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$399.00
SPECIMEN REQUIREMENT:
2 mL Serum
Ambient
Current testing for Gluten-Reactivity and (CD) includes serum IgG and IgA against gliadin and
tissue transglutaminase-2 (tTG2). These antibodies are measured against minor components of a
wheat protein called alpha-gliadin. However, as noted above, wheat consists of multiple proteins
and peptides including, alpha-gliadin, alpha-beta-gliadin, omega-gliadin, low- and high-molecular
weight glutenins, gluteomorphin, prodynorphin, farinin, serpin, amylases, globulins, albumins,
agglutinins and more. Any of these antigens has a capacity to challenge the immune system.
Because of this heterogeneity of gluten proteins and peptides, multiple variations in T-cell
responses may occur against them. Recent medical research indicates that a large number of
gluten epitopes, may be implicated in the development of Gluten-Reactivity, CD and other
associated conditions such as NCWR.
Why, if there are several proteins in wheat, do we assess reactivity to only one? The repertoire
and hierarchy of gluten peptides stimulate the intestinal T-cells and results in a significant
elevation of IgG and IgA production. Publications regarding T cell reactions stimulated our
concept for the development of the original Array 3 – Wheat/Gluten Proteome Reactivity and
Autoimmunity (launched in 2011).
Comprehensive quantitative mapping of T-cell epitopes was determined in CD.17 Results
demonstrated that patients respond to a heterogeneous array of peptides; some recognized many
peptides from single or multiple gliadin families, while others reacted to only one peptide. These
results confirmed that a large number of gluten epitopes may be implicated in the development of
CD and associated diseases. Indeed, a T-cell line from one Celiac patient failed to recognize any
of the 21 tested peptides, which confirmed that a large number of gluten and other wheat protein
epitopes are implicated in development of CD and associated disorders. This suggests that other
gliadin peptides and proteins are involved in the pathogenesis of Gluten-Reactivity and CD.
We extended this heterogeneity in T-cell responses to gluten and other proteins or peptides
originated from wheat to humoral immune responses by measuring IgG and IgA antibodies
against multiple wheat antigens and peptides as well as enzymes associated with wheat/gluten
autoimmunities. Heterogeneity in IgG and IgA antibodies against these antigens was confirmed
by variation in antibody response against different wheat associated antigens on individual basis.
Research, performed by Aristo Vojdani,
18 confirms that different Gluten-Reactive and CD
patients recognize an array of gluten and non-gluten antigens. For example, one patient reacts to
omega-gliadin, but not to alpha-gliadin. The second patient reacts to all gliadin peptides, and the
third patient reacts only to the wheat germ agglutinin.
Up to 86 % of patients recognize a different array of peptides.
17 And yet, commercially, the only
peptide that is tested is alpha-gliadin 33 MER. A panel of gluten peptides, which includes a
number of the more common immunodominant antigens, would provide new opportunities to
screen, prevent disease development in individuals at risk,
19 and increase the sensitivity of the test
to identify Gluten-Reactivity (with or without the enteropathy CD).
Antigens Tested (IgG and IgA tested separately for each antigen)
• Wheat
• Wheat Germ Agglutinin
• Non-Gluten Proteins-A*
• Non-Gluten Proteins-B*
• Gliadin Toxic Peptides*
• Native + Deamidated
Alpha-Gliadin-33-mer
• Alpha-Gliadin-17-mer
• Gamma-Gliadin-15-mer
• Omega-Gliadin-17-mer
• Glutenin-21-mer
• Gluteomorphin+Prodynorphin
• Gliadin-Transglutaminase Complex
• Microbial Transglutaminase*
• Transglutaminase-2
• Transglutaminase-3
• Transglutaminase-6
CLINICAL USE:
• Identify possible Celiac disease, non-celiac gluten
sensitivity, dermatitis herpetiformis, gluten ataxia or
other wheat/gluten-related disorder.
• Assess autoimmune reactivity associated with wheat
proteins and peptides.
RECOMMENDED FOR PATIENTS WHO:
Have non-responsive GI symptoms.
• Present multiple-symptom complaints (including
Chronic Fatigue Syndrome and Fibromyalgia).
• Suffer from depression or neuro-autoimmunity.
Cyrex adheres to and surpasses the highest standards of clinical laboratory testing worldwide. A Cyrex-designed quality control criterion called The Double Assurance System (QC2™) is the standard operating procedure at Cyrex Laboratories. In fact, Cyrex’s proprietary QC2™ method enhances the reproducibility, specificity and sensitivity of all Cyrex arrays. Only Cyrex tests contain the accuracy enhancements provided by The Double Assurance System.
Before ordering please consider the following: • Patient has been clear of immunosuppressant AND/OR corticosteroid drugs for at least 60 days. • Patient has had timely and adequate antigen exposure in order to measure antibody responses.
Q: Are there any medications, foods, conditions or other factors that could interfere with the results of a Cyrex test?A: Yes. While Cyrex is unable to provide an exhaustive answer to this question due to the interactive complexities and varieties of medications and patient circumstances, the following has been noted:
a. Immunosuppressant and corticosteroid drugs can reduce antibody production and cause false negative results. b. Limited assessments on the effects of aspirin, acetaminophen, and antipsychotics on Arrays 1-4 have been performed. No noticeable effects were observed. c. Inhalers can affect the results of Cyrex's oral fluid testing (Array 1). Wait two weeks after completion of inhalant dosages before collecting the specimen. d. Unknown cross-reactive epitopes from foods and microorganisms may stimulate the antibody production in the absence of a true antigen. Cyrex has already developed Array 4 in order to recognize the most common antigens in this regard. e. A gluten-free diet can cause false negative results on gluten protein/peptide tests. f. Certain conditions, such as ileal pouch surgery, may cause a false positive celiac serology.1
1. Lian L, Remzi FH, Kiran RP, Fazio VW, Shen B. Clinical implication of false-positive celiac serology in patients with ileal pouch. Dis Colon Rectum. 2010 Oct; 53(10):1446-1451.
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