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Hansson, Tony
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Publications (10 of 29) Show all publications
Dahlbom, I., Nyberg, B.-I., Berntson, L. & Hansson, T. (2016). Simultaneous detection of IgA and IgG antibodies against tissue transglutaminase: The preferred pre-biopsy test in childhood celiac disease. Scandinavian Journal of Clinical and Laboratory Investigation, 76(3), 208-216.
Open this publication in new window or tab >>Simultaneous detection of IgA and IgG antibodies against tissue transglutaminase: The preferred pre-biopsy test in childhood celiac disease
2016 (English)In: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 76, no 3, 208-216 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: IgA antibodies against tissue transglutaminase (anti-TG2) is a reliable marker of celiac disease (CD). However, IgA-deficient patients are not identified and young children may lack IgA anti-TG2. Combined detection of IgA and IgG (IgA/IgG) against deamidated gliadin peptides (DGP) has shown a high diagnostic performance for untreated CD. Here we examined the utility of IgA/IgG anti-TG2, IgA/IgG anti-DGP and IgA/IgG against a mix of TG2 and DGP (anti-TG2/DGP) in finding CD among children.

Methods: Serum antibodies against TG2, DGP, and TG2/DGP were determined with ELISA in 242 children referred to a paediatric gastroenterologist. Fifty had untreated CD verified by an intestinal biopsy and 192/242 children had other diseases than CD.

Results: Forty-eight untreated CD children had increased IgA/IgG anti-TG2, 47/50 had increased IgA/IgG anti-DGP and 46/50 had increased IgA/IgG anti-TG2/DGP. One control subject had increased IgA/IgG anti-TG2 and IgA/IgG anti-TG2/DGP, whereas 7/192 control subjects had increased IgA/IgG anti-DGP. The IgA/IgG anti-TG2 assay had the best performance with a sensitivity of 96%, a specificity of 99.5% and the area under the ROC-curve was 0.996 (95% CI 0.992-1, p < 0.0001).

Conclusions: Detection of one antibody is not sufficient when screening for untreated CD among children due to cases of IgA deficiency. The inclusion of DGP antigens in the IgA/IgG combination assays seems to affect the sensitivity and specificity negatively, whereas detection of IgA/IgG anti-TG2 has the potential of finding most untreated CD patients, including those with IgA deficiency.

Keyword
tissue transglutaminase, gliadin, children, autoantibodies, Celiac disease
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-294678 (URN)10.3109/00365513.2015.1137348 (DOI)000372195200005 ()26924622 (PubMedID)
Funder
VINNOVA, 2007-00084
Available from: 2016-06-01 Created: 2016-05-26 Last updated: 2017-11-30Bibliographically approved
Hansson, T., Dahlbom, I., Tuvemo, T. & Frisk, G. (2015). Silent coeliac disease is over-represented in children with type 1 diabetes and their siblings. Acta Paediatrica, 104(2), 185-191.
Open this publication in new window or tab >>Silent coeliac disease is over-represented in children with type 1 diabetes and their siblings
2015 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 104, no 2, 185-191 p.Article in journal (Refereed) Published
Abstract [en]

AimThis study measured autoantibodies against tissue transglutaminase (anti-tTG) to detect untreated coeliac disease in children with type 1 diabetes and their siblings. MethodsAnti-tTG was measured in prospectively collected sera from 169 children at the onset of diabetes, 88 of their siblings and 96 matched control children. Coeliac disease was confirmed with a small intestinal biopsy. ResultsCoeliac disease was diagnosed in five children before diabetes onset. A further 12 children were diagnosed after diabetes onset, without any gastrointestinal symptoms, and 11 of these had anti-tTG at the onset of diabetes, with the remaining child showing seroconversion within 6months. Hence, all the children with both diseases had anti-tTG at or before diabetes diagnosis, and the prevalence of coeliac disease was 10.1%. Moreover, 6.8% of the siblings and 3.1% of the control children had elevated levels of anti-tTG. None of the siblings reported any coeliac-related symptoms, despite being positive for anti-tTG, and coeliac disease has so far been biopsy confirmed in 4.5%. ConclusionSilent coeliac disease is over-represented in children with type 1 diabetes and their siblings. All diabetes children and their siblings should be tested and followed for the presence of anti-tTG and coeliac disease.

Keyword
Autoantibodies, Coeliac disease, tissue transglutaminase, Type 1 diabetes
National Category
Pediatrics Endocrinology and Diabetes
Identifiers
urn:nbn:se:uu:diva-246809 (URN)10.1111/apa.12823 (DOI)000348731000024 ()25283799 (PubMedID)
Available from: 2015-03-16 Created: 2015-03-10 Last updated: 2017-12-04Bibliographically approved
Enroth, S., Dahlbom, I., Hansson, T., Johansson, Å. & Gyllensten, U. (2013). Prevalence and sensitization of atopic allergy and coeliac disease in the Northern Sweden Population Health Study. International Journal of Circumpolar Health, 72, 21403.
Open this publication in new window or tab >>Prevalence and sensitization of atopic allergy and coeliac disease in the Northern Sweden Population Health Study
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2013 (English)In: International Journal of Circumpolar Health, ISSN 2242-3982, E-ISSN 2242-3982, Vol. 72, 21403- p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Atopic allergy is effected by a number of environmental exposures, such as dry air and time spent outdoors, but there are few estimates of the prevalence in populations from sub-arctic areas.

OBJECTIVE:

To determine the prevalence and severity of symptoms of food, inhalation and skin-related allergens and coeliac disease (CD) in the sub-arctic region of Sweden. To study the correlation between self-reported allergy and allergy test results. To estimate the heritability of these estimates.

STUDY DESIGN:

The study was conducted in Karesuando and Soppero in Northern Sweden as part of the Northern Sweden Population Health Study (n=1,068). We used a questionnaire for self-reported allergy and CD status and measured inhalation-related allergens using Phadiatop, food-related allergens using the F×5 assay and IgA and IgG antibodies against tissue transglutaminase (anti-tTG) to indicate prevalence of CD.

RESULTS:

The prevalence of self-reported allergy was very high, with 42.3% reporting mild to severe allergy. Inhalation-related allergy was reported in 26.7%, food-related allergy in 24.9% and skin-related allergy in 2.4% of the participants. Of inhalation-related allergy, 11.0% reported reactions against fur and 14.6% against pollen/grass. Among food-related reactions, 14.9% reported milk (protein and lactose) as the cause. The IgE measurements showed that 18.4% had elevated values for inhalation allergens and 11.7% for food allergens. Self-reported allergies and symptoms were positively correlated (p<0.01) with age- and sex-corrected inhalation allergens. Allergy prevalence was inversely correlated with age and number of hours spent outdoors. High levels of IgA and IgG anti-tTG antibodies, CD-related allergens, were found in 1.4 and 0.6% of participants, respectively. All allergens were found to be significantly (p<3 e-10) heritable, with estimated heritabilities ranging from 0.34 (F×5) to 0.65 (IgA).

CONCLUSIONS:

Self-reported allergy correlated well with the antibody measurements. The prevalence of allergy was highest in the young and those working inside. Heritability of atopy and sensitization was high. The prevalence of CD-related autoantibodies was high and did not coincide with the self-reported allergy.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-206290 (URN)10.3402/ijch.v72i0.21403 (DOI)000325721900153 ()23986895 (PubMedID)
Available from: 2013-08-30 Created: 2013-08-30 Last updated: 2017-12-06Bibliographically approved
Lindholm, Å., Blomquist, C., Bixo, M., Dahlbom, I., Hansson, T., Sundström-Poromaa, I. & Burén, J. (2011). No difference in markers of adipose tissue inflammation between overweight women with polycystic ovary syndrome and weight-matched controls. Human Reproduction, 26(6), 1478-1485.
Open this publication in new window or tab >>No difference in markers of adipose tissue inflammation between overweight women with polycystic ovary syndrome and weight-matched controls
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2011 (English)In: Human Reproduction, ISSN 0268-1161, E-ISSN 1460-2350, Vol. 26, no 6, 1478-1485 p.Article in journal (Refereed) Published
Abstract [en]

Background: Previous studies have indicated that peripheral circulating markers of inflammation are elevated in women with polycystic ovary syndrome (PCOS), but thus far no studies concerning markers of inflammation in adipose tissue have been published. The aim of the study was to investigate whether patients with PCOS display increased expression of inflammatory markers in adipose tissue.

Methods: Twenty overweight patients with PCOS, 10 lean patients with PCOS and 20 overweight controls had subcutaneous fat biopsies and blood samples taken. Adipose tissue levels of mRNA of inflammatory markers were determined by use of real-time PCR.

Results: Overweight patients with PCOS had higher relative adipose tissue chemokine ligand 2 (P < 0.01), and its cognate receptor (P < 0.05), tumour necrosis factor-alpha (P < 0.001), interleukin (IL)-10 (P < 0.001) and IL-18 (P < 0.001) and the monocyte/ macrophage markers CD14 (P < 0.01) and CD163 (P < 0.01) mRNA levels compared with lean women with PCOS. There were no differences between overweight patients with PCOS and overweight control subjects in this respect. Within the PCOS group, markers of adipose tissue inflammation correlated significantly with obesity-related metabolic disturbances, but when data were adjusted for age and BMI, most correlations were lost.

Conclusions: Overweight, rather than the PCOS diagnosis per se, appears to be the main explanatory variable for elevated adipose tissue inflammation in patients with PCOS.

Keyword
polycystic ovary syndrome, adipose tissue, inflammatory markers, metabolic syndrome, overweight
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-152021 (URN)10.1093/humrep/der096 (DOI)000290818400024 ()21478181 (PubMedID)
Available from: 2011-04-20 Created: 2011-04-20 Last updated: 2017-12-11Bibliographically approved
Gingnell, M., Dahlbom, I., Lindholm, Å., Hudecova, M., Arnadottir, R., Hansson, T. & Sundström-Poromaa, I. (2011). Patients with polycystic ovary syndrome have lower levels of IgM anti-phosphorylcholine antibodies than healthy women. Gynecological Endocrinology, 27(7), 486-490.
Open this publication in new window or tab >>Patients with polycystic ovary syndrome have lower levels of IgM anti-phosphorylcholine antibodies than healthy women
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2011 (English)In: Gynecological Endocrinology, ISSN 0951-3590, E-ISSN 1473-0766, Vol. 27, no 7, 486-490 p.Article in journal (Refereed) Published
Abstract [en]

Introduction. IgM antibodies against phosphorylcholine (IgM anti-PC) are natural autoantibodies, possibly exerting one of the atheroprotective functions of the immune system. Increased levels of these antibodies reduce the development of atherosclerosis in mice, and low levels of IgM anti-PC have been associated with increased risk for cardiovascular disease (CVD). This study compared levels of IgM anti-PC in women with polycystic ovary syndrome (PCOS, n = 111) and healthy controls (n = 79). Method. Levels of IgM anti-PC were measured with ELISA. Results. The median level of IgM anti-PC in patients with PCOS was not significantly different compared to control subjects. However, the proportion of patients with PCOS with low levels of IgM anti-PC, defined as number of individuals below the median level, was significantly higher than among healthy controls, p < 0.05. Patients with PCOS in the oldest age quintile had significantly lower level of IgM anti-PC than control subjects of similar age (p < 0.05) and younger women with PCOS (p < 0.01). Conclusion. Our results indicate that women with PCOS more frequently display below-median levels of IgM anti-PC than controls and older women with PCOS have lower median anti-PC levels. Further studies of how this finding translates into actual CVD risk in women with PCOS are needed.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-140555 (URN)10.3109/09513590.2010.501880 (DOI)000291221600007 ()20645890 (PubMedID)
Available from: 2011-01-05 Created: 2011-01-05 Last updated: 2017-12-11Bibliographically approved
Dahlbom, I., Korponay-Szabó, I. R., Kovács, J. B., Szalai, Z., Mäki, M. & Hansson, T. (2010). Prediction of clinical and mucosal severity of celiac disease and dermatitis herpetiformis by quantification of IgA/IgG serum antibodies to tissue transglutaminase. Journal of Pediatric Gastroenterology and Nutrition - JPGN, 50(2), 140-146.
Open this publication in new window or tab >>Prediction of clinical and mucosal severity of celiac disease and dermatitis herpetiformis by quantification of IgA/IgG serum antibodies to tissue transglutaminase
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2010 (English)In: Journal of Pediatric Gastroenterology and Nutrition - JPGN, ISSN 0277-2116, E-ISSN 1536-4801, Vol. 50, no 2, 140-146 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: We analysed whether the quantification of autoantibodies against tissue transglutaminase could be used to predict mucosal destruction and disease severity in patients with gluten sensitivity. Patients and Methods: One hundred seventy patients with coeliac disease (CD), comprising 52 children with severe malabsorption (group 1), 59 children with mild symptoms (group II), 59 adults (group III), 134 patients with dermatitis herpetiformis (DH), and 131 disease controls, were studied. Serial serum samples of patients in groups I and II on a gluten-free diet were also included. Serum levels of antibodies against recombinant tissue transglutaminase were determined with ELISA using standard curves for quantification of antibodies. Results: Immunoglobulin (Ig)A antibodies against tissue transglutaminase (IgA-TGA) were detected in all of the patients with CD and in 95% of the DH patients. The IgA-TGA and IgG-TGA levels were higher in group I (P < 0.001). The IgG-TGA levels and positivity rate in group I (100%)were higher than in group II (81%), group III (73%), and the DH group (67%). Elevated IgA-TGA and IgG-TGA levels in combination predicted a more severe small intestinal atrophy (P < 0.0001) with a specificity of 99% for Marsh IIIb-IIIc (flat) lesions. The kinetics of the IgA-TGA decrease during diet differed between groups I and II. Conclusions: High levels of IgA-TGA and IgG-TGA antibodies were associated with the grade of mucosal villous atrophy and a more severe clinical presentation. The combined measurement of IgA-TGA and IgG-TGA enables a noninvasive prediction of small intestinal villous atrophy with high accuracy, and may reduce the need for a biopsy in patients with suspected CD.

Keyword
coeliac disease, dermatitis herpetiformis, IgA autoantibodies, IgG autoantibodies, tissue transglutaminase, transglutaminase type 2
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-96690 (URN)10.1097/MPG.0b013e3181a81384 (DOI)000273994000007 ()
Available from: 2008-02-06 Created: 2008-02-06 Last updated: 2017-12-14
Frisk, G., Hansson, T., Dahlbom, I. & Tuvemo, T. (2008). A unifying hypothesis on the development of type 1 diabetes and celiac disease: Gluten consumption may be a shared causative factor. Medical Hypotheses, 70(6), 1207-1209.
Open this publication in new window or tab >>A unifying hypothesis on the development of type 1 diabetes and celiac disease: Gluten consumption may be a shared causative factor
2008 (English)In: Medical Hypotheses, ISSN 0306-9877, E-ISSN 1532-2777, Vol. 70, no 6, 1207-1209 p.Article in journal (Refereed) Published
Abstract [en]

This paper presents a hypothesis of the aetiology of the increasing incidence of type 1 diabetes (T1D). This together with the global increased incidence of celiac disease (CID) and that these increases cannot be explained by genetic factors suggest a common environmental factor for these two diseases. Even though enterovirus (EV) infections are believed to trigger T1D and gluten is the trigger of CD, the increasing intake of gluten containing products all over the world could be the trigger for both diseases directly and indirectly. It has been shown that the duration of exposure to gluten is related to the prevalence of T1D. It has also been shown that T1D patients at onset have an inflammatory reaction in the gut. Hence, early diagnose of CD followed by elimination of dietary gluten will lead to a decreased incidence of T1D.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-16874 (URN)10.1016/j.mehy.2007.05.058 (DOI)000256576200025 ()18249499 (PubMedID)
Available from: 2008-06-09 Created: 2008-06-09 Last updated: 2017-12-08Bibliographically approved
Lagerqvist, C., Dahlbom, I., Hansson, T., Jidell, E., Juto, P., Olcén, P., . . . Ivarsson, A. (2008). Antigliadin immunoglobulin A best in finding celiac disease in children younger than 18 months of age. Journal of Pediatric Gastroenterology and Nutrition - JPGN, 47(4), 428-35.
Open this publication in new window or tab >>Antigliadin immunoglobulin A best in finding celiac disease in children younger than 18 months of age
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2008 (English)In: Journal of Pediatric Gastroenterology and Nutrition - JPGN, ISSN 0277-2116, E-ISSN 1536-4801, Vol. 47, no 4, 428-35 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: The aim was to investigate age-dependent serum levels and occurrence of elevated celiac disease (CD)-related antibodies in young children, to define the optimal serological procedure when selecting for small intestinal biopsy. PATIENTS AND METHODS: Included were 428 children with biopsy verified CD (median age 16 months; range 7.5 months-14 years) and 216 controls (median age 2.7 years; range 8.5 months-14.6 years). Immunoglobulin (Ig) A antibodies against gliadin (AGA-IgA), tissue transglutaminase (tTG-IgA), and endomysium (EMA-IgA) were analysed. RESULTS: Increased serum AGA-IgA levels were found in 411 of 428 CD cases, tTG-IgA in 385 of 428, and EMA-IgA in 383 of 428. In the control group, 11 of 216 had increased levels of AGA-IgA, 5 of 216 of tTG-IgA, and 8 of 216 of EMA-IgA. In CD children younger than 18 months, elevated AGA-IgA occurred in 97% and elevated tTG-IgA and EMA-IgA were found in 83% of the cases. Conversely, in CD children older than 18 months, elevated AGA-IgA occurred in 94%, and elevated tTG-IgA and EMA-IgA were found in 99% of the cases. CONCLUSIONS: In children older than 18 months, both tTG-IgA and EMA-IgA are sufficiently accurate to be used as a single antibody marker, whereas a large proportion of younger children with CD lack these antibodies. Therefore, when selecting children for small intestinal biopsy, the detection of a combination of AGA-IgA and tTG-IgA is optimal for identifying untreated CD in children younger than 18 months.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-105063 (URN)10.1097/MPG.0b013e31817d80f4 (DOI)18852634 (PubMedID)
Available from: 2009-06-01 Created: 2009-06-01 Last updated: 2017-12-13
Dahlbom, I., Agardh, D. & Hansson, T. (2008). Protein A and protein G ELISA for the detection of IgG autoantibodies against tissue transglutaminase in childhood celiac disease. Clinica Chimica Acta, 395(1-2), 72-6.
Open this publication in new window or tab >>Protein A and protein G ELISA for the detection of IgG autoantibodies against tissue transglutaminase in childhood celiac disease
2008 (English)In: Clinica Chimica Acta, ISSN 0009-8981, E-ISSN 1873-3492, Vol. 395, no 1-2, 72-6 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: To investigate if the detection of celiac disease (CD) in children was improved by using alternative conjugates for assessment of tissue transglutaminase (tTG) autoantibodies. Methods: Serum samples from 108 biopsy confirmed CD children and 42 control subjects were investigated for the presence of autoantibodies with tTG coated microplates using protein A (PA), protein G (PG), anti-IgG, or anti-IgA as conjugates. Results: Of the 108 CD children, 86 (80%) were IgG-tTG positive, 91 (84%) were positive with the PA-conjugate, 94 (87%) were positive with the PG-conjugate, and 103 (95%) were IgA-tTG positive. Among the 42 controls. 4 (10%) were IgG-tTG positive, 5 (12%) were positive with both the PA- and PG conjugates. whereas 3 (7%) were IgA-tTG positive. Compared with IgG-tTG the concordance was 93% for PA and 95% for PG, with a positive correlation between antibody levels (r=0.967 and r=0.975. p< ;0.0001). All but one CD child were found positive by combining IgG-tTG and IgA-tTG detection. Conclusions: The sensitivity of IgG-tTG detection with ELISA increased by protein A or protein G conjugates, whereas the specificity was reduced as compared with anti-IgG conjugate. The combined measurement of IgA-tTG and IgG-tTG still seems to be the optimal procedure when screening children for CD.

Keyword
celiac disease, ELISA, protein A, protein G, tissue transglutaminase
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-17807 (URN)10.1016/j.cca.2008.05.005 (DOI)000258799300014 ()18514068 (PubMedID)
Available from: 2008-09-01 Created: 2008-09-01 Last updated: 2017-12-08Bibliographically approved
Peterson, C., Hansson, T., Skott, A., Bengtsson, U., Ahlstedt, S. & Magnusson, J. (2007). Detection of Local Mast-Cell Activity in Patients With Food Hypersensitivity. Journal of investigational allergology & clinical immunology, 17(5), 314-320.
Open this publication in new window or tab >>Detection of Local Mast-Cell Activity in Patients With Food Hypersensitivity
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2007 (English)In: Journal of investigational allergology & clinical immunology, ISSN 1018-9068, E-ISSN 1698-0808, Vol. 17, no 5, 314-320 p.Article in journal (Refereed) Published
Abstract [en]

Background: Mast cells play a central role in many inflammatory diseases and assessment of their activation may be of use to provide objective confirmation of the outcome of food challenge in the diagnosis of food hypersensitivity. However, to date, assessment of mastcell activation using serum markers has been unsuccessful. Objective: The aim of this study was to explore whether locally released tryptase could be detected in stool samples from patients with food hypersensitivity. Methods: Nine patients (median age, 55 years; range, 26 - 68 years) with food hypersensitivity confirmed by double-blind placebo-controlled food challenge were included in the study. Tryptase concentration was assessed in stool samples collected before and after an open food challenge at home and symptoms were recorded throughout the study. Tryptase concentration was also assessed in stool samples from 16 apparently healthy individuals (median age, 44 years; range, 27 - 72 years). Results: Measurement of fecal tryptase levels in 16 healthy control subjects revealed an upper limit of the normal range (mean + 2 SD of log transformed data) of 10 ng/g. Fecal tryptase levels exceeded 10 ng/g in 7 out of 9 patients in one or more samples obtained during the study. The tryptase levels varied between patients in response to the food challenge and the individual mean levels of tryptase correlated with the corresponding levels of the inflammatory marker eosinophil protein X (ρ = 0.7500, P = .02). Conclusion: Measurement of tryptase levels in stool samples is feasible using the method described here. Our results revealed elevated concentrations of fecal tryptase in patients with food hypersensitivity. However, several factors, including food exposure, may account for the increase in fecal tryptase and further studies are necessary to elucidate the role of mast cells in food hypersensitivity.

Keyword
Asthma, Mast cell, Tryptase, Eosinophil, EPX, Food hypersensitivity, Gastrointestinal
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-12923 (URN)000250535800006 ()17982924 (PubMedID)
Available from: 2008-01-28 Created: 2008-01-28 Last updated: 2017-12-11Bibliographically approved
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