Celiac.com 07/26/2013 - There are a number of highly specific and sensitive blood tests that can be used in diagnosing celiac disease; however histological examination of a biopsy taken by endoscopy remains the gold standard for celiac diagnosis.

Photo: CC-- Alexandre DulaunoyHowever, not every patient wants to undergo an endoscopy, and many will happily undergo additional blood tests to avoid or delay endoscopy.

In an effort to help clinicians make accurate celiac diagnosis without endoscopy and biopsy, the company Nestec S.A. of Vevey, Switzerland, a research and testing subsidiary of Nestlé has obtained U.S. Patent No. 8,409,819, entitled "Methods to predict risk for celiac disease by detecting anti-flagellin antibody levels."

The inventors have shown that a subset of at risk patients had elevated anti-CBir1 antibodies and that this correlated with HLA-DQ2.5 and HLA-DQ8 genotypes.

The inventors showed that a group at risk patients have elevated anti-CBir1 antibodies that correlate with HLA-DQ2.5 and HLA-DQ8 genotypes.

Their patent contains two independent claims, numbers 1 and 9, each of which describes a method to aid in predicting whether a patient who is EMA positive, or who has a relative with celiac disease, is at risk for developing celiac disease.

Each method relies on the CBir1 flagellin antigen, specifically the N-terminal residues 1-147, to determine whether or not a sample from an at-risk patient contains anti-CBir1 flagellin antibodies.

Flagellin is a part of what makes up bacterial flagella, the molecular mechanism that drives the propeller-like motion in bacteria. The inventors theorize that individuals at risk for celiac disease may have an aggressive immune response to resident bacterial proteins, in this case flagellin.

This method for predicting celiac disease risk may help clinicians to diagnose patients who wish to avoid endoscopy, or who wish additional tests before doing so. The new patent also notes that the method might help to identify patients at risk of developing celiac disease before any symptoms are present.

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