Groundbreaking Blood Test Detects Celiac Disease in Patients Without Gluten Exposure

Getting a reliable diagnosis for coeliac disease has long required patients to endure weeks of consuming gluten—a painful process for many already following gluten-free diets. Now, a groundbreaking blood test could eliminate this need by detecting gluten-specific T cells, allowing clinicians to identify coeliac disease even in patients who have been avoiding gluten.

Researchers at Walter and Eliza Hall Institute (WEHI, Victoria, Australia), along with industry partner Novoviah Pharmaceuticals (Brisbane City, Australia) set out to develop a non-invasive, reliable diagnostic method for coeliac disease that works regardless of a patient’s current diet, streamlining the path to diagnosis and care. The test builds on WEHI’s 2019 discovery that the immune marker interleukin 2 (IL-2) spikes in the blood of people with coeliac disease shortly after gluten is consumed. Using this insight, the team designed an “in-tube” blood test that stimulates patient blood samples with gluten. If IL-2 levels rise in response, it indicates the presence of coeliac disease. Unlike conventional serology or biopsy-based testing, this method doesn’t require patients to resume eating gluten.

In the new study published in Gastroenterology, researchers evaluated blood samples from 181 participants, including individuals with treated and untreated coeliac disease, non-coeliac gluten sensitivity, and healthy controls. After a day of in-tube gluten exposure, the test detected coeliac disease with 90% sensitivity and 97% specificity—even in participants strictly avoiding gluten. These results highlight its strong diagnostic performance and potential real-world value. The test may be especially valuable for detecting silent or asymptomatic coeliac disease and identifying individuals at risk of severe reactions to gluten.

With up to 80% of coeliac cases globally still undiagnosed, and existing tests ineffective without regular gluten intake, this innovation could significantly improve early detection and long-term outcomes. The WEHI researchers are now working with Novoviah Pharmaceuticals to validate the test across broader populations and gather real-world data. They hope its adoption in clinical pathology labs will follow, once ultrasensitive cytokine testing becomes more widely available.

“There are likely millions of people around the world living with undiagnosed coeliac disease simply because the path to diagnosis is difficult, and at times, debilitating,” said Associate Professor Jason Tye-Din, Head of WEHI’s Coeliac Research Laboratory. “This new test promises to simplify and speed up accurate diagnosis, while also avoiding the suffering that comes with eating gluten for extended periods to reactivate coeliac disease. By eliminating the need for a gluten challenge, we’re addressing one of the biggest deterrents in current diagnostic practices. This test could be a game-changer, sparing thousands of people the emotional and physical toll of returning to gluten. It's a major step towards faster, safer diagnosis.”

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Novoviah Pharmaceuticals