Researchers at the University of Oslo have identified 24 blood proteins that may serve as biomarkers for celiac disease, potentially offering a more precise way to monitor gut inflammation and healing than current standard testing. The team analyzed 264 blood and tissue samples to determine if systemic protein levels could reflect intestinal damage, a development that could supplement existing diagnostic methods.
Identifying Inflammatory Protein Profiles
The study, published in the journal Gastroenterology, utilized a proteomics platform to measure 92 inflammatory proteins in serum samples collected between 2018 and 2024. Researchers compared samples from 161 adults with untreated celiac disease against 40 control individuals who were biopsy-negative for the condition.
The analysis revealed that 24 of these proteins were significantly elevated in patients with untreated celiac disease compared to healthy individuals. These protein levels generally tracked with celiac antibody titers and the severity of intestinal injury as measured by the Marsh scale. After one year on a gluten-free diet, most inflammatory markers decreased; however, nine proteins remained significantly elevated, suggesting that some patients may experience persistent, low-grade intestinal inflammation despite dietary adherence.
Limitations of Current Diagnostic Monitoring
Jostein Holen Ibsen, a physician and PhD fellow at the University of Oslo, noted that current blood tests often become less reliable once a patient begins a gluten-free diet.
Clinical Potential for Future Testing
The research team emphasizes that these new biomarkers are intended to complement, not replace, existing clinical methods. Professor Knut E. A. Lundin noted that the discovery provides a potential path toward more accurate monitoring of disease activity. Five of the identified proteins were specifically linked to the severity of gut damage, with three of those able to distinguish between healthy mucosa and severe lesions.
Further large-scale studies are required before these markers can be integrated into routine clinical practice. Researchers must now determine which specific proteins offer the greatest diagnostic utility for long-term follow-up.
How New Blood Tests Differ from Celiac Screenings?
How do these new blood tests differ from current celiac screenings? The new biomarker approach uses proteomics to detect a range of 24 inflammatory proteins that appear to correlate more closely with actual intestinal tissue inflammation and recovery.
Does a gluten-free diet completely eliminate gut inflammation?
Not necessarily. The study found that while inflammatory protein levels dropped significantly after one year of treatment, nine specific proteins remained elevated in patients following a gluten-free diet. This suggests that some individuals may continue to have low-grade, "quiet" inflammation in the gut even when they are diligent about their dietary restrictions.
Will these biomarkers replace the need for a gastroscopy?
The researchers do not intend for these markers to replace current methods like gastroscopy or serology. Instead, they hope the biomarkers will provide a more comprehensive, non-invasive "picture" of how the disease is progressing, offering clinicians a more reliable way to track patient health during follow-up visits.
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