CICA TEST COMPONENTS
Genetic
More than 95% of patients with celiac disease possess HLA-DQ2.5 and/or HLA-DQ8 genotype. More than 90% of those with celiac have the DQ2.5 genotype. Absent these markers, development of celiac is highly unlikely.
Crohn’s disease is triggered by a variety of environmental and genetic factors. It is described as a chronic inflammatory bowel disease (IBD) caused by a dysregulation of the immune response to intestinal flora and in parallel, accompanied by a defect of the epithelial barrier.
The predominant genetic markers are:
- NOD2/CARD15 associated with the innate immune system and the activation of nuclear factor кB (NF- кB).
- T300A mutation in the ATG16L1 gene increases its susceptibility to degradation by Caspase 3 and thus is associated with autophagy.
Serologic/Antibody
Tissue transglutaminase antibody (tTG) – IgA & IgG
In active celiac disease, damaged enterocytes produce tTG, therefore antibodies against tTG (IgA and/or IgG) are indicative of an active disease process. In patients with normal total IgA levels and negative tTG antibodies, the diagnosis of active celiac disease is unlikely. However, a certain percentage of patients with celiac disease may be seronegative. If tTG IgA is negative, while celiac disease is suspected, then additional markers included in this panel become more relevant in the diagnosis of gluten-related disorders.
Deamidated gliadin peptide (DGP) antibody - IgA & IgG
Deamidated gliadin can bind with tTG and become immunogenic. Therefore, detecting the presence of elevated IgA and/or IgG antibodies against DGP is an additional indicator of an active celiac disease process.
Anti-Saccharomyces Cerevisiae Antibody (ASCA)
ASCA is an indicator for the presence of Crohn’s disease. The presence of ASCA may also reflect increased intestinal inflammation and permeability, including that associated with active celiac disease.
Total Serum IgA
It is common for celiac disease patients to be IgA deficient. It is the most common immunologic deficiency (1:400-1:700 in the general population and 1:50 in celiac disease patients) and may be the single largest contributor to false negative results in biopsy confirmed celiac disease patients. Total Serum IgA is used as a measurement to qualify IgA testing for tissue transglutaminase (tTG) and deaminated gliadin peptide (DGP) antibody levels. When IgA levels are low or deficient, it is important to check IgG levels for both tTG and DGP (included in this array).
Who Should Test?
- Those with gastrointestinal symptoms and autoimmune disorders that might suggest a problem with gluten
- Those with increased intestinal permeability which has been linked to autoimmune disorders and other conditions
- Those suspected to have Crohn’s or celiac disease
- Those suffering from symptoms of IBS including diarrhea, bloating or cramping
- Those with chronic fatigue
- Those with malabsorption of nutrients or iron deficiency
Sample Report
Preparation:
No fasting required. Because antibody titers are connected to exposure, avoiding gluten on purpose may result in lower serological results. As a result, while interpreting tTg and DGP serology data, the patient's gluten exposure should be taken into account. For genetic component only: Consuming gluten prior to testing will not affect the results. Maintain present eating habits. There is no need to adjust gluten consumption. Diagnosed celiac disease individuals should continue to follow a gluten-free lifestyle, utilizing this test to monitor and assess the impact of gluten-free living on tTg and DGP antibodies. The stringent guidelines related to a gluten-free diet must be followed to prevent celiac disease activity and may not be the same for all celiac patients. The time it takes for the antibody level to go from positive to negative has been reported to be anywhere from a few months to a year or more. If you have been diagnosed with celiac disease, talk to your doctor about whether this test is right for you.
Test Results:
5-7 Business days once the lab receives the specimen. May take longer based on weather, holiday or lab delays.
