Saliva Testing for Celiac Disease

In Italy, the government underwrites the cost of testing first degree relatives of those with Celiac Disease. About 10% of first degree relatives of those with CD, will also have the condition.  Given that the proposed incidence of Celiac Disease in the US is 1/133, would it not be great if the US government also paid for screening?  (Many insurance companies will not pay for testing if the person does not have symptoms.)  Even better, would it not be great if screening for Celiac Disease was just a regular part of healthcare?

There are several issues that would need to be considered before massive screening could take place.  First, the test would have to be very reliable to avoid false positives.  The blood tests available now are very reliable.  Second, an ideal test would be easy to perform and inexpensive.  Obtaining and processing a large number of blood samples would be challenging as well as expensive.  The Italians feel they may have come up with a test that is reliable and convenient.  The test checks saliva samples for evidence of Celiac Disease.  The first published study appeared in the January 2011 edition of the Journal of Pediatric Gastroenterology and Nutrition.  The results of the study were very impressive. Four thosand two hundred forty two saliva samples were collected from childre from6-8 years of age - regardless of a family history of CD.   Of 32 children that tested positive on the saliva test, 31 also tested positive for the antibody tests and 28 of those showed damage to the small intestine after biopsies were performed.  While this sounds like a home run for the Italians, it is still too early to tell.  To be validated, the study must be replicated. In spite of this, one US company has begun offering saliva tests for Celiac.  This is really premature.  Over the years many promising therapies/tests have not stood up to repeated examination. It is too soon in the game to use saliva testing for Celiac Disease.