New approach to celiac testing identifies more Australians at risk

Dr. Jason Tye-Din from the Walter and Eliza Hall Institute and colleagues have developed a new approach to detecting celiac disease, revealing this immune disorder is far more common than previously recognized. Credit: Walter and Eliza Hall Institute

Australian researchers have developed a new approach to detecting coeliac disease, revealing this immune disorder is far more common than previously recognised.

In a study of more than 2500 Victorians the researchers combined traditional antibody testing (measuring the immune response to gluten) with an assessment of specific markers. They found more than half of Australians had for developing . The research is published online today in the journal BMC Medicine.

Dr Jason Tye-Din from the Immunology division at the Walter and Eliza Hall Institute and Dr Bob Anderson, chief scientific officer at US ImmusanT, worked with Barwon Health, Deakin University, Healthscope Pathology and the University of Queensland Diamantina Institute to develop and trial the new diagnostic approach.

Dr Tye-Din said the new approach of combining the genetic test with a panel of antibody tests would increase the accuracy of testing, decrease overall medical costs by reducing invasive diagnostic tests, and avoid medically unnecessary use of a gluten-free diet.

"Currently, bowel biopsies are recommended for anybody with positive antibody tests," he said. "In this study the inclusion of a simple genetic test helped identify a substantial number of people whose antibody tests were falsely positive and who did not actually require a bowel biopsy to test for the possibility of coeliac disease."

Coeliac disease is caused by an inappropriate immune response to dietary gluten. Gluten can be found in wheat, rye, barley and oats. When gluten is consumed, it can cause a wide range of complaints from chronic tiredness, iron deficiency, osteoporosis, itchy rash, and headaches to various digestive symptoms. Coeliac disease damages the lining of the and can lead to significant medical complications such as autoimmune disease, infertility, and cancer. Coeliac disease usually develops in childhood and is life-long, but early diagnosis and treatment can reduce the risk of adverse health complications.

Dr Tye-Din said the newly developed testing strategy showed coeliac disease potentially affected at least one in 60 Australian women and one in 80 men. Previous estimates had the number of Australians with coeliac disease as no more than one in 100. Although this study is the first to reveal that more than half of Australians have genetic risk factors for developing coeliac disease, it is not yet known why the disease develops in only some people.

Dr Tye-Din, who is also a gastroenterologist at The Royal Melbourne Hospital, said the findings were surprising and shed new light on the medical burden of coeliac disease in Australia. "It is concerning that a significant number of people in the community with coeliac disease have not been diagnosed," he said. "Accurate and timely diagnosis is important for the health of patients with coeliac disease. Making a diagnosis based on a blood test alone or commencing a gluten-free diet without a confirmatory bowel biopsy is inappropriate and can impose an unnecessary and lifelong treatment.

"Although small bowel biopsy is needed to confirm coeliac disease it is costly and invasive. Reducing unnecessary procedures is better for patients, eliminating an invasive test, and better for the economy by reducing healthcare costs," Dr Tye-Din said. "This study provides a strategy to improve the diagnosis of coeliac disease in the community by combining the benefits of antibody and genetic testing."

add to favorites email to friend print save as pdf

Related Stories

Research gives new insight into coeliac disease

Oct 11, 2012

For the first time, scientists have visualised an interaction between gluten and T-cells of the immune system, providing insight into how coeliac disease, which affects approximately 1 in 133 people, is triggered.

Vaccine trial flags challenge to celiac disease

Apr 03, 2009

An effective clinical treatment for coeliac disease (or gluten intolerance) is the ultimate objective of WEHI clinician scientist, Dr Bob Anderson. This month will see the beginning of a Phase 1 clinical trial for an experimental ...

Orange flour for gluten-free bread

Mar 11, 2013

During the processing of fruit and vegetables one third is discarded as 'waste'. The waste or by-product can be described as the core, pips and peel of the fruit or vegetable. This waste can be costly for ...

Recommended for you

Guidelines presented for diagnosing focal liver lesions

1 hour ago

(HealthDay)—Focal liver lesions (FLLs) are mostly benign, and can be diagnosed based on knowledge of their presentation, associated clinical and laboratory features, and natural history, according to clinical ...

Factors tied to neck, back pain improvement identified

6 hours ago

(HealthDay)—Observational registry-based research can inform patients and physicians about prognosis for subacute or chronic neck or low back pain, according to a study published in the Aug. 1 issue of ...

User comments