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Are antiepidermal transglutaminase antibodies titre correlated with dermatitis herpetiformis lesions during the disease follow-up?

BACKGROUND
Dermatitis herpetiformis (DH) is characterized by the presence of antitissue transglutaminase (tTG) IgA antibodies in patient sera. In 2002, antiepidermal transglutaminase (eTG) antibodies have been identified in DH patients. Nowadays, their role is still controversial. The aim of this study was to evaluate any association between presence/absence of anti-eTG antibodies and cutaneous manifestations during the follow-up.


METHODS
Anti-eTG and anti-tTG antibodies from 13 patients on gluten-free diet (GFD) were studied during follow-up on ELISA. Cutaneous manifestations baseline differences among age, gender, anti-eTG IgA, anti-tTG IgA, and treatment groups were tested by the Wilcoxon Rank Sum and Fisher's Exact Test. In order to investigate the associations of cutaneous manifestations with age, gender, anti-eTG IgA, anti-tTG IgA, and treatment groups the mixed-effects (ME) model was performed. To test whether the cutaneous manifestations in treatment groups were different according to the anti-eTG levels, an exploratory interaction analysis was carried out using the ME Model.


RESULTS
Seven patients (53.85%) had an anti-eTG value greater than 22 AU/mL, while six (46.15%) were classified as anti-eTG value <22 AU/mL. A significant correlation between anti-eTG antibodies and cutaneous manifestations was observed. No significant cutaneous manifestations differences existed in treatment groups according to the anti-eTG antibodies levels. Anti-tTG antibodies resulted negative in every patient serum.


CONCLUSIONS
Anti-eTG antibodies persist much longer after the elimination of gluten from the patients diet compared to anti-tTG antibodies and seem to be a valid marker for monitoring the disease during the follow-up.