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    New Blood Test Will Spot Celiac Disease Without Gluten Consumption


    Jefferson Adams


    • Anyone who has ever tried to get an official diagnosis for celiac disease has likely experienced one very unpleasant reality: Having to eat wheat for a couple of weeks to make sure the antibody tests are accurate. Currently celiac diagnosis requires glute


    Image Caption: Photo: CC--Vladimer Shioshvili

    Celiac.com 01/22/2018 - Celiac disease is marked by HLA-DQ2/8-restricted responses of CD4+ T cells to gluten from wheat, barley or rye.


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    Currently, in order to properly diagnose celiac disease based on serology and duodenal histology doctors need patients to be on gluten-containing diets. This is a problem for many people, who prefer not to begin ingesting wheat again once they have adopted a gluten-free diet. This can present challenges for doctors attempting to diagnose celiac disease.

    It is known that HLA-DQ–gluten tetramers can be used to detect gluten-specific T cells in the blood of patients with celiac disease, even if they are on a gluten-free diet. The team set out to determine if an HLA-DQ–gluten tetramer-based assay can accurately identify patients with celiac disease.

    The research team included Vikas K. Sarna, Knut E.A. Lundin, Lars Mørkrid, Shuo-Wang Qiao, Ludvig M. Sollid, and Asbjørn Christophersen. They are variously affiliated with the Department of Immunology, Oslo University Hospital – Rikshospitalet, Norway; the KG Jebsen Coeliac Disease Research Centre, University of Oslo, Norway; the Department of Gastroenterology, Oslo University Hospital – Rikshospitalet, Norway; the Department of Medical Biochemistry, Oslo University Hospital – Rikshospitalet, Norway; and with the Centre for Immune Regulation, Oslo University Hospital – Rikshospitalet and University of Oslo, Norway.

    For their study, the team produced HLA-DQ–gluten tetramers and added them to peripheral blood mononuclear cells isolated from 143 HLA-DQ2.5+ subjects. There were a total of 62 subjects with celiac disease on a gluten-free diet, 19 subjects without celiac disease on a gluten-free diet due to perceived sensitivity, 10 subjects with celiac disease on a non-gluten-free diet, and 52 seemingly healthy individuals as control subjects.

    The team used flow cytometry to measure T cells that bound HLA-DQ–gluten tetramers. They then used researchers blinded to sample type, except for samples from subjects with celiac disease on a gluten-containing diet, to conduct laboratory tests and flow cytometry gating analyses. They also conducted analysis on test precision using samples from 10 subjects.

    They found that an HLA-DQ–gluten tetramer-based test that detects gluten-reactive T cells identifies patients with and without celiac disease with a high level of accuracy, regardless of whether patients are on a gluten-free diet.

    This test could conceivably allow celiac diagnosis while suspected patients are still on a gluten-free diet. The team notes that their results require a larger study for validation.

    Could reliable celiac diagnosis be done without making patients consume gluten? Will that become common? Stay tuned for more developments.

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    Guest AWOL cast iron stomach

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    Hope this test becomes available sooner than later. It is very much needed.

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    Guest mrister

    Posted

    Sounds promising and a great development, but this brings up the point that you should not self-diagnose celiac disease. If you work out, by your own process of elimination, that gluten is problematic for you, rather than self-diagnose and put yourself on a gluten free diet, you should immediately visit your doctor and go through the correct process to diagnose celiac disease. Most people don't know, that when you cut gluten out of your diet, you cease to produce the gluten antibodies your doctor would be looking for as part of your diagnosis. This makes it very hard to diagnose unless you start eating gluten again. Plus there are other things your doctor needs to keep an eye on, which won't be happening if you self-diagnose.

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    Guest Stephanie

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    This sounds promising. I would like to know what the rate of false negatives ends up being and whether there is a positive correlation with false negatives and the length of time on a gluten-free diet.

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    Guest Emily

    Posted

    Sounds promising and a great development, but this brings up the point that you should not self-diagnose celiac disease. If you work out, by your own process of elimination, that gluten is problematic for you, rather than self-diagnose and put yourself on a gluten free diet, you should immediately visit your doctor and go through the correct process to diagnose celiac disease. Most people don't know, that when you cut gluten out of your diet, you cease to produce the gluten antibodies your doctor would be looking for as part of your diagnosis. This makes it very hard to diagnose unless you start eating gluten again. Plus there are other things your doctor needs to keep an eye on, which won't be happening if you self-diagnose.

    I was self diagnosed by my mother 13 years ago. There wasn't a lot of option back in 2005, if any, like there are now. Going back on a gluten diet isn't an option for me as I have a very severe reaction to it. There really isn't an option for me besides hoping this new test for celiac disease is successful. You're very right if someone has recently realized they might have a gluten sensitivity or intolerance.

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  • About Me

    Jefferson Adams is a freelance writer living in San Francisco. He has covered Health News for Examiner.com, and provided health and medical content for Sharecare.com. His work has appeared in Antioch Review, Blue Mesa Review, CALIBAN, Hayden's Ferry Review, Huffington Post, the Mississippi Review, and Slate, among others.

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  • Related Articles

    Jefferson Adams
    Celiac.com 06/05/2017 - Doctors diagnose celiac disease by confirming various clinical, genetic, serologic, and duodenal morphology features. Based on retrospective data, recent pediatric guidelines propose eliminating biopsy for patients with IgA-TTG levels more than 10-times the upper limit of normal (ULN), along with a few other criteria.
    One retrospective study showed that researchers using levels of IgA-TTG and total IgA, or IgA-TTG and IgG against deamidated gliadin (IgG-DGL) could identify patients both with and without celiac disease. A team of researchers recently set out to validate the positive and negative predictive values (PPV and NPV) of these diagnostic procedures.
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    In all, the team found 592 patients with celiac disease, 345 who did not have celiac disease, and 24 with no final diagnosis.
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    Source:
    Gastroenterology. DOI: http://dx.doi.org/10.1053/j.gastro.2017.04.023  
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    Jefferson Adams
    Celiac.com 07/13/2017 - Until recently, duodenal biopsy was considered the gold standard for diagnosing celiac disease, but that is changing.
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    After making some adjustments to the analytical method for measuring the antibody, a team of researchers recently set out to to determine whether such serum tests can reliably diagnose celiac disease in large numbers adult patients without the need for small bowel biopsy.
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    They are variously associated with the Royal Derby Hospital, the Department of Pathology, and the Derby Digestive Diseases Centre at the Royal Derby Hospital in Derby, UK.
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    As a realist of these findings, the study team has changed the diagnostic guidelines for their center, and will now make celiac diagnosis based on cut-off levels of IgA-tissue transglutaminase.
    This is exciting news. For many, many years, the biopsy was considered the gold standard for diagnosing celiac disease.
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    Source:
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    Jefferson Adams
    Celiac.com 08/28/2017 - After 14-day gluten challenge, an HLA-DQ-gluten tetramer blood test provides better detection of celiac disease than biopsy. Can that lead to new disease detection methods in patients who are already on a gluten-free diet?
    Doctors attempting to diagnose celiac disease are often confronted by patients who have already given up gluten. For such patients, diagnostic guidelines currently call for a gluten challenge of at least 14 days, followed by duodenal biopsy. There isn't much good data on how many false-positive results are generated by this method. To get a better picture, a team of researchers recently studied responses to 14-day gluten challenge in subjects with treated celiac disease.
    The research team included Vikas K Sarna, Gry I Skodje, Henrik M Reims, Louise F Risnes, Shiva Dahal-Koirala, Ludvig M Sollid, and Knut E A Lundin. They are variously affiliated with the Department of Immunology and Transfusion Medicine, Oslo University Hospital, Norway; K. G. Jebsen Coeliac Disease Research Centre, University of Oslo, Norway; Department of Clinical Service, Oslo University Hospital, Norway; Department of Pathology, Oslo University Hospital, Norway; Centre for Immune Regulation, University of Oslo and Oslo University Hospital, Norway; and the Department of Gastroenterology, Oslo University Hospital, Norway.
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    The team is calling for further study. Being able to diagnose celiac disease without biopsy could really help to improve the entire diagnostic process, and could easily lead to an increase in diagnosis.
    Source:
    Gut

    Jefferson Adams
    Celiac.com 09/27/2017 - Patients who have clinical, genetic and histological signs of celiac disease, but no serological markers, present a challenge when it comes to making a diagnosis. If the patient doesn't have elevated antibodies, what signs do doctors look for? What's the best way to evaluate the patient's natural history and response to a gluten-free diet?
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    The research team included Maria Pina Dore; Giovanni Mario Pes; Ivana Dettori; Vincenzo Villanacci; Alessandra Manca and Giuseppe Realdi. They are variously affiliated with the Internal Medicine Section, Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy, with the Baylor College of Medicine, Michael E. DeBakey VAMC, Houston, TX, USA, the Pathology Section, Department of Molecular and Translational Medicine, Spedali Civili and University of Brescia, Brescia, Italy, and with the Pathology Section, Department of Clinical and Experimental Medicine, University of Sassari in Sassari, Italy.
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    Source:
    BMJ Open Gastro. 2017;4(1):e000159

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    Bakery On Main started in the small bakery of a natural foods market on Main Street in Glastonbury, Connecticut. Founder Michael Smulders listened when his customers with Celiac Disease would mention the lack of good tasting, gluten-free options available to them. Upon learning this, he believed that nobody should have to suffer due to any kind of food allergy or dietary need. From then on, his mission became creating delicious and fearlessly unique gluten-free products that were clean and great tasting, while still being safe for his Celiac customers!
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    Read more at: Sciencedaily.com