Usefulness of the organ culture system in the in vitro diagnosis of coeliac disease: a multicentre study.
OBJECTIVE
Diagnosis of coeliac disease is based on the presence of villous atrophy which recovers following a gluten-free diet. The presence of circulating antiendomysial antibodies as well as their disappearance after a gluten-free diet supports the diagnosis. It has also been demonstrated that antiendomysial antibodies are detectable in supernatants of cultured intestinal biopsies from patients with coeliac disease. The objective of this study was to compare the histology and antiendomysial antibodies in culture supernatants of intestinal biopsies to validate the in vitro organ culture system as a future diagnostic tool for coeliac disease.


METHODS
Seventy-five antiendomysial serum-positive patients on a gluten-containing diet were evaluated. Patients underwent endoscopy with 5 biopsy fragments: 3 for histology, 1 cultured with and the other without gliadin-peptide activator. Antiendomysial antibodies were evaluated in all culture supernatants.


RESULTS
Sixty-eight patients had evidence of villous atrophy, while 73 out of 75 were positive to the organ culture system. The agreement rate between organ culture and histology results was 94%.


CONCLUSIONS
As all the centres participating in the study obtained good agreement between organ culture and histology results, the new system could be considered a reliable tool for the diagnosis of coeliac disease. Nevertheless, it is possible to highlight cases with an organ culture-positive and -negative histology. This feature could be of considerable interest because, as the sensitivity of organ culture seems to be greater than the initial histology, the new system might be useful in uncertain cases where the risk of missing the diagnosis of coeliac disease is high.
Picarelli
Antonio
A
Department of Clinical Sciences, University La Sapienza, Rome, Italy. a.picarelli@flashnet.it
Di Tola
Marco
M
Sabbatella
Luigi
L
Anania
Maria Cristina
MC
Calabrò
Antonio
A
Renzi
Daniela
D
Bai
Julio Cesar
JC
Sugai
Emilia
E
Carroccio
Antonio
A
Di Prima
Lidia
L
Bardella
Maria Teresa
MT
Barisani
Donatella
D
Ribes-Koninckx
Carmen
C
Aliaga
Ester Donat
ED
Gasparin
Maurizio
M
Bravi
Enzo
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D001118:Argentina / Q000453:epidemiology; D001323:Autoantibodies / Q000276:immunology; D001706:Biopsy; D002446:Celiac Disease / Q000453:epidemiology / Q000276:immunology / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009924:Organ Culture Techniques / Q000379:methods; D015203:Reproducibility of Results
D001323:Autoantibodies