A look at the first blood test for celiac disease

Researchers found that in people with celiac disease, following gluten ingestion, certain inflammatory molecules associated with clinical symptoms occur in the bloodstream. These recently discovered biomarkers are the basis for the blood test.

A clear diagnosis in a few hours is possible

A research team has recently discovered biomarkers that could form the basis for the world's first celiac disease blood test. The researchers found that in people with celiac disease, after ingestion of gluten, certain inflammatory molecules occur in the bloodstream that are associated with clinical symptoms.

The current method of diagnosing celiac disease can take weeks to months. The affected person must ingest gluten and endure the unpleasant side effects until the diagnosis is made. A blood test could shorten this process to a few hours. According to the World Gastroenterology Organisation (WGO), about 1% of the population in Western countries suffers from the disease.

Dr. Robert P. Anderson, one of the leading authors of the study, explained that "for the first time, we have recognized the inflammatory reaction experienced by patients with celiac disease in the first few hours after the gluten intake”. He considers that the discovery could also make better treatments possible for patients with similar clinical pictures.

Experts assume that the official figures for patients diagnosed with celiac disease do not correspond to complete reality and that the number of unreported cases is significantly higher.

Increase in inflammatory molecules in blood circulation

Dr. Anderson’s team recognized that an injection of gluten peptides in patients with celiac disease caused clinical symptoms such as dizziness or vomiting. In addition, higher amounts of certain molecules were detected in the immune system.

"The unpleasant symptoms associated with the disease are due to an increase in inflammatory molecules in the bloodstream. For example, interleukin-2 is produced by the T-cells of the immune system," explained Dr. Anderson. He added: "This is like the reaction to an infection. However, gluten is the trigger for people with celiac disease.”

Researchers are already working on the blood test

The research team came across the inflammatory molecules during the search for possible treatment measures against celiac disease. The researchers observed how the injection of gluten peptides caused symptoms associated with an increased amount of blood markers. In other tests, the researchers found the same increase in IL-2, among others, after patients with celiac disease had ingested gluten.

Dr. Jason A. Tye-Din noted that scientists were already working on using the research results to develop a blood test for celiac disease. He added: "For the many people who follow a gluten-free diet without a formal diagnosis of celiac disease, a blood test before and four hours after taking a small gluten-containing meal could provide certainty. This would be a drastic step forward from the current situation where affected people have to eat gluten for several weeks and then go through an invasive procedure."

Source:
Gautam Goel G et al., Science Advances 2019; 5(8): eaaw7756. doi:10.1126/sciadv.aaw7756.

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