How Antibody Tests Can Detect Celiac Disease in Children

Although celiac disease seems to be genetic, it is not always expressed clinically. Studies who have looked at its genetic predisposition have determined a certain prevalence of the disease in asymptomatic relatives of the patient's first degree and monocyte twins. However, until now the form of genetic inheritance remains unknown.

In celiac disease, symptoms such as stomach pain, diarrhea, vomiting, swollen belly, lack of appetite are some of the most common issues that can be present. Despite the frequency with which it occurs in the population, there are still doubts about it that should be resolved.

From a scientific standpoint, celiac disease is considered the "permanent intolerance to wheat gluten, barley, rye and probably oats," characterized by an immune-based inflammatory reaction in the mucosa of the small intestine that hinders the correct assimilation of nutrients. In other words, the proteins of the mentioned grains damage the intestinal villi in charge of absorbing the macro and micronutrients of the food. Although, as the popular proverb says, each person is different, and symptoms resulting from this condition will vary depending on each patient. Some patients would have a mild reaction, while others would have a more severe reaction to gluten. 

In children it is common to find defects in tooth enamel, anorexia and brittle hair. In adolescence, a teenage girl could experience a late first period, headaches, and/or constipation, while an adult could experience depression, dermatitis herpetiformis, miscarriages and/or infertility, osteoporosis, and iron deficiency anemia. 

How is celiac disease diagnosed?

In most cases, it is through a clinical examination and a blood test that makes it possible to establish a diagnosis of suspected celiac disease. These studies should include serologic markers of celiac disease, such as antigliadin, antiendomysial and tissue antitransglutaminase antibodies. Although this system is effective in many cases, it is not always possible to determine the pathology only with them and it is necessary to resort to an intestinal biopsy (an extraction of a small part of the tissue of the small intestine through a device that is inserted through nose and mouth without anesthesia).

However, there are always new methods being investigated in order to determine whether someone suffers from celiac disease or not. Experts focus on this problem since there are many patients who are “asymptomatic” and do not display those conditions that characterize people with celiac disease in most cases.

According to the latest studies on this area, there is an antibody test that can help detect celiac disease, especially in asymptomatic children. The screening is called Serum TG2A, which can possibly advance the diagnosis of this condition in children. This finding was possible thanks to Michelle Jansen and her colleagues at the University Medical Center in Rotterdam where the team that conducted a study focused on the children's TG2A levels and how they can work as source information to predict whether someone can be suffering from celiac disease.

The test and its results

During the test, a total of more than 4,400 children were screened for serum TG2A with at leas 1.4% (a total of 60 children) who were positive TG2A. All these children were around 6 years old. The test consisted of researching medical history along with serum TG2A and a complete physical examination. Also, those participants with positive serologies underwent duodenal biopsies and were compared with a certain degree of enteropathy in their small intestines.

According to the tests, these were the results found:

• 60.8% of the children were found to suffer from celiac disease
• 19.6% did not have celiac disease
• 19.6% were considered to be at risk for celiac disease in the future 

It is worth mentioning that these results for people considered to be potential celiac patients in the future were inconclusive. It was also seen that the investigators found that children suffering from celiac disease had lower body mass indexes than children that were not found to suffer from celiac disease. However, neither of the groups that were studied were found to have relevant differences in their gastrointestinal symptoms, and both were considered asymptomatic.

According to the experts, it is a solid statement to say that most asymptomatic children found positive in TG2A developed celiac disease within 3 years after the screenings, which makes the evaluation highly reliable.

Most experts consider this finding regarding TG2A screening as a relevant and consistent advance in celiac disease diagnosis, especially given the tendency of some children to be completely asymptomatic.

What is the current treatment of celiac disease?

Fortunately, it is not only the diagnosis process that is in constant advance, thanks to technologic development and the modernization of processes. The treatment of celiac disease does not involve the intake of any type of medication. Simply following a gluten-free diet can help aid the villous lesion to be repaired. As much as possible, processed, packaged and / or processed foods should be avoided, and fresh foods should be a part of every meal, like meat, fish, vegetables, and fruit. People with celiac disease do not have any nutritional problems derived from this gluten-free diet, since the gluten protein of these grains that are avoided are not indispensable for the body.

Researchers have discovered that the administration of a new type of nanoparticles, coated with protein targets directed to the T lymphocytes that cause autoimmune diseases (which would be the category celiac disease fits in), allows their reprogramming to regulatory T lymphocytes and the selective elimination of the disease in question. They do it through a new cellular chain mechanism that regulates the immune response.

The research has managed to restore normal blood glucose levels in mice with type 1 diabetes, motor function in mice with a disease similar to multiple sclerosis and the structure and functionality of the joints in mice with arthritis. The group of Type 1 Diabetes from the Department of Physiology and Immunology of the University of Barcelona, led by Thomas Stratmann, and other researchers from Canada and the USA, has also participated in the work.

It is important to mention that any advances achieved in the field of autoimmune diseases are relevant for celiac disease as well.