Intestinal intraepithelial lymphocytes and anti-transglutaminase in a screening algorithm for coeliac disease

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Abstract
We have noticed the frequent publication of important advances in the serological screening of coeliac disease (CD), such as the interesting and useful technique described by Baldas et al ( Gut 2000; 47 :628–31). Humoral screening of CD is coming closer than ever towards representing an affordable population wide strategy ( Gut 2000; 47 :628–31), largely due to the identification of tissue transglutaminase (tTG) as the main—if not only—autoantigen for antiendomysial antibodies (EMA).1 This finding hightlights the possibility of antigen specific testing and, today, determination of anti-tTG is a valid alternative to EMA.2 However, we believe that the recent advances in the cellular component of the diagnosis of CD have been somewhat overlooked. The study of intestinal intraepithelial lymphocytes (IEL) by flow cytometry3 has added specificity to mere histological study of the small bowel biopsy. It has been shown that CD is characterised by an important increase in the TcR-γδ …