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Celiac

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Information

Celiac disease is a systemic autoimmune disease with a pronounced genetic predisposition which may affect different organ systems. Celiac disease is triggered by the consumption of gluten, which makes up about 90% of the protein contents of many cereal grains. In most cases, the disease manifests as severe inflammation and damage to the mucous membrane of the small intestine (enteropathy).

Both genetic and environmental factors contribute to the development of celiac disease. Enteropathy, which is characteristic of celiac disease, is caused by an overreaction of the immune system to gluten components, especially the so-called gliadin. Gliadin is only partially digested in the small intestine. If there are gaps in the intestinal epithelium, as is typical in patients with celiac disease, the resulting gliadin fragments (peptides, consisting of 33 amino acids, 33-mer) can pass through the intestinal barrier and reach the connective tissue underneath. There, the enzyme tissue transglutaminase (tTG) modifies (deamidates) the amino acid glutamine (Q) into the amino acid glutamate (E) at certain sites of the gliadin peptides. This modification brings on an immunological reaction in the case of genetic predisposition. The activation of B cells leads to the production of antibodies against the deamidated gliadin peptides and against the body’s own tissue transglutaminase. In addition, the T cells secrete pro-inflammatory cytokines which cause an inflammatory reaction in the tissue. The immunological overreaction and the inflammation of the epithelium of the small intestine lead to apoptosis of the enterocytes, atrophy of the villi and widening of the intestinal crypts (hyperplasia). These damages mean the intestinal mucosa is no longer able to absorb sufficient nutrients from the digested food and to transport them into the bloodstream.

Diagnostic Guidelines

The prevalence of the disease is estimated to amount to approximately 1%, although experts believe there are a large number of additional cases which are not diagnosed due to “atypical” or mild symptoms. In conjunction with the resulting disturbance of nutrient absorption, a wide range of clinical gastrointestinal and non-gastrointestinal symptoms can develop (including chronic diarrhea, vomiting, abdominal pain, cramps, short stature, weight loss, delayed puberty, spontaneous abortions, anemia and osteoporosis). Furthermore, dermatitis herpetiformis (Duhring’s disease), a chronic skin rash, can occur.

According to the guidelines of the European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) (Husby et al., 2020), patients with relevant symptoms should first be tested for anti-tTG antibodies (IgA) and total IgA antibodies, as these antibodies are particularly specific and sensitive. If the anti-tGG IgA is more than ten times the antibody concentration at the upper limit of normal (> 10x ULN) and a sample taken later is positive for anti-endomysium (EmA) IgA, a biopsy, which is otherwise required to confirm the diagnosis, can be omitted. The guidelines also emphasize the usefulness of celiac-specific IgG-based tests in other cases, such as tests for the detection of antibodies against deamidated gliadin peptides (DGP). If there is a general IgA deficiency – as often observed in celiac disease patients – anti-DGP antibodies (IgG) are considered an important alternative indicator of celiac disease. EmA, which targets tTG as antigen, can be detected in IIFT on tissue sections of primate liver, primate esophagus or primate intestine.

Celiac products

For Research Use Only. Not For Use In Diagnostic Procedures.
The individual product regulatory statements may vary, please refer to the instructions for use for more information.

wdt_ID Method Parameter Substrate Species/ Antigen
478 EUROLINE Autoimmune Gastrointestinal Diseases IgA
(tissue transglutaminase (endomysium), gliadin-analogue
fusion peptide (GAF-3X), mannan (ASCA)) 		EUROLINE
479 EUROLINE Autoimmune Gastrointestinal Diseases IgG
(tissue transglutaminase (endomysium),
gliadin-analogue fusion peptide (GAF-3X),
parietal cell antigen (PCA) separately
Intrinsic factor, mannan (ASCA))		 EUROLINE
480 IFA antibodies against endomysium
(EMA IgA control)
481 IFA antibodies against endomysium
(EMA IgG control)
482 ELISA tissue transglutaminase
(endomysium) 		antigen-coated
microplate wells 		recombinant,
expression with baculovirus vector
in insect cells
483 ELISA tissue transglutaminase
(endomysium) 		antigen-coated
microplate wells 		recombinant,
expression with baculovirus vector
in insect cells
484 EUROLINE Celiac Disease Profile
(tissue transglutaminase (endomysium),
gliadin-analogue fusion peptide (GAF-3X) separately)		 EUROLINE
485 IFA Celiac Disease Screen (EM) EUROPattern
endomysium		 oesophagus monkey
486 IFA endomysium oesophagus monkey
487 IFA EUROPLUS
endomysium
gliadin (GAF-3X) 		2 BIOCHIPs per field:
oesophagus
gliadin (GAF-3X) BIOCHIPs 		monkey
488 IFA Celiac Disease Screen 9B
endomysium
tissue transglutaminase (tTG)		 3 BIOCHIPs per field:
oesophagus
transfected cells
control transfection 		monkey
EU 90
EU 90
489 IFA antibodies against endomysium plus gliadin (GAF-3X)
(EMA plus gliadin GAF-3X IgA control)
490 IFA antibodies against endomysium plus gliadin (GAF-3X)
(EMA plus gliadin GAF-3X IgG control)
491 IFA endomysium small intestine monkey
492 IFA EUROPLUS
endomysium
gliadin (GAF-3X) 		2 BIOCHIPs per field:
small intestine
gliadin (GAF-3X) BIOCHIPs 		monkey
493 IFA endomysium
endomysium 		small intestine
oesophagus
(2 BIOCHIPs per field) 		monkey
monkey
494 IFA EUROPLUS
endomysium
gliadin (GAF-3X)
endomysium
endomysium 		4 BIOCHIPs per field:
small intestine
gliadin (GAF-3X) BIOCHIPs
oesophagus
liver 		monkey
monkey
monkey
495 IFA endomysium
endomysium
endomysium 		liver monkey
496 IFA endomysium liver monkey
497 IFA EUROPLUS
endomysium
gliadin (GAF-3X) 		2 BIOCHIPs per field:
liver
gliadin (GAF-3X) BIOCHIPs 		monkey
498 IFA endomysium
endomysium 		liver
small intestine
(2 BIOCHIPs per field) 		monkey
monkey
499 IFA EUROPLUS
endomysium
endomysium
gliadin (GAF-3X) 		3 BIOCHIPs per field:
liver
small intestine
gliadin (GAF-3X) BIOCHIPs 		monkey
monkey
500 IFA endomysium umbilical cord human
501 IFA antibodies against gliadin (GAF-3X)
(gliadin GAF-3X IgA control)
502 IFA antibodies against gliadin (GAF-3X)
(gliadin GAF-3X IgG control)
Method Parameter Substrate Species/ Antigen
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Contact our Autoimmune Product Team for further details and information
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