title: Usefulness of the organ culture system in the in vitro diagnosis of coeliac disease: a multicentre study.
abstract: 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.
authors.affiliation: Department of Clinical Sciences, University La Sapienza, Rome, Italy. a.picarelli@flashnet.it
authors.forename: Antonio
authors.initials: A
authors.lastname: Picarelli
authors.forename: Marco
authors.initials: M
authors.lastname: Di Tola
authors.forename: Luigi
authors.initials: L
authors.lastname: Sabbatella
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Anania
authors.forename: Antonio
authors.initials: A
authors.lastname: Calabrò
authors.forename: Daniela
authors.initials: D
authors.lastname: Renzi
authors.forename: Julio Cesar
authors.initials: JC
authors.lastname: Bai
authors.forename: Emilia
authors.initials: E
authors.lastname: Sugai
authors.forename: Antonio
authors.initials: A
authors.lastname: Carroccio
authors.forename: Lidia
authors.initials: L
authors.lastname: Di Prima
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Bardella
authors.forename: Donatella
authors.initials: D
authors.lastname: Barisani
authors.forename: Carmen
authors.initials: C
authors.lastname: Ribes-Koninckx
authors.forename: Ester Donat
authors.initials: ED
authors.lastname: Aliaga
authors.forename: Maurizio
authors.initials: M
authors.lastname: Gasparin
authors.forename: Enzo
authors.initials: E
authors.lastname: Bravi
mesh_terms: 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
chemical_list: D001323:Autoantibodies