J Gastrointestin Liver Dis. 2023 Dec 22;32(4):536-544. doi: 10.15403/jgld-4926.

Matej Hrunka ¹, Lubomír Janda ², Michaela Štastná ³, Tereza Pinkasová ⁴, Jakub Pecl ⁵, Lumír Kunovský ⁶, Petr Díte ⁷, Petr Jabandžiev ⁸

Author information

¹Department of Pediatrics, University Hospital Brno, Faculty of Medicine, Masaryk University Brno, Brno, Czech Republic. . hrunka.matej@fnbrno.cz.

²Veterinary Research Institute, Brno, Czech Republic. lubomir.janda@vri.cz.

³Veterinary Research Institute, Brno, Czech Republic. michaela.stastna@vri.cz.

⁴Department of Pediatrics, University Hospital Brno, Faculty of Medicine, Masaryk University Brno, Brno, Czech Republic. pinkasova.tereza@fnbrno.cz.

⁵Department of Pediatrics, University Hospital Brno, Faculty of Medicine, Masaryk University Brno, Brno, Czech Republic. pecl.jakub@fnbrno.cz.

⁶2nd Department of Internal Medicine - Gastroenterology and Geriatrics, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc; Department of Surgery, University Hospital Brno, Faculty of Medicine, Masaryk University Brno, Brno; Department of Gastroenterology and Digestive Endoscopy, Masaryk Memorial Cancer Institute, Brno, Czech Republic. lumir.kunovsky@gmail.com.

⁷Department of Gastroenterology, University Hospital Brno, Faculty of Medicine, Masaryk University Brno, Brno; Department of Internal Medicine and Cardiology, University Hospital Ostrava, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic. pdite.epc@gmail.com.

⁸Department of Pediatrics, University Hospital Brno, Faculty of Medicine, Masaryk University Brno, Brno, Czech Republic. jabandziev.petr@fnbrno.cz.

Abstract

Celiac disease is a common gastroenterological illness. Current diagnostics of the disease are based on serological markers and histology of duodenal biopsies. Hitherto, a strict gluten-free diet is the only effective treatment and is necessary for good control of the disease. Serological tests in current use have very high specificity and sensitivity for diagnostics, but in follow-up they have some limitations. Their levels do not accurately reflect mucosal healing, and they are unable to detect minimal transgressions in the diet. This problem is significant in patients with IgA deficiency, and there exist no robust follow-up tools for monitoring these patients' adherence to treatment. For their follow-up, we currently use IgG-based tests, and these antibodies persist for a long time even when a patient has stopped consuming gluten. More accurate and specific biomarkers are definitely needed. Adherence to a gluten-free diet is essential not only for intestinal mucosa healing and alleviation of symptoms but also for preventing complications associated with celiac disease. Here, we summarize current evidence regarding noninvasive biomarkers potentially useful for follow-up not only of patients with IgA deficiency but for all patients with celiac disease. We describe several very promising biomarkers with potential to be part of clinical practice in the near future.