Blood Test Simplifies Diagnosis of Celiac Disease

Blood for serology and cytokine release assays was drawn in the morning immediately before (d0) and on day six (d6) after commencing gluten challenge, or prior to commencing a gluten-free diet (GFD) in untreated CD patients.

Serum transglutaminase (tTG-IgA), deamidated gliadin peptide (DGP)-immunoglobulin (Ig)A and DGP-IgG were evaluated with commercial kits (INOVA Diagnostics; San Diego, CA, USA). Plasma interferon gamma (IFN-γ) levels on d0 and d6 were measured in triplicate by enzyme-linked immunosorbent assay (ELISA) and measured on an automated ELISA reader. The investigators also performed the IFN-γ ELISPOT assay and spot-forming units (SFU) in individual wells were counted using an automated AID ELISPOT reader system (Autoimmun Diagnostika GmbH; Strasberg, Germany) and results expressed as SFU per 106 peripheral blood mononuclear cells (PBMC).

The authors concluded that the whole blood cytokine release assays appear to be sensitive and specific potential diagnostic test for CD patients following GFD. As an added benefit over current diagnostic tests being performed on patients already following GFD, the mobilization of gluten-reactive T-cells specific for CD into the bloodstream requires oral gluten challenge for only three days instead of the weeks or months required for diagnosis based on abnormal small bowel histology.

Jason Tye-Din, MBBS, PhD, FRACP, a gastroenterologist and a coauthor of the study said, “A test that simplifies diagnosis for patients is likely to significantly enhance disease detection. This new diagnostic approach is encouraging and we hope that larger studies can validate these findings and establish its role in the diagnosis of celiac disease, with the possibility of avoiding intestinal biopsies for diagnosis altogether.” The study was published on January 3, 2014, in the journal Clinical & Experimental Immunology.

Related Links:
Walter and Eliza Hall Institute
INOVA Diagnostics
Autoimmun Diagnostika GmbH