A Breath Test for Celiac Disease? Yes Please!

Celiac.com 05/20/2019 – A stuffy and obscure-sounding scientific paper has more than a few people excited about a breakthrough breath test to help manage diabetes, celiac disease and other conditions.

Celiac is one of the most common and misdiagnosed disease. The process of getting a proper diagnosis can be long and convoluted. In part, that’s because people with celiac disease may have few or no symptoms. In fact, these days, most people diagnosed with celiac disease report few or no symptoms.

In fact, it’s not at all uncommon for a person with celiac disease to suffer for up to 10 years before getting a proper celiac diagnosis.

In diabetes, glucagon increases blood glucose levels. In diabetes treatment, DPP-4 inhibitors are used to reduce glucagon and blood glucose levels.  According to Wikipedia, they do this by increasing levels of incretin, GLP-1 and GIP, “which inhibit glucagon release, which in turn increases insulin secretion, decreases gastric emptying, and decreases blood glucose levels.”

The excitement arrises because a team of scientists has developed a selective, non-invasive breath test that could be used to diagnose and treat celiac disease and Type-II diabetes.

The development team set out to develop a selective, non-invasive, stable-isotope 13C-breath test that can detect dipeptidyl peptidase-4 inhibitors (DPP4i), a class of orally available, small molecule inhibitors for the management of Type-II diabetes. 

The team included Roger Yazbeck, Simone Jaenisch, Michelle Squire, Catherine A. Abbott, Emma Parkinson-Lawrence, Douglas A. Brooks & Ross N. Butler. The team’s paper carries the very weighty title: Development of a 13C Stable Isotope Assay for Dipeptidyl Peptidase-4 Enzyme Activity A New Breath Test for Dipeptidyl Peptidase Activity.

If you read that title, and understood only the words “breath test,” you are not alone. The title and the paper are highly scientific. The takeaway is that the test they developed could be useful in diagnosing, treating, and managing diabetes and gastrointestinal diseases, including celiac disease.

The team’s paper describes in detail their development process for the stable-isotope 13C-breath test for DPP4. The test could potentially help to treat and manage diabetes, celiac disease, and other conditions, including certain cancers.

“Furthermore,” the paper reads “the significant pool of DPP4 in the small bowel and in inflammatory conditions suggests that a DPP4 breath test could also have potential application as a non-invasive method to measure intestinal function/integrity and immune status. Certain cancers also exhibit high expression of DPP4 as exemplified by the adenocarcinoma cell line in this study and this may provide a measure of cancer activity and response to therapy.”

Imagine a quick non-invasive breath test that can do all that. That’s exciting stuff. Among other things, it could mean better treatment, and less unnecessary suffering. We say: Yes, please!

Do you find the idea of a breath test for diabetes and celiac disease an exciting prospect? Share comments below.

Read more in Nature.com Scientific Reports; volume 9, Article number: 4906 (2019.

Also of interest is D Detel, M Persic, & J Varljen’s paper titled “Serum and intestinal dipeptidyl peptidase IV (DPP IV/CD26) activity in children with celiac disease,” and published in the Journal of Pediatric Gastroenterology and Nutrition; 45, 65–70

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