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Title: Detection of New Antibody Improves Diagnosis of Coeliac Disease in Patients With Type 1 Diabetes: Presented at UEGW

"Detection of New Antibody Improves Diagnosis of Coeliac Disease in Patients With Type 1 Diabetes: Presented at UEGW"

By Adrian Burton MADRID, SPAIN -- November 4, 2003 -- Screening of patients who have type 1 insulin dependent diabetes mellitus (IDDM1) for an immunoglobulin G 1 (IgG1) isotype serum antiendomysial antibody (IgG1 EMA) doubles the number of cases of coeliac disease (CD) that can be detected. Currently, between 2% and 8% of IDDM1 patients are known also to have coeliac disease. However, the true figure may be much higher, and physicians need to know if they are to treat patients appropriately. "Coeliac [disease] and IDDM1 are two autoimmune processes that affect two different organs [the intestine and pancreas], but the pathologies share the same genetic background," explained Marco di Tola, a biologist at the department of clinical sciences, University La Sapienza, Rome, Italy, who presented the findings here November 3rd at the 11th United European Gastroenterology Week. The EMAs currently used in the diagnosis of coeliac disease belong to the immunoglobulin A (IgA) class, but the Dr. di Tola's group found subjects who had IgG1 EMAs independent of their having IgAs. To test the diagnostic power of this new antibody, the researchers screened adults with IDDM1 for both antibodies. None of the 93 patients were known to have coeliac disease before screening. Eighty-three blood donors were used as controls. Biopsy samples from all subjects underwent histology and organ culture with and without gliadin. No EMAs were found in serum from the control population. Thirteen patients were found to be positive for EMAs (13.8%). IgA EMAs were found in six IDDM1 of the 13 patients EMA positive patients (46.2%), and IgG1 EMAs were found in a further seven (53.8%). Biopsy examination confirmed all 13 positive patients to have coeliac disease. Among the patients with IDDM1 in the study, the prevalence of celiac disease was 6.4% for IgA-EMA positive patients and 7.4% for IgG1-EMA positive patients. Therefore, Dr. di Tola said, the new test was able to pick up twice as many CD positive patients as did biopsy. The new test could improve the ability to screen for coeliac disease in IDDM1 patients, concluded Dr. di Tola. With such information, physicians can make more informed treatment decisions. [Study title: IGG1 EMA Detection Strongly Increases the Prevalence of Coeliac Disease in the Patients Affected by Type 1 Diabetes Mellitus. Abstract Mon-G-022]

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