In Vitro Method For Diagnosis

[ravenwoodglass]

I don't know how long it will be until doctors start to use this method routinely but hopefully it won't be too long. It would negate the need for any gluten challenge and be better for diagnosis than a hit or biopsy. You can find the complete article at the link.

In Vitro Gliadin Challenge: Diagnostic Accuracy and Utility for the Difficult Diagnosis of Celiac Disease

OBJECTIVES: Diagnosis of celiac disease is difficult when treatment with gluten-free diet (GFD) is started before diagnosis and/or when the results of tests are inconsistent. The objective of this study was to evaluate the in vitro gliadin challenge.

METHODS: The study cohort included patients without celiac disease (negative controls, n=57), patients with celiac disease (positive controls, n=166 untreated and n=55 on GFD), and patients with difficult diagnosis (n=59). All patients underwent endoscopy for collection of duodenal samples, which served for the diagnosis of celiac disease and for the in vitro evaluation of the gliadin-induced mucosal expression of seven inflammatory markers: PY99, ICAM-1 (intercellular cell adhesion molecule), HLA-DR, CD3, CD25, CD69, and transglutaminase 2 IgA. Diagnostic work-up for celiac disease included the search of specific serum antibodies. Patients of the difficult diagnosis group were asked to stop GFD for repeated search of these antibodies under untreated conditions. The area under the receptor-operated curve (ROC) was used for statistical analyses on accuracy.

RESULTS: HLA-DR had the highest accuracy for celiac disease diagnosis in analyses on negative controls and positive controls also excluding patients on GFD (area under ROC=0.99). Accuracy of test did not increase combining data of HLA-DR with data of other markers. Findings were similar in the 39 patients of the difficult diagnosis group undergoing the search celiac disease-specific antibodies under untreated conditions.

CONCLUSIONS: The in vitro response of mucosal HLA-DR to gliadin is an accurate tool for the diagnosis of celiac disease also in patients with difficult diagnosis.

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[beachbirdie]

I don't know how long it will be until doctors start to use this method routinely but hopefully it won't be too long. It would negate the need for any gluten challenge and be better for diagnosis than a hit or biopsy. You can find the complete article at the link.

Wow.

Just. Wow.

It would be awesome to see this in practice! So much suffering in people who are sick but diagnostic methods miss them.

Thanks for posting!

[Ninja]

This sounds great! I can't wait until something like this becomes a regular practice. Yay science!!

[Bubba's Mom]

They need better testing..that's for sure. I wonder how long it will take to get this the norm for testing? At least someone is working on it!

[Skylark]

Wow, maybe I could finally get tested without poisoning myself.

[ravenwoodglass]

Wow, maybe I could finally get tested without poisoning myself.

I hope they start doing this test routinely with all endos including those on folks still on gluten. I imagine there are a lot of folks with the label gluten intolerant because of negatives endos that would have been diagnosed celiac instead.