By Van Waffle
Summary: With conventional tests, a person already on a gluten-free diet must undertake a gluten challenge for weeks or months in order to be diagnosed with celiac disease. Many patients would rather avoid unpleasant symptoms and remain undiagnosed. To investigate a more practical cytokine release test, researchers from Walter and Eliza Hall Institute in Melbourne, Australia, collaborated with biotechnology company ImmusanT in Boston. Instead of looking for protein antibodies in the blood as commonly used tests do, the test detects specific T-cells that respond to gluten.
The study followed 38 diagnosed subjects: some with recently diagnosed, untreated celiac disease, some with celiac disease who had already adopted a gluten-free diet, and some with diagnosed non-celiac gluten sensitivity who had already adopted a gluten-free diet. All participants provided blood samples immediately before undertaking a three-day gluten challenge, then provided another blood test six days after the first. The second blood test detected T-cells in 85 percent of patients with celiac disease, even those who had previously adopted a gluten-free diet. Patients with diagnosed non-celiac gluten sensitivity tested negative. Most participants experienced unpleasant symptoms such as nausea during the brief challenge, but all quickly returned to normal.
Conclusion: The cytokine release test shows promise for quickly diagnosing celiac disease in people who have previously adopted a gluten-free diet. It avoids prolonged gluten exposure and illness. However, the test group was small so more extensive research is required. Since the celiac disease status of each patient was already known, further studies must evaluate whether the test can accurately establish initial diagnosis.
 “Ex-vivo whole blood secretion of interferon (IFN)-y and IFN-y-inducible protein-10 measured by enzyme-linked immunosorbent assay are as sensitive as IFN-y enzyme-linked immunospot for the detection of gluten-reactive T cells in human leucocyte antigen (HLA)-DQ2-5+-associated coeliac disease”, Ontiveros N, Tye-Din JA, Hardy MY, Anderson RP, #Clinical & Experimental Immunology# 2014 Jan 3 [Epub] doi: 10.1111/cei.12232