title: Tetramer-visualized gluten-specific CD4+ T cells in blood as a potential diagnostic marker for coeliac disease without oral gluten challenge.
abstract: BACKGROUND
  Diagnosing coeliac disease (CD) can be challenging, despite highly specific autoantibodies and typical mucosal changes in the small intestine. The T-cell response to gluten is a hallmark of the disease that has been hitherto unexploited in clinical work-up.
  
  
  OBJECTIVE
  We aimed to develop a new method that directly visualizes and characterizes gluten-reactive CD4+ T cells in blood, independently of gluten challenge, and to explore its diagnostic potential.
  
  
  METHODS
  We performed bead-enrichment of DQ2.5-glia-α1a and DQ2.5-glia-α2 tetramer+ cells in the blood of control individuals, treated (TCD) and untreated patients (UCD). We visualized these cells by flow cytometry, sorted them and cloned them. We assessed their specificity by antigen stimulation and re-staining with tetramers.
  
  
  RESULTS
  We detected significantly more gliadin-tetramer+ CD4+ effector memory T cells (TEM) in UCD and TCD patients, compared to controls. Significantly more gliadin-tetramer+ TEM in the CD patients than in controls expressed the gut-homing marker integrin-β7.
  
  
  CONCLUSIONS
  Quantification of gut-homing, gluten-specific TEM in peripheral blood, visualized with human leukocyte antigen (HLA) -tetramers, may be used to distinguish CD patients from healthy individuals. Easy access to gluten-reactive blood T cells from diseased and healthy individuals may lead to new insights on the disease-driving CD4+ T cells in CD.
authors.affiliation: Centre for Immune Regulation and Department of Immunology, University of Oslo and Oslo University Hospital - Rikshospitalet, Oslo, Norway.
authors.forename: Asbjørn
authors.initials: A
authors.lastname: Christophersen
authors.affiliation: Centre for Immune Regulation and Department of Immunology, University of Oslo and Oslo University Hospital - Rikshospitalet, Oslo, Norway.
authors.forename: Melinda
authors.initials: M
authors.lastname: Ráki
authors.affiliation: Centre for Immune Regulation and Department of Immunology, University of Oslo and Oslo University Hospital - Rikshospitalet, Oslo, Norway.
authors.forename: Elin
authors.initials: E
authors.lastname: Bergseng
authors.affiliation: Centre for Immune Regulation and Department of Immunology, University of Oslo and Oslo University Hospital - Rikshospitalet, Oslo, Norway ; Department of Transplantation Medicine, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital - Rikshospitalet, Oslo, Norway.
authors.forename: Knut Ea
authors.initials: KE
authors.lastname: Lundin
authors.affiliation: Department of Gastroenterology, Oslo University Hospital - Ullevål, Oslo, Norway.
authors.forename: Jørgen
authors.initials: J
authors.lastname: Jahnsen
authors.affiliation: Centre for Immune Regulation and Department of Immunology, University of Oslo and Oslo University Hospital - Rikshospitalet, Oslo, Norway.
authors.forename: Ludvig M
authors.initials: LM
authors.lastname: Sollid
authors.affiliation: Centre for Immune Regulation and Department of Immunology, University of Oslo and Oslo University Hospital - Rikshospitalet, Oslo, Norway.
authors.forename: Shuo-Wang
authors.initials: SW
authors.lastname: Qiao
keywords: Blood test; T cells; celiac disease; diagnostic marker; diagnostics; gliadin; gluten; gluten reactivity; histology; human leukocyte antigen; immunology
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