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Multicenter Study
. 2017 Aug 17;7(1):8671.
doi: 10.1038/s41598-017-07242-4.

Progress towards non-invasive diagnosis and follow-up of celiac disease in children; a prospective multicentre study to the usefulness of plasma I-FABP

M P M Adriaanse  1 , A Mubarak  2 , R G Riedl  3 , F J W Ten Kate  4 , J G M C Damoiseaux  5 , W A Buurman  6   7 , R H J Houwen  2 , A C E Vreugdenhil  8 ; Celiac Disease Study Group
Collaborators, Affiliations
Multicenter Study

Progress towards non-invasive diagnosis and follow-up of celiac disease in children; a prospective multicentre study to the usefulness of plasma I-FABP

M P M Adriaanse et al. Sci Rep. .

Abstract

This prospective study investigates whether measurement of plasma intestinal-fatty acid binding protein (I-FABP), a sensitive marker for small intestinal epithelial damage, improves non-invasive diagnosing of celiac disease (CD), and whether I-FABP levels are useful to evaluate mucosal healing in patients on a gluten-free diet (GFD). Ninety children with elevated tTG-IgA titres and HLA-DQ2/DQ8 positivity were included (study group). Duodenal biopsies were taken, except in those fulfilling the ESPGHAN criteria. Plasma I-FABP levels and tTG-IgA titres were assessed sequentially during six months of follow-up. Eighty children with normal tTG-IgA titres served as control group. In 61/90 (67.8%) of the children in the study group an increased I-FABP level was found; in all these children CD diagnosis was confirmed. Interestingly, in 14/30 (46.7%) children with slightly elevated tTG-IgA titres (<10x upper limit of normal), an increased I-FABP level was found. In all these children the diagnosis of CD was confirmed histologically. After gluten elimination for six weeks I-FABP levels had decreased towards levels in the control group. Measurement of plasma I-FABP, in addition to tTG-IgA, EMA-IgA and HLAtyping, enables non-invasive diagnosing of CD in a substantial number of children, and might therefore be of value in the diagnostic approach of CD.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Study protocol.
Figure 2
Figure 2
Study visits and measurements at disease presentation and during follow-up of all included patients.
Figure 3
Figure 3
Plasma I-FABP results of all included patients with a clinical suspicion of celiac disease.
Figure 4
Figure 4
Plasma I-FABP levels are significantly elevated in celiac disease patients compared to control individuals (A). Plasma I-FABP levels (B) and tTG-IgA titres (C) in celiac disease patients after initiation of a gluten-free diet (Figure B includes patients with elevated I-FABP levels at diagnosis only, n = 79, 21, 74, 70, 76 at t = 0, 3, 6, 12 and 26, respectively). *Significantly different as compared with week 0, p < 0.05.
Figure 5
Figure 5
Plasma I-FABP levels stratified for the degree of villous atrophy at time of diagnosis of CD. *Significantly elevated compared with controls, #Significantly elevated compared with Marsh 0, and Marsh I.
Figure 6
Figure 6
Correlation between plasma I-FABP levels and serum tTG-IgA titres at time of presentation.
See this image and copyright information in PMC

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