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New & Improved Celiac Blood test: Neo-tTg antibodies

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Apparently there is a new celiac blood test (tTg neo-epitope [tTg-neo]), which is said to be more reliable than the current favourite: (anti-tTg).

Does anyone have any more info on this test and when it will become widely available?

Some quotes that i could glean from a google search:

"More novel diagnostic antibodies for celiac disease"
In view of the multiple false positives and false negatives described for tTg-IgA and in view of the better performance of the tTg-neo compared to the tTg-IgA, in celiac disease diagnosis it is suggested that the neo-tTg should be included in the  growing  list  of  novel diagnostic  techniques  for celiac disease

 

http://www.sciencedirect.com/science/article/pii/S0022175915300727
"tTg-neo autoantibody effectiveness outperforms the tTg ones in diagnosing celiac disease." & "Comparing antibody activity as a reflection of intestinal damage, tTg-neo IgA, IgG and check antibodies, correlated better with the degree of the intestinal atrophy than tTg antibodies"

 

http://laboratory-manager.advanceweb.com/Archives/Article-Archives/Evolution-of-Celiac-Disease-Testing.aspx
the neo-epitope assay was a much better screening tool for celiac disease in pediatric and adult samples compared with assays using pure tTg"......

"It was revealed in his study that high positive results for neo-epitope antibodies correlate with the severity of mucosal damage. Therefore, he stated that confirmatory small bowl biopsy might not be needed in patients with high levels of celiac disease antibodies.......

Also the neo-epitope ELISA assay was able to identify celiac disease patients who have been tested negative with conventional antibody assays. In the same year, Tonutti demonstrated that the neo-epitope IgA test became positive earlier than anti-tTg assays.

Two years later, Bizzaro confirmed that the neo-epitope ELISA assay had a very high sensitivity and that this method for measuring anti-complex antibodies could be used as a reliable test for screening in the general population or in at-risk groups. He also stated that one could hypothesize that these antibodies were present early in the natural course of celiac disease and, therefore, had a predictive value for clinical and subclinical disease patients.

These and further studies (comprising more than 50,000 samples) demonstrated the superior performance of the neo-epitope antigen as a highly sensitive and specific screening assay for both adults and pediatrics. Due to its very good correlation with MARSH criteria, biopsy could be potentially avoided in cases of high levels of neo-epitope antibodies. Studies also demonstrated that the neo-epitope IgA antibodies represented a sensitive marker for both celiac disease and DH.

More importantly, it showed that antibodies to the neo-epitope could be positive up to 12 months earlier than anti-tTg antibodies. This shortens the time to diagnosis, which has an important impact on the health improvement status of the patients.

 

 

 

 

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This is great news!  I have been researching since you posted this.  I found this:

http://pubs.sciepub.com/ijcd/2/2/8/

It talks about the new antibody testing.  It confirms that the TTG is not able to catch all celiacs and that a full panel is best.   I have been pushing the full panel because I always test negative to the TTG even on follow-up testing.  

"Multiple serological tests are on the market and the most frequently used test is IgA-tTG. This is not sensitive enough to be used alone, and combined tests enhance detection. Several combinations have been studied but not accurately compared to each other. The most frequently used combination is anti IgG-DGP with IgA-tTG, however, increasingly the new generation of anti neo-epitope DGP+tTG IgG+IgA is being used."

It emphasizes that celiac disease is not just the classical intestinal symptoms or malnutrition:

"It has been shown that the classic intestinal clinical picture of malnutrition, chronic diarrhea and nutritional deficiencies are disappearing and extraintestinal presentations are emerging. Skin, endocrine, skeletal, hepatic, hematological, thrombophylic, gynecological, fertility, dental and behavioral abnormalities are often described. Nowadays, we are witnessing an epidemiological shift in the disease phenotype toward a more advanced age, and increased prevalence of latent, hyposymptomatic or asymptomatic behavior [12]. All these changes make the diagnosis of the disease more difficult and the reliance on symptomatology more remote [3]. These are some of the reasons why serological screening and diagnosis of celiac disease have achieved prime importance."

i have not heard of anyone using the new testing yet.  Inquiring minds want to know!  

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