Allergy Testing

When you become pregnant, many changes occur inside your body. They include blood pressure changes, hormone changes, and may include skin texture changes. However, these changes are not the same for everyone. No one knows why, but some women who have eczema pre-pregnancy find that their eczema flare-ups seem to be worse; while other women find that their eczema goes away entirely for the duration of the pregnancy. If you find that you have a bout of eczema while pregnant, then this article is written just for you.

It is likely that you skin is especially dry and irritated during this period. Hence, you will need to set up a regimen of moisturizing your skin and keep to it. It is important to use an emollient daily.

Regular doctor visits are essential so that you can keep your doctor up-to-date on changes in your skin condition, whether good or bad. However, before you embark on any alternative or seemingly natural treatment methods for your eczema, like allergy testing, hypnotherapy, aromatherapy, massage, or chiropractic, you have to discuss them over with your doctor.

Make sure that you consume healthy meals and drink lots of water to keep the impurities flushed out of your body. Try to avoid allergens and irritants as much as possible and get enough rest because it helps to keep your immune system in tip-top shape.

Some of the common eczema medications are not recommended for use during pregnancy. If you plan to breastfeed, then antibiotics are not recommended. Other medications like calcineurin inhibitors, which are applied to the skin topically, are also not recommended for women that are pregnant. The effects on a developing fetus have not been established, so it is best to refrain from using these medications all together.

You should also not use corticosteroids, without your doctor's recommendation. Cyclosporine does not have any completed research on whether it causes birth defects or not so it should not be used if you are pregnant either. Two other medications that you need to steer clear of if you are pregnant include mycophenolate mofetil and interferon gamma.

A darkening of skin during pregnancy, or melasoma, is quite common. This usually happens in areas where there is a scar, freckle, mole, or on the nipples. If they are causing you distress, do tell your doctor about them.

Some research studies have found that if you nurse your baby for at least six months, your risk of getting atopic dermatitis reduces. In breast milk, there is an ingredient that decreases the development of the allergic response, unlike cows milk. Cows milk is sometimes a trigger for eczema flare-ups. That is why it is of primary importance to be careful about your diet while pregnant and after your bring your precious little bundle home.

Many people want to change the look of the face and are looking for ways to do so. If that is the case, then you should consider dermal fillers. You can correct scars or other imperfections on your face using this procedure.

In the early 1980s people have been using bovine collagen, which was approved by the FDA. This became very popular and was used to fix fine lines and scars and the results could last upwards of three months. The problem with these dermal fillers was that the person could be allergic to the bovine collagen used, which means that you had to do a skin test before the treatment.

Many times people were not happy with the results also. So there was a need for new ways of the process to be done. New fillers that came in the market then were more effective in eliminating wrinkles and folds on the skin. With these procedures, the patient did not have to undergo frequent treatments and did not have to worry about allergy testing.

The new dermal filler is not as expensive as the older methods and is relatively safer and painless to inject. It is also hypoallergenic and can last a fairly long time. It should also be fairly consistent and have the same results each time also. Remember that with the new treatments, you should avoid over injecting your face with the filler because you want to retain a normal youthful appearance.

Many people chose to inject the product in the cheeks, in the lips and other areas on the face to get fuller looks. With these new procedures, the procedure can be relatively short. The patient just has to come for an hour and have the person administer the injection and they can go home instantly.

Many people call these lunch time procedures because they take a relatively short period to administer. After the procedure, the doctor tells the patient not to manipulate the area for a while to avoid shifting the product. Apply a cool pack onto the affected area after the product to reduce swelling. You will most likely have to redo the procedure every five to six months.

If you are considering dermal fillers, then make sure you understand the latest techniques and find a doctor who can administer the product effectively and efficiently. If done correctly, your face will regain a youthful appearance.

Allergy and Sinus Infections Relationship

When you have an allergy, sinus infections are common. It all starts with an allergy to molds, dust, pollen or other substance. This triggers antibodies that lead to nasal congestion and sinus congestion. At first the sinus drainage is clear and stringy. It is the body's natural response to a respiratory allergen. The body is attempting to clear the pollen or other allergen out of the body. You blow your nose and the allergen is flushed out.

Treatment of Simple Sinus Congestion Resulting from an Allergy

The treatment of simple sinus congestion due to an allergy involves the use of antihistamines. These are medications that block the histamine receptors in the respiratory tract and turn off the mucus production. Benadryl is a common antihistamine that is available over the counter. It can make you very tired however.

So can chlorpheniramine, another antihistamine that is commonly used in allergy preparations. Fortunately, there are several other antihistamines out there that do not make you tired. These include the use of sinus medications Zyrtec and Claritin, both available over the counter. These are non-sedating antihistamines that also block the histamine 1 receptors of the nasal passages. Taking antihistamines can prevent sinusitis.

When an Allergy turns into a Sinus Infection

If sinus congestion due to an allergy is not treated properly, there is a chance of a sinusitis. Bacteria normally live in the nasal passages and these can feed off the mucus made in the nasal passages and sinus cavities. The bacteria can get into the maxillary sinuses or in the ethmoid sinuses, located in the forehead between the eyes. The bacteria quickly multiply and feed off the mucus. The bacteria also turn the nasal mucus yellow or green and the mucus becomes thicker. This makes it difficult to drain the sinuses and there is increased pain from the buildup of thick nasal and sinus mucus.

The most common bacteria that cause a sinus infection from allergy include Streptococcus species and Staphylococcus species. These can get better using the following antibiotics: Bactrim, erythromycin based medications, cephalosporins, quinolone antibiotics like Cipro and penicillin based antibiotics. Due to the high incidence of resistances among the common bacteria found in the nasal passages, two or more antibiotics may need to be attempted or a culture of the nose might need to be cultured in order to find out what's growing and what it is sensitive to.

Who gets Sinus Infections from an Allergy?

Sinusitis resulting from allergy can occur at any age. Even newborn babies are born with sinuses so that if they get an allergy to something, it can go on to cause a sinus infection. Allergies, however, are rare to occur for the first time in the elderly so it is less likely to be this kind of infection if they get a sinus problem. Most simple allergies occur in the youth and in young adults. Determining the cause of the allergy can help you and the doctor by avoiding the allergen altogether or taking antihistamines when exposed to the specific allergen.

Allergy Testing

You can test for allergies by doing skin testing. Skin testing puts a small amount of an allergen under the skin using a thin needle. After twenty-four hours or more, the doctor checks to see if there is an allergic response to the allergen in the place where the needle was inserted. If there is redness or induration in the area of the needle puncture, there is an assumed allergy to the allergen. These are the things you need to avoid in order to stay away.

Is an Allergic Sinus Infection Dangerous?

In general, it is not dangerous to get a sinus infection due to allergy. It can be painful, with pain on touching the skin overlying the sinuses and generalized facial pain and there can be a lot of blowing one's nose and taking Tylenol, Aleve, or ibuprofen. On the other hand, this type of infection can spread to the eyes, up through the nasolacrimal duct, or can spread to the brain, leading to meningitis or encephalitis. These are serious complications of allergy sinus infections that can result in loss of consciousness, seizures and death. Antibiotics can help these complications, especially if they are treated early enough.

Preventing a Sinusitis

The best way to stop a sinusitis arising out of an allergy is to treat the allergy aggressively. This means using antihistamines and blowing your nose frequently to clear the sinus passages. If you think you have an allergy sinus infection, see your doctor about getting an antibiotic.

Steroids for dogs: In the control of intense allergy symptoms, anti-inflammatory steroids provide highly effective relief of inflammation and swelling. They are most often used for a short period of time while testing is performed and other means of control of the symptoms of dog allergies is put into place.

Anti-inflammatory steroids are usually prescribed orally and initially given at a starting dose, with subsequent doses tapered until discontinued. A dog steroid should never be stopped abruptly or before the completion of the entire series of doses is given as prescribed by your veterinarian. This is because tapering the drug correctly is necessary in order to prevent a possible deficit of adrenaline in the dog's body.

Be aware that canine steroids are also used for other medical conditions other than the allergies that dogs have, these include inflammation of the brain, spine, stomach, and intestines, as well as arthritis and immune mediated diseases.

In dog allergy treatment, canine steroids are considered the most problematic of canine medications because of the side effects of both short term and long term steroid use. However, this should not dissuade you from the use of a canine steroid because there are instances when a canine steroid is the only medication capable of bringing quick control of the severe symptoms of dog allergies.

Although intended for short-term use, there are situations when a dog steroid must be used on a continuing or on-going basis. However, when possible they should be used only for short-term treatment for dog allergies, or other conditions as determined by your family veterinarian.

Side effects from anti-inflammatory steroids in dogs are more numerous than in cats. The most common are a drastic increased in appetite and continuous thrust, with the resulting frequent urination and unexpected weight gain. Other side effects include mood swings, which can be disconcerting, and panting. Long term steroid use can cause skin lesions and very serious changes inside the body, most notably Cushing's Disease. With long term steroid use these internal changes can shorten the dog's life span.

Nevertheless, anti-inflammatory steroids are one of the most important and highly effective canine medications used today. When needed, canine steroids are efficient in controlling inflammation and swelling, allowing relief from symptoms, and allowing time for blood tests, lab work, allergy skin testing, and for determining and implementing a course of treatment most suitable to your dog.

Many people suffer from allergies. The problem that most allergy sufferers face is that it is difficult to pinpoint just what it is that they are allergic to. This is where allergy tests come in. But how effective are they in discovering exactly what it is you're allergic to? Are they accurate? Are there many ways to even perform the tests? We're going to try to answer some of these questions as well as explain how allergy tests work. Hopefully, by the time you're done reading this, you'll have a pretty good understanding of allergy tests are.

The basic premise behind giving allergy tests is very simple. Your allergist will inject you with small portions of each allergen to determine exactly what it is that you are allergic to. However, in reality, it isn't quite that simple. There are several methods to giving these tests and unfortunately all allergists give them differently.

The one method, which takes the longest, is to start with the smallest dose of allergen for each allergy. Since there are about 8 or 9 outdoor and 8 or 9 indoor allergies, this comes out to about 16 to 18 shots for each allergen at each dosage level. There are approximately 6 or 7 dosage levels for giving these tests. So by the time you are done testing, you could effectively have gotten as many 126 shots. While this may sound on the verge of insanity, it actually goes by very fast. Each dosage level is administered simultaneously in these standard kits. So you're getting about 8 shots at a time.

The way the test works is simple. After each dose is given, a period of about 10 minutes is allowed to pass. The allergist then checks to see if there are any signs of a reaction. If not, then they move up to the next dosage. Now, each allergen can react at a different dosage. So each reaction point has to be noted. Obviously, very detailed record keeping is involved here.

Other allergists simply go the direct route and administer the highest test dosage to start with and work their way down. This is not as accurate because an allergen that reacts at dose 6 may not react at dose 3 but will react at dose 4. Why does this matter? Because the ultimate serum created will actually be a little stronger than it needs to be. Granted, the difference is slight but many allergists feel that difference is significant enough.

But how accurate are these tests, even if you go the long route? Truthfully, they aren't as accurate as people want to think. The reason, as explained to me by my allergist, is because the skin, which is where the tests are given, reacts differently to allergens than the actual sinus passages. To get a more accurate result, you would have to inject each sinus passage, one shot at a time, and then what for a reaction. The amount of time it would take to administer these tests under those conditions would make testing virtually impossible. So skin testing is the best we can hope for.

So because the tests themselves are not that accurate, the actual allergy shot created for them is only going to be so accurate. This is why many people who take allergy shots get very little relief from them, if any.

Therefor, the alternative to allergy testing and allergy shots is simply to treat your allergies with natural foods and herbs. You can find such treatments by visiting our website.

To YOUR Health,

Steve Wagner

This article will discuss about general food allergies testing, which is also known as Serological tests for immunoglobulin G4 (IgG4). This is based on the question from a friend of mine, candida sufferer. She wanted to know whether I am familiar or knowledgeable about IgG4 testing for food allergies.

She's having trouble finding anything for the layperson on this test on the Internet. Her ND (Naturopath Doctor) did the test on her and it shows that she's allergic to several foods, such as eggs, dairy products, tomatoes, oranges, Candida Albicans, wheat, and gluten.

After reading that list, she is wondering what she is going to eat, because she loves pasta and she loves nothing better than to throw some tomatoes on noodles. She's been on the list for a bit but has not started any dietary changes because she wanted to wait to see the blood test. She said that she's not very symptomatic compared to most people so it is difficult for her to accept that she has a yeast allergy, although now she is quite convinced she does.

In my opinion, if you are like her and really like pastas, there are pastas made from soy, corn, quinoa and other wheat-free products. I tried a rice pasta the other day, and it tasted quite good. So you may want to try it.

About the general food allergies test, I read somewhere that testing for IgG4 against foods is not recommended as a diagnostic tool because food-specific IgG4 does not indicate food allergy, but rather a physiological response of the immune system after being exposed to food.

If a person is feeling like they have allergies, they may need to have an allergy test to figure out where the problem is coming from. Allergy testing will involve having skin or blood tests done to determine what substance or allergen is bringing on the problem. Skin tests are the most common because they are fast, reliable, and much less expensive than blood tests. However, any one of them can be used.

A small amount of a suspected allergy-causing item can be placed on or below the skin to see if a reaction starts. There are three types of skin tests that can be performed to determine the problem. It will be up to the person and the doctor to decide what is going to be the best route in finding the culprit.

A skin prick test is done by using a drop of solution containing a possible allergen on the skin and a series of scratches or needle pricks that allow the solution to enter the skin. If the skin develops a red or raised itchy area, it is going to mean that the person is allergic to the allergen. This is called a positive reaction.

Putting a small amount of allergen solution into the skin does an Intradermal test. An intradermal allergy test may be done when a substance does not cause a reaction in the skin prick test but is still thought of as an allergen for the patient. This is going to be the more sensitive test than others and is often found to be positive in people that do not have symptoms to the allergy.

A skin patch test is something that is placed on a pad and is taped to the skin for 24 to 72 hours. This test is used to find a skin allergy called contact dermatitis. In addition, a blood test can be performed on a patient. Allergy blood tests are going to look for things in the blood that are called antibodies. Blood tests are not always as sensitive as skin tests but are most often used for people that are not able to have the skin test performed on them.

The most common type of blood test is called radio-allergo-sorbent testing or RAST. It is used to determine the blood level of a type of antibody that the blood may produce in response to a particular allergen. IGE levels are often higher in those that have allergies or an asthma problem. RAST may be used for people who cannot have skin tests like those that are taking different medications like antidepressants because this will make the tests less accurate.

There are other lab testing methods like the immunosassay capture test and it may be used by your health care professional to find out more information on what is causing your allergy problems. Again, it is all up to the patient and the doctor to determine what types of testing are going to be used to find the real reason behind the allergy.

ArteFill has been in development and under study in patients since the year 1998, finally gaining approval for use by the FDA in October of 2006. During this series of testing, ArteFill proved to be as safe as the temporary filler that was used as the control. ArteFill was created due to a high demand by patients for permanent dermal filler, and it is the first permanent injectable filler that has been approved by the FDA.

ArteFill is an American improvement on the European filler Artecoll, which has been used in over 400,000 procedures this past decade. ArteFill is used on patients to treat a person's unwanted folds near your nose and mouth. It can also be used in off-label treatments for acne scars, lip augmentations, and other types of wrinkles on the face.

ArteFill is composed of a grouping of millions of synthetic micro spheres and suspended in a purified collagen gel. This gel also contains the localized anesthetic lidocaine in an effort to reduce injection discomfort.

How the Filler Works

When a person is to undergo an ArteFill treatment to an area, the ArteFill is injected into the skin located under the wrinkle targeted for correction. The synthetic micro spheres of ArteFill are created to be non-sorbable when in the body, meaning that the body cannot metabolize or absorb them. This gives ArteFill its ability to last as filler in the body, and to last far longer than the other injectable products on the market.

The micro spheres that are injected into the skin serve to stimulate the body's natural production of collagen in an effort to encapsulate the individual micro spheres. This leads to a mixture of naturally produced collagen and artificial micro spheres that amounts to approximately 80/20 collagen/micro sphere to fill the wrinkle. The original collagen of the ArteFill injection will be absorbed into the body and replaced by the newly produced collagen over the next few weeks. It is this gradual replacement of product by naturally replenished molecules that leads to the lasting effects of ArteFill.

Who Can Have the Procedure?

The only people who cannot receive this procedure are those who are deemed allergic to it through routine testing. The ideal patient for an ArteFill procedure will be one who has already exhausted many of the other options on the market and are now ready to receive a permanent effect as opposed to repeated temporary administrations. As for who can't receive the procedure: it cannot be administered to those with a bovine collagen allergy or to a person who has chronic infections of the skin. It is also not recommended for the thinner areas of the face, such as around the eyes or lips. A skin test is required 30 days prior to any treatment to determine if one is allergic to ArteFill (bovine collagen).

Side Effects?

To this day there are very few known side effects of an ArteFill treatment. The effects that are known happen rarely, but can include swelling and/or lumps in the area, pain and/or sensitivity of the injection site, and redness of the flesh. Some patients have reported a feeling of firmness in the area, but this usually resolves over time as the injected collagen is absorbed. Rare cases of granuloma formation have been encountered.

In certain situations where an individual is experiencing an allergic reaction to an unknown substance, they may be referred to an allergy specialist who will perform specific types of tests to determine what is causing their reaction.

The most common type of testing which an allergist performs is a skin test where the surface of the skin is lightly scratched or punctured with a needle containing known allergens which cause swelling or redness around the area if the individual is allergic to that specific allergen.

However, in some cases a blood test may be given instead which is relatively more expensive but may be more beneficial in some cases to determine certain food allergies, or when an individual is taking certain medications. A blood test may also be recommended for some people with certain skin conditions such as extensive eczema.

Blood Tests

Two of the blood tests which may be performed are the 'RAST' or 'radioallergosorbent test' and the 'ELISA' or 'enzyme-linked immunosorbent assay'. Both of these tests are done by adding the suspected allergens to a small sample of blood taken from the individual and then analyzed to determine the level of certain antibodies.

The 'RAST' is the most commonly performed of the two tests and used to determine the levels of 'IgE antibodies'. If the'IgE antibodies' are at high levels, this indicates that the individual is allergic to the particular allergen which was used in the testing.

In the 'ELISA' test the levels of 'IgG antibodies' which are produced when various foods are eaten is measured to try and determine the type of foods the individual is allergic to.

The skin testing which is done to determine certain types of allergies is known to be more effective and less expensive than the blood tests however, in certain situations these may be recommended as an alternative.

Genetic tests exist for Celiac disease and are highly accurate for determining the risk of the disease. When a complete genetic panel is performed the possibility that someone having or ever getting this autoimmune disease can be determined to an extremely high degree of certainty. Unfortunately, some tests are misleading because they do not include a portion of the genetic pattern that may be present that can predispose to this gluten sensitivity disease though the report may imply absence of increased risk.

Some genetic tests can be done without a doctor's order. Insurance coverage for the Celiac genetics is highly variable. A couple of laboratories can run the tests on samples obtained from a mouth swab that is painless and well accepted by children. Genetic testing can be done at any age while blood tests for Celiac are not recommended before a year of age. Celiac genetic tests are not affected by eating gluten or not.

If you do not have the commonly recognized HLA genetic patterns DQ2 or DQ8 that are associated with Celiac disease you are believed to not be at risk for the full autoimmune disease. You don't need to be periodically retested. However, you still could be intolerant or sensitive to gluten. Knowing your genetics can be very helpful if you have a family member with Celiac disease or they or you have other autoimmune diseases associated with a risk of Celiac.

HLA DQ2 and DQ8 are the simple designations for complex white blood cell patterns or types that are known to be associated with an increase risk of Celiac disease. The HLA term stands for human leukocyte antigen. Leukocytes are white blood cells. Antigens are proteins that serve or elicit an immune response by the body. So, the HLA system is a complex set of proteins on the surface of white blood cells. Everyone has two copies of a DQ protein pattern. You get one copy of DQ from your mom and one from your dad. Having at least one copy of either is necessary and sufficient to develop the disease. Having two copies of either or one of both increases the risk even more.

These protein patterns are inherited just like the red blood cell proteins that constitute what is commonly known your "blood type". I, for example, am A positive blood type. This means I have a pattern of proteins designated A and Rh+ on the surface of my red blood cells. On the other hand I have a white blood cell type pattern DQ2/DQ7 inherited from my parents. My Dad gave me a DQ2 and my Mom the DQ7. You have two DQ patterns on your white blood cells that you received from your parents and you give one of your DQ types to each of your children.

Since only a single copy of either DQ2 or DQ8 can be associated with an increase risk of developing Celiac disease, most laboratories test for the presence of either and simply report their presence or absence. However, knowing if you have one or two copies not only provides additional information about degree of your risk. It also may predict the severity. It also provides information about your parents and your childrens' risk of inheriting an at risk gene. If you have DQ2 and DQ8 we know your complete DQ pattern. We also known one of your parents had at least DQ2 and the other DQ8. All of your children will either get a DQ2 or a DQ8. So, both your parents and all of your children are at risk for Celiac in that situation. If you have only copy of DQ2 or DQ8 then we only know that at least one of your parents had one copy of the risk gene and each of your children will have a 50-50 chance of inheriting such a risk gene from you.

Other non-HLA genetic factors are involved in the risk of celiac disease. These are still being worked out. However, one poorly understood and little known fact to most doctors and almost all patients is that HLA DQ2 and DQ8 testing done by some laboratories does not include the full spectrum of at risk components of these patterns. DQ2 and DQ8 are a summary blood type designations or serotypes for the presence of several protein subunits. There are alpha and beta subunits to these protein patterns. The beta subunit is the most influential and important component. Most laboratories only test for and report the beta subunit. However, the alpha subunit does carry risk on its own, albeit much less than the presence of the beta subunit or the presence of both alpha and beta subunit.

The most commonly used laboratories for celiac disease genetic testing in the U.S. are Kimball Genetics, LabCorp, Quest, Prometheus, and Enterolab. The Laboratory at Bonfils in Denver not only provides testing directly but also does the testing for several hospitals, Quest and Enterolab. Bonfils only does beta subunit testing. They report results of DQ2 and DQ8 negative based on the absence of the beta subunits associated with DQ2 and DQ8. However this is somewhat misleading since someone could have only the alpha subunit and be "partially" DQ2.

Though the risk of being "half" DQ2 positive from only having the alpha subunit is low overall it is still there. Furthermore, there are people who may believe that they are DQ2 or DQ8 negative based on testing from Bonfils, Quest or Enterolab. These people and/or their doctor may exclude the possibility that they have or are at risk for ever getting Celiac disease when in fact this may or may not be true.

The existence of DQ2 and DQ8 negative Celiac disease has been debated. It is probably clouded to some degree by this confusion about the genetics. Most experts assert that the presence of DQ2 or DQ8 is a requirement to develop the disease and their absence excludes the possibility. However, reports of DQ2 and DQ8 negative Celiac disease persist.

I have a couple of patients who have the positive results for the specific blood tests for CD, endomysial or tissue transglutaminase antibody; and classic biopsy features but were reported DQ2 and DQ8 negative by laboratories who only test for the beta subunit. Ideally, they should be re-testing for alpha unit positive "half" DQ2 or DQ8 but this will depend on their insurance coverage. In the meantime, I am remain concerned that many patients and doctors may be lulled into a false sense of security by negative genetic tests incompletely done or that diagnoses of Celiac disease may be or have been withdrawn on some individuals based on incomplete genetic results.

This issue of DQ2 and DQ8 testing is further complicated by reviews on the subject that are incomplete or vague. The best reviews I have found are by Ludvig Sollid and Benedicte Lie of Oslo, Norway "Celiac Genetics: Current Concepts and Practical Applications" Clinical Gastroenterology and Hepatology 2005 and Bourgey's 2007 review. In a recent update article by Victorien, there is a general review the genetics of celiac disease including the association of myosin IXB gene (MYO9B). However, it doesn't explain the DQ2 or DQ8 typing well. They conclude that "To date, only HLA-DQ2 or HLA-DQ8 typing is clinically relevant..." but fail to point out that HLA DQ2 and DQ8 typing should include both alpha and beta subunits.

It is clear that both HLA and non-HLA genetic factors are important in the risk of Celiac disease. However, the absence of the high-risk genes does not preclude adverse reactions to gluten including leaky gut, skin, digestive and neurological symptoms. When genetic testing is used to try to assess the risk or exclude CD then I recommend that full testing including both alpha and beta subunit typing. Hopefully more research will better define the genetics of both Celiac disease as well as non-celiac gluten sensitivity or the so called "gluten syndrome".

Selected References:

Bourgey, M et al. HLA related genetic risk for Coeliac disease. Gut 2007; 56:1054-1059.

Johnson, TC et al. Relationship of HLA-DQ8 and severity of Celiac disease: Comparison of New York and Parisian cohorts. Clin Gastroenterol Hep 2004; 2:888-894.

Kaukinen K. et al. HLA-DQ typing in the diagnosis of Celiac disease. Am J Gastroenterol 2002; 97(3): 695-699.

Lundin, KE. HLA-DQ8 as an Ir gene in Coeliac disease. Gut 2003; 52:7-8

Mazzarella G. et al. An immunodominant DQ8 restricted gliadin peptide activates small intestine immune response in in vitro cultured mucosa from HLA-DQ8 positive but not HLA-DQ8 negative Coeliac patients. Gut 2003; 52:57-62.

Sollid, LM and Lie, BA. Celiac disease genetics: Current concepts and practical applications. Clin Gastro Hep 2005; 3:843-851.

Wolters,VM and Wijenga C. Genetic background of celiac disease and its clinical applications. Am J Gastroenterol 2008; 103:190-195.