A blood test will soon be enough to diagnose the celiac condition. With a simple sampling, you can avoid gastroduodenoscopy with the biopsy of duodenal villi now in use in those who discover the disease in adulthood. While in children it is already possible to make a venous sampling to understand whether or not the subject is intolerant to gluten. We talked about it with Dr. Paoletta Preatoni, Aid Autonomous Section of Clinical Gastroenterology at Humanitas.
The antibody positivity and a protein complex as markers of celiac disease
The novelty, based on research into the positivity of certain antibodies, could soon be a reality and thus make the lives of specialists and patients suffering from celiac disease very much easier.
The hypothesis was brought to light by a study published in the journal “Gastroenterology”, which stressed that adults, at the time of diagnosis, already have a positive antibody to anti-transglutaminase IgA and anti-endomysial antibodies that report the disease. Researchers from the division of gastroenterology and hepatology of the Mayo Clinic thus went to test the usefulness of a protein complex (tTG-DGP) as a diagnostic marker of celiac disease and as a marker of healing of the intestinal mucosa during a gluten-free diet.
The test demonstrated a sensitivity of 99 percent and a specificity of 100 percent, i.e. no false positives, in distinguishing celiac from healthy people.
“This study projects us towards the use of a new biomarker useful both for diagnostic purposes and for monitoring celiac disease, which, in selected subjects, could avoid the execution of duodenal biopsy for both the diagnosis and monitoring of patients with celiac disease,” said Edoardo Savarino, gastroenterologist member of the Italian Society of Gastroenterology and Digestive Endoscopy.
The need for further studies and the benefits of the new system
Before the new diagnostic method can be put into clinical practice, it is necessary to carry out further studies to assess the actual gain in terms of both diagnosis and costs.
A faster, safer and less invasive approach would help to make the diagnostic process less traumatic and easier to apply. The direct consequence that experts imagine is the “flooding” of several cases of suspected but never identified celiac disease.
“In our country – said Giuseppe Di Fabio, president of the Italian Celiac Disease Association – it is estimated that, compared to about two hundred thousand patients diagnosed to date, there are four hundred thousand people who still do not know they are celiac”.
The opinion of Humanitas
“The current diagnosis of celiac disease in adults is based on two distinct moments of serological detection of positive antibodies to antitranglutaminase and/or antiendomysium and or deaminated antigliadin and subsequent histological confirmation on duodenal biopsies obtained with EGDS – explained the specialist -. This recent article published in Gastroenterology, if confirmed by further studies and will be feasible in terms of applicability and costs, could pave the way for a future diagnostic methodology (since the test compared to others at our disposal would seem to have a sensitivity of 100%) but especially monitoring the healing of intestinal mucosa as the values correlate linearly with the degree of villare atrophy.