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T-cell receptor repertoire analysis as a diagnostic test for coeliac disease/gluten sensitivity

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Coeliac disease is a condition with very variable symptoms (including diarrhoea, vomiting, abdominal bloating, fatigue and impaired cognition) that occur when gluten, an integral component of wheat, barley and rye, is eaten. Coeliac disease affects at least 1% of the UK population and we are aware that many of those affected by the condition, possibly as many as 2/3, remain undiagnosed. While in some cases this is due to the fact that they have not presented to the medical profession, for a significant proportion, it is because current tests give an uncertain or negative result, even when the patient does have coeliac disease. At present, a blood test and duodenal biopsy, the latter examined in an unavoidably subjective manner by a pathologist, are the gold standard for diagnosis, but concordance between pathologists is poor and gluten must be eaten for at least several weeks prior to either test to avoid a false negative result. Coeliac disease is caused by T-cell mediated injury to the epithelial lining of the intestine, with many of the T-cells responding to gluten. We therefore believe that a holistic analysis of the T-cell receptor repertoire in biopsies and/ or blood, which determines what the T-cell population therein can respond to) holds the key to diagnosing the condition with greater sensitivity and/ or accuracy and have raw data from such an analysis from 3 T-cell receptor loci, on one of which we have developed a preliminary algorithm, which appears to be able to separate coeliac disease biopsies from normal biopsies. We seek a computational biology MPhil student to continue this work rapidly, not least because of the obvious potential benefit to a significant proportion of the UK population who are gluten-sensitive, but lack a diagnosis of such.

This talk is part of the Computational and Systems Biology series.

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