<<Disclaimer: Verify this information before applying it to your situation.>>
Feedback sought regarding Enterolab report. It is a little confusing to read, but two things struck me: one, the gene test is done somewhere else, and two, has anyone else ever heard of the notion that there are genes that predispose to Celiac but are not the known Celiac genes? It was my understanding that Prometheus looks not only for the main two genes that are known, but also a third which to date has succeeded in identifying Celiac in all biopsy-diagnosed Celiacs who previously had negative gene test results. Dr. Fine seems to be saying he can find yet another set of genes which predispose to Celiac.
I wonder if anyone else knows anything authoritative about this.
I have cut and pasted the two key points. I was unable to include the full Enterolab results due to list length restrictions on posts, but have tried to leave as much as possible for informational purposes.
Thanks.
I will post a summary of responses.
Hilary
"Molecular Gene Analysis performed by: Laboratories at Bonfils"
"Although you do not possess the main genes predisposing to celiac sprue
(HLA-DQ2 or HLA-DQ8), HLA gene analysis reveals that you have a
genotype
that predisposes to gluten sensitivity [either HLA-DQB1*03xx (HLA-DQ3,
not
0302), or any HLA-DQB1*05xx or any HLA-DQB1*06xx (HLA-DQ1)]."
Final Laboratory Report
Date: 1/7/06
Gluten Sensitivity Testing
Fecal Antigliadin IgA 15 Units (Normal Range <10 Units)
Fecal Antitissue Transglutaminase IgA 12 Units (Normal Range <10
Units)
Microscopic Fecal Fat Score: 135 Units &nbs! p; (Normal Range < 300 Units)
HLA-DQ Gene Molecular analysis: HLA-DQB1*0301, 0301
Analysis of this stool sample indicates you have dietary gluten
sensitivity. For optimal health and prevention of small intestinal
damage,
osteoporosis, damage to other tissues (like nerves, joints, pancreas,
skin,
liver, am! ong others), and malnutrition, recommend a strict gluten free
diet. If you are experiencing any symptoms, these may resolve following
a
gluten free diet. As gluten sensitivity is a genetic syndrome, you may
want to have your relatives screened as well.
Although you do not possess the main genes predisposing to celiac sprue
(HLA-DQ2 or HLA-DQ8), HLA gene analysis reveals that you have a
genotype
that predisposes to gluten sensitivity [either HLA-DQB1*03xx (HLA-DQ3,
not
0302), or any HLA-DQB1*05xx or any HLA-DQB1*06xx (HLA-DQ1)].
The numeric value of an antibody is not a measure of clinical
severity. Values of 10 Units can be associated with the same reactions
as
the maximum values we measure (200-300). Most positive reactions are
between 20 and 80 Units. An analogy would be trying to use the level of
antibodies to penicillin in a person who has had an allergic ! reaction
to
penicillin to determine if it would be safe for them to take penicillin
again. This obviously is not done because those with demonstrated
penicillin allergy could not take penicillin without the risk of
suffering
severe health consequences. Although gluten sensitivity is not a true
allergy like penicillin allergy, the concept is the same.
Interpretation of Fecal IgA to the Human Enzyme Tissue
Transglutaminase:
Values greater than or equal to 10 Units indicate that the immune
reaction
to gliadin has resulted in an autoimmune reaction to the human enzyme
tissue transglutaminase. It is this autoantibody that may be
responsible
for the many autoimmune diseases associated with gluten sensitivity.
Interpretation of Quantitative Fecal Fat Microscopy: A fecal fat score
less than 300 indicates there is no malabsorbed dietary fat in stool
indicating that digestion and absorption of nutrients is normal.
Interpretation Of HLA-DQ Testing by Molecular Analysis and Conversion
to
"Serologic Equivalent": Today HLA-DQ gene testing is done by analyzing
DNA
using molecular techniques. In the past, the methods were done by
analyzing
blood cells for the antigens produced by the genes, and these past
methods
were responsible for the most commonly known nomenclature for HLA-DQ
genes
even today (using integers such as "DQ2"). These are called "serologic
equivalents" to the specifically analyzed gene material. The serologic
equivalents are as follows:
* If the first two numbers of the molecular type are 05, the serologic
equivalent is DQ1 subtype DQ5
* If the first two numbers of the molecular type are 06, the serologic
equivalent is DQ1 subtype DQ6
* If the molecular type is 0201, the serologic equivalent is DQ2 * If
the
molecular type is 0301, the serologic equivalent is DQ3 subtype DQ7
* If the molecular type is 0302, the serologic equivalent is DQ3
subtype DQ8
* If the molecular type is 0303, the serologic equivalent is DQ3
subtype DQ9
* If the first two numbers of the molecular type are 03 but it is not
0301,
0302, or 0303, the serologic equivalent is DQ3
* If the first two numbers of the molecular type are 04, the serologic
equivalent is DQ4
The gluten sensitive, celiac genes are HLA-DQB1*0201 and HLA-DQB1*0302
(HLA-DQ2 and HLA-DQ8, respectively).
The other gluten sensitive genes are any molecular type involving
another
HLA-DQB1*03 number (i.e., HLA-DQ3), or any HLA-DQB1*05 number, or any
HLA-DQB1*06 n! umber (i.e., HLA-DQ1)
If you have one gluten sensitive gene, then your offspring have a 50%
chance of receiving the gene from you, and at least one of your parents
passed it to you. Having two copies of a gluten sensitive or celiac
gene,
means that each of your parents, and all of your children (if you have
them) will possess at least one copy of the gene. Two copies also means
there is an even stronger predisposition to gluten sensitivity than
having
one gene and the resultant immunologic gluten sensitivity or celiac
disease
may be more severe.
For more information about result interpretation, please see
http://www.enterolab.com/What_Happens
Stool Analysis performed by: Frederick Ogunji, Ph.D., EnteroLab
Molecular Gene Analysis performed by: Laboratories at Bonfils
Interpretation of all results by: Kenneth D. Fine, M.! D., EnteroLab
*Support summarization of posts, reply to the SENDER not the Celiac List*
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