Published online Jul 14, 2020. doi: 10.3748/wjg.v26.i26.3780
Peer-review started: January 16, 2020
First decision: April 8, 2020
Revised: May 13, 2020
Accepted: July 1, 2020
Article in press: July 1, 2020
Published online: July 14, 2020
Currently, duodenal biopsy is the only way to evaluate mucosal healing in celiac disease (CD). There is no reliable widely available non-invasive marker of persistent villous atrophy (VA), which is one of the core pathological signs of active CD.
There is ongoing attempt to search for non-invasive markers for mucosal healing in CD, as persistent VA is one of the risk factors for malignant complications and possibly higher mortality rates in CD.
Closer analysis of currently available non-invasive CD relevant markers, such as the exact value of anti-tissue transglutaminase antibodies (aTTG), anti-deamidated gliadin peptide antibodies (aDGP), or combination with ultrasonographic signs of active CD could help in prediction of persistent VA.
We analyzed data from the database of patients with CD followed-up at the Department of Gastroenterology and Internal Medicine, University Hospital Brno from 2014 to 2018. The symptoms, laboratory signs, exact values of aTTG, aDGP, ultrasonographic signs of active CD were correlated to persistent VA.
Calculation of new cut-off values of aTTG and aDGP IgA improved the sensitivity, specificity, and negative predictive value for VA. The combination with expert bowel ultrasound examination achieved even better accuracy.
We found out that a combination of currently available non-invasive CD relevant markers could help in prediction of persistent VA.
This could lead to more personalized approaches and closer follow-ups of CD patients, including repeated evaluation of adherence to GFD, thorough searches for nutritional deficiencies and possibly also follow-up duodenal biopsy and search for complications of CD.