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Celiac disease testing offers new insight into autoimmune disease

Category: Celiac Disease Testing

Celiac disease has probably been with the human race since the dawn of agriculture some 10,000 years ago. When humans first shifted from a diet of nuts, tubers and a little bit of meat to one based more on cultivated grains, they put themselves at risk for new diseases caused by abnormal reactions to the gluten proteins associated with wheat. Celiac was first named and written about in the first century by the Greek physician, Aretaeus, who called it koiliakos, based on the Greek word for abdomen.

It is only recently that medicine has started to figure out exactly what is going on with the disease, and the findings may shed light on other autoimmune diseases, according to Dr Alesso Fasano, professor of pediatrics, medicine and physiology at the Center for Celiac Research at the University of Maryland School of Medicine.

Fasano writes in the latest Scientific American that celiac disease seems to come about through a combination of three factors. The patient must have a genetic predisposition to the disease, they have an unusually permeable intestinal wall and they are exposed to the gluten protein. Fasano also argues that this sort of three-factor system seems to underlie many other autoimmune diseases as well. They seem to also require a genetic susceptibility and a leaky gut combined with an environmental trigger of some sort.

Fasano thinks that this means treatments for celiac disease may offer clues about how to treat other autoimmune disorders as well. He writes that that the new insight of a three-factor trigger for celiac disease means that if the theory is correct, removing any one of the three factors should stop the disease.

Celiac disease was diagnosed for years by way of the symptoms it produced in the patients, followed by a biopsy of the small intestine. Patients with the disease suffer from an inability to digest gluten, and so often present with muscle weakness and bone pain, chronic diarrhea, abdominal bloating and weight loss. However, mild cases can be mistaken for other illnesses, such as anemia or osteoporosis, easily.

Celiac testing has evolved with the discovery that people with the disease produce antibodies to gluten in high amounts. It is now possible to detect the presence of the disease with a blood test in people who display non-traditional symptoms.

A gut biopsy remains the gold standard, because it is possible to detect gluten antibodies through celiac testing even in people who do not in fact have the disease.

Nonetheless, the advent of simple celiac testing resulted in the discovery that the disease was approximately 100 times more common in the U.S. population than had been previously thought. The actual number had been masked by the many alternative diagnoses that are proffered when the disease is in a mild stage.

There is some evidence that not only is it more common than previously thought, but that it may be increasing in the population. A recent study found that it was four times more common in the current U.S. population than it was in the 1950s. Another recent study has found that it is possible, though rare, for elderly patients to develop the disease even if they didn't have it earlier in life.

Celiac disease has long been treated by removing gluten from the diet. This is a difficult and expensive process, because wheat and wheat products are one of the basic foods used around the world and their characteristics are not easy to replicate with other grains. This makes gluten-free food quite expensive, even though the demand for it grows as celiac testing identifies more and more people who are susceptible to gluten.