{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:03:41Z","timestamp":1792065821230,"version":"4.4.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2017,5,19]],"date-time":"2017-05-19T00:00:00Z","timestamp":1495152000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100006662","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006662","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000380","name":"Biomedical Research Centre based at Guy's and St Thomas\u2019","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000380","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010872","name":"NHS Foundation Trust and King's College London","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010872","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,8,4]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:p>There has been a dramatic increase in requests for coeliac disease (CD) serological screening using immunoglobulin (Ig)A tissue transglutaminase antibodies (IgA-tTG). Recently, the UK National Institute for Health and Care Excellence has revised its guidance, recommending that total IgA should also be measured in all samples. This is justified, as false-negative results may occur with IgA deficiency. However, implementation of this guidance will incur considerable expense. Tests that measure IgA-tTG antibodies can detect IgA deficiency, indicated by low background signal. This provides an opportunity to identify samples containing IgA \u2264 0\u00b72g\/l, obviating the need for unselected IgA measurement. We investigated the feasibility of this approach in two centres that use the EliA\u2122 Celikey\u2122 assay or QUANTA Lite\u00ae enzyme-linked immunosorbent assay to quantify IgA-tTG antibodies. In both cases, total IgA correlated strongly with background IgA-tTG assay signal. Using the Celikey\u2122 assay, a threshold of &amp;lt;\u00a017\u00b75 response units achieved 100% sensitivity (95% confidence intervals 79\u00b74\u2013100%) for detection of IgA \u2264 0\u00b72g\/l, circumventing the need for IgA testing in &amp;gt;\u00a099% of sera. A similar principle was demonstrated for the QUANTA Lite\u00ae assay, whereby a threshold optical density of &amp;lt;\u00a00\u00b70265 also achieved 100% sensitivity (95% confidence intervals 78\u00b72\u2013100%) for IgA \u2264 0\u00b72\u00a0g\/l, avoiding unnecessary IgA testing in 67% of cases. These data suggest that CD screening tests can identify samples reliably containing low IgA in a real-life setting, obviating the need for blanket testing. However, this approach requires careful individualized validation, given the divergent efficiency with which assays identify samples containing low IgA.<\/jats:p>","DOI":"10.1111\/cei.12982","type":"journal-article","created":{"date-parts":[[2017,5,3]],"date-time":"2017-05-03T00:22:43Z","timestamp":1493770963000},"page":"352-358","source":"Crossref","is-referenced-by-count":7,"title":["Implementation of National Institute for Health and Care Excellence (NICE) guidance to measure immunoglobulin A with all coeliac screens: can an affordable solution be devised?"],"prefix":"10.1093","volume":"189","author":[{"given":"D J","family":"Mac Lochlainn","sequence":"first","affiliation":[{"name":"Royal Victoria Hospital, Belfast, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Hira-Kazal","sequence":"additional","affiliation":[{"name":"Department of Immunology, West Hertfordshire NHS Trust, Hemel Hempstead Hospital, Hemel Hempstead, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Varney","sequence":"additional","affiliation":[{"name":"Department of Immunology, Eastbourne Hospital, Eastbourne, East Sussex, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8275-8488","authenticated-orcid":false,"given":"J","family":"Maher","sequence":"additional","affiliation":[{"name":"Department of Immunology, Eastbourne Hospital, Eastbourne, East Sussex, UK"},{"name":"Division of Cancer Studies, King's College London, Guy's Hospital, London, UK"},{"name":"Department of Allergy and Clinical Immunology, King's College Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2017,5,19]]},"reference":[{"key":"2021120808094093400_cei12982-bib-0001","first-page":"19","article-title":"Be vigilant for patients with coeliac 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