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Oliveira LC, Dornelles AC, Nisihara RM, Bruginski ERD, Santos PID, Cipolla GA, Boschmann SE, Messias-Reason IJD, Campos FR, Petzl-Erler ML, Boldt ABW. The Second Highest Prevalence of Celiac Disease Worldwide: Genetic and Metabolic Insights in Southern Brazilian Mennonites. Genes (Basel) 2023; 14:genes14051026. [PMID: 37239386 DOI: 10.3390/genes14051026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/28/2023] Open
Abstract
Celiac disease (CD), despite its high morbidity, is an often-underdiagnosed autoimmune enteropathy. Using a modified version of the Brazilian questionnaire of the 2013 National Health Survey, we interviewed 604 Mennonites of Frisian/Flemish origin that have been isolated for 25 generations. A subgroup of 576 participants were screened for IgA autoantibodies in serum, and 391 participants were screened for HLA-DQ2.5/DQ8 subtypes. CD seroprevalence was 1:29 (3.48%, 95% CI = 2.16-5.27%) and biopsy-confirmed CD was 1:75 (1.32%, 95% CI = 0.57-2.59%), which is superior to the highest reported global prevalence (1:100). Half (10/21) of the patients did not suspect the disease. HLA-DQ2.5/DQ8 increased CD susceptibility (OR = 12.13 [95% CI = 1.56-94.20], p = 0.003). The HLA-DQ2.5 carrier frequency was higher in Mennonites than in Brazilians (p = 7 × 10-6). HLA-DQ8 but not HLA-DQ2.5 carrier frequency differed among settlements (p = 0.007) and was higher than in Belgians, a Mennonite ancestral population (p = 1.8 × 10-6), and higher than in Euro-Brazilians (p = 6.5 × 10-6). The glutathione pathway, which prevents reactive oxygen species-causing bowel damage, was altered within the metabolic profiles of untreated CD patients. Those with lower serological positivity clustered with controls presenting close relatives with CD or rheumatoid arthritis. In conclusion, Mennonites have a high CD prevalence with a strong genetic component and altered glutathione metabolism that calls for urgent action to alleviate the burden of comorbidities due to late diagnosis.
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Affiliation(s)
- Luana Caroline Oliveira
- Laboratory of Human Molecular Genetics, Department of Genetics, Federal University of Paraná (UFPR), Centro Politécnico, Jardim das Américas, Curitiba 81531-990, Paraná, Brazil
- Postgraduate Program in Genetics, Department of Genetics, Federal University of Paraná (UFPR), Centro Politécnico, Jardim das Américas, Curitiba 81531-990, Paraná, Brazil
| | - Amanda Coelho Dornelles
- Laboratory of Human Molecular Genetics, Department of Genetics, Federal University of Paraná (UFPR), Centro Politécnico, Jardim das Américas, Curitiba 81531-990, Paraná, Brazil
| | - Renato Mitsunori Nisihara
- Laboratory of Molecular Immunopathology, Department of Clinical Pathology, Clinical Hospital, Federal University of Paraná (UFPR), Rua General Carneiro, 181 Prédio Central, 11° Andar, Alto da Glória, Curitiba 80060-240, Paraná, Brazil
| | - Estevan Rafael Dutra Bruginski
- Postgraduate Program in Pharmaceutical Sciences, Laboratory of Bioscience and Mass Spectrometry, Department of Pharmacy, Federal University of Paraná (UFPR), Av. Pref. Lothário Meissner, 632, Jardim Botânico, Curitiba 80210-170, Paraná, Brazil
| | - Priscila Ianzen Dos Santos
- Laboratory of Human Molecular Genetics, Department of Genetics, Federal University of Paraná (UFPR), Centro Politécnico, Jardim das Américas, Curitiba 81531-990, Paraná, Brazil
- Postgraduate Program in Internal Medicine, Federal University of Paraná (UFPR), Rua General Carneiro, 181 Prédio Central, 11° Andar, Alto da Glória, Curitiba 80060-240, Paraná, Brazil
| | - Gabriel Adelman Cipolla
- Laboratory of Human Molecular Genetics, Department of Genetics, Federal University of Paraná (UFPR), Centro Politécnico, Jardim das Américas, Curitiba 81531-990, Paraná, Brazil
- Postgraduate Program in Genetics, Department of Genetics, Federal University of Paraná (UFPR), Centro Politécnico, Jardim das Américas, Curitiba 81531-990, Paraná, Brazil
| | - Stefanie Epp Boschmann
- Laboratory of Molecular Immunopathology, Department of Clinical Pathology, Clinical Hospital, Federal University of Paraná (UFPR), Rua General Carneiro, 181 Prédio Central, 11° Andar, Alto da Glória, Curitiba 80060-240, Paraná, Brazil
- Postgraduate Program in Internal Medicine, Federal University of Paraná (UFPR), Rua General Carneiro, 181 Prédio Central, 11° Andar, Alto da Glória, Curitiba 80060-240, Paraná, Brazil
| | - Iara José de Messias-Reason
- Laboratory of Molecular Immunopathology, Department of Clinical Pathology, Clinical Hospital, Federal University of Paraná (UFPR), Rua General Carneiro, 181 Prédio Central, 11° Andar, Alto da Glória, Curitiba 80060-240, Paraná, Brazil
- Postgraduate Program in Internal Medicine, Federal University of Paraná (UFPR), Rua General Carneiro, 181 Prédio Central, 11° Andar, Alto da Glória, Curitiba 80060-240, Paraná, Brazil
| | - Francinete Ramos Campos
- Postgraduate Program in Pharmaceutical Sciences, Laboratory of Bioscience and Mass Spectrometry, Department of Pharmacy, Federal University of Paraná (UFPR), Av. Pref. Lothário Meissner, 632, Jardim Botânico, Curitiba 80210-170, Paraná, Brazil
| | - Maria Luiza Petzl-Erler
- Laboratory of Human Molecular Genetics, Department of Genetics, Federal University of Paraná (UFPR), Centro Politécnico, Jardim das Américas, Curitiba 81531-990, Paraná, Brazil
- Postgraduate Program in Genetics, Department of Genetics, Federal University of Paraná (UFPR), Centro Politécnico, Jardim das Américas, Curitiba 81531-990, Paraná, Brazil
| | - Angelica Beate Winter Boldt
- Laboratory of Human Molecular Genetics, Department of Genetics, Federal University of Paraná (UFPR), Centro Politécnico, Jardim das Américas, Curitiba 81531-990, Paraná, Brazil
- Postgraduate Program in Genetics, Department of Genetics, Federal University of Paraná (UFPR), Centro Politécnico, Jardim das Américas, Curitiba 81531-990, Paraná, Brazil
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Poslt Königová M, Sebalo Vňuková M, Řehořková P, Anders M, Ptáček R. The effectiveness of gluten-free dietary interventions: A systematic review. Front Psychol 2023; 14:1107022. [PMID: 37034934 PMCID: PMC10075251 DOI: 10.3389/fpsyg.2023.1107022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 02/17/2023] [Indexed: 04/11/2023] Open
Abstract
Celiac disease is a chronic autoimmune gastroenterological disorder in which the digestion of gluten leads to damage and constant inflammation in the small intestine. Moreover, there are associated physical and mental health problems related to celiac disease, i.e., a lower health-related quality of life and increased depression and anxiety symptoms. The only effective treatment for celiac disease is lifelong adherence to a gluten-free diet. However, researchers suggest that strict adherence to a gluten-free diet ranges from 42 to 80%, depending on the definition and method of assessment that was utilized. This review examines interventions designed for those who need to adhere to life-long dietary measures and their success in terms of increasing gluten-free dietary adherence and improving their health-related quality of life. In April 2022, the Scopus, Web of Science, PubMed and ProQuest databases were searched using the following terms: "coeliac disease" OR "celiac disease" AND "gluten free diet" AND "intervention" AND "health related quality of life" AND "diabetes." Eight studies were suitable for this review. The studies were used to analyze different intervention techniques and their impact on gluten-free dietary adherence, quality of life, and the reasons for dietary nonadherence. The studies revealed statistically significant improvements in the knowledge base regarding celiac disease and the gluten-free diet, dietary adherence and quality-of-life satisfaction immediately after the intervention and at a three-month follow-up. Some studies were also focused on behavioral and cognitive aspects of nonadherence to dietary measures.
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Ching CK, Lebwohl B. Celiac Disease in the Elderly. CURRENT TREATMENT OPTIONS IN GASTROENTEROLOGY 2022; 20:238-249. [PMID: 36818495 PMCID: PMC9937540 DOI: 10.1007/s11938-022-00397-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/29/2022] [Indexed: 10/16/2022]
Abstract
Purpose of review This review highlights literature from the past several years and explores the impact on current understanding of celiac disease diagnosis, complications, and management in older adults. Recent findings Celiac disease in the elderly is becoming increasingly prevalent but remains underdiagnosed, with a high potential burden of downstream morbidity and modestly increased risk of mortality. Clinical presentations are often related to extraintestinal symptoms and can be subtle. Duodenal biopsy remains the gold-standard for diagnosis in older adults, along with supporting serologies. Refractory celiac disease is a particular concern in the aging population, and treatment for this rare condition remains unsatisfactory. Older adults exhibit lower rates of mucosal healing, though the reasons for this are poorly understood. Summary Current understanding of celiac disease in the elderly continues to advance, though significant knowledge gaps persist. Large, prospective studies are needed to further characterize celiac disease pathogenesis, complications, and management in older adults.
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Affiliation(s)
- Charlotte K. Ching
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Benjamin Lebwohl
- Division of Digestive and Liver Diseases, Columbia University Irving Medical Center, New York, NY, USA
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Wan Y, Zhang B. The Impact of Zinc and Zinc Homeostasis on the Intestinal Mucosal Barrier and Intestinal Diseases. Biomolecules 2022; 12:biom12070900. [PMID: 35883455 PMCID: PMC9313088 DOI: 10.3390/biom12070900] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/06/2022] [Accepted: 06/11/2022] [Indexed: 02/04/2023] Open
Abstract
Zinc is an essential trace element for living organisms, and zinc homeostasis is essential for the maintenance of the normal physiological functions of cells and organisms. The intestine is the main location for zinc absorption and excretion, while zinc and zinc homeostasis is also of great significance to the structure and function of the intestinal mucosal barrier. Zinc excess or deficiency and zinc homeostatic imbalance are all associated with many intestinal diseases, such as IBD (inflammatory bowel disease), IBS (irritable bowel syndrome), and CRC (colorectal cancer). In this review, we describe the role of zinc and zinc homeostasis in the intestinal mucosal barrier and the relevance of zinc homeostasis to gastrointestinal diseases.
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Lee YJ, Ting WH, Yang YW, Lin CJ, Hsieh YT, Huang CY, Lo FS, Chu CC, Lin CL, Lin WS, Lai TS. HLA-DQ genotype and biochemical characterization of anti-transglutaminase 2 antibodies in patients with type 1 diabetes mellitus in Taiwan. FASEB J 2020; 34:8459-8474. [PMID: 32362042 DOI: 10.1096/fj.202000269r] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 04/14/2020] [Accepted: 04/15/2020] [Indexed: 12/15/2022]
Abstract
Human Leukocyte Antigen (HLA)-DQ2 and HLA-DQ8 are genetic risk factors for Type 1 Diabetes Mellitus (T1DM) and Celiac disease (CD) in Caucasians, but their association with Taiwanese Han population is unknown. We screened 532 Taiwanese T1DM patients for CD biomarkers including anti-tissue transglutaminase (TGM2), anti-gliadin and anti-neoepitope antibodies (Abs), sequencing DQB1 genotypes, and characterized the TGM2 Abs. We report that 3.76% of Taiwanese patients had TGM2-Abs and all had no CD's symptoms. In contrast to Caucasian's CD patients, DQ2/DQ8 only constituted ~4/5 of TGM2-Abs positive patients, while the other ~1/5 patients belonged to different HLA genotypes. Either anti-gliadin or anti-neoepitope Abs coexisted with ~3/4 of TGM2-Abs positive patients that were likely due to gluten-ingestion, while the cause of TGM2-Abs production for other ~1/4 of patients was unknown. Purified anti-TGM2 IgA (TGA) and anti-TGM2 IgG (TGG) could bind on endothelial cells surface, recognized native better than denatured forms of TGM2, and TGA inhibited TGM2's transamidation activity by up to 80% but TGG had no effects. Epitope mapping of all TGM2-Abs positive sera demonstrated that TGM2-Abs had heterogeneity in specificities. This is the first study on the differences between Taiwanese Han group and Caucasian in HLA genotypes and properties of TGM2-Abs.
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Affiliation(s)
- Yann-Jinn Lee
- Institute of Biomedical Sciences, MacKay Medical College, New Taipei City, Taiwan, ROC.,Department of Medicine, MaKkay Medical College, New Taipei City, Taiwan, ROC.,Department of Pediatric Endocrinology, MacKay Children's Hospital, Taipei, Taiwan, ROC.,Department of Medical Research, MacKay Memorial Hospital Tamsui District, New Taipei City, Taiwan, ROC.,Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC
| | - Wei-Hsin Ting
- Department of Medicine, MaKkay Medical College, New Taipei City, Taiwan, ROC.,Department of Pediatric Endocrinology, MacKay Children's Hospital, Taipei, Taiwan, ROC.,MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan, ROC
| | - Yi-Wen Yang
- Institute of Biomedical Sciences, MacKay Medical College, New Taipei City, Taiwan, ROC
| | - Cheng-Jui Lin
- MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan, ROC.,Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan, ROC
| | - Yu-Ting Hsieh
- Institute of Biomedical Sciences, MacKay Medical College, New Taipei City, Taiwan, ROC.,Department of Clinical Laboratory, MacKay Memorial Hospital, Taipei, Taiwan, ROC
| | - Chi-Yu Huang
- Department of Medicine, MaKkay Medical College, New Taipei City, Taiwan, ROC.,Department of Pediatric Endocrinology, MacKay Children's Hospital, Taipei, Taiwan, ROC.,MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan, ROC
| | - Fu-Sung Lo
- College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC.,Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
| | - Chen-Chung Chu
- Department of Medical Research, MacKay Memorial Hospital Tamsui District, New Taipei City, Taiwan, ROC
| | - Chiung-Ling Lin
- Department of Medical Research, MacKay Memorial Hospital Tamsui District, New Taipei City, Taiwan, ROC
| | - Wen-Shan Lin
- Department of Medical Research, MacKay Memorial Hospital Tamsui District, New Taipei City, Taiwan, ROC
| | - Thung-S Lai
- Institute of Biomedical Sciences, MacKay Medical College, New Taipei City, Taiwan, ROC
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Kalkan Ç, Karakaya F, Soykan I. Similarities and differences between older and young adult patients with celiac disease. Geriatr Gerontol Int 2017; 17:2060-2067. [DOI: 10.1111/ggi.13020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 12/15/2016] [Accepted: 01/17/2017] [Indexed: 12/13/2022]
Affiliation(s)
- Çağdaş Kalkan
- Ankara University Faculty of Medicine; Department of Gastroenterology; Ankara Turkey
| | - Fatih Karakaya
- Ankara University Faculty of Medicine; Department of Gastroenterology; Ankara Turkey
| | - Irfan Soykan
- Ankara University Faculty of Medicine; Department of Gastroenterology; Ankara Turkey
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Itthivadhanapong P, Jantathai S, Schleining G. Improvement of physical properties of gluten-free steamed cake based on black waxy rice flour using different hydrocolloids. Journal of Food Science and Technology 2016; 53:2733-41. [PMID: 27478229 DOI: 10.1007/s13197-016-2245-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 05/01/2016] [Accepted: 05/03/2016] [Indexed: 11/26/2022]
Abstract
This study aimed to compare the effects of 1 % addition of four selected hydrocolloids (xanthan, guar, hypdroxypropylmethylcellulose and carrageenan) on quality characteristics of batter and of black waxy rice steamed cake compared to a control without hydrocolloids. Dynamic frequency sweeps of the batters at 25 °C indicated that all formulations exhibited gel-like behaviour with storage moduli (G') higher than loss moduli (G″). Hydrocolloids increased the apparent viscosity and the thixotropic behaviour, depending on the type of hydrocolloids. Xanthan had the greatest effects on both moduli, whereas carrageenan had the smallest effects. During a storage period of 4 days the cakes with xanthan remained softer than control samples. The overall acceptability of cake with xanthan and guar were higher than control. This study is the first report on using black waxy rice flour as a main raw material in gluten free cake. The results of this study provided useful information for selection hydrocolloids as ingredients that can help to improve the physical properties of waxy rice steamed cake.
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Affiliation(s)
- Pimchada Itthivadhanapong
- Faculty of Home Economics Technology, Rajamangala University of Technology Krungthep, Bangkok, 10120 Thailand
| | - Srinual Jantathai
- Department of Food Technology and Nutrition, Faculty of Technology, Mahasarakham University, Mahasarakham, 44150 Thailand
| | - Gerhard Schleining
- Department of Food Sciences and Technology, University of Natural Resources and Life Sciences Vienna, Muthgasse 18, 1190 Vienna, Austria
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Zhao Z, Zou J, Zhao L, Cheng Y, Cai H, Li M, Liu E, Yu L, Liu Y. Celiac Disease Autoimmunity in Patients with Autoimmune Diabetes and Thyroid Disease among Chinese Population. PLoS One 2016; 11:e0157510. [PMID: 27427767 PMCID: PMC4948776 DOI: 10.1371/journal.pone.0157510] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 05/30/2016] [Indexed: 12/17/2022] Open
Abstract
The prevalence of celiac disease autoimmunity or tissue transglutaminase autoantibodies (TGA) amongst patients with type 1 diabetes (T1D) and autoimmune thyroid disease (AITD) in the Chinese population remains unknown. This study examined the rate of celiac disease autoimmunity amongst patients with T1D and AITD in the Chinese population. The study included 178 patients with type 1 diabetes and 119 with AITD where 36 had both T1D and AITD, classified as autoimmune polyglandular syndrome type 3 variant (APS3v). The study also included 145 patients with type 2 diabetes (T2D), 97 patients with non-autoimmune thyroid disease (NAITD), and 102 healthy controls. Serum islet autoantibodies, thyroid autoantibodies and TGA were measured by radioimmunoassay. TGA positivity was found in 22% of patients with either type 1 diabetes or AITD, much higher than that in patients with T2D (3.4%; p< 0.0001) or NAITD (3.1%; P < 0.0001) or healthy controls (1%; p<0.0001). The patients with APS3v having both T1D and AITD were 36% positive for TGA, significantly higher than patients with T1D alone (p = 0.040) or with AITD alone (p = 0.017). T1D and AITD were found to have a 20% and 30% frequency of overlap respectively at diagnosis. In conclusion, TGA positivity was high in the Chinese population having existing T1D and/or AITD, and even higher when both diseases were present. Routine TGA screening in patients with T1D or AITD will be important to early identify celiac disease autoimmunity for better clinical care of patients.
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Affiliation(s)
- Zhiyuan Zhao
- Department of Endocrinology, The Second Hospital of Jilin University, Changchun, Jilin, China
| | - Jing Zou
- Department of Endocrinology, The Second Hospital of Jilin University, Changchun, Jilin, China
| | - Lingling Zhao
- Department of Endocrinology, The Second Hospital of Jilin University, Changchun, Jilin, China
| | - Yan Cheng
- Department of Endocrinology, The Second Hospital of Jilin University, Changchun, Jilin, China
| | - Hanqing Cai
- Department of Endocrinology, The Second Hospital of Jilin University, Changchun, Jilin, China
| | - Mo Li
- Department of Endocrinology, The Second Hospital of Jilin University, Changchun, Jilin, China
| | - Edwin Liu
- Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, Aurora, Colorado, United States of America
| | - Liping Yu
- Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, Aurora, Colorado, United States of America
| | - Yu Liu
- Department of Endocrinology, The Second Hospital of Jilin University, Changchun, Jilin, China
- * E-mail:
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Nagyová Ľ, Košičiarová I, Rybanská J, Holienčinová M. Celiac disease: the situation on the Slovak market. POTRAVINARSTVO 2016. [DOI: 10.5219/582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Celiac disease, also known as celiac sprue, non‐tropical sprue, idiopathic sprue, idiopathic steatorrhoea and gluten‐sensitive enteropathy, is a serious genetic autoimmune disease, which damages the villi of the small intestine and interferes with absorption of nutrients from food. The latest researches show that while in the 1970s the prevalence of celiac disease in the world was 0.03%, in the present years the estimated prevalence is 1%. In average, the prevalence of celiac disease in the Western countries is close to 1:100. The celiac disease occurs more often in the case of women than of men, at a ratio of 2.8:1. The aim of the present paper was to bring few information about the celiac disease, highlight the increasing number of celiacs, as well as to determine the Slovak celiacs opinion about the situation on Slovak market and their consumer behaviour on the market of gluten free products. As research methods, there have been used the methods of survey and structured questionnaire consisting of 22 questions. The total number of respondents was 130 randomly selected celiacs from all over the Slovak republic. For a deeper analysis of the obtained results, there have been set out four assumptions and ten hypotheses, which have been tested with the use of Pearson´s chi-square test, Mann-Whitney U-Test and Cramer´s contingency coefficient. The results of the present paper show, that despite the fact that few of our findings are pleasing - almost 52% of our respondents stay that the labelling of gluten free products is sufficient, over 74% of respondents think that they have enough information about the availability of gluten free products and more than 89% of respondents think that the present scope of range of gluten free products is better as before; there are still some shortcomings, which has to be reduced or eliminated - only less than 7% of respondents think that the price of gluten free products is adequate, over 45% of respondents use this possibility of granting a monetary contribution for compensation of increased expenses on a special diet, almost 65% of respondents think that the scope of range of gluten free products is in the Slovak market insufficient, 53% of respondents think that the availability of gluten free products in the Slovak market is inadequate and only 48% of respondents prefer the domestic producers of gluten free products.
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Bidmon-Fliegenschnee B, Lederhuber HC, Csaicsich D, Pichler J, Herzog R, Memaran-Dadgar N, Huber WD, Aufricht C, Kratochwill K. Overexpression of Hsp70 confers cytoprotection during gliadin exposure in Caco-2 cells. Pediatr Res 2015; 78:358-64. [PMID: 26086640 DOI: 10.1038/pr.2015.112] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 03/10/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND In Celiac disease (CD), cytoskeletal integrity of intestinal cells is disrupted by gliadin exposure. This study investigates the role of heat shock protein (Hsp)70 during cytoskeletal recovery in CD by assessing its induction and effects on junctional proteins. METHODS Using an in-vitro model of CD, cytoskeletal injury and recovery was assessed in gliadin-exposed Caco-2 cells by measuring cellular distribution of ezrin, E-cadherin, and Hsp70 by differential centrifugation. Effects of Hsp70 were tested by an in-vitro repair assay, based on the incubation of injured or recovered cytoskeletal cellular fractions in noncytoskeletal supernatants containing low or high levels of Hsp70, or by transient transfection of Caco-2 cells with Hsp70. RESULTS Cytoskeletal disruption of ezrin and E-cadherin was demonstrated in gliadin-exposed Caco-2 cells by their significant shift from the cytoskeletal pellet into the noncytoskeletal supernatant fraction. Recovery from gliadin exposure was associated with induction and cytoskeletal redistribution of Hsp70. The in-vitro repair assay delineated direct evidence for HSP-mediated repair by stabilization of junctional proteins by Hsp70. Overexpression of Hsp70 resulted in significantly increased cytoskeletal integrity. CONCLUSION Our results establish an essential role of HSP-mediated cytoskeletal repair in Caco-2 cells during recovery from in-vitro gliadin exposure.
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Affiliation(s)
| | - Hans Ch Lederhuber
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Dagmar Csaicsich
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Judith Pichler
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Rebecca Herzog
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Nima Memaran-Dadgar
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Wolf-Dietrich Huber
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Christoph Aufricht
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Klaus Kratochwill
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
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Zamani M, Modares-Sadegi M, Shirvani F, Zamani H, Emami MH. The involvement of the HLA-DQB1 alleles in the risk and the severity of Iranian coeliac disease patients. Int J Immunogenet 2014; 41:312-7. [PMID: 24917237 DOI: 10.1111/iji.12128] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 03/19/2014] [Accepted: 04/27/2014] [Indexed: 12/31/2022]
Abstract
Coeliac disease (CD) is a highly prevalent autoimmune disorder that is triggered by the ingestion of wheat gluten and related proteins in genetically susceptible individuals. The CD is associated with human leucocyte antigen (HLA) genes particularly with HLA-DQ alleles encoding HLA-DQ2 and DQ8 proteins. To define risk and severity alleles for CD, a total of 120 definite CD patients and 100 healthy controls were genotyped for HLA-DQB1 gene. HLA-DQB1 genotyping was performed in all patients and controls using PCR-SSP technique, and to evaluate the clinical relevance of testing for HLA-DQB1 and determining absolute risk of disease, prevalence-corrected positive predictive value and prevalence-corrected negative predictive value (PcPPV and PcNPV) were calculated. Our results for a first time show that DQB1*02:00 and DQB1*03:02 alleles and DQB1*02:01/03:02 genotype very significantly associated with increased risk of patients with CD, and DQB1*03:01,4 allele provides protection against CD in Iranian patients. Furthermore, the PcPPV for DQB*02:01 and 03:02 alleles in CD were 0.014 and 0.012, respectively, and the highest absolute risk presented by DQB*0201/0302 genotype (PcPPV = 0.079) and 98% of patients with CD carried DQB1*02:01/x or DQB1*03:02/x genotype. The results also clearly demonstrated that the DQB1*02:01 allele significantly associated with severity of CD, while DQB1*03:02 allele associated with mild form of CD. These results suggest that clinically suspected individuals for CD and first-degree relatives of patients with CD to be screened for HLA-DQB*0201 and DQB*0302 alleles for possible early diagnosis and treatments.
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Affiliation(s)
- M Zamani
- Faculty of Medicine, Department of Medical Genetics, Tehran University of Medical Sciences, Tehran, Iran; Department of Neurogenetics, Iranian Centre of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran
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Moossavi S. Gliadin is an uncatalogued Toll-like receptor ligand. JOURNAL OF MEDICAL HYPOTHESES AND IDEAS 2014. [DOI: 10.1016/j.jmhi.2013.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Hybenová E, Štofirová J, Mikulajová A. Celiac disease and gluten-free diet. POTRAVINARSTVO 2013. [DOI: 10.5219/276] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Celiac disease is an autoimmunity inflammatory disorder of the small intestine caused by the ingestion of gluten in genetically predisposed individuals. The prevalence of the disorder is around 1 % of the Western population and is still increasing. The symptoms of celiac disease include chronic abdominal pain, diarrhoea, and growth retardation in children, and chronic fatigue and headache, bowel complaints, reduced fertility, dermatitis herpetiformis, osteoporosis, nerve and brain disorders, increasing risk of intestinal cancer. The clinical diagnosis of the disease is based on the serological tests and bowel biopsy. The treatment is a long-life gluten-free diet. It is necessary exclude from the diet wheat, rye, barley and probably oats and buckwheat and their products. The novel approaches for celiac disease are focused on the genetic manipulation of nontoxic gluten proteins, enzyme therapy, immune modulation, and induction of oral tolerance to gluten.
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Kawamura-Konishi Y, Shoda K, Koga H, Honda Y. Improvement in gluten-free rice bread quality by protease treatment. J Cereal Sci 2013. [DOI: 10.1016/j.jcs.2013.02.010] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Rodrigues FT, Fanaro GB, Duarte RC, Koike AC, Villavicencio ALC. A sensory evaluation of irradiated cookies made from flaxseed meal. Radiat Phys Chem Oxf Engl 1993 2012. [DOI: 10.1016/j.radphyschem.2012.02.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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16
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Catamo E, Segat L, Lenarduzzi S, Petix V, Morgutti M, Crovella S. CD14 polymorphisms correlate with an augmented risk for celiac disease in Italian patients. Genes Immun 2012; 13:489-95. [DOI: 10.1038/gene.2012.23] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Are immunoglobulin A anti-gliadin antibodies helpful in diagnosing coeliac disease in children younger than 2 years? J Pediatr Gastroenterol Nutr 2012; 54:110-2. [PMID: 21857243 DOI: 10.1097/mpg.0b013e31823255c9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The usefulness of immumoglobulin (Ig) A antibodies to gliadin (AGA-IgA) in addition to IgA anti-endomysium and tissue transglutaminase antibodies was evaluated in 4122 children younger than 2 years with a suspicion of coeliac disease (CD). Eight percent (312/4122) displayed IgA anti-endomysium and/or IgA anti-tissue transglutaminase, whereas 2.1% (85/4122) displayed only AGA-IgA. Clinical data were obtained for 62 of 85 children with isolated AGA-IgA, and 33 children underwent a duodenal biopsy. Histologically proven CD was established for 5 patients, whereas 57 children were diagnosed to experience other diseases. The systematic detection of AGA-IgA using native gliadin conferred no additional diagnostic benefit for the diagnosis of CD in children younger than 2 years of age, except for rare cases.
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Harmon GS, Lebeck LK, Weidner N. Gluten-dependent enteropathy and atypical human leukocyte antigen alleles. Hum Pathol 2011; 42:1112-6. [PMID: 21292306 DOI: 10.1016/j.humpath.2010.10.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2010] [Revised: 10/25/2010] [Accepted: 10/27/2010] [Indexed: 12/19/2022]
Abstract
The risk for developing celiac disease is associated with the major histocompatibility complex class II human leukocyte antigen DQ2 and DQ8. We retrospectively reviewed the medical records of 127 consecutive cases of adult-onset celiac disease evaluated at a single United States center to determine the distribution of the associated human leukocyte antigen DQA1 and DQB1 alleles. The median patient age of diagnosis was 41 (range, 16-81) years. Ninety-five adults underwent human leukocyte antigen DQ typing. Eighty patients were DQ2 positive, 24 were DQ8 positive, and 11 were DQ2 and DQ8 positive. Four patients carried the uncommon, low-risk haplotype DQ2.2 (DQA1*02 and DQB1*02) without DQA1*05. Two patients did not carry human leukocyte antigen DQ2 or DQ8. All of the patients with atypical human leukocyte antigen DQ responded to a gluten-free diet. Although the majority of patients carry the human leukocyte antigen DQ2 or DQ8, gluten-dependent enteropathy periodically presents in adults with low-risk alleles.
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Affiliation(s)
- Gregory S Harmon
- Department of Medicine, Division of Gastroenterology, University of California, San Diego, La Jolla, CA 92093, USA
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19
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Brazowski E, Cohen S, Yaron A, Filip I, Eisenthal A. FOXP3 expression in duodenal mucosa in pediatric patients with celiac disease. Pathobiology 2011; 77:328-34. [PMID: 21266832 DOI: 10.1159/000322049] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2010] [Accepted: 10/14/2010] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE It was the aim of this study to evaluate the number of 2 lymphoid subpopulations, CD8(+) cells and FOXP3(+), in the duodenum mucosa from pediatric celiac patients. METHODS Tissue sections prepared from paraffin-embedded biopsies of the descending duodenum of 61 celiac patients with Marsh grade 1 (M1), M2 and M3 disease and biopsies from 21 age-matched non-celiac (NC) patients were immunohistostained with anti-CD8 or FOXP3 antibodies. RESULTS The histological Marsh grade correlated with the mean number of FOXP3(+) cells in the lamina propria (LP) mucosa (8.9 ± 1.1, 6.8 ± 2.4, 24.5 ± 2.6 and 31.1 ± 2.8 for NC, M1, M2 and M3 biopsies, respectively; p < 0.001). Using a cutoff point of 15 cells, 95% of NC and 88% of M1 biopsies had a mean of <15 FOXP3(+) cells compared with 14% for M2 and 13% for M3 biopsies. The number of FOXP3(+) cells in the epithelial mucosa also correlated with transglutaminase type 2 serum levels from the celiac patients. Unlike the FOXP3(+) cells, CD8(+) lymphocytes were present in both LP and surface epithelial mucosa and significantly different only in the LP mucosa of the M2 and M3 groups. CONCLUSION The number of FOXP3(+) cells is substantially increased in the mucosa of celiac patients at advanced stages. Characterization of the activity of these cells in celiac and in other inflammatory bowel diseases will enable us to understand the significance of these cells in celiac disease.
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Affiliation(s)
- Eli Brazowski
- Pathology Institute, Tel Aviv University, Tel Aviv, Israel
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20
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Sciarini LS, Ribotta PD, León AE, Pérez GT. Effect of hydrocolloids on gluten-free batter properties and bread quality. Int J Food Sci Technol 2010. [DOI: 10.1111/j.1365-2621.2010.02407.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Duerksen DR, Wilhelm-Boyles C, Veitch R, Kryszak D, Parry DM. A comparison of antibody testing, permeability testing, and zonulin levels with small-bowel biopsy in celiac disease patients on a gluten-free diet. Dig Dis Sci 2010; 55:1026-31. [PMID: 19399613 DOI: 10.1007/s10620-009-0813-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2008] [Accepted: 04/02/2009] [Indexed: 12/18/2022]
Abstract
Active celiac disease is associated with positive endomysial (EMA) and tissue transglutaminase (TTG) antibodies, elevated zonulin levels, and increased intestinal permeability. There is little known about what happens to these immunologic and structural abnormalities in patients on a gluten-free diet and their correlation with small-bowel biopsy changes. Adult patients previously diagnosed with celiac disease and on a gluten-free diet for greater than 1 year were considered for the study. All patients underwent the following: measurement of EMA and TTG antibodies, serum zonulin levels, intestinal permeability (IP) testing with lactulose/mannitol ratios, food diary analysis for gluten ingestion and small- bowel biopsy. A total of 21 patients on a gluten-free diet for a mean of 9.7 years completed the study. There were ten patients who had normalization of intestinal biopsies, IP and TTG, and EM antibodies. Six patients had Marsh type 2 or 3 lesions and all had either abnormal IP (5/6) or TTG antibody (4/6). In patients with Marsh type 3 lesions, there was a correlation between IP and zonulin levels. A subgroup of patients with celiac disease on a gluten-free diet has complete normalization of intestinal biopsies, intestinal permeability defects, and antibody levels. Patients with Marsh type 3 lesions have abnormal TTG antibodies and intestinal permeability with zonulin levels that correlate with IP. These abnormalities may be due to continued gluten ingestion. Further study is needed to determine the clinical utility of TTG antibodies and IP testing in following patients with celiac disease.
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Affiliation(s)
- D R Duerksen
- Department of Medicine, Division of Gastroenterology, St. Boniface Hospital, University of Manitoba, C5120 409 Tache Ave, Winnipeg, MB, R2H 2A6, Canada.
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Renzetti S, Courtin C, Delcour J, Arendt E. Oxidative and proteolytic enzyme preparations as promising improvers for oat bread formulations: Rheological, biochemical and microstructural background. Food Chem 2010. [DOI: 10.1016/j.foodchem.2009.09.028] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Arakeri G, Arali V, Brennan PA. Cleft lip and palate: an adverse pregnancy outcome due to undiagnosed maternal and paternal coeliac disease. Med Hypotheses 2010; 75:93-8. [PMID: 20188484 DOI: 10.1016/j.mehy.2010.01.047] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2010] [Accepted: 01/29/2010] [Indexed: 01/09/2023]
Abstract
Development of orofacial component involves a complex series of events. Any insult to this significant event can lead to various orofacial cleft defects. The main categories among orofacial clefts are isolated cleft palate and cleft lip with or without cleft palate. There have been many factors implicated in the development of the anomaly. The environmental factors which contribute and the genes which predispose to the condition remain obscure despite decades of research. Though it is generally agreed that folic acid deficiency is a contributory factor for non-syndromic cleft lip and palate, fewer concerns are directed towards the role for maternal/paternal nutrition in orofacial cleft origin. However, previously undescribed, here we consider the potential influence of maternal and paternal coeliac disease on the etiology of non-syndromic cleft lip and palate as an unfavorable pregnancy outcome. We postulated this relationship based on our observation, study and an empirical survey, and could be due either to (I) folic acid mal absorption (II) a genetically mediated genomic imprinting system.
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Affiliation(s)
- Gururaj Arakeri
- Peter Brennan's Indian academy of craniofacial researches (PBIACR), Shahapur, Karnataka, India.
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Luongo D, D'Arienzo R, Bergamo P, Maurano F, Rossi M. Immunomodulation of Gut-Associated Lymphoid Tissue: Current Perspectives. Int Rev Immunol 2009; 28:446-64. [DOI: 10.3109/08830180903236486] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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25
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Renzetti S, Arendt E. Effect of protease treatment on the baking quality of brown rice bread: From textural and rheological properties to biochemistry and microstructure. J Cereal Sci 2009. [DOI: 10.1016/j.jcs.2009.02.002] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gao Y, Kristinsson SY, Goldin LR, Björkholm M, Caporaso NE, Landgren O. Increased risk for non-Hodgkin lymphoma in individuals with celiac disease and a potential familial association. Gastroenterology 2009; 136:91-8. [PMID: 18950631 PMCID: PMC3227529 DOI: 10.1053/j.gastro.2008.09.031] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2008] [Revised: 08/29/2008] [Accepted: 09/18/2008] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Celiac disease (CD), a common digestive disease, is well known to be associated with excess non-Hodgkin lymphoma (NHL) risk. However, there are only limited data on risk in the current era of serologic testing and human leukocytes antigen typing to screen for CD. There is also no information on the role of family history of CD in relation to lymphoma risk. METHODS We identified 37,869 NHL, 8323 Hodgkin lymphoma (HL), and 13,842 chronic lymphocytic leukemia patients diagnosed in Sweden between 1965 and 2004, as well as 236,408 matched controls and 613,961 first-degree relatives. Using logistic regression, we calculated odds ratios and 95% confidence intervals as measures of risks adjusted for matching factors. RESULTS Overall we found persons with a hospital discharge diagnosis of CD to have a 5.35-fold (95% CI, 3.56-8.06) increased NHL risk. Risk of HL was borderline increased (OR=2.54, 95% CI, 0.99-6.56); however, there was no excess chronic lymphocytic leukemia risk. Persons diagnosed with CD in 1975-1984, 1985-1994, and 1995-2004 had a 13.2-fold (95% CI, 3.63-48.0), 7.90-fold (95% CI, 3.38-18.5), and 3.84-fold (95% CI, 2.28-6.45) increased risk of NHL, respectively (P(trend)< .0001). Individuals with a sibling affected with CD had a 2.03-fold (95% CI, 1.29-3.19) increased NHL risk. CONCLUSIONS Persons with CD have an increased NHL risk; however, the excess risk has tapered off substantially in the last 4 decades. The observed excess NHL risk among individuals with a sibling affected with CD suggests shared susceptibility. Future studies are needed to explore the roles of gluten intake, secondary intestinal inflammation, and susceptibility genes in relation to subsequent risk of developing lymphoma.
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Affiliation(s)
- Ying Gao
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892-7236, USA.
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Celiac disease in the elderly. ACTA ACUST UNITED AC 2008; 5:697-706. [DOI: 10.1038/ncpgasthep1281] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2008] [Accepted: 09/22/2008] [Indexed: 12/16/2022]
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Microstructure, fundamental rheology and baking characteristics of batters and breads from different gluten-free flours treated with a microbial transglutaminase. J Cereal Sci 2008. [DOI: 10.1016/j.jcs.2007.07.011] [Citation(s) in RCA: 178] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Bassotti G, Villanacci V, Mazzocchi A, Mariano M, Incardona P, Clerici C, Morelli A. Antroduodenojejunal motor activity in untreated and treated celiac disease patients. J Gastroenterol Hepatol 2008; 23:e23-8. [PMID: 18702684 DOI: 10.1111/j.1440-1746.2007.04868.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIM Patients with celiac disease may present with abnormal upper gut motor activity. However, it is not known if these abnormalities persist after the introduction of a gluten-free diet. The present study aimed to compare antroduodenojejunal motor variables recorded in untreated celiac patients with those of celiac patients given a gluten-free diet and healthy volunteers. METHODS Eleven untreated celiac disease patients, 12 age- and sex-matched celiac patients on a gluten-free diet (at least 12 months), and 33 controls entered the study. Antroduodenojejunal motility was recorded for 6 h during fasting and for 3 h after a standard meal by means of a perfused, multiple lumen catheter. RESULTS More than 80% of untreated celiac patients had discrete motor abnormalities of the upper gut, in both fasting and fed recordings, compared to the other subjects. Patients on a gluten-free diet also showed motor abnormalities, albeit to a lesser extent. In these patients histological evaluation showed the persistence of mild mucosal abnormalities. CONCLUSIONS Upper gut motor abnormalities are frequent in patients with celiac disease, even in those on a gluten-free diet. In the latter group, these abnormalities may suggest an incomplete adherence to the dietary regimen.
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Affiliation(s)
- Gabrio Bassotti
- Gastroenterology and Hepatology Section, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy
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Niewinski MM. Advances in celiac disease and gluten-free diet. ACTA ACUST UNITED AC 2008; 108:661-72. [PMID: 18375224 DOI: 10.1016/j.jada.2008.01.011] [Citation(s) in RCA: 141] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2007] [Accepted: 10/15/2007] [Indexed: 01/02/2023]
Abstract
Celiac disease is becoming an increasingly recognized autoimmune enteropathy caused by a permanent intolerance to gluten. Once thought to be a rare disease of childhood characterized by diarrhea, celiac disease is actually a multisystemic disorder that occurs as a result of an immune response to ingested gluten in genetically predisposed individuals. Screening studies have revealed that celiac disease is most common in asymptomatic adults in the United States. Although considerable scientific progress has been made in understanding celiac disease and in preventing or curing its manifestations, a strict gluten-free diet is the only treatment for celiac disease to date. Early diagnosis and treatment, together with regular follow-up visits with a dietitian, are necessary to ensure nutritional adequacy and to prevent malnutrition while adhering to the gluten-free diet for life. The purpose of this review is to provide clinicians with current updated information about celiac disease, its diverse clinical presentation and increased prevalence, the complex pathophysiology and strong genetic predisposition to celiac disease, and its diagnosis. This review focuses in detail on the gluten-free diet and the importance of intense expert dietary counseling for all patients with celiac disease. Recent advances in the gluten-free diet include food allergen labeling as well as the US Food and Drug Administration's proposed definition of the food-labeling term gluten-free. The gluten-free diet is complex and patients need comprehensive nutrition education from a skilled dietitian.
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Affiliation(s)
- Mary M Niewinski
- Department of Pediatrics/Genetics, University of Illinois at Chicago Medical Center, Chicago, IL, USA.
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Abstract
INTRODUCTION Contrary to early beliefs, celiac disease (CD) is relatively common; however, it still remains underdiagnosed since most cases are atypical, with few or no gastrointestinal symptoms and predominance of extraintestinal manifestations. As a consequence, the diagnosis of the disorder often requires a multidisciplinary approach. Also some oral ailments have been described in celiac patients. In this study, we review the papers that have reported oral manifestations in subjects with CD. METHODS A comprehensive literature search was conducted in Medline and Embase databases using appropriate key words. Additional papers were selected by cross-referencing from the retrieved articles. RESULTS Dental enamel defects are the oral lesions most closely related to CD. There are conflicting data on the association between CD and recurrent aphthous stomatitis. A correlation of CD with atrophic glossitis has been reported, although robust evidence in support of it is lacking. Patients with CD have caries indexes seemingly lower than healthy individuals, but they may experience delay in tooth eruption. Occurrence of other oral mucosal lesions in CD subjects is likely occasional. CONCLUSIONS Patients with systematic dental enamel defects should be screened for CD even in the absence of gastrointestinal symptoms. CD screening tests for patients with oral aphthae or idiopathic atrophic glossitis should be selectively considered during a medical evaluation that focuses on all aspects of the patient's status.
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Celiacs disease is not a major risk factor for the development of childhood idiopathic thrombocytopenic purpura. J Pediatr Hematol Oncol 2008; 30:185. [PMID: 18376277 DOI: 10.1097/mph.0b013e31815d9d2c] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Affiliation(s)
- Herbert Wieser
- Deutsche Forschungsanstalt für Lebensmittelchemie and Hans-Dieter-Belitz-Institut für Mehl- und Eiweißforschung, Lichtenbergstr. 4, D-85748 Garching, Germany
- Corresponding author. Phone: +49 89 289 13260. Fax: +49 89 289 14183. E-mail:
| | - Peter Koehler
- Deutsche Forschungsanstalt für Lebensmittelchemie and Hans-Dieter-Belitz-Institut für Mehl- und Eiweißforschung, Lichtenbergstr. 4, D-85748 Garching, Germany
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Dawidowicz K, Ea HK, Lahalle S, Qubaja M, Lioté F. Unexplained polyarthralgia and celiac disease. Joint Bone Spine 2007; 75:325-8. [PMID: 18069037 DOI: 10.1016/j.jbspin.2007.05.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2007] [Accepted: 05/16/2007] [Indexed: 12/30/2022]
Abstract
Celiac disease is an immunological disorder whose best-known manifestations are gastrointestinal symptoms. However, early joint manifestations are common and frequently overlooked features of celiac disease. We report a case in which unexplained inflammatory polyarthralgia and iron-deficiency anemia led to the diagnosis of celiac disease. Autoimmune thyroiditis was also a feature. Early diagnosis and treatment of celiac disease protect patients against complications such as digestive neoplasis. A simple and rapid tool for achieving the early diagnosis is the measurement of the serum of anti-gliadin, anti-endomysial and anti-tissue transglutaminase antibodies. However, a duodenal biopsy remains the only means of making the definitive diagnosis of celiac disease.
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Affiliation(s)
- Karen Dawidowicz
- Rheumatology Federation, Lariboisière Teaching Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
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Paterson BM, Lammers KM, Arrieta MC, Fasano A, Meddings JB. The safety, tolerance, pharmacokinetic and pharmacodynamic effects of single doses of AT-1001 in coeliac disease subjects: a proof of concept study. Aliment Pharmacol Ther 2007; 26:757-66. [PMID: 17697209 DOI: 10.1111/j.1365-2036.2007.03413.x] [Citation(s) in RCA: 175] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Lifelong adherence to a strict gluten-free diet is the cornerstone of coeliac disease treatment. Elucidation of disease pathogenesis has created opportunities for novel therapeutic approaches to coeliac disease. AT-1001 is an inhibitor of paracellular permeability whose structure is derived from a protein secreted by Vibrio cholerae. AIM To determine the safety and tolerability of 12 mg doses of AT-1001 in coeliac disease subjects challenged with gluten. METHODS An in-patient, double-blind, randomized placebo-controlled safety study utilizing intestinal permeability, measured via fractional excretions of lactulose and mannitol, as an exploratory measure of drug efficacy. RESULTS Compared to placebo, no increase in adverse events occurred in patients exposed to AT-1001. Following acute gluten exposure, a 70% increase in intestinal permeability was detected in the placebo group, while none was seen in the AT-1001 group. Interferon-gamma levels increased in four of seven patients (57%) of the placebo group, but only in four of 14 patients (29%) of the AT-1001 group. Gastrointestinal symptoms were more frequently detected in the placebo group when compared to the AT-1001 group (P = 0.018). CONCLUSIONS AT-1001 is well tolerated and appears to reduce intestinal barrier dysfunction, proinflammatory cytokine production, and gastrointestinal symptoms in coeliacs after gluten exposure.
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Affiliation(s)
- B M Paterson
- Alba Therapeutics Corporation, Baltimore, MD 21201, USA.
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Abstract
Celiac disease (CD) is a common autoimmune disorder characterized by an immune response to ingested gluten and has a strong HLA association with HLA-DQ2 and HLA-DQ8 molecules, but human HLA-DQ risk factors do not explain the entire genetic susceptibility to gluten intolerance. CD is caused by the lack of immune tolerance (oral tolerance) to wheat gluten. In this sense, the expression of soluble HLA-G in CD is of special interest because the molecule plays an important role in the induction of immune tolerance. The enhanced expression of soluble HLA-G found in CD may be part of a mechanism to restore the gluten intolerance. In this editorial, we review recent progress in understanding CD in relation to its prevalence, diagnosis and possible mechanisms of pathogenesis.
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