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New Blood Tests Can Spot Gluten Sensitivity Among Enteropathy Patients Who Test Negative for Anti–Tissue Transglutaminase


New Blood Tests for Celiac Disease

Celiac.com 04/20/2010 - A team of researchers recently set out to determine whether new serology assays can detect gluten sensitivity among enteropathy patients seronegative for anti–tissue transglutaminase.

Emilia Sugai, Hui Jer Hwang, Horacio Vázquez, Edgardo Smecuol, Sonia Niveloni, Roberto Mazure, Eduardo Mauriño, Pascale Aeschlimann, Walter Binder, Daniel Aeschlimann and Julio C. Bai comprised the research team.

They are variously affiliated with the Small Bowel Section of the Department of Medicine at C. Bonorino Udaondo Gastroenterology Hospital in Buenos Aires, Argentina, the Matrix Biology and Tissue Repair Research Unit at the Cardiff University School of Dentistry in Cardiff, UK, and with INOVA Diagnostics, Inc., of San Diego, California.

Some patients with celiac disease may not show a normal positive reaction to the test most commonly used for IgA anti–tissue transglutaminase (anti-tTG) antibodies.

The research team set out to determine the usefulness of newer assays incorporating synthetic deamidated gliadin-related peptides (DGPs), or other TG isoenzymes as antigen, for detecting gluten sensitivity in IgA anti-tTG–seronegative patients.

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The team tested blood samples drawn at diagnosis from 12 anti-tTG–seronegative patients with a celiac-like enteropathy, from 26 patients with skin biopsy–proven dermatitis herpetiformis (DH) and, lastly, from 26 patients with IgA anti-tTG–positive celiac disease.

All patients showed typical levels of total IgA. On each patient, the team conducted intestinal biopsy and serum testing for detection of IgA and IgG isotypes of both anti-DGP and anti-tTG in a single assay (tTG/DGP Screen; INOVA Diagnostics). They also tested each patient for simultaneous detection of both IgA and IgG anti-DGP antibody isotypes (DGP Dual; INOVA Diagnostics). Lastly, they tested each patient for the detection of antibodies to transglutaminase 3 (TG3) or transglutaminase 6 (TG6).

All patients who showed positive anti-tTG results also tested positive in anti-DGP assays.

The tTG/DGP Screen caught six of the 19 anti-tTG seronegatives (31.6%), while anti-DGP Dual produced caught five of these cases (26.3%). Whereas both assays detected 2 anti-tTG–negative DH patients with partial villous atrophy, they were positive in only 2 of the 5 cases with no histologically discernible mucosal damage. Testing for antibodies to TG3 and TG6 caught seven of the 19 anti-tTG–negative patients (36.8%), five of whom also tested positive for anti-DGP.

From these results, the team concludes that using tTG/DGP Screen, or anti-DGP Dual, to detect anti-DGP improves diagnostic sensitivity of gluten sensitive patients with non–IgA- deficiency, or anti-tTG–seronegativity, and celiac-like enteropathy. The same enhancement is also achieved by detecting antibodies to other TG isoenzymes.

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1 Response:

 
Waitinggame
Rating: ratingfullratingfullratingfullratingfullratingempty Unrated
said this on
04 May 2012 10:34:38 AM PDT
Interesting! I tested negative to tTG and total Iva was normal, yet I was five times above positive marker on GDP IgA test! Still infesting phase and waiting for biopsy to see if I have celiac. Thanks for posting this!




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You may find these interesting, they're from Professor Marios Hadjivassiliou, a leading expert on gluten ataxia: http://www.acnr.co.uk/pdfs/volume2issue6/v2i6reviewart2.pdf Best of luck helping your daughter

Yep. The one that is most relevant I think is the post by Backtalk. Backtalk went back on gluten and have to a colostomy done on an emergency basis. Not fun. She regretted ignoring the gluten-free diet.

Welcome Lochella Hopefully you can draw some comfort from finally having an answer and thus starting the path to good health. Healing is going to come from your own body as you progress on the gluten free diet and it stops fighting itself and starts repairing that damage. You're still in the very early days and it's not an instant process sadly. 6 months is the usual figure bandied around for seeing significant improvement, although hopefully you'll get some signs of improvement much quicker than that. The single best thing you can do is to eat good simple whole foods and make sure absolutely no gluten gets into your diet. There's some tips here: With stomach pains peppermint tea is my go to drink. Avoiding caffeine seems to help as well as its rough on digestion at the best of times. This may be a time to ease up on alcohol as well and consider dropping dairy, many find they're lactose intolerant but this can correct itself in time. You will find lots of good info, advice and support here, I hope the community is of help to you as it was to me. Best of luck!

I recently got diagnosed with Celiac disease I must of had it my whole life. I'm 35 I've always had severe stomach problems, in and out of hospitals and misdiagnosed until now. My small intestine is severely damaged I'm now waiting to see a dietitian and my specialist wants to see me again in 2 weeks. How do some of you deal with the pain of the healing process and what helps you? I'm in so much pain?

I recently got diagnosed with Celiac disease I must of had it my whole life, in 35 I've always had severe stomach problems in and out of hospitals and misdiagnosed until now. My small intestine is severely damaged in now waiting to see a dietitian and my specialist wants to see me again in 2 weeks. How do some of you deal with the pain of the healing process and what helps you? I'm in so much pain?