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Simplified diagnosis of coeliac disease

Diagnosis of coeliac disease requires a tissue sample from the small intestine, which can be extremely unpleasant. Researchers at the Faculty of Medicine have developed a blood test which provides a rapid, painless answer.

As many as 100 000 Norwegians may suffer from coeliac disease, which causes the immune system to think that gluten is a virus or bacteria. This causes the body to trigger an unnecessary inflammatory reaction in the small intestine, a so-called autoimmune reaction. Tissue and enzymes are attacked, the villi become damaged and the patient can suffer weight loss, reduced absorption of nutrients and stomach pains.

Unpleasant diagnostics

If you suspect that you have coeliac disease, you currently have to undergo an extensive investigation. While consuming gluten-containing foods, you must take a blood test followed by a tissue sample from the small intestine. If you have embarked on a gluten-free diet, you must begin to consume gluten-containing foods again. If you do have coeliac disease, this may result in pain and considerable discomfort.

The tissue samples are taken by gastroscopy, which means a tube being inserted down through your throat to the duodenum. The tissue samples must also be taken in order to obtain a definite diagnosis. This can be very unpleasant, and children are put under anaesthetic during this type of examination.

Researchers at the Faculty have now developed a new blood test that makes it much simpler to diagnose coeliac disease.

A misunderstanding by the body’s immune system

Postdoctoral fellow Asbjørn Christophersen explains:

“When the food that you eat enters the small intestine, it is reduced to tiny fractions and presented to the T cells on so-called HLA molecules.

The HLA molecules present various elements of what you consume, as well as what is inside the cells.

The task of the T cells is to monitor cells to see if they are infected by viruses or bacteria.

In the case of coeliac disease, the T cells think that gluten is a virus or bacteria.

Image comparing healthy duodenum with duodenum damaged by coeliac disease
Left: Healthy duodenum. Right: Duodenum showing villi damaged by coeliac disease
Photo: UiO