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Found 12 results

  1. This article originally appeared in the Autumn 2010 edition of Journal of Gluten Sensitivity. Celiac.com 01/10/2011 - As an author, researcher, and gluten-free advocate, I work hard to raise awareness for celiac disease and gluten issues, particularly when it comes to increasing the diagnosis rate. Part and parcel of improving diagnosis is proper testing. Evidence is mounting that indicates that blood testing may not be the most effective way to test for celiac disease, and I would recommend that people who suspect they have celiac disease to check with their doctors about other testing options. Celiac disease, which is essentially an autoimmune reaction to gluten, a protein found in wheat, barley, and rye, affects approximately three million Americans, but according to estimates, only three percent of them have been properly diagnosed with the disease. Once celiac disease is diagnosed, treatment is simple—following a gluten-free diet. With so many American celiacs going without a diagnosis, this painful and potentially fatal autoimmune disorder, with its easy method of treatment, attention needs to be focused on effective, efficient testing. Although awareness of celiac disease and gluten-free living is increasing in the various medical fields, accurate and reliable testing has not been definitively tackled or uniformly implemented by medical practitioners. Currently a popular method of testing is a blood test, but some people with celiac disease can get blood testing many times and the results will nevertheless be negative. Although blood testing has been successful in diagnosing some people with celiac disease, this method is inaccurate at least 80 percent of the time, according to Dr. Datis Kharrazian, Blood Chemistry Seminar instructor and the formulator for Apex Energetics, Inc. supplements. To understand how blood testing works, a basic grasp of the workings of the immune system is essential. Antibodies are part of the immune system and designed to attack specific antigens, or invaders, of the body. Tests can be conducted that find an increase of antibodies in the system, which are on the prowl for certain foreign invaders. Specifically, anti-gliadin, or anti-gluten antibodies, can be tested for; when these exist in the system in large amounts, it is a sign of the autoimmune disorder, celiac disease. Although this may sound workable in theory, in practice blood testing is insufficient and inaccurate due to the fact that the autoimmune response doesn’t occur in the blood stream, but in the small intestine, as the immune system attacks this organ’s absorptive finger-like structures called villi which line the inside. Thus, for the sake of reliability, this suggests that testing should be focused on the gut. So what method can we turn to? Fortunately, there is another method apart from an intestinal biopsy, which is an invasive as well as expensive procedure. It turns out that the immune cells which surround the gut also can be located in large numbers in the stool, making a stool anti-gliadin antibody test a reliable alternative to blood testing. Stool testing may be more accurate than blood testing and is more convenient. One doesn’t need a doctor’s prescription for the test, which can be conducted in the privacy of one’s own home with an online-ordered kit from EnteroLab, which according to its website, is “a registered and fully accredited clinical laboratory specializing in the analysis of intestinal specimens for food sensitivities.” Enterolab offers the Anti-Gliadin Antibodies Stool Test as well as additional tests which can be ordered may be important diagnostic tools for people who have celiac disease or gluten-sensitivity. These additional tests include the Tissue Transglutaminase Stool Test, which tests whether gluten is actively attacking the intestine and other tissues, the Malabsorption Test, used to determine whether the intestine is malabsorbing nutrients due to the autoimmune reaction to gluten, or the Celiac and Gluten-Sensitivity Gene Test. The lab also offers a Milk Sensitivity Test, which tests for reactions to casein, a milk protein With millions of celiac Americans living with their disease undiagnosed, we can’t afford to waste time with inaccurate and inefficient testing. The anti-gliadin antibodies stool test, so easily available to the public, is a great stride forward for the celiac community. Talk with your health care provider today about this alternative to celiac blood testing.
  2. Celiac.com 06/26/2014 - Imagine being able to go to a party, or a restaurant, and test any food on your plate for gluten. A company called 6SensorLabs is developing a gluten sensor based on existing protein sensing technology that is already commercially available and proven to work. The company is looking to design a gluten test that can be used with all types of food. The portable test would work by placing a sample of food would be placed in a disposable pod and placing the pod in a sensor. Once activated, the device would tell you, in two minutes or less, if the food sample contained any gluten over the FDA standard of 20 ppm gluten or more. The sensor could also be used to detect gluten in any packaged foods. The sensor is designed to test a specific section of food on your plate, or a sauce, soup or liquid. It would not be able to detect traces of gluten that might be hiding somewhere else on your plate. While the product would have its limits in this respect, it would give users the ability to detect gluten in many cases. Would you want such a tool? Would it be helpful for you?
  3. Celiac.com 10/24/2012 - Doctors can face challenges when attempting to diagnose celiac disease in patients who have already begun a gluten-free diet, and/or when the results of tests are inconsistent. To better understand this problem, a group of researchers set out to assess the benefits of an in vitro gliadin challenge. The research team included Raffaella Tortora, MD, Ilaria Russo, PhD, Giovanni D. De Palma, MD, Alessandro Luciani, PhD, Antonio Rispo, MD, Fabiana Zingone, MD, Paola Iovino, MD, Pietro Capone, MD and Carolina Ciacci, MD. The study cohort included 57 patients without celiac disease, 166 patients with untreated celiac disease, 55 patients with celiac disease on a gluten-free diet, and 59 patients with challenging diagnosis. The team provided all patients with 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. Researchers asked patients in the challenging diagnosis group to stop gluten-free diet to facilitate the search for these antibodies under untreated conditions. They used the area under the receptor-operated curve (ROC) for statistical analyses on accuracy. For patients with and without celiac disease (not including those on a gluten-free diet) HLA-DR offered the best accuracy for diagnosing celiac disease (area under ROC = 0.99). Combining the data from the HLA-DR with data of other markers did not increase test accuracy. The team found similar results in the 39 patients of the difficult diagnosis group undergoing the search celiac disease-speciï¬c antibodies under untreated conditions. In vitro testing of mucosal HLA-DR to gliadin is an accurate tool for the diagnosing celiac disease, and also works in patients who are hard to diagnose. Source: Am J Gastroenterol 2012; 107:111–117; doi:10.1038/ajg.2011.311; published online 27 September 2011
  4. There are two classes of antibodies seen in untreated celiac disease. Antibodies directed against a fragment of gluten called gliadin, and antibodies directed against a particular tissue in the body itself. The two main areas in the body which can be attacked by its own antibodies are the aendomysial (the covering of muscle), and the reticulin ( the framework for kidney and liver), but there are others. To conduct the test, 5ccs of blood is drawn from the patient, and the blood cells are removed. The gliadin test is usually an automated machine-read test, which means there is little room for interpretor error. However, currently in the USA there is no standard methods for conducting the test, or normal ranges for the results. The endomysial tests are more dependent on the experience and ability of a pathologist who looks at a pattern of staining produced by the patients serum on a slice of monkey esophagus. While this test is done in similar way in most labs, there are many differences in how the results are interpreted. How good are these tests? If all of the blood test results are positive a celiac disease diagnosis is 90% accurate. However, there are several circumstances in which the tests can be inaccurate. IGA and IGG are two different varieties of antibodies which are produced by most peoples immune systems. There is a different blood test for each of the antibodies. Of the two tests, the IGA gliadin and IGA endomysial tests are the most accurate. However, this test can become negative relatively quickly after going on a gluten-free diet (3-6 months), which can cause a false negative test result. The IGG is less specific, and can sometimes be positive in non-celiacs. Also, about 4% of celiacs have no IgA at all! For these reasons it is very important that both tests are done for an accurate diagnosis. The biopsy is still considered the "standard candle" to confirm a blood diagnosis, and give a 100% sure diagnosis. For all tests for celiac disease it is necessary that one is on a gluten-containing diet, or false-negative test results could be given. Blood tests may also be useful in following up a known celiac and confirm that the diet is indeed free of large amounts of gluten. Also, because of the lack of standardization, keep in mind that blood test results may not be directly comparable from one lab to the next.
  5. Celiac.com 06/10/2013 - Researchers have known for some time that immunoglobulin G antibodies against deamidated gliadin peptides are about as accurate as tissue transglutaminase and endomysium autoantibodies in diagnosing celiac disease in adults. However, not much is known about their predictive value in infants with a suspected gluten enteropathy. A team of researchers recently set out to determine if antibodies to deamidated gliadin peptides could be an accurate predictor of celiac disease in infants. The research team included S. Amarri, P. Alvisi, R. De Giorgio, M.C. Gelli, R. Cicola, F. Tovoli, R. Sassatelli, G. Caio, and U. Volta. They are affiliated with the Pediatric Unit, IRCCS - Arcispedale Santa Maria Nuova, Reggio Emilia, Italy. To test whether deamidated gliadin immunoglobulin G antibodies are more reliable than traditional tests for screening celiac disease in infants, the researchers tested 65 children under 2 years of age for deamidated gliadin immunoglobulin G, tissue transglutaminase and endomysium immunoglobulin A, and gliadin immunoglobulins A and G. The group included 42 infants with malabsorption, along with 23 infants as control subjects. Thirty-seven of the 42 children with malabsorption had deamidated gliadin antibodies, associated with tissue transglutaminase and endomysial antibodies in 33, and with gliadin immunoglobulins A and G in 21 and 29, respectively. The team conducted intestinal biopsy in 34 of the 37 children who tested positive for deamidated gliadin antibodies. Thirty-two of the 34 showed villous atrophy consistent with celiac disease, while one of the remaining two had a Marsh 1 and the other showed normal mucosa. The control group showed only gliadin immunoglobulins A (4.3 %) and G (39.1 %). The results showed that deamidated gliadin, tissue transglutaminase and endomysial antibodies were significantly more sensitive for celiac disease than gliadin immunoglobulins G and A. High levels of deamidated gliadin antibodies correlated with severe intestinal damage. For infants, deamidated gliadin antibodies showed a higher diagnostic accuracy for celiac disease than gliadin antibodies. High levels of deamidated gliadin antibodies are good predictors of severe gluten-dependent duodenal damage. Source: J Clin Immunol. 2013 Apr 5.
  6. IMMCO Diagnostics serves the entire US and is located in Buffalo, NY. Their phone number is 800-537-TEST. IMMCO sends specimen collection kits free of charge to doctors, clinics, etc. nationwide. When the sample is taken, the doctor places it in the appropriate tube, seals it, and returns it either by business reply mail or FedEx. Results are generated within 24 hours of receipt. Each collection kit includes a Test Request Form which lists the entire catalog of tests and a Fee Schedule. IMMCO was established in 1971. The staff prides itself on depth of knowledge and expertise in this field. Most of the tests have been established on the basis of original research, and IMMCO continues to invest a great deal of its resources in R&D. President, Dr. Vijay Kumar, is one of the foremost experts in autoimmunity. Kevin Lawson can supply more information about the company. They have newsletters and technical information available for interested parties, and, of course, are eager to supply interested doctors with collection kits. You can contact him at: IMMTEST@AOL.COM IMMCO Diagnostics, Inc., Specializing in Autoimmune Disease Diagnosis.
  7. Celiac.com 07/26/2012 - For people with celiac disease, the average delay from first symptoms to professional diagnosis is almost 12 years. Moreover, once those people seek medical attention, there is a high risk of misdiagnosis. In fact, researchers estimate that seven cases of celiac disease go undiagnosed or misdiagnosed for every case that is correctly identified. Current tests for celiac disease require a doctor to conduct a biopsy, followed by a professional analysis of the biopsy results, usually at a specialized lab. Using this method, each test is invasive, often takes several days to produce results, and costs many hundreds of dollars. That is all set to change thanks to a pioneering new testing system that offers quick, accurate, cost-effective diagnosis and monitoring of celiac disease. The pioneering new test was developed with EU-funding, and will soon undergo clinical trials in Slovenia. If those trials are successful the test should be available in hospitals and clinics across Europe and elsewhere within a few years. The technology was developed in the celiac disease-Medics project by a consortium of 20 partners with funding from the European Commission. The system is the result of a confluence of innovative technologies from several scientific disciplines including microfluidics, nanotechnology and genetic testing. In addition to celiac disease, the technology can also be used to diagnose and monitor a wide variety of other diseases, including autoimmune disorders, such as rheumatoid arthritis, spondylitis, thyroiditis, and even cancer - basically any disorder that can be detected by looking for DNA or protein markers. Before celiac disease-Medics, explains project coordinator Ciara O'Sullivan, a research professor in the Nanobiotechnology & Bioanalysis Group at Universitat Rovira i Virgili in Spain, "there was nothing like this available for celiac disease." Rather than costs of several hundred dollars for a normal biopsy and analysis for celiac disease, the new celiac disease-Medics test will cost less than twenty Euro, and the biomedical interface device a one-time clinic expense of about 6,000 Euro. Instead of an invasive biopsy, the new test requires only one drop of blood placed into a device that looks like a credit card, but incorporates several innovative components: a micro-structured fluid network for precise control reagents, a specially adapted surface for capturing the biological components being sought, and an electrically driven sensor system that provides fast detection. Once the sample is taken, the disposable device will be placed into a biomedical interface instrument and analysis of the blood sample is carried out in a matter of minutes. Results can then be immediately output to the hospital information system and added to the patient's electronic health record (EHR). Prof O'Sullivan says that the device provides both DNA testing - specifically for variants of the HLA gene associated with the disease - and testing for gluten antibodies. This is important, because testing either alone can return false positives. Testing for both means the results ensures accurate results. Because the device can detect gluten antibodies, it can be used to monitor the patient's response to gluten-free treatment Trials will be conducted over the summer on two to three hundred patients at University Medical Centre Maribor in Slovenia. Results will be compared to the results of celiac tests done with analyzed tissue samples from biopsies. 'We hope to have a product on the market within two years,' Prof O'Sullivan says. 'We are also looking to launch a follow-up project, probably with public funding, to adapt and extend the system to test for and monitor many other types of diseases.' Source: Cordis Europa
  8. Celiac.com 06/15/2012 - Diagnosing celiac disease can be challenging for doctors if a patient has already started a gluten-free diet, and/or when test results are inconsistent. A research team set out to evaluate the in vitro gliadin challenge in such patients. Researchers included Raffaella Tortora MD; Ilaria Russo PhD; Giovanni D De Palma MD; Alessandro Luciani PhD; Antonio Rispo MD; Fabiana Zingone MD; Paola Iovino MD; Pietro Capone MD; and Carolina Ciacci MD They are variously affiliated with the Department of Clinical and Experimental Medicine at Federico II University of Naples in Naples, Italy; the Department of Surgery, Endoscopy Unit at Federico II University of Naples in Naples, Italy; the Institute of Pediatrics at the University of Foggia in Foggia, Italy; and the University of Salerno, School of Medicine, Gastroenterology at Campus di Baronissi in Salerno, Italy. For their study, the team included 57 patients without celiac disease (negative controls), 166 patients with untreated celiac disease and 55 patients with celiac disease following a gluten-free diet (positive controls), and 59 patients with difficult diagnosis. The team conducted duodenal biopsies on all patients which provided the data for diagnosing the 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. As part of their diagnostic work-up for celiac disease, the team included a test for specific serum antibodies. The team asked patients in the difficult diagnosis group to discontinue their gluten-free diets to that they could test for antibodies under untreated conditions. To maintain statistical accuracy, the team used the area under the receptor-operated curve (ROC) to analyze the results. They found that HLA-DR was most accurate in diagnosing celiac disease on negative controls and positive controls, excluding patients on a gluten-free diet (area under ROC=0.99). Test accuracy did not increase by combining HLA-DR data with data of other markers. The results were similar in the 39 patients of the difficult diagnosis group who underwent the test for celiac disease-specific antibodies under untreated conditions. Finally, the results showed that in vitro response of mucosal HLA-DR to gliadin is an accurate tool for diagnosing celiac disease, including in patients with difficult diagnosis. Source: The American Journal of Gastroenterology. 2012;107(1):111-117.
  9. Question: Do I have to re-introduce gluten in order to have an accurate gluten sensitivity test done? Answer: Yes and No If a person knows they are sensitive to gluten and have gone on a gluten-free diet, and want to know if they can have gluten again, then a challenge is in order (reintroduce gluten). THIS IS STRONGLY NOT RECOMMENDED. The gluten challenge has many cases of people who were damaged (some permanently) from the reaction to reintroducing gluten Even Small Amounts of Gluten Cause Relapse in Children With Celiac Disease, Journal of Pediatric Gastroenterology and Nutrition 34:26­30, and it is no longer a requirement for diagnosing celiac disease Am J Clin Nut 1999;69:354-65. Among 374 children in whom celiac disease was diagnosed before the age of 2, 5% developed an auto-immune disorder while on a gluten-free diet. Of those who went gluten-free, had years of no symptoms, then went back on a gluten-containing diet, 3.65% prevalence of systemic auto-immune disease with less than 12 months of eating gluten 9.1 % prevalence for 13-36 months of eating gluten again 26.3% prevalence for > 36 months of eating gluten again This means 1 out of 4 people who were sensitive to gluten, went gluten-free and eliminated all of their symptoms developed auto-immune diseases within 3 years of eating gluten again. Gastroenterology 1999;117:297-303. If you know you are Gluten Sensitive, and you've gone on a gluten-free diet, and you want to know "am I better", then testing will confirm you are being successful in 'quieting down' the inflammatory cascade that occurs with gluten sensitivity and which sets one up for the development of autoimmune disease. And if you want to 'throw the dice', if you want to gamble that you won't be the '1 out of 4' who develops an autoimmune disorder, then you would want to first check and make sure your tests are negative while being on a gluten-free diet, then do your gluten challenge and test again 1-2 months later. Once again, not recommended to do this. Many people do not develop celiac disease until later in life. So even if one tests negative now, if they're genetically vulnerable, celiac disease can develop at any time as a result of the body no longer able to handle the stress of life. Something will be the 'straw that broke the camels back' and a person who has had negative tests in the past will begin producing the antibodies and begin the tissue destruction that will eventually manifest as Gluten Sensitivity and/or celiac disease. So in this scenario, these people want to know if they're genetically vulnerable. The question is, am I sensitive to wheat? When a test looking at Gluten Sensitivity comes back positive, it tells us the immune system is reacting to an exposure to gluten. And if you are not eating gluten, it's one of a few things: A hidden exposure to gluten A cross-reactive food A cross-reactive virus or bacteria A poorly functioning GI Tract (consider Array #2-Intestinal Antigenic Permeability Screen) An unknown cause (potentially Refractory Sprue).
  10. Celiac.com 08/04/2011 - People who use direct-to-consumer genetic tests sold by deCODEme and 23andMe frequently receive misleading results, because these tests do not accurately predict risk factors. So say two geneticists, who conducted two studies that assessed the accuracy of test predictions relative to various known disease risks. Presenting their results from both studies at the annual conference of the European Society of Human Genetics, the scientists have gone so far as to call for a ban on the tests. The first study was conducted by Rachel Kalf, from the department of epidemiology at Erasmus University Medical Centre in Rotterdam. Using established genotype frequencies, Kalf simulated genotype data for 100,000 individuals. She then used the formulas and risk data provided by the test companies to predict risks for eight common multi-factorial diseases: age-related macular degeneration (AMD); atrial fibrillation; celiac disease; Crohn's disease; heart attack; prostate cancer; and Type 1 and Type 2 diabetes (T2D). Kalf noted that both companies assigned an increased risk to a substantial part of the test group. However, Kalf says the risk of disease in this group was often substantially lower than the risk in the rest of the study group. For example, for AMD, which has the highest predictive ability of all eight diseases, both companies assumed that the risk in the population was around 8 percent. However, among subject assigned an increased risk factor, 23andMe estimated risk at 16 percent, while deCODEme's estimated that 19 percent would develop AMD. This contrasts with a risk of about 4 percent for the rest of the study population. This means that people in the higher risk group may have a four-fold increased risk of disease, but "are still far more likely not to develop the disease at all," explains co-researcher Cecile Janssens. For T2D, using the risk levels of about 25 percent assigned by the companies, 32 percent of those in the higher risk group would actually develop T2D compared to just 22 percent in the rest of the study population. "This difference in disease risk is too small to be of relevance," says Janssens. Source: Science Blog
  11. Am J Gastroenterol. 2006;101(7):1597-1600. Celiac.com 08/14/2006 – In an effort to increase the diagnosis rate of celiac disease, researchers in Italy conducted a study to determine the accuracy of two of the new "at home" type rapid commercial celiac disease test kits--both of which require only one drop of whole blood to gain results. Both of the kits detect IgA-IgG anti-human-transglutaminase antibodies (anti-h-tTG) in serum and IgA anti-h-tTG antibody in a single drop of whole blood. The researchers analyzed the serum samples of 114 biopsy-confirmed celiacs, 120 healthy controls, 20 first-degree relatives of celiacs, and 75 diseased controls, and compared them to the standard enzyme-linked immunosorbent assay testing method. Whole blood samples were taken in 51 of the biopsy-confirmed celiacs and 100 controls. The serum-based test was found to be positive in all 114 celiac patients, or 100% sensitivity, and among the controls which included three with celiac disease there was 94.9% sensitivity. The accuracy of the blood drop-based assay testing was positive in 46 of the 51 celiacs tested, which equals 90.2% sensitivity. The accuracy, however, is actually higher because five of the patients who tested negative had total IgA deficiency, so the real sensitivity level is actually 95.8%. All 100 controls tested negative which equals 100% specificity. Given the high degree of accuracy of the two commercial test kits that were evaluated the researchers conclude that general practitioners should utilize these low cost kits during standard office visits whenever celiac disease is suspected.
  12. J Pediatr. 2004 May;144(5):632-6 Celiac.com 05/10/2004 - Italian researchers compared the serum samples from 39 celiac disease patients who were diagnosed with celiac disease after their first biopsy with 32 controls who had normal duodenal mucosa and 32 healthy volunteers. Salivary transglutaminase autoantibodies were detected in 97.4% of the patients who had celiac disease, and in 100% of their corresponding serum samples. All of the 32 healthy volunteers tested negative for both serum and saliva transglutaminase autoantibodies. The researchers conclude "This study demonstrates that it is possible to detect salivary transglutaminase autoantibodies in celiac disease with a non-invasive, simple to perform, reproducible and sensitive method."
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