Scientists have identified biomarkers that could form the basis of the world's first blood test for
celiac disease. They discovered that exposure to gluten in people with celiac disease causes a rise
in certain inflammatory molecules in the bloodstream that correlates with common symptoms.
The current method for diagnosing celiac disease can take weeks or months. It involves people
having to consume gluten and experience the very unpleasant side effects for all of that time. A
blood test could cut that time to hours.
The biotechnology firm ImmusanT Inc., of Cambridge, MA, led the international team behind
the recent discovery, which features in the journal Science Advances.
For the first time," says co-senior study author Dr. Robert P. Anderson, Chief Scientific Officer
of ImmusanT, we have described the inflammatory reaction that patients with celiac disease
experience in the immediate hours after they are exposed to gluten."
Dr. Anderson suggests that the findings could also lead to methods that help to spot people
without celiac disease — but who have similar symptoms — and guide them to more suitable
Celiac disease is a lifelong condition that affects around 1% of people in Western countries,
according to figures from the World Gastroenterology Organization.
People with celiac disease have an adverse immune reaction to gluten, a protein that is present in
wheat, rye, barley, and foods that contain them, such as pasta and bread.
The presence of gluten in the gut causes the immune system to attack the small intestine. The
attack damages the digestive system and reduces its ability to absorb nutrients, causing a range of
The symptoms of celiac disease include bloating, diarrhea, vomiting, the presence of too much
fat in the stools (steatorrhea), anemia due to iron deficiency, and weight loss. In children, it can
also result in failure to thrive.
People with celiac disease have to follow a gluten-free diet for the rest of their lives.
Dr. Anderson and his colleagues discovered that injecting gluten peptides into people with celiac
disease led to symptoms, such as nausea and vomiting, as well as higher levels of certain
immune-system molecules. Peptides are short chains of amino acids.
The unpleasant symptoms associated with the disease are linked to an increase in inflammatory
molecules in the bloodstream, such as interleukin-2 (IL-2), produced by T cells of the immune
system," he explains.
This response is similar to what happens when an infection is present; however, for people with
coeliac disease, gluten is the trigger, he adds.
Scientists at ImmusanT identified the inflammatory molecules while running a trial of a potential
celiac treatment. They saw how the injection of gluten peptides led to symptoms that correlated
with raised levels of blood markers.
In further tests, the researchers also showed that when people with celiac disease consumed
gluten, they experienced the same rise in IL-2.
Work on using the findings to develop a simple blood test for celiac disease is already underway,
says study author Dr. Jason A. Tye-Din, an associate professor and head of celiac research at the
Walter and Eliza Hall Institute in Australia.
Dr. Tye-Din, who is also a gastroenterologist at The Royal Melbourne Hospital, adds that [f]or
the many people following a gluten-free diet without a formal diagnosis of celiac disease, all that
might be required is a blood test before, and 4 hours after, a small meal of gluten.
This would be a dramatic improvement on the current approach, which requires people to
actively consume gluten for at least several weeks before undergoing an invasive procedure to
sample the small intestine.
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