{"doi":"10.3390/nu15245083","title":"Dynamics of Serologic Change to Gluten in Celiac Disease Patients","abstract":"Serologic measures of tissue transglutaminase (tTG) immunoglobulin A (IgA) and deamidated gliadin peptide (DGP) IgA and immunoglobulin G (IgG) are hallmark tests utilized when diagnosing individuals for celiac disease (CeD) and for monitoring adherence to a gluten-free diet (GFD), currently the only available treatment for CeD. We address two issues in this study: (i) the relapse to seropositivity for CeD patients who resume a gluten containing diet and (ii) the correlation between two different tTG-IgA assays near the upper limit of normal (ULN) designated thresholds. Regarding the first issue, often a suspected CeD individual is put back on a gluten diet to return to their serologic levels. However, we show it requires a substantial amount of gluten for serology to return to a positive level. For example, in one study of 22 patients treated with placebo and taking 84 g of gluten over 6 weeks, only two converted from seronegative to seropositive for tTG-IgA. Regarding the second topic, we compare the relationship for different serologic assays, namely tTG-IgA AB (recombinant, ULN = 4 units/mL) vs. tTG-IgA (non-recombinant, ULN = 20 units). There is a strong correlation between both measurements as evidenced by a Pearson coefficient of R = 0.8584; however, we observed that the cross-correlation in terms of sensitivity and specificity improved substantially by using an ULN value of three instead of four for the tTG-IgA AB (recombinant) assay. This result suggests that assay thresholds used for initial diagnosis in patients who have not yet started a GFD may need to be adjusted for monitoring and in the setting of a diagnostic gluten challenge.","journal":"Nutrients","year":2023,"id":354515,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":7,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9632,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":687024,"name":"Ana Pilar Ramos","orcid":"0000-0003-0191-7024","position":1,"is_corresponding":false},{"id":535957,"name":"Vasiliy Loskutov","orcid":null,"position":2,"is_corresponding":false},{"id":856694,"name":"Anna Norum","orcid":null,"position":3,"is_corresponding":false},{"id":237531,"name":"Adam C. Bledsoe","orcid":"0000-0002-6166-6661","position":4,"is_corresponding":false},{"id":695054,"name":"Rok Seon Choung","orcid":"0000-0002-3621-8816","position":5,"is_corresponding":false},{"id":856688,"name":"Matthew A. Dickason","orcid":null,"position":6,"is_corresponding":false},{"id":856692,"name":"Jennifer A. Sealey‐Voyksner","orcid":null,"position":7,"is_corresponding":false},{"id":237522,"name":"Joseph A. Murray","orcid":"0000-0003-1941-9090","position":8,"is_corresponding":false},{"id":855778,"name":"Jack A. Syage","orcid":"0000-0002-6336-7198","position":0,"is_corresponding":true}],"reference_count":34,"raw_metadata":null,"created_at":"2026-07-19T01:13:06.959762Z","pmid":"38140342","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}