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  • Jefferson Adams
    Jefferson Adams

    New Urine Test Can Spot Gluten in Celiac Patients

    Reviewed and edited by a celiac disease expert.

      The detection of gluten immunogenic peptides in the urine of celiac patients reveals transgressions in the gluten-free diet and incomplete mucosal healing.


    Caption: Image: CC--Retinafunk

    Celiac.com 06/12/2018 - A life-long gluten-free diet is the only proven treatment for celiac disease. However, current methods for assessing gluten-free diet compliance are lack the sensitivity to detect occasional dietary transgressions that may cause gut mucosal damage. So, basically, there’s currently no good way to tell if celiac patients are suffering gut damage from low-level gluten contamination.

    A team of researchers recently set out to develop a method to determine gluten intake and monitor gluten-free dietary compliance in patients with celiac disease, and to determine its correlation with mucosal damage. The research team included ML Moreno, Á Cebolla, A Muñoz-Suano, C Carrillo-Carrion, I Comino, Á Pizarro, F León, A Rodríguez-Herrera, and C Sousa. They are variously affiliated with Facultad de Farmacia, Departamento de Microbiología y Parasitología, Universidad de Sevilla, Sevilla, Spain; Biomedal S.L., Sevilla, Spain; Unidad Clínica de Aparato Digestivo, Hospital Universitario Virgen del Rocío, Sevilla, Spain; Celimmune, Bethesda, Maryland, USA; and the Unidad de Gastroenterología y Nutrición, Instituto Hispalense de Pediatría, Sevilla, Spain.

    For their study, the team collected urine samples from 76 healthy subjects and 58 patients with celiac disease subjected to different gluten dietary conditions. To quantify gluten immunogenic peptides in solid-phase extracted urines, the team used a lateral flow test (LFT) with the highly sensitive and specific G12 monoclonal antibody for the most dominant GIPs and an LFT reader. 

    They detected GIPs in concentrated urines from healthy individuals previously subjected to gluten-free diet as early as 4-6 h after single gluten intake, and for 1-2 days afterward. The urine test showed gluten ingestion in about 50% of patients. Biopsy analysis showed that nearly 9 out of 10 celiac patients with no villous atrophy had no detectable GIP in urine, while all patients with quantifiable GIP in urine showed signs of gut damage.

    The ability to use GIP in urine to reveal gluten consumption will likely help lead to new and non-invasive methods for monitoring gluten-free diet compliance. The test is sensitive, specific and simple enough for clinical monitoring of celiac patients, as well as for basic and clinical research applications including drug development.

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    I have the celiac type that affects skin and nervous system. If I consume it my cognitive ability takes a dive as well as many other symptoms, include trouble in the bathroom. Does not show up as 'positive' in current diagnosis methods unless a hideous rash is present (skin biopsy). I'm always hoping there is active research for my type : (   This new detection method is a nice stepping stone for majority but gathering from this article I assume wouldn't suit me.

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    The idea of having a jar available (like ketone strips) for home use by those of us who were diagnosed by biopsy, follow a gluten free diet, yet still have symptoms. We could access whether or not there is hidden gluten in our diets then figure out where modifications need to be made or if there is something different going on.

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    In response to Trisha's comment, there is a home urine test for the detection of gluten consumption called Gluten Detective. However it is only sensitive to 500 mg of gluten which is 10 to 20 times more than was detectable in method used in this study. And the methodology described in the article is not feasible as a home test but maybe it will be adapted one day? As a newly diagnosed person with celiac disease I was concerned about whether I was following the diet as well as I thought I was,  so I bought and used the Gluten Detective kit for use with a stool sample - it is 10 times more sensitive than the urine kit and will detect 50 mg of inadvertent gluten ingestion in the previous several days. It is expensive for a single use test ($25) but I must say the results were very re-assuring that I had not been exposed to gluten. Around the same time I had my tTGA tested and, while still high 3 months after diagnosis and starting the gluten-free diet, my antibodies had dropped from 3600 to 150. So both those pieces of data re-assured me that I was on track to recovery. But it would be terrific to have a simple, quick & inexpensive home test kit to monitor our gluten ingestion.

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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 2,000 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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