Dynamics of celiac disease-specific serology after initiation of a gluten-free diet and use in the assessment of compliance with treatment

Background: The usefulness of celiac disease-related serology in monitoring patients on a gluten-free diet has been debated. Aim: To describe serologic changes over time and assess whether serology tests can predict compliance with the gluten-free diet. Methods: Sera obtained at baseline and every 3 months thereafter for 1 year in 82 adult celiac disease patients were assayed for: (1) IgA antigliadin, (2) IgA anti-tissue transglutaminase, (3) IgA endomysial, (4) IgA, and (5) IgG anti-deamidated gliadin peptides, (6) dual detection of IgA and IgG anti-deamidated gliadin peptides, (7) a single assay for IgA and IgG of both anti-deamidated gliadin peptide and anti-tissue transglutaminase, and (8) IgA antiactin antibodies. Results: At 3 months after diagnosis, most antibody assays significant decrease in mean concentrations (p < 0.0001) and the percentage of positive samples (p < 0.0001) with further improvement in subsequent determinations. Strictly adherents had significantly lower concentrations of antibodies (p < 0.01 to p < 0.00001) and smaller proportion of positive samples for IgA endomysial, IgA antiactin antibodies and IgA antigliadin (15.6%, 17.4% and 23.9%, respectively) than partially compliant. At 1 year, IgA endomysial (p < 0.02), IgA antiactin antibodies (p < 0.05) and anti-tissue transglutaminase (p < 0.02) predicted the degree of compliance. Conclusions: Gluten-free diet treatment produced rapid and significant qualitative and quantitative changes in celiac disease-related antibodies which may be useful for monitoring dietary compliance. (C) 2009 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.