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  • Jefferson Adams
    Jefferson Adams

    Lock & Key Antibody Test Could Boost Celiac Disease Diagnosis

    Celiac.com 01/01/2014 - By enabling researchers to link antibodies with certain diseases, a new method could help uncover and confirm environmental triggers for diseases such as celiac and autism.

    Photo: CC--zebbleThe researchers have two goals, according to professor Patrick Daugherty, a researcher with the department of chemical engineering and the Center for BioEngineering at University of California, Santa Barbara.

    First, they want to create diagnostic tests for diseases for which there are currently no blood tests. Next, they want to figure out what causes the diseases.

    The process works by mining an individual’s immunological memory—a veritable catalog of the pathogens and antigens encountered by his or her immune system

    Every time we encounter a pathogen, our bodies mounts an immune response in the form of antibodies that are specific for given antigens; molecular, microbial, chemical, etc. Each time our bodies mount this response, they form “memory cells” that are activated by subsequent encounters with that specific antigen. Responses can vary, from minor reactions to serious autoimmune diseases in which the body turns against its own tissues and its immune system responds by destroying them, such as in the case of Type 1 diabetes and celiac disease.

    People with celiac disease, for example, will have certain antibodies in their blood that bind to specific peptides—short chains of amino acids—present in wheat, barley, and rye. These peptides are the gluten that trigger adverse reactions in certain people. In the same way that a lock is meant to take only one key, these antibodies will only attach to specific sequences of amino acids that make up the peptides.

    The researchers want to figure out which antibodies are linked to specific diseases. “People with celiac disease have two particular antibody types in their blood, which have proved to be enormously useful for diagnosis,” says Daugherty.

    Source:



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  • About Me

    Jefferson Adams earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in biology, anatomy, medicine, science, and advanced research, and scientific methods. He previously served as Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

  • Related Articles

    Scott Adams
    Lancet 2002;359:945-946.
    Celiac.com 04/12/2002 - According to a report published in the March 16th issue of The Lancet, a new anti-transglutaminase antibody test developed by Dr. Luis Sorell and colleagues from the Centre for Genetic Engineering and Biotechnology in Havana, Cuba can accurately diagnose people with celiac disease in less than 10 minutes. The assay consists of a nitrocellulose strip that is placed in serum or plasma specimens, and it detects both IgA and IgG antibodies to transglutaminase, which prevents misdiagnosis of patients who have IgA deficiency, a trait that is frequently seen in people with celiac disease. If two dots appear it indicates a positive result. To determine the assays accuracy Dr. Sorell and colleagues evaluated 50 patients with untreated celiac disease along with 40 patients who had other gastrointestinal disorders. The results showed that the assay was 100% accurate, all of the patients with diagnosed celiac disease tested positive, and all of the patients with other disorders tested negative. Ultimately the assay could be used for an inexpensive mass-screening program for celiac disease.

    Jefferson Adams
    Celiac.com 03/10/2014 - A new blood test under development by researchers at Walter and Eliza Hall Institute can rapidly and accurately diagnose celiac disease without the prolonged gluten exposure needed for current tests.
    The new blood test is supposedly accurate after only three days of gluten consumption, not the several weeks or months traditionally required to make a diagnosis using intestinal biopsies.
    Researchers from the Melbourne institute, with colleagues from biotechnology company ImmusanT in Boston, US, led a study of the blood test in 48 participants, the results of which were published in the journal Clinical & Experimental Immunology.
    Furthermore, says Dr Jason Tye-Din, gastroenterologist and head of celiac research at Hall, preliminary results show that the new diagnostic test can accurately detect celiac disease within 24 hours.
    Dr Tye-Din said that the blood test built on fundamental research discoveries the team had made about coeliac disease.
    "This 'cytokine release' test measures the T cell response to gluten after three days of consumption, and a positive response is highly predictive of coeliac disease," he said. "With this test, we were able to detect a T cell response in the majority of study participants known to have coeliac disease and importantly, the test was negative in all of the patients who did not have coeliac disease, even though they followed a gluten-free diet and thought gluten was the cause of their symptoms."
    The researchers hope larger studies will confirm its role as a widely used tool for diagnosing coeliac disease.
    Source:
    Medicalxpress.com.

    Jefferson Adams
    Celiac.com 06/06/2014 - Celiac disease guidelines suggest that some patients with high anti-tTG ab levels might be diagnosed without biopsy.
    A team of Indian researchers recently reviewed their celiac disease database to determine if anti-tissue transglutaminase (tTG) antibody (ab) titers correlate with severity of villous abnormalities in Indian patients, and to find out a cutoff value of anti-tTG ab fold-rise that might best predict celiac disease. The researchers included P. Singh, L. Kurray, A. Agnihotri, P. Das, A.K. Verma, V. Sreenivas, S. Datta Gupta, and G.K. Makharia. The are affiliated with the Departments of Gastroenterology and Human Nutrition, Pathology, and Biostatistics at the All India Institute of Medical Sciences in New Delhi, India.
    The team reviewed data on 366 anti-tTG ab-positive individuals who received duodenal biopsies. The team conducted anti-tTG ab screens before patients began a gluten-free diet, and they expressed anti-tTG ab results in terms of fold-rise by calculating ratio of observed values with cutoff value. Celiac disease was diagnosed only in patients with positive serology, villous atrophy greater than Marsh grade 2, and clear response to gluten-free diet.
    Average anti-tTG fold-rise in groups with Marsh grade ≤2 was 2.6 (±2.5), grade 3a was 4.0 (±3.9), 3b was 5.7 (±5.1), and 3c was 11.8 (±8.0). Overall positive likelihood ratio for diagnosing celiac disease was 15.4 and 27.4 at 12- and 14-fold-rise of anti-tTG ab titer, respectively.
    The positive predictive value of diagnosis of celiac disease was 100% when anti-tTG ab titer was 14-fold higher over the cutoff value. Fifty-seven (43.9%) patients with anti-tTG titer rise less than 2-fold also had celiac disease. Levels of anti-tTG rise directly with severity of villous abnormality. High anti-tTG ab titers indicate likely villous atrophy.
    Contrary to emerging wisdom, even patients with anti-tTG ab levels less than 2-times baseline should receive mucosal biopsies, because many patients with celiac disease have such low levels.
    Source:
     J Clin Gastroenterol. 2014 Feb 27.

    Jefferson Adams
    Celiac.com 08/20/2015 - Celiac disease is frequently mis-diagnosed. Even when patients received endoscopy, celiac disease is often missed or not detected.
    A team of researchers recently assessed the accuracy of finger prick-based point-of-care tests in the detection of celiac disease, and developed an algorithm for diagnosis.
    The research team included PD Mooney, SH Wong, AJ Johnston, M Kurien, A Avgerinos, and DS Sanders. They are variously affiliated with the Royal Hallamshire Hospital, Sheffield, United Kingdom and the University of Sheffield, Sheffield, United Kingdom.
    Their team conducted a prospective study of two groups of celiac disease patients evaluated at the Royal Hallamshire Hospital in Sheffield UK from March 2013 through February 2014.
    In group one, the team evaluated 55 patients at high risk for celiac disease, and who tested positive for endomysial antibody, using the Biocard test (BHR Pharmaceuticals, Nuneaton, UK) and the Celiac Quick Test (Biohit Healthcare UK, Ellesmere Port, UK), which measure antibodies to tissue transglutaminase (anti-tTG), and the Simtomax test (Tillotts Pharma, Rheinfelden, Switzerland), which measures deamidated gliadin peptide antibodies (DGP).
    Group 2 included 508 consecutive patients who received an endoscopy for any reason, received the DGP test, and also were evaluated using a diagnostic algorithm that incorporated results from the DGP test and data on symptoms.
    For both groups, point-of-care tests were administered at the time of endoscopy, and the results compared against results from histologic analyses of duodenal biopsy specimens from all patients.
    In group 1, the DGP test identified patients with celiac disease with 94.4% sensitivity, the Celiac Quick Test identified patients with 77.8% sensitivity (P = .03 vs the DGP test), while the Biocard test identified patients with 72.2% sensitivity (P = .008 vs the DGP test).
    In group 2, the DGP test identified patients with celiac disease with 92.7% sensitivity (95% confidence interval, 83.0-97.3), 85.2% specificity (95% confidence interval, 81.5-88.3), a positive predictive value of 49.2% (95% confidence interval, 40.3-58.2), and a negative predictive value of 98.7% (95% confidence interval, 96.8-99.5).
    Measurement of serum anti-tTG identified patients with celiac disease with 91.2% sensitivity (95% confidence interval, 81.1-96.4), 87.5% specificity (95% confidence interval, 84.0-90.4), a positive predictive value of 53.0% (95% confidence interval, 43.6-62.2), and a negative predictive value of 98.5% (95% confidence interval, 96.5-99.4).
    The algorithm identified patients with celiac disease with 98.5% sensitivity, and has the potential to reduce duodenal biopsies by 35%. In this prospective study, the test for DGP identified celiac patients with comparable sensitivity and specificity as standard serologic analysis of anti-tTG.
    Conducting the DGP test before endoscopy might increase the accuracy of the diagnosis of celiac disease.
    These results look promising, but further study is needed, in lower-prevalence populations, to more accurately determine the potential benefits of the DGP test in celiac screening.

    Source:
    Clin Gastroenterol Hepatol. 2015 Jul;13(7):1278-1284.e1. doi: 10.1016/j.cgh.2015.01.010. Epub 2015 Jan 26.

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