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  • Jefferson Adams

    New Blood Test Will Spot Celiac Disease Without Gluten Consumption

    Jefferson Adams
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    Reviewed and edited by a celiac disease expert.

      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


    Photo: CC--Vladimer Shioshvili
    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.

    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.



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    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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    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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    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 Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,500 articles on celiac disease. His coursework includes studies in science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. He previously served as SF 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.


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