CICA (Celiac, IBS, and Crohn's Array)
CICA (Celiac, IBS, and Crohn's Array)
Find out if gluten is impacting your health
“Imagine gluten ingestion on a spectrum. At one end, you have people with celiac disease, who cannot tolerate one crumb of gluten in their diet. At the other end, you have the lucky people who can eat pizza, beer, pasta and cookies – and have no ill effects whatsoever. In the middle, there is a murky area of gluten reactions, including gluten sensitivity.” - Alessio Fasano, M.D., Mass. General Hospital.
The Celiac, IBS, and Crohn’s Array (CICA) evaluates your genetic risk for celiac disease and checks for genetic markers associated with Crohn’s disease.
The CICA is designed to provide an accurate evaluation of GI tract function by gathering information from various pathways.
Optionally, it can be combined with the Alcat Test 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.
Who may benefit
- Those with gastrointestinal symptoms and autoimmune disorders that might suggest a problem with gluten
- Those with increased intestinal permeability which has been linked to autoimmune disorders and other conditions
- Those suspected to have Crohn’s or celiac disease
- Those suffering from symptoms of IBS including diarrhea, bloating or cramping
- Those with chronic fatigue
- Those with malabsorption of nutrients and/or nutrient deficiency
- Those with unexplained symptoms such as unintended weight loss or skin rash
- Those seeking increased health efficiency or high performance lifestyle
CICA Test Components
More than 95% of patients with celiac disease possess HLA-DQ2.5 and/or HLA-DQ8 genotype. More than 90% of those with celiac have the DQ2.5 genotype. Absent these markers, development of celiac is highly unlikely.
Crohn’s disease is triggered by a variety of environmental and genetic factors. It is described as a chronic inflammatory bowel disease (IBD) caused by a dysregulation of the immune response to intestinal flora and in parallel, accompanied by a defect of the epithelial barrier.
The predominant genetic markers are:
- NOD2/CARD15 associated with the innate immune system and the activation of nuclear factor кB (NF- кB).
- T300A mutation in the ATG16L1 gene increases its susceptibility to degradation by Caspase 3 and thus is associated with autophagy.
Tissue transglutaminase antibody (tTG) – IgA & IgG
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.
Deamidated gliadin peptide (DGP) antibody - IgA & IgG
Deamidated 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.
Anti-Saccharomyces Cerevisiae Antibody (ASCA)
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.
Total Serum IgA
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 deamidated 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).
Option 1: Celiac, IBS, and Crohn’s Array (CICA) Full Array- (Genetic + Serologic)
Option 2: Celiac, IBS, and Crohn’s Array (CICA) - Genetic Only
Option 3: Celiac, IBS, and Crohn’s Array (CICA) - Serologic/Antibody Only