Blood proteins may help doctors track intestinal damage and recovery in coeliac disease.
Researchers in Norway have found that certain proteins in the blood may help doctors better understand how coeliac disease affects the gut and whether damage continues after treatment begins. The findings suggest that these proteins could one day improve the way patients are checked for signs of inflammation and recovery. However, more research is needed before the findings can be turned into a test used in everyday medical care.
Coeliac disease is a condition in which the body’s immune system reacts to gluten, a protein found in wheat, barley, and rye. When someone with the condition eats gluten, the immune system can cause inflammation that damages the lining of the small intestine. This damage can make it harder for the body to take in vitamins, minerals, and other nutrients from food. Symptoms can vary, and some people may have ongoing intestinal damage even when they do not feel especially unwell. At present, the main treatment is a strict gluten-free diet. Avoiding gluten can help the intestine heal and reduce the immune response. However, checking whether the gut has fully recovered can be difficult. Blood tests commonly used to follow the condition may become less reliable after a patient has stopped eating gluten, leaving some people uncertain about whether inflammation or damage remains.
A research team from the University of Oslo and Oslo University Hospital investigated whether proteins in the blood could provide a clearer picture. These proteins may act as biomarkers, meaning measurable signs that help show what is happening inside the body. The team studied 264 blood and tissue samples from people with coeliac disease, including samples collected before treatment and after one year on a gluten-free diet. Samples from people without the condition were also included for comparison. The samples had been collected at Rikshospitalet in Norway in the six-year span between 2018 and 2024. Researchers used a method called proteomics, which allows scientists to measure many different proteins at the same time. This gave the team a way to compare protein levels among people with untreated coeliac disease, those following a gluten-free diet, and healthy participants.
The analysis identified 24 proteins linked to coeliac disease. Nine appeared to have a stronger connection with the amount of damage in the intestine. These proteins may help researchers estimate how active the disease is and how much harm has occurred in the gut. People with untreated coeliac disease generally had the highest levels of proteins linked to inflammation, while healthy participants had the lowest levels. Researchers also found changes in protein levels after patients had spent a year following a gluten-free diet. This suggests that the proteins may reflect changes in the body as treatment takes effect and the intestine begins to recover.
However, the results also showed that some people following a gluten-free diet continued to have slightly higher levels of certain proteins than those without coeliac disease. The finding raises the possibility that inflammation may remain in some patients even when they are following their diet carefully. The study does not establish that every patient on a gluten-free diet has ongoing intestinal damage, and further work is needed to understand what the differences mean for individual patients.
Doctors currently diagnose coeliac disease through blood tests that look for certain antibodies, often followed by a gastroscopy. During this procedure, a doctor uses a thin camera to examine the upper digestive tract and may collect small tissue samples from the intestine. After diagnosis, patients are often monitored by their general practitioner using blood tests that measure antibodies linked to the disease. Those tests can be less useful once gluten has been removed from the diet. A lower antibody level does not always provide a complete picture of how well the intestinal lining has healed. The newly identified proteins may eventually help fill this gap by providing extra information alongside existing tests, rather than replacing them.
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Blood proteins may offer new clues to gut health in celiac disease
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