Researchers Identify New Biomarker in Celiac Disease

Immunogenic epitopes derived from neoepitopes of deamidated gliadin peptides (DGP) and tissue transglutaminase (tTG) can be measured via an assay to diagnose celiac disease and mucosal healing, according to results from a new study.

Assays are used to measure tTG and other common biomarkers for celiac disease. However, assays do not accurately diagnose celiac disease when measuring biomarkers in blood samples.

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The researchers sought to discover biomarkers of celiac disease derived from neoepitopes of DGP and tTG fragments, to determine if immune reactivity against these epitopes can identify celiac disease and mucosal healing.

The researchers evaluated serum samples from the following: participants with treated and healed celiac disease (n=85), patients with treated but unhealed celiac disease (n=81), patients with untreated celiac disease (n=82), disease controls (n=27), and healthy controls (n=217).  

A fluorescent peptide microarray platform was used to measure antibody binding intensity of each synthesized tTG-DGP epitope. 

Overall, 172 immunogenic epitopes of the tTG-DGP complex were identified. Compared with the controls, the participants with celiac disease showed increased immune reactivity against the epitopes.

Neoepitopes derived from the tTG-DGP complex identified participants with celiac disease with 99% sensitivity and 100% specificity. The assay identified patients with mucosa healing status with 84% sensitivity and 95% specificity.

Participants with treated but unhealed celiac disease with mucosa had higher average antibody-binding intensity in serum (15.1 ± 7.5) compared with participants who were treated and had healed celiac disease with mucosa (5.5 ± 3.4).

Serum samples from patients with untreated celiac disease had the greatest mean antibody-binding intensity against the tTG-DGP complex (32.5 ± 16.4).

—Colleen Murphy

Reference:

Choung RS, Rostamkolaei SK, Ju JM, et al. Synthetic neoepitopes of the transglutaminase–deamidated gliadin complex as biomarkers for diagnosing and monitoring celiac disease [published online October 17, 2018]. Gastroenterology. https://doi.org/10.1053/j.gastro.2018.10.025.