The mouth as source of antibody tests and biopsy for diagnosis of celiac disease?

The mouth may produce the specific diagnostic blood antibodies and manifest the characteristic microscopic changes of celiac disease according to a study published by researchers from Palermo, Italy. Both endomysial antibody (EMA) and tissue transglutaminase antibodies (TTG) were detectable in more than half of twenty eight adults and children with newly diagnosed celiac disease who agreed to participate in the study. The presence of and degree of lymphocyte infiltration in the mouth correlated well with the detection of antibodies from swab of the mouth.

Further research into the feasibility of diagnosing celiac disease from sampling of the mouth without requiring a small intestine biopsy is indicated. Combined with genetic testing for presence of HLA DQ2 and/or DQ8, currently obtainable from a mouth swab, such testing could be highly accurate and non-invasive. It must be remembered that using EMA and TTG and presence of either DQ2 and/or DQ8 will select out those with celiac disease by strict criteria but could miss individuals with the gluten syndrome or non-celiac gluten sensitivity.

Reference:

Carrocio A., et al. “Oral mucosa of coeliac disease patients produces antiendomysial and antitransglutaminase antibodies:The diagnostic usefulness of an in vitro culture system.” Aliment Pharmacol Ther. 2007; 25 (12):1471-1477