Celiac.com 07/11/2023 – A team of scientists including those from the Walter and Eliza Hall Institute and the University of Melbourne Australia, led by Dr Jason Tye-Din, presented their recent research to assess the sensitivity of objective measures of determining gluten exposure, at this year’s Digestive Disease Week (DDW) meeting in Chicago. DDW is the largest international gathering of physicians, researchers and academics in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery. Overall, their data demonstrated that Gluten Detect’s GIP technology is the “most sensitive approach to detect accidental gluten exposure in celiac disease patients on a gluten free diet.”
The first of the two studies presented was conducted over 12 months and involved 52 adult patients with celiac disease who, based on questioning, indicated they were on a strict gluten free diet. Testing done before the administration of a gluten challenge though, indicated that a surprising 87{5676e3b156b07d12bd9df9fe13d641a85da396026abde11a1ff2d0afc1b3c015} (45 of the 52) of these patients tested positive using Gluten Detect’s GIP technology at least once.
These 52 study participants were randomized into five groups, four of which received different doses of gluten with the other group receiving a placebo (no gluten). Subsequent GIP testing results correlated very well with gluten ingested as gluten peptides were detected in stool starting one day after the gluten exposure, however no gluten was detected in samples from subjects given the placebo. Additionally, the gluten dose that the participants received correlated with the gluten excretion duration, whereby the higher the dose of gluten ingested, the longer that gluten was detectable in stool.
In the second part of the study, twelve of these study participants with a range of different GIP test results were followed-up for an additional 12 to 24 months with food diaries, questionnaires and GIP stool testing. The frequency of positive GIP test results stayed the same for individual participants during the study, possibly indicative of habitual dietary and lifestyle choices. Interestingly, the results of the questionnaire demonstrated a correlation between positive test results and frequency of dining out. Review of the corresponding food diaries did not indicate any obvious sources of gluten exposure activity, pointing out the limitations of this type of subjective data as a means to determine dietary compliance.
This well designed and comprehensive study demonstrated the clinical value of testing using Gluten Detect’s GIP technology to monitor gluten free dietary compliance. Overall, the conclusions from the study are as follows:
Stool testing using this technology is a highly sensitive way to determine accidental gluten exposure with the optimal detection time being 1-2 days after a gluten exposure.
The larger the gluten exposure, the longer that GIPs are detectable in stool using this technology.
More frequent sampling and testing improves detection.
Positive GIP test results are more common than expected in a celiac population on a strict gluten free diet and future studies should correlate GIP test results with extent of intestinal damage.
Neither food diaries nor questionnaires indicated any obvious sources of gluten exposure, demonstrating the limitations of these subjective approaches to monitoring dietary compliance.
More data is needed, but this study indicates dining practices are an important consideration for avoidance of unintentional gluten exposure.
The authors also noted that although positive test results have not yet been correlated with extent of intestinal damage, a negative test result is a very good indication of excellent compliance with the gluten free diet.
STOOL GLUTEN IMMUNOGENIC PEPTIDE DETECTION IS HIGHLY SENSITIVE AFTER LOW-DOSE GLUTEN CHALLENGE AND REVEALS A HIGH BACKGROUND RATE OF UNINTENDED GLUTEN INTAKE IN TREATED CELIAC DISEASE Assoc. Prof. Jason Tye-Din DDW ePoster Library. Tye-Din J. 05/09/2023; 380762; Tu1902 Link to DDW poster:
https://eposters.ddw.org/ddw/2023/ddw-2023/380762/jason.tye-din.stool.gluten.immunogenic.peptide.detection.is.highly.sensitive.html
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