Gluten antibodies are specific proteins produced by the immune system because it views gluten (the proteins found in wheat, rye, and barley) as a threat. In individuals with celiac disease, consuming gluten triggers an abnormal immune response, leading to higher than normal levels of these antibodies in their blood.
Understanding the Immune Response to Gluten
Normally, the immune system defends the body against harmful invaders like bacteria and viruses. However, in people with celiac disease, a genetic predisposition causes their immune system to mistakenly identify gluten as a dangerous substance. When gluten is ingested, the immune system mounts an attack, producing antibodies specifically targeted at gluten or other components of the gut lining that react to gluten. This misguided immune attack primarily damages the villi—small, finger-like projections in the small intestine responsible for nutrient absorption—leading to a range of symptoms and malabsorption.
Types of Gluten Antibodies
Several specific types of antibodies are commonly tested to help diagnose celiac disease and monitor its management. These antibodies serve as crucial markers of the immune system's reaction to gluten.
Here are the primary types of gluten antibodies typically measured:
| Antibody Type | Full Name | Significance |
|---|---|---|
| tTG-IgA | Tissue Transglutaminase IgA | Most common and highly sensitive/specific test for celiac disease. |
| DGP-IgA / DGP-IgG | Deamidated Gliadin Peptide IgA / IgG | Useful for diagnosing celiac disease, especially in individuals who are IgA deficient or under 2 years old. |
| EMA-IgA | Endomysial Antibody IgA | Highly specific for celiac disease; often used as a confirmatory test after a positive tTG-IgA result. |
| Total IgA | Immunoglobulin A | Measured to ensure that an IgA deficiency isn't causing a false-negative tTG-IgA or EMA-IgA result. |
These antibodies are key indicators that the immune system is reacting to gluten, especially tTG-IgA, which is the primary screening tool for celiac disease.
Role in Diagnosis and Monitoring
The presence of elevated gluten antibodies in the blood is a strong indicator of celiac disease. Blood tests for these antibodies are typically the first step in diagnosing the condition. If antibody levels are high, a small bowel biopsy is often recommended to confirm the diagnosis by observing damage to the intestinal villi.
Furthermore, monitoring gluten antibody levels can be helpful after diagnosis. Once an individual with celiac disease adopts a strict gluten-free diet, their antibody levels should decrease and ideally normalize as the intestinal lining heals. Persistently high or rising antibody levels may indicate continued gluten exposure, either intentionally or unintentionally, or a non-responsive form of celiac disease.
Who Develops Gluten Antibodies?
While the provided reference specifically highlights that "People with celiac disease who eat gluten have higher than normal levels of certain antibodies in their blood," it's important to note that these antibodies are a hallmark of the autoimmune response characteristic of celiac disease. Not everyone who consumes gluten will develop these antibodies; they are primarily produced by the immune system of individuals with a genetic predisposition to celiac disease when exposed to gluten.
