Celiac.com 10/23/2009 - Current estimates put the number of celiac disease sufferers at about 1% of the general population. However, some celiac disease experts, like Dr. Andrew Fassano, predict that up to 10% of the general population may prove to suffer from gluten intolerance.
Easier, more reliable testing methods, such as blood antibody screening, have helped promote early detection of celiac disease, thus preventing serious complications of the disorder. Such tests also move researchers closer to knowing if Dr. Fassano’s prediction will hold true.
In addition to classic complaints such as indigestion, diarrhea, poor nutritional uptake, among others, people with both celiac disease and gluten intolerance often present with a wide variety of generalized symptoms, and many increasingly show no clinical symptoms at all.
A team of researchers recently set out to develop specific and sensitive immunoassays that can reliably detect celiac disease. In this case, they developed immunoassays for the detection of IgG and IgA antibodies to gliadin using synthetic peptides. The research team was made up of Anil K. Bansal, Matthew J. Lindemann, Vince Ramsperger, and Vijay Kumar.
The team looked serum results for endomysial (EMA) and tissue transglutaminase (tTG) antibody screens from 200 blood individuals with celiac disease, as well as from celiac disease control subjects, and healthy normal subjects.
In order to assess reliability of the Celiac G+ antibody test against EMA, which offers higher sensitivity and higher specificity, the team included samples with both high and low EMA titers. The team compared the Celiac G+ antibody assay against EMA and another commercially available gliadin peptide assays, together with tTG antibody assays.
The data show that as the EMA levels increased the sensitivity of detection of antibodies to synthetic peptides on both systems increased, reaching 100% at EMA titers greater than 160. Celiac G+ synthetic gliadin peptide assay provides markedly superior diagnostic performance compared with other gliadin peptide immunoassays.
Overall, the diagnostic performance of the Celiac G+ assay for IgA and IgG showed a sensitivity of 80% and 90% respectively in comparison with EMA. Compared to the other available synthetic peptide immunoassays, EMA positivity yielded sensitivities of 59% (IgA) and 75% (IgG). Specificity for celiac G+ antibody assay was 90–95% for IgA and IgG compared to 88–90% specificity for other similar assays.
The results show that Celiac G+ ELISA provides better sensitivity and better specificity compared with other available synthetic gliadin peptide immunoassays. Moreover, when used in combination with the IgA tTG antibody test, the IgG Celiac G+ antibody test offers an excellent screening algorithm for suspected cases of celiac disease.
As tests for celiac disease and gluten intolerance become better, easier, more reliable, as they become more sensitive and more specific and available to more people, more and more people will come to understand that they suffer from celiac disease and/or gluten intolerance. Every one of those discoveries offers someone a chance to improve their well-being and live a long, healthy life. For now, stay tuned...Annals of the New York Academy of Sciences. 2009 Sep; 1173:36-40