The Role of an IgA/IgG-Deamidated Gliadin Peptide Point-of-Care Test in Predicting Persistent Villous Atrophy in Patients With Celiac Disease on a Gluten-Free Diet

Lau, Michelle S; Mooney, Peter D.; White, William L.; Rees, Michael; Wong, Shawn; Kurien, Matthew; Trott, Nick; Leffler, Daniel A.; Hadjivassiliou, Marios; Sanders, David S.

doi:10.1038/ajg.2017.357

Cited by 32 publications

(18 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although normalisation of coeliac specific serology usually occurs on a GFD, it has been demonstrated that negative TTA cannot be used as a reliable marker of histological healing (31,32) . Our results confirm the need to focus our attention onto good dietary instruction in order to improve GFD adherence and on the investigation of non-invasive strategies to assess adherence to a GFD (24)(25)(26)33,34) . We think that these alternative methods to identify dietary lapses, including urinary gluten peptides, may be particularly useful for patients who do not require an invasive follow-up (scenario 4) and those in whom a case-by-case evaluation is needed (scenario 3) (33) .…”

Section: Discussionsupporting

confidence: 76%

“…those with persisting symptoms despite being on a GFD (1)(2)(3)(4) . Moreover, despite the availability of different non-invasive surrogate markers to assess GFD adherence (24)(25)(26) , there is still no widespread consensus on whether responsibility for coeliac patients' follow-up should be taken by dietitians, primary care physicians, gastroenterologists or tertiary referral centres (1)(2)(3)(4)19,(24)(25)(26)(27)(28) . Moreover, which follow-up modalities to employ are even more controversial.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Optimising the follow-up of adult coeliac disease with a clinical-based score to identify patients in need of a histological reassessment: a retrospective single centre study

et al. 2020

View full text Add to dashboard Cite

Follow-up modalities for adult coeliac patients remain controversial. Non-invasive markers to identify coeliac patients on a gluten-free diet (GFD) with persistence of villous atrophy (VA) are still lacking. We aim to develop a score to stratify coeliac patients on a GFD according to their risk of having persistent VA and to tailor follow-up modalities accordingly. The clinical notes of over 700 coeliac patients attending our unit (September 1999–November 2018) were retrospectively examined. A total of 273 patients on a GFD with a histological follow-up performed 12–24 months after diagnosis were selected. We developed a bivariable model based on diet adherence and clinical response evaluated by previously validated methods. A four-level score (0·5, 1·5, 3, 4) was obtained. Patients on a strict GFD and with good clinical conditions (score 4) have a very low risk of persistence of VA (2 (95 % CI 1, 5) %). Conversely, the risk is very high (46 (95 % CI 25, 68) %) in patients with poor adherence to a GFD and unsatisfactory clinical response (score 0·5). A score of 1·5 (poor GFD adherence and persistent well-being) is linked with a high risk (23 (95 % CI 14, 36) %). Risk is intermediate (6 (95 % CI 3, 10) %) in patients scoring 3 (strict GFD and no/partial clinical improvement). Three patients who developed complications belonged to this scenario. Patients at low risk of persistent VA can be followed-up non-invasively, whereas a biopsy should be repeated in those at high/very high risk. Case-by-case evaluation is needed in patients at intermediate risk. Studies on a larger sample size are required to confirm these data.

show abstract

Section: Discussionsupporting

confidence: 76%

mentioning

confidence: 99%

Optimising the follow-up of adult coeliac disease with a clinical-based score to identify patients in need of a histological reassessment: a retrospective single centre study

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Therefore, it is possible that the window of gluten exposure is missed by the time individuals are tested for GIPs. Notably, this is not the only non-invasive marker of gluten exposure available, and the last decade has seen a rise in the development of other commercially available tests, including point of care tests [39]. However, robustly designed studies are awaited to assess their place in clinical practice.…”

Section: Dietary Indiscretionmentioning

confidence: 99%

Non-Responsive Coeliac Disease: A Comprehensive Review from the NHS England National Centre for Refractory Coeliac Disease

et al. 2020

View full text Add to dashboard Cite

Coeliac disease is a common small intestinal enteropathy which manifests following ingestion of gluten in genetically susceptible individuals. Since gluten was identified as the driving factor in coeliac disease, the gluten-free diet (GFD) has remained the mainstay of treatment. While most individuals will display improvement in symptoms and signs of coeliac disease following institution of the GFD, up to 30% will continue to experience symptoms and/or have persisting intestinal inflammation. These individuals can be classified as having non-responsive coeliac disease (NRCD), which may be associated with dietary indiscretion, slow healing, refractory coeliac disease, and/or an alternative condition. The purpose of this review is to provide an overview of the causes of NRCD in adults, highlight a systematic approach to investigate these patients, and appraise the latest management aspects of this subset of coeliac disease.

show abstract

“…Various assessments have been done for this commercial kit, and it has been proved to have high sensitivity (95-100%) and specificity (93.1-95.7%) [26][27][28]. However, specificity of this test drastically reduced when used for patients on a gluten-free diet [26,29].…”

Section: Point-of-care Tests For Celiac Disease 31 Current Commerciamentioning

confidence: 99%

Challenges with Point-Of-Care Tests (POCT) for Celiac Disease

Wu¹,

Wallach²,

Shimoni³

2019

Celiac Disease - From the Bench to the Clinic

View full text Add to dashboard Cite

Current screening test for celiac disease involves blood test in centralized pathology laboratories, typically performing enzyme-linked immune-sorbent assays (ELISA) to detect specific celiac disease antibodies. Most of the current available celiac disease antibody tests detect anti-gliadin (AGA), anti-endomysial (EMA), anti-transglutaminase (tTG), or deamidated gluten peptide (DGP) antibodies from serum or whole blood samples. It requires blood collection from untreated celiac patients, which is often invasive and inconvenient. There is a rapid growth in demand for noninvasive celiac tests for the early and fast diagnosis of celiac disease to help potential celiac patients obtain results and take corresponding actions. Over the last decade, several point-of-care tests (POCT) have been introduced to the market, but these tests have not been widely accepted by clinicians. Moreover, the 2009 NICE guideline CG 86 recommended that self-tests and/or POCT for celiac disease should not be used as a substitute for laboratory-based tests. Here, we provide a background on the evolution of POCT for celiac disease. We discuss general principle of operation for the known commercial kits as well as the use of various antigens and antibodies in different tests developed over the years. Finally, we discuss challenges for future research directions in celiac disease POCTs.

show abstract

The Role of an IgA/IgG-Deamidated Gliadin Peptide Point-of-Care Test in Predicting Persistent Villous Atrophy in Patients With Celiac Disease on a Gluten-Free Diet

Abstract: Article title: The role of an IgA/IgG-deamidated gliadin peptide point of care test in predicting persistent villous atrophy in patients with celiac disease on a gluten free diet

Cited by 32 publications

References 49 publications

Optimising the follow-up of adult coeliac disease with a clinical-based score to identify patients in need of a histological reassessment: a retrospective single centre study

Optimising the follow-up of adult coeliac disease with a clinical-based score to identify patients in need of a histological reassessment: a retrospective single centre study

Non-Responsive Coeliac Disease: A Comprehensive Review from the NHS England National Centre for Refractory Coeliac Disease

Challenges with Point-Of-Care Tests (POCT) for Celiac Disease

Contact Info

Product

Resources

About