<<Disclaimer: Verify this information before applying it to your situation.>> I asked two questions with respect to the abstracts presented professionally by Drs. Green and Murray on the sensitivity of commercial labs on the antibody tests for diagnosis: >>Are the labs listed in the FAQ (last I checked) research or commercial? >>What about the sensitivity of the commercial labs for monitoring after >>diagnosis? For the first, Mike Jones, a list owner, pointed out that two were commercial, two research. You'll find the list of four in the message CELIAC DIAG-TST obtained by using a GET command to the listserv adddress for NEWCEL, a collection of files. The two hospitals listed are "research" (my interpretation: their antibody tests are backed up with biopsed celiac and biopsed normal blood samples) and two labs apparently "commercial". In the meantime, I also reread the abstracts, especially Dr. Murray's. His may not have been posted to the list. If someone has an electronic copy, it would be helpful to post it in this thread. What I glossed over with Dr. Murray's result was that for diagnosis, or the need for biopsy, from a commercial lab the sensitivity is not as low as 50% if all tests are combined and I quote: "When both IgG and IgA and endosymial IgA are combined in each individual lab (the sensitivity) was 90-100%...The specificity of the endosymial antibody in this limited survey was 100% in all participating laboratories. " He gives a complete table of sensitivity and selectivity for each of the four tests. The following response from IMMCO, one of the "labs" in that file: >>The results of our study, especially or endomysial antibodies, are unremarkable with almost, if not 100%, specificity and sensitivity. If you any questions, I will be happy to discuss with individual or individuals on the issue. Sincerely, Vijay Kumar, Ph.D. [log in to unmask]<< (Dr. Kumar published some of the early research studies on the antibody test. "Unremarkable" for a research scientist means he/she doesn't have to publish an article for professional colleagues explaining why they couldn't get 100% sensitivity.) But for monitoring? The situation is grim, in my opinion. Since gluten exposure is less, fewer than four antibody tests frequently will be positive even in a reliable lab. Thus potential sensitivities of 50 % on the gliadin antibodies, the most useful for monitoring biopsed celiacs, are the reality for monitoring from commerical labs. Donald Baisch pointed out: >>The basic problem is that there are NO standard protocols for doing blood antibody tests....A number of us are supporting the Celiac Disease Foundation efforts to resolve and achieve a recogized standardard set of protocols for the four antibody serum tests needed to define the NEED for a small bowel biopsy. << (I question whether the same protocol is needed if all assays are biopsy backed.) While I applaud the CDF for pushing for standards, I fear the self-destructive effects of inter-group politics on general efforts, such as this, to really help celiacs. One group proposes and generates automatic opposition from the others. What's needed here is a competent panel to speak for the whole celiac community, professional and patient, to bring these commercial labs most of us are forced to use up to acceptable standards. Patients can't get their insurance companies to authorize biopsies every year or two for monitoring purposes, the alternative solution. So I propose such a panel with relevant expertise to work toward that goal. Noble goal, easily said, and then forgotten? Anyone with expertise and interest, please contact me by e-mail. Let's do it. Im volunteer because instruments and measurements are my business professionally. I can bring a different perspective as a biopsied celiac and do feel that celiacs themselves should have a voice, especially if consensus is foundering on technical differences of opinion. Kemp Randolph Long Island ----------------------------------------------------------- <[log in to unmask]> -----------------------------------------------------------