Intestinal biopsy is still considered the gold standard for diagnosis of celiac disease (CD) [3] (1-4). For more than 30 years, CD-related serology has been used as a valuable marker for diagnosis, screening, and noninvasive follow-up of patients (1, 5-9). Over the years, celiac serology has evolved, with the identification of newer and more specific antibodies and the improvement of technical approaches resulting in more reliable assays (10). Currently, the well-known endomysial (EmA) and anti-tissue transglutaminase (a-tTG) autoantibodies are considered to be among the most reliable noninvasive tools for detecting a disease in all of internal medicine (5,11-15). Although these exhibit very high sensitivity and specificity for CD (16-21), recent investigations have shown that accuracy of tests remains controversial in 2 areas. First, sensitivity has been considered unacceptable both in patients with minor degrees of mucosal damage and in cases with a more indolent clinical course (22,23). Second, current antibodies seem to have variable accuracy in the follow-up of patients on a gluten-free diet (24). Recently, a series of new antibody tests have demonstrated very high sensitivity for diagnosis of CD. One of these new assays detecting IgA antibodies to the fibrillar form of the depolymerized actin protein of the cytoskeleton is promising but not completely defined (25-27). Very recently, we have reported highly encouraging results with the use of ELISAs to detect antibodies binding synthetic deamidated gliadin-related peptides (DGPs). Both isotypes (IgA and IgG) of the peptide antibodies [anti-DGPs (a-DGPs)] have been shown to be highly sensitive and specific for active CD (28-31).
