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Early promise of simple screening for coeliac disease

A research letter by Cuban investigators in this weeks issue of THE LANCET highlights a new technique which could be used for screening of the intestinal disorder coeliac disease. The new approach is likely to be more user-friendly for patients as it is less invasive than conventional screening which relies on biopsy.

The enzyme transglutaminase elicits a specific immune response that underlies coeliac disease. Luis Sorell from the Centre for Genetic Engineering and Biotechnology, Havana, Cuba, and colleagues describe a simple and rapid test that detected these specific antibodies in the blood of patients with coeliac disease. The test, called an immunochromatographic assay, is a nitrocellulose strip with a reactive and a control zone. When the strip is dipped in serum or plasma, a positive result, indicating the presence of antibodies to transglutaminase, is seen as two dots on the strip. A negative assay shows only a control dot. Results are obtained in less than 10 minutes.

Results from the test were positive for all samples from 50 untreated coeliac patients, and negative for 40 non-coeliac patients with gastrointestinal disorders.

Luis Sorell comments: This immunochromatographic assay detects antibodies to transglutaminase quickly and easily. It is highly accurate in detection of untreated patients with coeliac disease, and detects both IgA and IgG antibodies to transglutaminase, which prevents misdiagnosis of patients with a deficit of IgA, a frequent trait of coeliac disease. The assay can be done in a doctors surgery, and seems to be a useful alternative way to screen for coeliac disease, especially in patients with few or with untypical symptoms, and in risk groupsie, people with insulin dependent diabetes, Downs syndrome, autoimmune diseases, and first degree relatives of patients with coeliac disease.


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Contact: Richard Lane
richard.lane@lancet.com
44-20-7424-4949
Lancet
14-Mar-2002


Page: 1

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