. (2016) · Journal of Immunological Methods · doi:10.1016/j.jim.2016.01.002 · Cited by 13 · see citing works
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1 of the 22 references couldn’t be matched to a known paper.
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ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease.
Mearin, M. L., Agardh, D., Antunes, H., Al‐toma, A., Auricchio, R., Castillejo, G., Catassi, C., Ciacci, C., Discepolo, V., Dolinsek, J., et al. (2022) · Journal of pediatric gastroenterology and nutrition · doi:10.1097/mpg.0000000000003540 · Cited by 186 · see citing works
The Gluten-Free Diet for Celiac Disease: Critical Insights to Better Understand Clinical Outcomes
Simón, E., Molero-Luís, M., Fueyo‐Díaz, R., Batlle, C. C., Crespo‐Escobar, P., & Montoro, M. A. (2023) · Nutrients · doi:10.3390/nu15184013 · Cited by 67 · see citing works
Sbravati, F., Cosentino, A. M., Lenzi, J., Fiorentino, M., Ambrosi, F., Salerno, A., Biase, A. D., Righi, B., Brusa, S., Valin, P. S., et al. (2021) · Digestive and Liver Disease · doi:10.1016/j.dld.2021.06.026 · Cited by 29 · see citing works
Monachesi, C., Verma, A. K., Catassi, G. N., Galeazzi, T., Franceschini, E., Perticaroli, V., Lionetti, E., & Catassi, C. (2021) · Nutrients · doi:10.3390/nu13010190 · Cited by 15 · see citing works
Review on pediatric coeliac disease from a clinical perspective
Wessels, M. M. S., Auricchio, R., Dolinšek, J., Donat, E., Gillett, P. M., Mårild, K., Meijer-Boekel, C. R., Popp, A., & Mearin, M. L. (2022) · European Journal of Pediatrics · doi:10.1007/s00431-022-04379-x · Cited by 12 · see citing works
Pjetraj, D., Pulvirenti, A., Moretti, M., Gatti, S., Catassi, G. N., Catassi, C., & Lionetti, E. (2024) · Nutrients · doi:10.3390/nu16152427 · Cited by 10 · see citing works
Meijer-Boekel, C. R., Bakker, J. A., Boers, A., Jansen, S. J., Mengi, Z., & Mearin, M. L. (2022) · Gastro Hep Advances · doi:10.1016/j.gastha.2022.04.015 · Cited by 8 · see citing works
Żochowska-Sobaniec, M., Jarocka‐Cyrta, E., Łotowska, J. M., & Sobaniec, P. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14030725 · Cited by 8 · see citing works
Monachesi, C., Verma, A. K., Catassi, G. N., Gatti, S., Lionetti, E., & Catassi, C. (2020) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0000000000002691 · Cited by 7 · see citing works
Establishment of a Chemiluminescent ELISA Method for Florfenicol in Eggs and Chicken Meat
Ge, M., Xing, Y., Sun, Y., Cai, W., Wang, Y., & Hu, X. (2024) · Food Analytical Methods · doi:10.1007/s12161-024-02690-x · Cited by 6 · see citing works
Ashton, J. J., Driscoll, K., Himsworth, J., Beattie, R. M., & Batra, A. (2022) · Archives of Disease in Childhood · doi:10.1136/archdischild-2021-323250 · Cited by 6 · see citing works
Mulder, L., Castelijn, D. A. R., van der Pol, P., Vermeer, M., Hollander, J. C., Kuiper, T., Bijnens, C., Bontkes, H. J., & Damoiseaux, J. G. M. C. (2023) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2023-1076 · Cited by 6 · see citing works
The follow-up of patients with celiac disease
Tola, M. D., Bontkes, H. J., Irure‐Ventura, J., López‐Hoyos, M., & Bizzaro, N. (2025) · Journal of Translational Autoimmunity · doi:10.1016/j.jtauto.2025.100278 · Cited by 6 · see citing works
Nevejan, L., Dobbels, P., Norman, G. L., Voreck, A., Bossuyt, X., & Hoovels, L. V. (2021) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2021-1207 · Cited by 6 · see citing works
Monachesi, C., Catassi, G. N., & Catassi, C. (2023) · Expert Review of Proteomics · doi:10.1080/14789450.2023.2270775 · Cited by 5 · see citing works
La diagnosi della malattia celiaca: introduzione alle linee guida SIPMeL 2025
Barrale, M., Brusca, I., Sorrentino, M. C., Villalta, D., & Bizzaro, N. (2025) · La Rivista Italiana della Medicina di Laboratorio - Italian Journal of Laboratory Medicine · doi:10.23736/s1825-859x.25.00281-6 · Cited by 3 · see citing works
Everything That Must Be Known About the Relationship of Gluten to Human Health
Sario, F. D., Monachesi, C., Verma, A. K., & Catassi, C. (2023) · Springer eBooks · doi:10.1007/978-3-031-28344-4_1 · Cited by 3 · see citing works
Nemțeanu, R., Danciu, M., Clim, A., Gîrleanu, I., Ciortescu, I., Gheorghe, L., Trifan, A. V., & Pleşa, A. (2023) · Gastroenterology and hepatology from bed to bench. · doi:10.22037/ghfbb.v16i2.2734 · Cited by 3 · see citing works
Klöti, S., Schaad, J., Spalinger, J. H., Schibli, S., Hart, L., Sokollik, C., & Righini‐Grunder, F. (2024) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1002/jpn3.12251 · Cited by 3 · see citing works
Choung, R. S., Ramakrishna, J., Pradhan, V., King, B., Guttman‐Yassky, E., Peeva, E., & Murray, J. A. (2025) · Archives of Dermatological Research · doi:10.1007/s00403-024-03784-6 · Cited by 3 · see citing works
Serological testing for celiac disease in children
Repo, M., Koskimaa, S., Paavola, S., & Kurppa, K. (2025) · Expert Review of Gastroenterology & Hepatology · doi:10.1080/17474124.2025.2462245 · Cited by 3 · see citing works
Linee guida SIPMeL per la diagnosi e il monitoraggio della malattia celiaca: revisione 2025
Barrale, M., SIPMeL, A. N. D. G.-A., Brusca, I., Villalta, D., Carbone, T., Sorrentino, M. C., Cinquanta, L., Infantino, M. G., Manfredi, M., Previtali, G., et al. (2025) · La Rivista Italiana della Medicina di Laboratorio - Italian Journal of Laboratory Medicine · doi:10.23736/s1825-859x.25.00286-5 · Cited by 2 · see citing works
Self-citationZifman, E., Schujovitzky, D., Moskovitz-Hivert, Y., & Galai, T. (2024) · Cureus · doi:10.7759/cureus.62951 · Cited by 1 · see citing works
Lattuada, M., Rebora, P., Fossati, C., Lazzerotti, A., Paolini, L., Cattoni, A., Panceri, R., Valsecchi, M. G., Biondi, A., & Zuin, G. (2025) · Frontiers in Pediatrics · doi:10.3389/fped.2025.1595256 · Cited by 1 · see citing works
Sansotta, N., Alessio, M. G., Norsa, L., Previtali, G., Ferrari, A., Guerra, G., & D’Antiga, L. (2020) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0000000000002764
Self-citationESPGHAN recommendations for paediatric coeliac disease follow-up
El‐Lababidi, N. (2023) · Pediatrie pro praxi · doi:10.36290/ped.2023.028
Serology and screening in celiac disease
Volta, U., Caio, G., & GIORGIO, R. D. (2024) · Elsevier eBooks · doi:10.1016/b978-0-443-13359-6.00012-1
Ancona, S., Malerba, F., Medina, F., Gandullia, P., Chiaro, A., Renzo, S., Angelis, P. D., Romano, C., Malamisura, M., Auricchio, R., et al. (2026) · European Journal of Pediatrics · doi:10.1007/s00431-026-06833-6
Monachesi, C., Ascani, M., Sario, F. D., Pjetraj, D., Sario, A. D., Mandolesi, A., Allegrini, G., Verma, A. K., Galeazzi, T., Gatti, S., et al. (2026) · Clinical and Translational Gastroenterology · doi:10.14309/ctg.0000000000001067
Topical Haemostatic Agents In Modern Surgery: A Mechanism-Oriented Classification
Ceylan, S., Kürkçüoğlu, E., & Kandemir, T. (2026) · OSMANGAZİ JOURNAL OF MEDICINE · doi:10.20515/otd.1990954
Stricker, S., Schönfeld, L. M., Rommel, F., Grunst, P., de Laffolie, J., & Rudloff, S. (2026) · Frontiers in Nutrition · doi:10.3389/fnut.2026.1930734
- Authors
- Sansotta, N., Alessio, M. G., Norsa, L., Previtali, G., Ferrari, A., Guerra, G., & D'Antiga, L.
- Affiliations
- Department of Paediatric Hepatology, Gastroenterology and Transplantation Bergamo Italy
- Clinical Chemistry Laboratory Bergamo Italy
- Ospedale Papa Giovanni XXIII (IT)
- Corresponding author
- Sansotta, Naire
- Norsa, Lorenzo
- ORCID
- Venue
- Journal of Pediatric Gastroenterology and Nutrition
- Publisher
- Wiley
- Published
- 2020-01
- Volume
- 70
- Issue
- 1
- Pages
- 37-41
- ISSN
- 0277-2116 (ISSN-L)
- 1536-4801
- OpenAlex
- W2979423463
- Cited by
- 31
- References
- 22
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 5 · 2023: 6 · 2022: 4 · 2021: 3 · 2020: 2
- FWCI
- 2.05
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Pediatric Gastroenterology and Nutrition (publishedVersion)
- PubMed (publishedVersion)
- BOA (University of Milano-Bicocca) (submittedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Celiac Disease Research and Management
- Health Sciences › Medicine › Surgery › Eosinophilic Esophagitis
- Life Sciences › Agricultural and Biological Sciences › Plant Science › Wheat and Barley Genetics and Pathology
- Keywords
- celiac disease, children, gluten-free diet, chemiluminescence immunoassay, ELISA, serological surveillance, age at diagnosis
- MeSH terms
- Autoantibodies, Celiac Disease, Child, Child, Preschool, Enzyme-Linked Immunosorbent Assay, Female, Humans, Immunoglobulin A, Male, Transglutaminases, Retrospective Studies, Reproducibility of Results, Luminescence, Diet, Gluten-Free
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