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Novel Test Detects Celiac Disease in Borderline or Negative Cases

By: Peter on March 16, 2011.

Current diagnostic tests for celiac disease rely on the detection of anti-tissue transglutaminase 2 plus anti-endomysial antibodies, and are reliable in most cases. Nevertheless, a biopsy is still required for confirmation and evaluation of the severity of the disease. No test is infallible, however, and there are a significant number of cases of “borderline” or “false-negative” antibody tests.

Transglutaminase can adopt two “conformations”

It is known that tissue transglutaminase 2 protein can exist in two “conformations” (or shapes) that can flip from one to the other. In a recent scientific paper by a Finnish research group, diagnostic tests have been developed which are specific for either the “closed” or “open” conformations of this enzyme.

Antibody specific for the “open” conformation of tissue transglutaminase 2 is more sensitive than conventional diagnostics

In addition to confirming cases detected with traditional assays, the new antibody was able to correctly identify 60% of cases of celiac disease which had previously shown negative or ambiguous antibody diagnostic results. This allowed the authors to detect active disease non-invasively.

As with all such studies, these promising results will need to be replicated elsewhere, and it will take time for these research laboratory results to translate into reliable diagnostic tests that can be used routinely.

Source:

Serodiagnostic Assays for Celiac Disease Based on the Open or Closed Conformation of the Autoantigen, Transglutaminase 2.

K Lindfors, O Koskinen, K Kurppa, K Laurila, P Collin, K Haimila, J Partanen, P Saavalainen, M Maki, and K Kaukinen
Pediatric Research Center, University of Tampere and Tampere University Hospital, Tampere, Finland.

J Clin Immunol, March 9, 2011

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4 comments to Novel Test Detects Celiac Disease in Borderline or “Negative” Cases

  • Ann Hayes

    Is tTransglutimate IgA the same test as the one you mentioned, tissue Transglutimate 2 ?

    And are they the same test as Extratransglut IgA ?

    I’m out in the reeds looking for a diagnosis. Thank you.

    • Peter

      Hi Ann,
      The work described in this paper is still at the resaerch stage, so the test is not currently available for general use.
      What I find exciting is that in the future, such a test may allow the detection of cases of borderline celiac disease which would otherwise be missed. It seems to me that it might be great to diganose celiac disease at an earlier stage—perhaps the intestinal damage might be more reversible if caught early.

      Good luck in getting a clear diagnosis: there are a number cases where patients have concluded that they are gluten-intolerant, but the diagnostic tests have been ambiguous.

  • NoGlutenEver

    try cryrexlabs

    • Peter

      Hi NoGlutenEver,
      I think you may be referring to commercial diganostic tests available from Cyrexlabs. As I mentioned in my comment to Ann Hayes, the test developed by this laboratory is still at the research stage, and is not currently available for general use.
      P.

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