Q&A: Celiac Disease Blood Test

Dear Today’s Practitioner,

“I’m confused about your article on Celiac disease or at least the first paragraph before the article in your newsletter (New ELISA/ELISPOT Blood Test for Celiac). The FDA approved a blood test for celiac disease back in 2004 (by Immco Diagnostics off the top of my head). But your newsletter lead in to the article makes it sound like a blood test for celiac is a new thing. Can you clarify this for me?”

Thanks,

Lisa A Lundy

Past Executive Director of the Integrative Medicine Consortium, Author of The Super Allergy Girl™ Allergy & Celiac Cookbook,Public speaker and Mom.

Thank you Lisa for your question. We circled back with ImmusanT to get an answer to your question.

Warmly,

Kimberly Lord Stewart, Editor and Director of Content for Today’s Practitioner

Answer:

Current blood tests supporting the diagnosis or exclusion of celiac disease include serology and genetic  tests, their clinical role is largely to triage patients who require further investigation, i.e. small bowel biopsy, while the patient is regularly consuming gluten. For adults and most children, there is no substitute for small biopsy when making a definitive diagnosis of celiac disease and the requirement for life-long gluten free diet. It has been proposed some children do not require biopsy if they show levels of tTG-IgA over 10x higher than the upper level of normal, have supporting genetic studies, and who have “typical” gastrointestinal symptoms. The blood test recently described is based on detecting T cells reacting to peptides in gluten that circulate in blood after oral gluten challenge in patients with celiac disease.

For these gluten-reactive T cells to circulate at high enough levels to be detected patients must be following a strict gluten free diet. Hence, the research study described a prototype blood test that detects the T cells that cause celiac disease, potentially a definitive test, for patients who would otherwise require a prolonged oral gluten challenge to cause intestinal injury and establish the diagnosis by intestinal histology. The blood T cell test for celiac disease does not have regulatory approval but provides proof of concept that T cell tests may become a new class of highly specific diagnostics and monitoring tolls for T-cell mediated diseases such as celiac disease.

Leslie J Williams

President & CEO

ImmusanT, Inc.