Skin tests for coeliac disease employing fractions of a gliadin digest.

Gliadin sub-fractions have been tested by intradermal injection in 19 adult patients with coeliac disease in remission and in 19 healthy adult controls. Fraction 3, obtained by SP Sephadex chromatography of a peptic-tryptic digest of gliadin, produced strong reactions (areas of erythema greater than 1 cm2) in 13 of the patients. Weak or negative reactions to fraction 3 were produced in the remaining patients, including 2 patients who were currently on prednisolone therapy in addition to a gluten-free diet. There was no correlation between time on a gluten free diet and severity of reaction in the patients not on prednisolone therapy. A strong reaction was observed with only one control and in the remaining controls all reactions were negative. Other fractions produced strong reactions in comparatively few patients. Skin tests using Fraction 3 could thus form part of the diagnosis for coeliac disease and could lead to a knowledge of the composition of the peptides which are important in the aetiology of this disease.