Tool For Diagnosis Of Celiac Disease Research Articles

Intraepithelial lymphocyte immunophenotype: a useful tool in the diagnosis of celiac disease.

According to new ESPGHAN guidelines, gluten challenge is considered necessary when there is doubt about the initial diagnosis of celiac disease (CD). The main aim of this study was to quantify intraepithelial lymphocyte (IEL) immunophenotype on celiac patients on gluten-containing diet (GCD) compared to those on gluten-free diet (GFD). Another aim was to evaluate the clinical utility of IELs in the CD diagnosis, especially in selected patients on GFD where diagnostic uncertainty remains. IEL immunophenotype (TCRγδ and NK-like IELs) were studied by flow cytometry in 111 children with CD (81 children with CD on GCD and 30 celiac patients on GFD) and a control group (10 children). Duration of GFD was 5.4±1.6years. TCRγδ IELs in celiac patients receiving a GCD or GFD were significantly higher (p<0.001) than in the control group. NK-like IELs in patients receiving a GCD or GFD were significantly lower than in the control group (p<0.001). We observed a permanent decrease of NK-like IELs and an increment of TCRγδ IELs after following an adequate establishment and compliance of a long-term GFD in celiac patients. Recognition of IELs changes in the intestinal mucosa on celiac patients after long-term establishment of a GFD could constitute a useful tool for CD diagnosis in various situations: in which there is doubt about the initial diagnosis and repeat biopsy is necessary (avoiding the need of gluten challenges), and in those patients with symptoms/signs suggestive of CD who maintain a low gluten diet.

Biosensors for the Diagnosis of Celiac Disease: Current Status and Future Perspectives.

Celiac disease (CD) is an autoimmune enteropathy initiated and sustained by the ingestion of gluten in genetically susceptible individuals. It is caused by a dysregulated immune response toward both dietary antigens, the gluten proteins of wheat, rye, and barley, and autoantigens, the enzyme tissue transglutaminase (TG2). The small intestine is the target organ. Although routine immunochemical protocols for a laboratory diagnosis of CD are available, faster, easier-to-use, and cheaper analytical devices for CD diagnosis are currently unavailable. This review focuses on biosensors, consisting of a physicochemical transducer and a bioreceptor, as promising analytical tools for diagnosis of CD and other diseases. Examples of recently developed biosensors as well as expectations for future lines of research and development in this field are presented.

Electrochemical immunosensor for anti-tissue transglutaminase antibodies based on the in situ detection of quantum dots

A miniaturized electrochemical biosensor array with in situ detection of quantum dots (QDs) was developed for the detection of anti-transglutaminase IgG antibodies (a celiac disease biomarker) in human sera. For the fabrication of the sensor, a 8-channel screen-printed carbon electrochemical arrays were used as transducers and modified with tissue-transglutaminase by adsorption. The immunologic reaction was carried out in a few simple steps: reaction with human serum, which contains the analyte of interest, followed by the immunoreaction with anti-human IgG labeled with CdSe/ZnS QDs and electrochemical detection of Cd2+ released from QDs. All steps were performed on the screen-printed arrays as the solid support, and the detection of Cd2+ was performed in situ after acid attack of the QDs without a transfer step by voltammetric stripping. The electrochemical response was correlated with the anti-transglutaminase IgG concentration. The developed electrochemical immunosensor is a trustful screening tool for celiac disease diagnosis discriminating between positive and negative sera samples with high sensitivity.

Small bowel capsule endoscopy, a modern tool for celiac disease diagnosis - case presentation

Abstract Celiac disease is a clinically heterogeneous disease characterized by an inadequate immunological response when patients with specific genetic phenotypes are exposed to gluten. This article presents a case of a young woman diagnosed in Gastroenterology Department of “ St. Andrew Apostle” Emergency Hospital of Constanta with celiac disease after multiple admissions into the hospital for unspecific symptoms such as pallor, fatigue, pirosis, weight loss and 1-2 soft stools/day. The history with period irregularities and infertility without a known cause, a recent unexplained bone fracture, the muscle weakness, neuropsychiatric symptoms characterized by sleep disturbances and irritability correlated with the biological features characterized by moderate feriprive anemia, Ca and Mg decreased level, thyroid autoimmune impairment and gastrointestinal symptoms raised the suspicion of an autoimmune disorder with multiple targets. The videcapsule endoscopy (VCE) revealed the specific pattern of the celiac disease: villous atrophy of jejunum, scalloping, absent folds and cobblestone mucosal pattern. Results were correlated with immunology tests results. The patient was transferred on a gluten free diet and the clinical and VCE controlsrevealed the healing of the jejunum mucosa. The VCE can be the tool for positive diagnosis of an unusual and heterogeneous celiac disease in patients with various symptoms without an apparent cause.

An electrochemical deamidated gliadin antibody immunosensor for celiac disease clinical diagnosis

The first electrochemical immunosensor (EI) for the detection of antibodies against deamidated gliadin peptides (DGP) is described here. A disposable nanohybrid screen-printed carbon electrode modified with DGP was employed as the transducer's sensing surface. Real serum samples were successfully assayed and the results were corroborated with an ELISA kit. The presented EI is a promising analytical tool for celiac disease diagnosis.

Silent celiac disease in a cohort of healthy adults

Background: Recent studies suggest that celiac disease (CD) is common in many developing countries. Because the disease may be under diagnosed in Cuba, we studied the presence of the disease in a group of apparently healthy adult.Aims/hypothesis: It was to assess for the first time, the presence of silent CD in a cohort of healthy Cuban adults individuals and to evaluate the tools for diagnosis of CD in this group.Methods: A total of 200 healthy Cuban adult from Havana City were evaluated. Tissue transglutaminase antibodies (tTGA) were determined by one-step immunochromatographic assay and by commercial ELISA kit. CD specific human leukocyte antigen (HLA) typing was performed by polymerase chain reaction amplification, using sequence-specific primers. In the subject positive for tTGA, the CD was confirmed by intestinal biopsy.Results: From the 200 studied individuals, only one subject was identified as positive by both assays, being submitted to duodenal biopsy. Morphological changes consistent with CD were found and also supported by HLA-DQ2 (HLA-DQA1*0501-DQB1*02). In the follow-up after one year, histological recovery was assessed by a second intestinal biopsy and the serological marker became negative.Conclusions: This study confirms the existence of silent CD among healthy adult in Cuba and highlights the importance of mass screening for this disease among them. The one-step immunochromatographic assay is a good tool for this purpose.

Usefulness of Antibodies to Deamidated Gliadin Peptides in Celiac Disease Diagnosis and Follow-up

The prevalence of the recently described deamidated gliadin peptide antibodies was compared with that of the routinely used antigliadin, antiendomysial, and tissue transglutaminase antibodies in the sera of 128 untreated celiac patients and 134 controls. Sensitivity and specificity for celiac disease were 83.6 and 90.3% for IgA and 84.4 and 98.5% for IgG antibodies to deamidated gliadin peptides. The new test displayed higher diagnostic accuracy than antigliadin antibodies and, although less sensitive than antiendomysial and tissue transglutaminase antibodies, showed significantly higher specificity than tissue transglutaminase antibodies (P < 0.001). Persistence of peptide antibodies after gluten withdrawal was an expression of low compliance with the diet and of the lack of improvement of the intestinal mucosa. The combined use of tissue transglutaminase and deamidated gliadin peptide antibodies seems to be a very useful tool for celiac disease diagnosis. Moreover, antibodies to deamidated gliadin peptides can be helpful in disease follow-up.

Celiac disease diagnosis in patients with giardiasis: high value of antitransglutaminase antibodies.

The main objective of this study is to assess the presence of celiac disease (CD) in patients with giardiasis and to evaluate the tools for diagnosis of CD in these patients. A total of 40 patients with giardiasis were evaluated. Celiac disease was confirmed or discarded by intestinal biopsy and serological markers. Antigliadin antibodies were determined by ELISA and antitransglutaminase antibodies by one-step immunochromatographic assay and ELISA. Out of the 40 patients with giardiasis 37 showed normal intestinal mucosa. In this group, IgA antibodies to gliadin were positive in 7 patients, yielding a specificity of 82%. All of them were negative for transglutaminase antibodies by the immunochromatographic assay and by ELISA (specificity of 100%). The remaining 3 patients showed a subtotal intestinal villous atrophy consistent with CD, however, only two presented IgA antibodies to transglutaminase and gliadin. Due to its low specificity antigliadin antibodies are not useful for the screening of CD in patients with giardiasis. On the other hand, antitransglutaminase antibodies are highly specific and sensitive. One-step immunochromatographic assay is an easy and economic alternative. The findings of villous atrophy must be supported by other markers of CD to achieve the diagnosis of CD in these patients.