Let's put it this way: if celiac disease were a thief, until now, to catch it we had to first open the door to our house and invite it to rob us. Because the gluten challenge, that medieval torture disguised as a medical procedure, works just like that: it forces you to feel bad to find out if you have reason to feel bad. But researchers at Walter and Eliza Hall Institute They found a way to catch the culprit without giving him the keys. A celiac disease test is based on a blood test that detects gluten-specific T cells even when they are “at rest.” It’s basically like catching a criminal by fingerprints instead of waiting for him to commit the crime.
The Celiac Disease Test That Works in Reverse
Today, to diagnose celiac disease with certainty, you sometimes have to follow a protocol that seems to have come from the Middle Ages: eat gluten for weeks (even if it makes you sick), then undergo a gastroscopy with intestinal biopsy. A process that has discouraged millions of people from seeking a diagnosis, leaving about 80% of celiacs without knowing it.
The new test developed in collaboration with Novaviah Pharmaceuticals completely turns the approach on its head. Instead of inducing an immune reaction by eating gluten, the patient's blood is exposed to gluten directly in the lab. If there are gluten-specific T cells, they release interleukin-2 (IL-2) in measurable amounts.
Jason Tye Din, a gastroenterologist who heads the celiac disease research laboratory, explains it well:
“There are probably millions of people in the world living with undiagnosed celiac disease simply because the journey to diagnosis is difficult and sometimes debilitating.”
Celiac disease, the numbers that count
The results published in the journal Gastroenterology speak clearly: 90% sensitivity and 97% specificity. Simply put, the test catches 9 out of 10 celiacs and is wrong only 3 out of 100 times when it says there is no celiac disease. The study involved 181 participants: 75 people who were already following a gluten-free diet, 13 with active, untreated celiac disease, 32 with non-celiac gluten sensitivity, and 61 healthy controls.
Olivia Moscatelli, a researcher who experienced first-hand the diagnosis of celiac disease at the age of 18, underlines a crucial aspect: “We also discovered that the intensity of the IL-2 signal correlates with the severity of the patient's symptoms, allowing us to also predict as severely a person with celiac disease could react to gluten, without actually having to eat it.”
The Celiac Disease Test That Sees the Invisible
One of the most important discoveries concerns the so-called “silent celiac disease“: people with no obvious symptoms but with ongoing intestinal damage. Current diagnostic methods often miss it, but this test can detect it. It’s like having a smoke detector that works even when you don’t see the flames yet.
The test even works in the presence of other autoimmune diseases like type 1 diabetes or Hashimoto’s thyroiditis, conditions that often create false positives on traditional tests. “The technology we use is highly sensitive and can detect IL-2 signal at exceptionally low levels,” Moscatelli explains. “It’s like being able to detect a single grain of sand in a swimming pool.”
The Celiac Disease Test of the Future is Already Here
As we have highlighted in this article, research on celiac disease is making great strides. This new diagnostic approach represents a paradigm shift that could finally bring to light that part of the “celiac disease iceberg” that remains hidden precisely because of diagnostic difficulties.
The team is now working with Novoviah to confirm the test’s accuracy in more diverse populations and gather the data needed for regulatory approvals. If all goes as planned, we may soon say goodbye to the paradox of having to feel bad to find out why we feel bad.
