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New study aims to refine the diagnostics of celiac disease

Published on 22.10.2021
Tampere University
Kalle Kurppa“The celiac disease is a unique autoimmune disease in that there is a curative treatment for it, namely the gluten-free diet,” Professor Kalle Kurppa says.
Undiagnosed celiac disease can cause serious complications, making early diagnosis and treatment highly important. A study starting at Tampere University (TAU) will investigate the efficacy of a new imaging technique developed by researchers at TAU for the early diagnosing of celiac disease. The study will also examine the extension of screening for celiac disease and the role of different environmental factors in the development of the disease.

Currently, most celiac disease patients are not diagnosed until adulthood. To prevent the complications of the disease – such as poor bone density, stunting and infertility – the researchers aim to shift the focus of celiac disease diagnosing to childhood.

Early diagnosis prevents damages

“I believe that these studies will help to diagnose celiac disease early at the stage when the interventions can still prevent serious or permanent complications,” says Kalle Kurppa, professor of child and adolescent health promotion and researcher of celiac disease.

“In the future, an even more ambitious goal is to prevent part of the celiac disease cases. In the coming few years, we will be able to continuously improve early diagnosing,” Kurppa mentions.

“The current methods are not necessarily sufficient for making a diagnosis even if we strongly suspect celiac disease, for example, based on blood tests,” he explains.

Micro CT imagining will be validated

The study will test a completely new method developed at Tampere University for the three-dimensional imaging of small intestine biopsies whose proof-of-concept study was published last year. The X-ray-based micro-CT device can be used to create a 3D reconstruction of small intestinal tissue biopsies with an accuracy of up to one micrometre over the entire sample.

Despite the increasing significance of blood tests, many celiac disease patients are still diagnosed based on small intestinal biopsies. The earlier the disease is screened in patients the more challenging histology-based diagnostics generally tend to be.

Accurate micro-CT images can significantly improve the diagnosing of celiac disease. The idea is that the disease could be found even in persons whose disease has not been confirmed by the existing methods.

“One of the purposes of this study is to find out how much better micro-CT is than the current histological methods. We already have preliminary evidence that this could be a much more sensitive and accurate approach, but we still need more research and validation in larger patient cohorts,” Kurppa explains.

The role of environmental factors in celiac disease will also be studied

“In the study, we are also trying to find environmental factors that predispose people to celiac disease and to see if that could open avenues to preventing the disease,” Kurppa says.

The celiac disease researchers are also collaborating with diabetes researchers. One common factor is enteroviruses, which are thought to be associated with the etiology of both type 1 diabetes and celiac disease.

Research data will come from, e.g., the large Hedimed study led by Professor Heikki Hyöty at Tampere University, and the international TEDDY study. In addition, the Finnish DIPP study is strongly involve d in both projects.

The Pediatric Research Foundation is funding the study on the significance of screening and early diagnosis of celiac disease in children with €100.000. Kurppa has already received another grant from the same Foundation for researching partly the same topic.

Photo: Jonne Renvall