Development of a more accurate and acceptable test for coeliac disease based on T cell receptor clonality: a pilot study
Principal Investigator: Dr Elizabeth Soilleux, Consultant Pathologist and Honorary Senior Clinical Lecturer
Institution: Department of Cellular Pathology, John Radcliffe Hospital, Oxford and University of Oxford
Research classification: Diagnosis of coeliac disease and dermatitis herpetiformis
Project start & duration: Jan 2015 (12 months plus 12 months' extension)
Grant awarded: £20k and £6.5k
Diagnosis of coeliac disease may be challenging, either because insufficient gluten has been eaten for current tests to be positive, or even when there is sufficient gluten in the diet there may be a proportion of cases which are not detectable by current means.
In the absence of dietary gluten, although the immune cells (lymphocytes) responsible for the disease remain with an affected person’s body, current tests are unable to detect them. This project aims to develop a test for coeliac disease that detects these gluten sensitive lymphocytes, based on current highly successful techniques for lymphocyte detection used in lymphoma diagnosis.
It is envisaged that this new test will be able to determine whether or not an individual has coeliac disease regardless of whether or not they have had recent gluten exposure. The test may also help clarify the “grey zone” into which some individuals fall when they have some features of coeliac disease, but not enough for a definitive diagnosis.
Duodenal biopsies which have been stored for research purposes will be analysed to determine the feasibility of this approach.
This is a pilot study and if successful further research will be required. Sometime in the future, it may be possible to undertake the test on a blood sample, reducing the need for endoscopy.
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