Antibodies are part of your immune system that identify and help eliminate foreign invaders in your body, like a virus. Autoantibodies—sometimes mistakenly produced by the immune system—attack your own tissues. This can lead to autoimmune disorders, such as celiac disease.
Celiac disease is a genetic, autoimmune disease characterized by inflammation of the small intestines when someone eats gluten, a protein found in wheat and other grains. Autoantibodies mistakenly identify gluten as foreign and attack the small intestine where it is present. The damage can cause abdominal pain, diarrhea, and failure to absorb nutrients from food. Your risk for having celiac disease increases if you have a family history of celiac disease, have an autoimmune disorder, such as thyroid disease or type 1 diabetes, or have some other genetic disorder, such as Down Syndrome or Turner Syndrome.
Testing 4 key antibody biomarkers, including the gold standard tTG-IgA, allows you to know how your body reacts to gluten and whether you have celiac disease. This test detects the presence of 4 autoantibody biomarkers associated with celiac disease: the tissue transglutaminase (tTG) antibodies tTG IgA and tTG IgG; and the deamidated gliadin peptide (DGP) antibodies DGP IgA and DGP IgG. It can be used to both screen for celiac disease and monitor your disease progression in response to dietary changes.
The results of this test alone will not provide enough information for healthcare professionals to definitively diagnose whether you have celiac disease. Follow-up tests, including an upper endoscopy and biopsy, are necessary to identify the cause of any symptoms you are experiencing.
Celiac disease non-profit Beyond Celiac recommends that people get tested for celiac disease if they have symptoms of celiac disease, have a first-degree relative with celiac disease, or have an associated autoimmune condition, such as type 1 diabetes, Down syndrome, Turner syndrome, Williams syndrome, and selective IgA deficiency¹,². Symptoms of celiac disease include chronic diarrhea, bloating, abdominal pain, or other digestive problems that last for more than two weeks³. Celiac disease can also cause an itchy, blistering skin rash (called Dermatitis Herpetiformis) with or without digestive symptoms. It is important to continue on a gluten-containing diet until you have been screened and tested for celiac disease.
Any result that is above these cutoff values is considered a positive result for each respective biomarker:
If this is your first test for celiac disease, the tTG IgA biomarker a verymost important indicator. A positive result is a strong indicator and, the more elevated the level, the likelier you are to have celiac disease.
A positive celiac disease screening test is only the beginning of your diagnosis. A positive serology (blood) test might indicate that you need to have an upper endoscopy and biopsy to confirm a celiac disease diagnosis. You should bring your celiac disease screening test results to a gastroenterologist for further celiac disease testing.
When monitoring your celiac disease, the interpretation of biomarker levels must be done in relation to your baseline levels. For example, if you began a gluten-free diet with antibodies >10 times more elevated than the cutoff listed above, it is acceptable to still have an elevated level after 3–4 months, as long as it has decreased. It's important to monitor your follow-up blood work with your gastroenterologist.
Any result that is below these cutoff values is considered a negative result for each respective biomarker:
Currently, the only way to treat and manage celiac disease is to follow a strict, lifelong gluten-free diet. Your diet should be devoid of any foods that contain gluten.
imaware thanks Beyond Celiac for advancing celiac disease research.
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