CICA: Serologic/Antibody Only-Cell Science Systems Kit:
Note: This is a test kit that will be mailed to you. It requires a blood draw. It is your responsibility to arrange the blood draw for your kit and payment of your specimen collection.
Fasting Required: No
Lab: Cell Science Systems
Specimen: Serum
Results: Average processing time 10-12 business days
Note: Result turnaround times are an estimate and are not guaranteed. Our reference lab may need additional time due to weather, holidays, confirmation/repeat testing, or equipment maintenance.
Patient Recommendations: Because antibody titers are exposure related, purposeful avoidance of gluten can cause a decrease of serological results. Therefore, the patient’s exposure to gluten containing grains should be considered when interpreting tTg and DGP serology results.
To assess the impact of gluten on tTg and DGP antibodies and the likelihood of active celiac disease: A study conducted on 20 adults with biopsy-proven celiac disease showed that a 14 day gluten challenge of = 3 grams increased antibody titers in 2/3 of the subjects on day 14 and 90% of the subjects on day 28. For those without a current diagnosis of celiac disease or wheat allergy, who have been avoiding gluten, a consumption of gluten (= 1 ½ slices of wheat bread or equivalent daily) for a minimum of the first two weeks of the last four weeks, prior to testing, is recommended.
Of the 4 celiac disease antibodies that are measured within the CICA, tTg-IgA is the most highly studied and most of our knowledge of the temporal relationship between the presence of antibody and the exposure to gluten come from that antibody. It is likely that the other antibodies have a similar pattern, but we cannot be certain.
For those in this category, who have been avoiding gluten for an extended period of time and who feel adverse reactions when gluten is consumed, a consultation with the health care provider regarding the re-introduction of gluten to the eating pattern prior to testing, is recommended. Perhaps another way to approach the issue of gluten avoidance prior to testing is to recommend testing in the individual’s current avoidance state. If the antibody results are positive then the avoidance did not have a significant effect. If the test is negative, then it is unknown whether the avoidance had an effect, so it might be helpful to retest after an interval of gluten exposure.
Medication and Supplement Instructions for CSS Testing:
- Testing does not need to be delayed because of medication or supplement use.
- Medications that are part of your daily routine should be continued as they are considered part of your normal physiological state.
- If possible, please avoid taking any oral medications, IV infusions, intramuscular (IM) injections, or oral supplements for 4 hours before blood draw.
- If you are taking medications that may impact white blood cell counts, it is recommended to collect an additional blood tube at the time of your draw.
- For short term medications (such as antibiotics) that will be discontinued, it is best to wait at least 2 weeks after completing the medication before completing your blood draw.
- If you are taking methylene blue, it is recommended to wait at least 72 hours after your last dose before proceeding with your blood draw for the Cellular Nutrition Assay.
- Fasting is not necessary
Description: The Celiac, IBS, and Crohn’s Array (CICA) evaluates your genetic risk for celiac disease, serum markers associated with active celiac disease process, and genetic serum markers associated with Crohn’s disease. The CICA is a comprehensive test array that analyzes genetic predisposition, detects specific antibodies, and measures potentially inflammatory cellular reactions all through one simple blood draw.
In active celiac disease, damaged enterocytes produce tTG, therefore antibodies against tTG (IgA and/or IgG) are indicative of an active disease process. In patients with normal total IgA levels and negative tTG antibodies, the diagnosis of active celiac disease is unlikely. However, a certain percentage of patients with celiac disease may be seronegative. If tTG IgA is negative, while celiac disease is suspected, then additional markers included in this panel become more relevant in the diagnosis of gluten-related disorders. Deaminated gliadin can bind with tTG and become immunogenic. Therefore, detecting the presence of elevated IgA and/or IgG antibodies against DGP is an additional indicator of an active celiac disease process. ASCA is an indicator for the presence of Crohn’s disease. The presence of ASCA may also reflect increased intestinal inflammation and permeability, including that associated with active celiac disease. It is common for celiac disease patients to be IgA deficient. It is the most common immunologic deficiency (1:400-1:700 in the general population and 1:50 in celiac disease patients) and may be the single largest contributor to false negative results in biopsy confirmed celiac disease patients. Total Serum IgA is used as a measurement to qualify IgA testing for tissue transglutaminase (tTG) and deaminated gliadin peptide (DGP) antibody levels. When IgA levels are low or deficient, it is important to check IgG levels for both tTG and DGP (included in this array).
Optionally, it can be combined with the Alcat Test at a discounted rate to evaluate innate immune cell responses to as many as 400 other foods (including gluten, gliadin, casein and whey) and substances for the most comprehensive assessment.
Reported:
- Total Serum IgA
- tTg (IgA and IgG)
- DGP (IgA and IgG)
- Anti-Saccharomyces Cerevisias Antibody (ASCA)