Letter: complications of coeliac disease despite a gluten‐free diet – authors' reply

Abstract

have widely variable levels of Adnab-9 antigen in stool water, all patients on GFD but one had very low levels of Adnab-9 binding. This decrease parallels the greatly diminished risk for developing GI malignancies such as oesophageal cancer or small bowel adenocarcinoma in patients with GFD. Together, this suggests that Adnab-9 might be a novel marker to predict risk of malignancy in patients with CD. In summary, there is clear need for objective biomarkers to predict cancer risk in patients with CD. Our results suggest that Adnab-9 immunoreactivity might serve this purpose. The observed decrease in Adnab-9 binding with GFD was similar to previously observed decrease in antitissue transglutaminase antibodies. However, as Adnab-9 is a premalignant marker, we hypothesise that Adnab-9 detection in stool water may be a more accurate and specific means to detect patients with CD who are at high risk to develop small bowel cancers. Prospective studies are needed to further investigate these ideas.