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Liu Y, Yao N, Wang Y, Dong Y, Wang L, Wang F, Wu Z, Wang S, Li B. The association of gluten-free diet with thyroid autoimmunity in patients with celiac disease: a meta-analysis. Food Funct 2024; 15:1089-1098. [PMID: 38205645 DOI: 10.1039/d3fo01573d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
Background: Thyroid autoimmunity is an immune response to thyroid antigens that causes varying degrees of thyroid dysfunction. The sole effective treatment for Celiac Disease (CD) is a gluten-free diet (GFD). However, the association between GFD and thyroid autoimmunity in patients with CD has not been confirmed. Methods: A comprehensive search of several databases, involving PubMed, Embase, Web of Science, Medline, and Cochrane databases, was conducted to identify studies that primarily addressed the effects of GFD on thyroid autoimmunity in CD subjects. The meta-analysis involved studies that compared the risk of ATPO and ATG antibody positivity in CD patients with GFD, the risk of developing AITD, and the risk of developing thyroid dysfunction. Fixed-effects models or random-effects models were used to calculate the odds ratios (ORs) and their 95% confidence intervals (95% CIs). Results: A total of 10 observational studies met the inclusion criteria and included 6423 subjects. The results indicated that GFD is positively associated with thyroid autoimmunity in the children subgroup of CD patients (OR = 1.61, 95%CI 1.06-2.43, P = 0.02). However, there was no significant difference in thyroid autoimmunity between the group adhering to GFD and the control group in the total CD population. Conclusion: The results seem to indicate that subjects with a more pronounced autoimmunity (such as to have an early onset of CD) appear to have a greater risk of thyroid autoimmunity.
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Affiliation(s)
- Yan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, P. R. China.
| | - Nan Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, P. R. China.
| | - Yuxiang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, P. R. China.
| | - Yibo Dong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, P. R. China.
| | - Ling Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, P. R. China.
| | - Fengdan Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, P. R. China.
| | - Zibo Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, P. R. China.
| | - Sizhe Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, P. R. China.
| | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, P. R. China.
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Vázquez-Polo M, Churruca I, Perez-Junkera G, Larretxi I, Lasa A, Esparta J, Cantero-Ruiz de Eguino L, Navarro V. Study Protocol for a Controlled Trial of Nutrition Education Intervention about Celiac Disease in Primary School: ZELIAKIDE Project. Nutrients 2024; 16:338. [PMID: 38337623 PMCID: PMC10857138 DOI: 10.3390/nu16030338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/12/2024] Open
Abstract
The only treatment for celiac disease (CD) is a strict and lifelong gluten-free diet (GFD), which must be safe and nutritionally balanced. Avoiding gluten brings difficulties with following the diet and can affect the social life of people with CD. The Zeliakide Project is a nutrition education program aimed at increasing the knowledge of the general population about healthy diets, CD and GFD, and, therefore, to improve the social inclusion and quality of life of people with CD. It is a one-month intervention program, two-armed cluster, non-randomised and controlled trial, conducted among 10-12-year-old children. Pre- and post-intervention evaluation and 1 month follow-up will be carried out to assess the effectiveness of the program. It is based on competencies and their respective learning outcomes. The teaching methodology chosen is a STEAM methodology: inquiry-based learning (IBL). A teaching unit has been created to develop the project, which, in the future, will be useful for the self-application of the program. This study will provide a valid and useful tool to achieve changes in the diet at the school level and will help to promote the social inclusion of people with CD. Moreover, it will enforce the STEAM competences of children.
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Affiliation(s)
- Maialen Vázquez-Polo
- Gluten 3S Research Group, Department of Nutrition and Food Science, Faculty of Pharmacy, University of the Basque Country UPV/EHU, 01006 Vitoria-Gasteiz, Spain; (M.V.-P.); (G.P.-J.); (I.L.); (A.L.); (J.E.); (V.N.)
- Bioaraba, Nutrition and Food Safety Group, 01009 Vitoria-Gasteiz, Spain
| | - Itziar Churruca
- Gluten 3S Research Group, Department of Nutrition and Food Science, Faculty of Pharmacy, University of the Basque Country UPV/EHU, 01006 Vitoria-Gasteiz, Spain; (M.V.-P.); (G.P.-J.); (I.L.); (A.L.); (J.E.); (V.N.)
- Bioaraba, Nutrition and Food Safety Group, 01009 Vitoria-Gasteiz, Spain
| | - Gesala Perez-Junkera
- Gluten 3S Research Group, Department of Nutrition and Food Science, Faculty of Pharmacy, University of the Basque Country UPV/EHU, 01006 Vitoria-Gasteiz, Spain; (M.V.-P.); (G.P.-J.); (I.L.); (A.L.); (J.E.); (V.N.)
- Bioaraba, Nutrition and Food Safety Group, 01009 Vitoria-Gasteiz, Spain
| | - Idoia Larretxi
- Gluten 3S Research Group, Department of Nutrition and Food Science, Faculty of Pharmacy, University of the Basque Country UPV/EHU, 01006 Vitoria-Gasteiz, Spain; (M.V.-P.); (G.P.-J.); (I.L.); (A.L.); (J.E.); (V.N.)
- Bioaraba, Nutrition and Food Safety Group, 01009 Vitoria-Gasteiz, Spain
- Centro Integral de Atención a Mayores San Prudencio, 01006 Vitoria-Gasteiz, Spain
| | - Arrate Lasa
- Gluten 3S Research Group, Department of Nutrition and Food Science, Faculty of Pharmacy, University of the Basque Country UPV/EHU, 01006 Vitoria-Gasteiz, Spain; (M.V.-P.); (G.P.-J.); (I.L.); (A.L.); (J.E.); (V.N.)
- Bioaraba, Nutrition and Food Safety Group, 01009 Vitoria-Gasteiz, Spain
| | - Jon Esparta
- Gluten 3S Research Group, Department of Nutrition and Food Science, Faculty of Pharmacy, University of the Basque Country UPV/EHU, 01006 Vitoria-Gasteiz, Spain; (M.V.-P.); (G.P.-J.); (I.L.); (A.L.); (J.E.); (V.N.)
| | - Leire Cantero-Ruiz de Eguino
- Gluten 3S Research Group, Department of Nutrition and Food Science, Faculty of Pharmacy, University of the Basque Country UPV/EHU, 01006 Vitoria-Gasteiz, Spain; (M.V.-P.); (G.P.-J.); (I.L.); (A.L.); (J.E.); (V.N.)
| | - Virginia Navarro
- Gluten 3S Research Group, Department of Nutrition and Food Science, Faculty of Pharmacy, University of the Basque Country UPV/EHU, 01006 Vitoria-Gasteiz, Spain; (M.V.-P.); (G.P.-J.); (I.L.); (A.L.); (J.E.); (V.N.)
- Bioaraba, Nutrition and Food Safety Group, 01009 Vitoria-Gasteiz, Spain
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Zhu X, Zhao XH, Zhang Q, Zhang N, Soladoye OP, Aluko RE, Zhang Y, Fu Y. How does a celiac iceberg really float? The relationship between celiac disease and gluten. Crit Rev Food Sci Nutr 2022; 63:9233-9261. [PMID: 35435771 DOI: 10.1080/10408398.2022.2064811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Celiac disease (CD) is an autoimmune intestinal disease caused by intolerance of genetically susceptible individuals after intake of gluten-containing grains (including wheat, barley, etc.) and their products. Currently, CD, with "iceberg" characteristics, affects a large population and is distributed over a wide range of individuals. This present review summarizes the latest research progress on the relationship between CD and gluten. Furthermore, the structure and function of gluten peptides related to CD, gluten detection methods, the effects of processing on gluten and gluten-free diets are emphatically reviewed. In addition, the current limitations in CD research are also discussed. The present work facilitates a comprehensive understanding of CD as well as gluten, which can provide a theoretical reference for future research.
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Affiliation(s)
- Xiaoxue Zhu
- College of Food Science, Southwest University, Chongqing, China
- National Demonstration Center for Experimental Food Science and Technology Education, Southwest University, Chongqing, China
| | - Xin-Huai Zhao
- School of Biological and Food Engineering, Guangdong University of Petrochemical Technology, Maoming, P. R. China
| | - Qiang Zhang
- School of Biological and Food Engineering, Guangdong University of Petrochemical Technology, Maoming, P. R. China
| | - Na Zhang
- Key Laboratory of Food Science and Engineering of Heilongjiang Province, College of Food Engineering, Harbin University of Commerce, Harbin, China
| | - Olugbenga P Soladoye
- Agriculture and Agri-Food Canada, Government of Canada, Lacombe Research and Development Centre, Lacombe, Alberta, Canada
| | - Rotimi E Aluko
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Yuhao Zhang
- College of Food Science, Southwest University, Chongqing, China
- National Demonstration Center for Experimental Food Science and Technology Education, Southwest University, Chongqing, China
| | - Yu Fu
- College of Food Science, Southwest University, Chongqing, China
- National Demonstration Center for Experimental Food Science and Technology Education, Southwest University, Chongqing, China
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4
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Enaud R, Tetard C, Dupuis R, Laharie D, Lamireau T, Zerbib F, Rivière P, Shili-Mismoudi S, Poullenot F. Compliance with Gluten Free Diet Is Associated with Better Quality of Life in Celiac Disease. Nutrients 2022; 14:nu14061210. [PMID: 35334866 PMCID: PMC8951042 DOI: 10.3390/nu14061210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 02/06/2023] Open
Abstract
The quality of life (QOL) of patients with celiac disease (CD) can be altered by both symptoms of the disease and by the restrictions of the gluten-free diet (GFD). The objective was to determine the factors associated with better QOL in a large cohort of CD patients. A link to an online survey was sent to the members of the French Association of Gluten Intolerant People (AFDIAG). The French-Celiac Disease Questionnaire (F-CDQ), scoring from 0 to 100, was used to measure the QOL. Other data collected were sociodemographic characteristics, information on CD, purchasing and consumption habits of gluten-free products, and a self-assessment scale (ranging from 0 to 10) to determine the compliance with the GFD. Among the 907 CD patients who returned the questionnaire, 787 were analyzed (638 women (81%); median age: 49 years; 71% with self-assessed GFD compliance > 8). Their median F-CDQ was 73 (range: 59−82). In multivariate analysis, the main factors associated with a better quality of life were the long duration of the GFD, good compliance with the GFD, and the number of follow-up visits. Compliance with and duration of the GFD are associated with a better quality of life in patients with CD. Taking this into consideration would offset its restrictive aspect and improve its adherence.
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Affiliation(s)
- Raphaël Enaud
- CHU de Bordeaux, Hôpital des Enfants, Service d’Hépato-Gastroentérologie Pédiatriques, 33000 Bordeaux, France; (R.E.); (C.T.); (T.L.)
| | - Candice Tetard
- CHU de Bordeaux, Hôpital des Enfants, Service d’Hépato-Gastroentérologie Pédiatriques, 33000 Bordeaux, France; (R.E.); (C.T.); (T.L.)
- CHU de Bordeaux, Centre Médico-chirurgical Magellan, Hôpital Haut-Lévêque, Gastroenterology Department, Université de Bordeaux, INSERM CIC 1401, 33000 Bordeaux, France; (R.D.); (D.L.); (F.Z.); (P.R.); (S.S.-M.)
| | - Raphaël Dupuis
- CHU de Bordeaux, Centre Médico-chirurgical Magellan, Hôpital Haut-Lévêque, Gastroenterology Department, Université de Bordeaux, INSERM CIC 1401, 33000 Bordeaux, France; (R.D.); (D.L.); (F.Z.); (P.R.); (S.S.-M.)
| | - David Laharie
- CHU de Bordeaux, Centre Médico-chirurgical Magellan, Hôpital Haut-Lévêque, Gastroenterology Department, Université de Bordeaux, INSERM CIC 1401, 33000 Bordeaux, France; (R.D.); (D.L.); (F.Z.); (P.R.); (S.S.-M.)
| | - Thierry Lamireau
- CHU de Bordeaux, Hôpital des Enfants, Service d’Hépato-Gastroentérologie Pédiatriques, 33000 Bordeaux, France; (R.E.); (C.T.); (T.L.)
| | - Frank Zerbib
- CHU de Bordeaux, Centre Médico-chirurgical Magellan, Hôpital Haut-Lévêque, Gastroenterology Department, Université de Bordeaux, INSERM CIC 1401, 33000 Bordeaux, France; (R.D.); (D.L.); (F.Z.); (P.R.); (S.S.-M.)
| | - Pauline Rivière
- CHU de Bordeaux, Centre Médico-chirurgical Magellan, Hôpital Haut-Lévêque, Gastroenterology Department, Université de Bordeaux, INSERM CIC 1401, 33000 Bordeaux, France; (R.D.); (D.L.); (F.Z.); (P.R.); (S.S.-M.)
| | - Sarah Shili-Mismoudi
- CHU de Bordeaux, Centre Médico-chirurgical Magellan, Hôpital Haut-Lévêque, Gastroenterology Department, Université de Bordeaux, INSERM CIC 1401, 33000 Bordeaux, France; (R.D.); (D.L.); (F.Z.); (P.R.); (S.S.-M.)
| | - Florian Poullenot
- CHU de Bordeaux, Centre Médico-chirurgical Magellan, Hôpital Haut-Lévêque, Gastroenterology Department, Université de Bordeaux, INSERM CIC 1401, 33000 Bordeaux, France; (R.D.); (D.L.); (F.Z.); (P.R.); (S.S.-M.)
- Correspondence:
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Söderström H, Rehn J, Cervin M, Ahlstermark C, Bybrant MC, Carlsson A. Compliance to a Gluten-Free Diet in Swedish Children with Type 1 Diabetes and Celiac Disease. Nutrients 2021; 13:nu13124444. [PMID: 34959996 PMCID: PMC8709103 DOI: 10.3390/nu13124444] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/01/2021] [Accepted: 12/09/2021] [Indexed: 12/25/2022] Open
Abstract
Children with type 1 diabetes (T1D) are at increased risk of celiac disease (CD). The replacement of insulin in T1D, and the exclusion of gluten in CD, are lifelong, burdensome treatments. Compliance to a gluten-free diet (GFD) in children with CD is reported to be high, while compliance in children with both diseases has scarcely been studied. To examine compliance to a GFD in children with both T1D and CD, we analyzed tissue transglutaminase IgA-antibodies (tTGA). Moreover, associations between compliance and age, sex, glycemic control, ketoacidosis (DKA), body mass index (BMI), and time of CD diagnosis were investigated. Of the 743 children diagnosed with T1D in southern Sweden between 2005 and 2012, 9% were also diagnosed with CD. Of these, 68% showed good compliance to a GFD, 18% showed intermediate compliance, and 14% were classified as non-compliant. Higher age, poorer HbA1c, and more DKAs were significantly (p < 0.05) associated with poorer compliance. In conclusion, we found that compliance to a GFD in children with T1D and CD is likely be lower than in children with CD only. Our results indicate that children with both T1D and CD could need intensified dietary support and that older children and children with poor metabolic control are especially vulnerable subgroups.
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Affiliation(s)
- Hanna Söderström
- Department of Clinical Sciences Lund, Lund University, 221 00 Lund, Sweden; (J.R.); (M.C.); (A.C.)
- Skåne University Hospital, 221 85 Lund, Sweden;
- Correspondence:
| | - Julia Rehn
- Department of Clinical Sciences Lund, Lund University, 221 00 Lund, Sweden; (J.R.); (M.C.); (A.C.)
| | - Matti Cervin
- Department of Clinical Sciences Lund, Lund University, 221 00 Lund, Sweden; (J.R.); (M.C.); (A.C.)
| | | | - Mara Cerqueiro Bybrant
- Department of Women’s and Children’s Health, Division of Pediatric Endocrinology, Karolinska Institutet, 171 76 Stockholm, Sweden;
| | - Annelie Carlsson
- Department of Clinical Sciences Lund, Lund University, 221 00 Lund, Sweden; (J.R.); (M.C.); (A.C.)
- Skåne University Hospital, 221 85 Lund, Sweden;
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Urbaszek K, Drabińska N, Szaflarska-Popławska A, Jarocka-Cyrta E. TMPRSS6 rs855791 Polymorphism Status in Children with Celiac Disease and Anemia. Nutrients 2021; 13:nu13082782. [PMID: 34444942 PMCID: PMC8398390 DOI: 10.3390/nu13082782] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/06/2021] [Accepted: 08/09/2021] [Indexed: 12/11/2022] Open
Abstract
Celiac disease (CD) is an autoimmune chronic inflammatory disease occurring in genetically predisposed individuals in response to the intake of gluten. Clinical presentation can be heterogeneous. Iron-deficient anemia (IDA) is one of the most common extra-intestinal manifestations of CD. Although IDA usually reverts with a gluten-free diet (GFD), some patients show persistent IDA, the mechanisms of which are poorly understood. Recent studies suggest an association between the rs855791 polymorphism in the TMPRSS6 gene and persistent IDA in adults with CD. The current study aimed to assess the potential link between rs855791 and persistent IDA in pediatric patients with CD. The study included 106 children diagnosed with CD between 2015 and 2019. Clinical and blood parameters (including blood count, serum iron) were collected at diagnosis and after ≥12 months of GFD, and the rs855791 genotype was assessed for each patient. IDA was present at diagnosis in 25 patients (23.6%); only three (3%) had persistent IDA after GFD. The prevalence of rs855791 genotypes was 9% (n = 10) for TT, 53% (n = 56) for CT, and 38% (n = 40) for CC. There was a tendency toward a higher proportion of the T allele in patients with IDA and lower hemoglobin in the TT genotype but without statistical significance. An association between rs855791 and persistent IDA was not observed. These findings suggest that persistent IDA is uncommon in pediatric patients with CD. The prevalence of rs855791 in children with CD is reported for the first time.
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Affiliation(s)
- Klaudia Urbaszek
- Department of Pediatrics, Gastroenterology and Nutrition, Faculty of Medicine, Collegium Medicum, University of Warmia and Mazury, Żołnierska 18A Str., 10-561 Olsztyn, Poland;
| | - Natalia Drabińska
- Institute of Animal Reproduction and Food Research of Polish Academy of Sciences, Tuwima 10 Str., 10-748 Olsztyn, Poland;
| | - Anna Szaflarska-Popławska
- Laboratory for Pediatric Endoscopy and Gastrointestinal Function Testing, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University of Torun, Jagiellonska 13-15, 85-067 Bydgoszcz, Poland;
| | - Elżbieta Jarocka-Cyrta
- Department of Pediatrics, Gastroenterology and Nutrition, Faculty of Medicine, Collegium Medicum, University of Warmia and Mazury, Żołnierska 18A Str., 10-561 Olsztyn, Poland;
- Correspondence:
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Gasbarrini G, Dionisi T, Corazza GR, Aronico N, Cammarota G, Ianiro G, De Vitis I, Candelli M, Mancarella FA, Simeoni S, Addolorato G, Bonvicini F. COVID-19 in celiac disease: a multicentric retrospective cohort study. Eur Rev Med Pharmacol Sci 2021; 25:4400-4404. [PMID: 34227075 DOI: 10.26355/eurrev_202106_26150] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Celiac disease (CD) is an autoimmune disorder, characterized by increased susceptibility to bacterial and viral infections. Therefore, the CD patients could be exposed to an increased risk of contracting SARS-CoV-2, a virus for which the WHO declared a pandemic status in March 2020. This study aims to investigate the incidence of SARS-CoV-2 infection in CD patients, to assess the impact of CD on the risk of contracting this virus. PATIENTS AND METHODS This retrospective multicentric cohort study evaluated 542 celiac patients, who answered a questionnaire concerning both the underlying disease (adherence to the gluten-free diet, residual symptoms) and the possible SARS-CoV-2 infection (swab outcome, presence and characteristics of symptoms and type of treatment received), referring to the period between 20th January 2020 and 27th October 2020. RESULTS Five patients (0.92%) tested positive; of these, 2 were asymptomatic and 3 developed symptoms of COVID-19. The incidence of SARS-CoV-2 infection in CD patients was not significantly different from the general population. The ratio of positive/diagnostic swabs tends to be higher in CD patients than in the general population (IR: 0.15; 0.06; p=0.06), whereas the number of subjects who performed the swab in this group is significantly lower (IR: 0.06; 0.15; p<0.001). CONCLUSIONS Although CD patients are more susceptible to infections, the incidence of SARS-CoV-2 infection in our sample was not significantly different from the general population. However, the positive/diagnostic swabs ratio seems to be higher, probably also due to the lower number of patients tested.
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Affiliation(s)
- G Gasbarrini
- Institute of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario.
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Gładyś K, Dardzińska J, Guzek M, Adrych K, Kochan Z, Małgorzewicz S. Expanded Role of a Dietitian in Monitoring a Gluten-Free Diet in Patients with Celiac Disease: Implications for Clinical Practice. Nutrients 2021; 13:1859. [PMID: 34072491 PMCID: PMC8228256 DOI: 10.3390/nu13061859] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/26/2021] [Accepted: 05/26/2021] [Indexed: 02/07/2023] Open
Abstract
Access to a registered dietitian experienced in celiac disease (CD) is still limited, and consultation when available focuses primarily on the elimination of gluten from the diet. Thus, the aim of this study was to evaluate the nutritional value of a gluten-free diet (GFD) in adult CD patients before, and one year after, the standard dietary education. The study included 72 CD patients on a GFD and 30 healthy controls. The dietary intake of both groups was assessed through a 3-day food diary, while adherence to a GFD in celiac subjects was assessed using Standardized Dietician Evaluation (SDE). Subsequently, all CD patients received detailed education on gluten sources, and 48 of them participated in a one-year follow-up. Results: Comparison with the control group showed that consumption of plant protein in CD patients was significantly lower, whereas fat and calories were higher. At baseline, only 62% of CD patients adhered to a GFD, but the standard dietary education successfully improved it. However, the nutritional value of a GFD after one year did not change, except for a reduced sodium intake. The CD subjects still did not consume enough calcium, iron, vitamin D, folic acid or fiber. In conclusion, while the standard dietary education improved GFD adherence, it did not significantly alter its nutritional value. Therefore, it is necessary to increase the role of a dietitian in the treatment of CD.
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Affiliation(s)
- Katarzyna Gładyś
- Department of Clinical Nutrition, Medical University of Gdansk, 80-211 Gdańsk, Poland; (J.D.); (Z.K.); (S.M.)
| | - Jolanta Dardzińska
- Department of Clinical Nutrition, Medical University of Gdansk, 80-211 Gdańsk, Poland; (J.D.); (Z.K.); (S.M.)
| | - Marek Guzek
- Department of Gastroenterology and Hepatology, Medical University of Gdansk, 80-211 Gdańsk, Poland; (M.G.); (K.A.)
| | - Krystian Adrych
- Department of Gastroenterology and Hepatology, Medical University of Gdansk, 80-211 Gdańsk, Poland; (M.G.); (K.A.)
| | - Zdzisław Kochan
- Department of Clinical Nutrition, Medical University of Gdansk, 80-211 Gdańsk, Poland; (J.D.); (Z.K.); (S.M.)
| | - Sylwia Małgorzewicz
- Department of Clinical Nutrition, Medical University of Gdansk, 80-211 Gdańsk, Poland; (J.D.); (Z.K.); (S.M.)
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9
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Barry HC. Early Introduction of Dietary Gluten Delays the Diagnosis of Celiac Disease in Breastfed Infants. Am Fam Physician 2021; 103:631. [PMID: 33982998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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10
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Garmaeva S, Gulyaeva A, Sinha T, Shkoporov AN, Clooney AG, Stockdale SR, Spreckels JE, Sutton TDS, Draper LA, Dutilh BE, Wijmenga C, Kurilshikov A, Fu J, Hill C, Zhernakova A. Stability of the human gut virome and effect of gluten-free diet. Cell Rep 2021; 35:109132. [PMID: 34010651 DOI: 10.1016/j.celrep.2021.109132] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 01/12/2021] [Accepted: 04/23/2021] [Indexed: 02/07/2023] Open
Abstract
The human gut microbiome consists of bacteria, archaea, eukaryotes, and viruses. The gut viruses are relatively underexplored. Here, we longitudinally analyzed the gut virome composition in 11 healthy adults: its stability, variation, and the effect of a gluten-free diet. Using viral enrichment and a de novo assembly-based approach, we demonstrate the quantitative dynamics of the gut virome, including dsDNA, ssDNA, dsRNA, and ssRNA viruses. We observe highly divergent individual viral communities, carrying on an average 2,143 viral genomes, 13.1% of which were present at all 3 time points. In contrast to previous reports, the Siphoviridae family dominates over Microviridae in studied individual viromes. We also show individual viromes to be stable at the family level but to vary substantially at the genera and species levels. Finally, we demonstrate that lower initial diversity of the human gut virome leads to a more pronounced effect of the dietary intervention on its composition.
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Affiliation(s)
- Sanzhima Garmaeva
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen 9713GZ, the Netherlands
| | - Anastasia Gulyaeva
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen 9713GZ, the Netherlands
| | - Trishla Sinha
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen 9713GZ, the Netherlands
| | - Andrey N Shkoporov
- APC Microbiome Ireland and School of Microbiology, University College Cork, Cork T12 YT20, Ireland
| | - Adam G Clooney
- APC Microbiome Ireland and School of Microbiology, University College Cork, Cork T12 YT20, Ireland
| | - Stephen R Stockdale
- APC Microbiome Ireland and School of Microbiology, University College Cork, Cork T12 YT20, Ireland
| | - Johanne E Spreckels
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen 9713GZ, the Netherlands
| | - Thomas D S Sutton
- APC Microbiome Ireland and School of Microbiology, University College Cork, Cork T12 YT20, Ireland
| | - Lorraine A Draper
- APC Microbiome Ireland and School of Microbiology, University College Cork, Cork T12 YT20, Ireland
| | - Bas E Dutilh
- Theoretical Biology and Bioinformatics, Science for Life, Utrecht University, Utrecht 3584 CH, the Netherlands
| | - Cisca Wijmenga
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen 9713GZ, the Netherlands
| | - Alexander Kurilshikov
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen 9713GZ, the Netherlands
| | - Jingyuan Fu
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen 9713GZ, the Netherlands; Department of Pediatrics, University of Groningen, University Medical Center Groningen, Groningen 9713GZ, the Netherlands
| | - Colin Hill
- APC Microbiome Ireland and School of Microbiology, University College Cork, Cork T12 YT20, Ireland
| | - Alexandra Zhernakova
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen 9713GZ, the Netherlands.
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11
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Weiman DI, Mahmud FH, Clarke ABM, Assor E, McDonald C, Saibil F, Lochnan HA, Punthakee Z, Marcon MA. Impact of a Gluten-Free Diet on Quality of Life and Health Perception in Patients With Type 1 Diabetes and Asymptomatic Celiac Disease. J Clin Endocrinol Metab 2021; 106:e1984-e1992. [PMID: 33524131 DOI: 10.1210/clinem/dgaa977] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Indexed: 02/13/2023]
Abstract
CONTEXT Celiac disease (CD) is a common comorbidity seen in patients with type 1 diabetes (T1D) and is frequently asymptomatic. As chronic conditions requiring significant lifestyle changes, there are limited reports assessing changes in health-related quality of life (HRQoL) during transition to a gluten-free diet (GFD) in patients with T1D who are asymptomatic for CD. OBJECTIVE This work aims to prospectively assess HRQoL and health perception in children and adults with T1D and asymptomatic CD after random assignment to GFD vs usual diet. METHODS Patients with T1D aged 8 to 45 years without CD symptoms were serologically screened for CD, with positive results confirmed with intestinal biopsy. Participants were randomly assigned in an open-label fashion to a GFD or gluten-containing diet (GCD) for 12 months. Generic and diabetes-specific HRQoL and self-perceived wellness (SPW) were assessed longitudinally. RESULTS A total of 2387 T1D patients were serologically screened. CD was biopsy-confirmed in 82 patients and 51 participants were randomly assigned to a GFD (N = 27) or GCD (N = 24). Excellent adherence to the assigned diets was observed. Overall, no changes in generic (P = .73) or diabetes-specific HRQoL (P = .30), or SPW (P = .41) were observed between groups over 12 months. Hemoglobin A1c (HbA1c) and gastrointestinal symptoms were consistent predictors of HRQoL and SPW. CONCLUSION HRQoL and SPW were not significantly affected by the adoption of a GFD over 12 months, but worsened with symptom onset and increased HbA1c. Our findings indicate that transition to a GFD can be made successfully in this population without adversely affecting quality of life.
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Affiliation(s)
- Daniel I Weiman
- Division of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Farid H Mahmud
- Division of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Antoine B M Clarke
- Division of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Esther Assor
- Division of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Charlotte McDonald
- Division of Endocrinology and Metabolism, St. Joseph's Health Care, Western University, London, Ontario, Canada
| | - Fred Saibil
- Division of Gastroenterology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Heather A Lochnan
- Department of Medicine and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Zubin Punthakee
- Division of Endocrinology, McMaster University, Hamilton, Ontario, Canada
| | - Margaret A Marcon
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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12
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Abstract
BACKGROUND A gluten-free diet (GFD) is required for the management of some conditions, whereas some Canadians may follow a GFD for discretionary reasons. We sought to estimate the prevalence of Canadians who adhere to a GFD, identify factors associated with adherence to a GFD, and describe and compare the location of food preparation and consumption for those who follow a GFD, those who report no dietary avoidances and those reporting other dietary avoidances. METHODS We used cross-sectional data from the 2015 Canadian Community Health Survey - Nutrition (n = 20 487). Demographic variables included sex, age group, ethnicity, highest level of household education and income adequacy. The relations between respondent characteristics and report of a GFD were estimated using logistic regression. Respondents were further categorized as avoiding dietary gluten, other dietary avoidances and no dietary avoidances. RESULTS An estimated 1.9% of Canadians follow a GFD. Women had 2 times higher odds (odds ratio [OR] 2.08, 95% confidence interval [CI] 1.32 to 3.27) of reporting a GFD than men. After adjustment for income adequacy, household education, sex, age group and ethnicity, residents of Ontario and Quebec had about half the odds (OR 0.52, 95% CI 0.31 to 0.87, and OR 0.55, 95% CI 0.32 to 0.94, respectively) of reporting a GFD compared with residents of Atlantic Canada. Canadians who followed a GFD consumed significantly fewer calories from foods prepared at restaurants than both Canadians who reported no dietary avoidances and those who reported dietary avoidances other than gluten. Canadians following a GFD reported that 2.0% (95% CI 1.1% to 2.9%) of their daily kilocalories were from foods prepared at restaurants, compared with 6.7% (95% CI 5.4% to 7.9%) for Canadians reporting 1 or more dietary avoidances other than gluten, and 6.4% (95% CI 6.0% to 6.9%) for those reporting no avoidances. INTERPRETATION The estimated 1.9% prevalence of dietary gluten avoidance likely includes individuals with celiac disease, wheat allergies and nonceliac gluten sensitivity, as well as individuals excluding gluten in the management of irritable bowel syndrome or for reasons related to dietary trends. Canadians eating GFDs consume fewer daily calories from restaurant-prepared foods than other Canadians, which may have social implications.
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Affiliation(s)
- Adriana Mudryj
- Department of Food and Human Nutritional Sciences (Mudryj, Waugh, Slater, Riediger), Faculty of Agricultural and Food Sciences, University of Manitoba; Department of Internal Medicine (Duerksen, Bernstein), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba; Department of Community Health Sciences (Slater, Riediger), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man
| | - Anne Waugh
- Department of Food and Human Nutritional Sciences (Mudryj, Waugh, Slater, Riediger), Faculty of Agricultural and Food Sciences, University of Manitoba; Department of Internal Medicine (Duerksen, Bernstein), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba; Department of Community Health Sciences (Slater, Riediger), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man
| | - Joyce Slater
- Department of Food and Human Nutritional Sciences (Mudryj, Waugh, Slater, Riediger), Faculty of Agricultural and Food Sciences, University of Manitoba; Department of Internal Medicine (Duerksen, Bernstein), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba; Department of Community Health Sciences (Slater, Riediger), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man
| | - Donald R Duerksen
- Department of Food and Human Nutritional Sciences (Mudryj, Waugh, Slater, Riediger), Faculty of Agricultural and Food Sciences, University of Manitoba; Department of Internal Medicine (Duerksen, Bernstein), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba; Department of Community Health Sciences (Slater, Riediger), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man
| | - Charles N Bernstein
- Department of Food and Human Nutritional Sciences (Mudryj, Waugh, Slater, Riediger), Faculty of Agricultural and Food Sciences, University of Manitoba; Department of Internal Medicine (Duerksen, Bernstein), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba; Department of Community Health Sciences (Slater, Riediger), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man
| | - Natalie D Riediger
- Department of Food and Human Nutritional Sciences (Mudryj, Waugh, Slater, Riediger), Faculty of Agricultural and Food Sciences, University of Manitoba; Department of Internal Medicine (Duerksen, Bernstein), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba; Department of Community Health Sciences (Slater, Riediger), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.
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13
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Suárez-González M, Bousoño-García C, Jiménez-Treviño S, Díaz-Martín JJ. Gluten-Free Diet: Nutritional Strategies to Improve Eating Habits in Children with Celiac Disease: A Prospective, Single-arm Intervention Study. Nutrients 2021; 13:nu13041108. [PMID: 33800620 PMCID: PMC8065720 DOI: 10.3390/nu13041108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/23/2021] [Accepted: 03/24/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Elimination of gluten-containing cereals and consumption of ultra-processed gluten-free foods might cause an unbalanced diet, deficient in fiber and rich in sugar and fat, circumstances that may predispose celiac children to chronic constipation. Aim: to evaluate if counseling with a registered dietitian (RD) was capable of improving eating and bowel habits in a celiac pediatric population. Methods: Dietetic, lipid profile and stool modifications were analyzed, comparing baseline assessments with those twelve months after receiving heathy eating and nutrition education sessions. At both time points, 3-day food records, a bowel habit record and a lipid panel were conducted. Calculated relative intake of macro- and micro-nutrients were compared with current recommendations by the European Food Safety Authority (EFSA). Student’s paired t-test, McNemar test, Mandasky test and Pearson correlation tests were used. Results: Seventy-two subjects (58.3% girls) with a mean (standard deviation (SD)) age of 10.2 (3.4) years were included. Baseline diets were imbalanced in macronutrient composition. Significant improvements were observed in their compliance with dietary reference values (DRVs), where 50% of the subjects met fat requirements after the education and 67% and 49% with those of carbohydrates and fiber, respectively (p < 0.001). Celiac children decreased red meat and ultra-processed foods consumption (p < 0.001) and increased fruits and vegetables intake (p < 0.001), leading to a reduction in saturated fat (p < 0.001) and sugar intake (p < 0.001). Furthermore, 92% of the patients achieved a normal bowel habit, including absence of hard stools in 80% of children constipated at baseline (p < 0.001). Conclusions: RD-led nutrition education is able to improve eating patterns in children with celiac disease (CD).
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Keller A, Rimestad ML, Friis Rohde J, Holm Petersen B, Bruun Korfitsen C, Tarp S, Briciet Lauritsen M, Händel MN. The Effect of a Combined Gluten- and Casein-Free Diet on Children and Adolescents with Autism Spectrum Disorders: A Systematic Review and Meta-Analysis. Nutrients 2021; 13:470. [PMID: 33573238 PMCID: PMC7912271 DOI: 10.3390/nu13020470] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 12/15/2022] Open
Abstract
There has been a growing interest in the gastrointestinal system and its significance for autism spectrum disorder (ASD), including the significance of adopting a gluten-free and casein-free (GFCF) diet. The objective was to investigate beneficial and safety of a GFCF diet among children with a diagnosis of ASD. We performed a systematic literature search in Medline, Embase, Cinahl, and the Cochrane Library up to January 2020 for existing systematic reviews and individual randomized controlled trials (RCTs). Studies were included if they investigated a GFCF diet compared to a regular diet in children aged 3 to 17 years diagnosed with ASD, with or without comorbidities. The quality of the identified existing reviews was assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR). The risk of bias in RCTs was assessed using the Cochrane Risk of Bias Tool, and overall quality of evidence was evaluated using Grades of Recommendation, Assessment, Development, and Evaluation (GRADE). We identified six relevant RCTs, which included 143 participants. The results from a random effect model showed no effect of a GFCF diet on clinician-reported autism core symptoms (standardized mean difference (SMD) -0.31 (95% Cl. -0.89, 0.27)), parent-reported functional level (mean difference (MD) 0.61 (95% Cl -5.92, 7.14)) or behavioral difficulties (MD 0.80 (95% Cl -6.56, 10.16)). On the contrary, a GFCF diet might trigger gastrointestinal adverse effects (relative risk (RR) 2.33 (95% Cl 0.69, 7.90)). The quality of evidence ranged from low to very low due to serious risk of bias, serious risk of inconsistency, and serious risk of imprecision. Clinical implications of the present findings may be careful consideration of introducing a GFCF diet to children with ASD. However, the limitations of the current literature hinder the possibility of drawing any solid conclusion, and more high-quality RCTs are needed. The protocol is registered at the Danish Health Authority website.
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Affiliation(s)
- Amélie Keller
- Section of Epidemiology, Department of Public Health, University of Copenhagen, 1014 Copenhagen, Denmark
| | | | - Jeanett Friis Rohde
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, 2000 Frederiksberg, Denmark; (J.F.R.); (C.B.K.); (S.T.); (M.N.H.)
- The Danish Health Authority, 2300 Copenhagen, Denmark;
| | | | - Christoffer Bruun Korfitsen
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, 2000 Frederiksberg, Denmark; (J.F.R.); (C.B.K.); (S.T.); (M.N.H.)
- The Danish Health Authority, 2300 Copenhagen, Denmark;
| | - Simon Tarp
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, 2000 Frederiksberg, Denmark; (J.F.R.); (C.B.K.); (S.T.); (M.N.H.)
- The Danish Health Authority, 2300 Copenhagen, Denmark;
| | - Marlene Briciet Lauritsen
- Psychiatry, Aalborg University Hospital and Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark;
| | - Mina Nicole Händel
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, 2000 Frederiksberg, Denmark; (J.F.R.); (C.B.K.); (S.T.); (M.N.H.)
- The Danish Health Authority, 2300 Copenhagen, Denmark;
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Rodríguez-Herrera A, Reyes-Andrade J, Rubio-Escudero C. Rationale for Timing of Follow-Up Visits to Assess Gluten-Free Diet in Celiac Disease Patients Based on Data Mining. Nutrients 2021; 13:nu13020357. [PMID: 33503952 PMCID: PMC7912674 DOI: 10.3390/nu13020357] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/13/2021] [Accepted: 01/16/2021] [Indexed: 01/21/2023] Open
Abstract
The assessment of compliance of gluten-free diet (GFD) is a keystone in the supervision of celiac disease (CD) patients. Few data are available documenting evidence-based follow-up frequency for CD patients. In this work we aim at creating a criterion for timing of clinical follow-up for CD patients using data mining. We have applied data mining to a dataset with 188 CD patients on GFD (75% of them are children below 14 years old), evaluating the presence of gluten immunogenic peptides (GIP) in stools as an adherence to diet marker. The variables considered are gender, age, years following GFD and adherence to the GFD by fecal GIP. The results identify patients on GFD for more than two years (41.5% of the patients) as more prone to poor compliance and so needing more frequent follow-up than patients with less than 2 years on GFD. This is against the usual clinical practice of following less patients on long term GFD, as they are supposed to perform better. Our results support different timing follow-up frequency taking into consideration the number of years on GFD, age and gender. Patients on long term GFD should have a more frequent monitoring as they show a higher level of gluten exposure. A gender perspective should also be considered as non-compliance is partially linked to gender in our results: Males tend to get more gluten exposure, at least in the cultural context where our study was carried out. Children tend to perform better than teenagers or adults.
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Affiliation(s)
| | - Joaquín Reyes-Andrade
- Unidad de Gastroenterología y Nutrición, Instituto Hispalense de Pediatría, 41013 Seville, Spain;
| | - Cristina Rubio-Escudero
- Department of Computer Languages and Systems, University of Seville, 41013 Seville, Spain
- Correspondence: ; Tel.: +34-955421018
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16
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Pilolli R, De Angelis M, Lamonaca A, De Angelis E, Rizzello CG, Siragusa S, Gadaleta A, Mamone G, Monaci L. Prototype Gluten-Free Breads from Processed Durum Wheat: Use of Monovarietal Flours and Implications for Gluten Detoxification Strategies. Nutrients 2020; 12:E3824. [PMID: 33327648 PMCID: PMC7765144 DOI: 10.3390/nu12123824] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/09/2020] [Accepted: 12/11/2020] [Indexed: 12/14/2022] Open
Abstract
In this investigation, we reported the production of prototype breads from the processed flours of three specific Triticum turgidum wheat genotypes that were selected in our previous investigation for their potential low toxic/immunogenic activity for celiac disease (CD) patients. The flours were subjected to sourdough fermentation with a mixture of selected Lactobacillus strains, and in presence of fungal endoproteases. The breads were characterized by R5 competitive enzyme linked immunosorbent assay in order to quantify the residual gluten, and the differential efficacy in gluten degradation was assessed. In particular, two of them were classified as gluten-free (<20 ppm) and very low-gluten content (<100 ppm) breads, respectively, whereas the third monovarietal prototype retained a gluten content that was well above the safety threshold prescribed for direct consumption by CD patients. In order to investigate such a genotype-dependent efficiency of the detoxification method applied, an advanced proteomic characterization by high-resolution tandem mass spectrometry was performed. Notably, to the best of our knowledge, this is the first proteomic investigation which benefitted, for protein identification, from the full sequencing of the Triticum turgidum ssp. durum genome. The differences of the proteins' primary structures affecting their susceptibility to hydrolysis were investigated. As a confirmation of the previous immunoassay-based results, two out of the three breads made with the processed flours presented an exhaustive degradation of the epitopic sequences that are relevant for CD immune stimulatory activity. The list of the detected epitopes was analyzed and critically discussed in light of their susceptibility to the detoxification strategy applied. Finally, in-vitro experiments of human gastroduodenal digestion were carried out in order to assess, in-silico, the toxicity risk of the prototype breads under investigation for direct consumption by CD patients. This approach allowed us to confirm the total degradation of the epitopic sequences upon gastro-duodenal digestion.
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Affiliation(s)
- Rosa Pilolli
- Institute of Sciences of Food Production, CNR-ISPA, 70126 Bari, Italy; (A.L.); (E.D.A.); (L.M.)
| | - Maria De Angelis
- Department of Soil, Plant and Food Science, Università degli Studi di Bari Aldo Moro, 70126 Bari, Italy; (M.D.A.); (C.G.R.); (S.S.)
| | - Antonella Lamonaca
- Institute of Sciences of Food Production, CNR-ISPA, 70126 Bari, Italy; (A.L.); (E.D.A.); (L.M.)
| | - Elisabetta De Angelis
- Institute of Sciences of Food Production, CNR-ISPA, 70126 Bari, Italy; (A.L.); (E.D.A.); (L.M.)
| | - Carlo Giuseppe Rizzello
- Department of Soil, Plant and Food Science, Università degli Studi di Bari Aldo Moro, 70126 Bari, Italy; (M.D.A.); (C.G.R.); (S.S.)
| | - Sonya Siragusa
- Department of Soil, Plant and Food Science, Università degli Studi di Bari Aldo Moro, 70126 Bari, Italy; (M.D.A.); (C.G.R.); (S.S.)
| | - Agata Gadaleta
- Department of Agricultural and Environmental Sciences, Università degli Studi di Bari Aldo Moro, 70126 Bari, Italy;
| | | | - Linda Monaci
- Institute of Sciences of Food Production, CNR-ISPA, 70126 Bari, Italy; (A.L.); (E.D.A.); (L.M.)
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17
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Mumolo MG, Rettura F, Melissari S, Costa F, Ricchiuti A, Ceccarelli L, de Bortoli N, Marchi S, Bellini M. Is Gluten the Only Culprit for Non-Celiac Gluten/Wheat Sensitivity? Nutrients 2020; 12:E3785. [PMID: 33321805 PMCID: PMC7762999 DOI: 10.3390/nu12123785] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 12/05/2020] [Accepted: 12/07/2020] [Indexed: 12/12/2022] Open
Abstract
The gluten-free diet (GFD) has gained increasing popularity in recent years, supported by marketing campaigns, media messages and social networks. Nevertheless, real knowledge of gluten and GF-related implications for health is still poor among the general population. The GFD has also been suggested for non-celiac gluten/wheat sensitivity (NCG/WS), a clinical entity characterized by intestinal and extraintestinal symptoms induced by gluten ingestion in the absence of celiac disease (CD) or wheat allergy (WA). NCG/WS should be regarded as an "umbrella term" including a variety of different conditions where gluten is likely not the only factor responsible for triggering symptoms. Other compounds aside from gluten may be involved in the pathogenesis of NCG/WS. These include fructans, which are part of fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs), amylase trypsin inhibitors (ATIs), wheat germ agglutinin (WGA) and glyphosate. The GFD might be an appropriate dietary approach for patients with self-reported gluten/wheat-dependent symptoms. A low-FODMAP diet (LFD) should be the first dietary option for patients referring symptoms more related to FODMAPs than gluten/wheat and the second-line treatment for those with self-reported gluten/wheat-related symptoms not responding to the GFD. A personalized approach, regular follow-up and the help of a skilled dietician are mandatory.
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Affiliation(s)
| | - Francesco Rettura
- Gastrointestinal Unit, Department of Translational Sciences and New Technologies in Medicine and Surgery, University of Pisa, 56124 Pisa, Italy; (M.G.M.); (S.M.); (F.C.); (A.R.); (L.C.); (N.d.B.); (S.M.); (M.B.)
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18
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Airaksinen L, Laurikka P, Huhtala H, Kurppa K, Salmi T, Saavalainen P, Kaukinen K, Lindfors K. Influence of HLA-DQ2.5 Dose on Clinical Picture of Unrelated Celiac Disease Patients. Nutrients 2020; 12:nu12123775. [PMID: 33317091 PMCID: PMC7764246 DOI: 10.3390/nu12123775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 12/07/2020] [Indexed: 12/13/2022] Open
Abstract
The clinical phenotype of celiac disease varies considerably among patients and the dosage of HLA-DQ2.5 alleles has been suggested to be a contributing factor. We investigated whether HLA-DQ2.5 allele dosage is associated with distinct clinical parameters at the time of diagnosis and with patients’ response to a gluten-free diet. The final cohort included 605 carefully phenotyped non-related Finnish celiac disease patients grouped as having 0, 1 or 2 copies of HLA-DQ2.5. Clinical data at the time of diagnosis and during gluten-free diet were collected systematically from medical records and supplementary interviews. An increasing HLA-DQ2.5 dose effect was detected for celiac disease antibody positivity at diagnosis (p = 0.021) and for the presence of any first-degree relatives with celiac disease (p = 0.011 and p = 0.031, respectively). Instead, DQ2.5-negative patients were suffering most often from classical symptoms at diagnosis (p = 0.007 between HLA groups). In addition, during follow-up they were most often symptomatic despite a gluten-free diet (p = 0.002 between groups). Our results thus suggest that increasing HLA-DQ2.5 dose only has a minor effect on the clinical picture of celiac disease. However, HLA-DQ2.5-negative patients should not be overlooked in clinical practice and particular attention should be paid to this patient group during gluten-free diet.
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Affiliation(s)
- Laura Airaksinen
- Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland; (L.A.); (P.L.); (T.S.); (K.K.)
| | - Pilvi Laurikka
- Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland; (L.A.); (P.L.); (T.S.); (K.K.)
| | - Heini Huhtala
- Faculty of Social Sciences, Tampere University, 33520 Tampere, Finland;
| | - Kalle Kurppa
- Tampere Centre for Child Health Research, Tampere University Hospital and Tampere University, 33521 Tampere, Finland;
- Department of Pediatrics, Seinäjoki Central Hospital and University Consortium of Seinäjoki, 60220 Seinäjoki, Finland
| | - Teea Salmi
- Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland; (L.A.); (P.L.); (T.S.); (K.K.)
- Department of Dermatology, Tampere University Hospital, 33521 Tampere, Finland
| | - Päivi Saavalainen
- Research Programs Unit, Immunobiology, and Haartman Institute, Department of Medical Genetics, University of Helsinki, 00014 Helsinki, Finland;
| | - Katri Kaukinen
- Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland; (L.A.); (P.L.); (T.S.); (K.K.)
- Department of Internal Medicine, Tampere University Hospital, 33521 Tampere, Finland
| | - Katri Lindfors
- Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland; (L.A.); (P.L.); (T.S.); (K.K.)
- Correspondence:
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Kraleva D, Evans S, Pinto A, Daly A, Ashmore C, Pointon-Bell K, Rocha JC, MacDonald A. Protein Labelling Accuracy for UK Patients with PKU Following a Low Protein Diet. Nutrients 2020; 12:nu12113440. [PMID: 33182603 PMCID: PMC7696494 DOI: 10.3390/nu12113440] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 01/02/2023] Open
Abstract
A phenylalanine (protein)-restricted diet is the primary treatment for phenylketonuria (PKU). Patients are dependent on food protein labelling to successfully manage their condition. We evaluated the accuracy of protein labelling on packaged manufactured foods from supermarket websites for foods that may be eaten as part of a phenylalanine-restricted diet. Protein labelling information was evaluated for 462 food items (“free from”, n = 159, regular, n = 303), divided into 16 food groups using supermarket website data. Data collection included protein content per portion/100 g when food was “as sold”, “cooked” or “prepared”; cooking methods, and preparation instructions. Labelling errors affecting protein content were observed in every food group, with overall protein labelling unclear in 55% (n = 255/462) of foods. There was misleading, omitted, or erroneous (MOE) information in 43% (n = 68/159) of “free from” foods compared with 62% (n = 187/303) of regular foods, with fewer inaccuracies in “free from” food labelling (p = 0.007). Protein analysis was available for uncooked weight only but not cooked weight for 58% (n = 85/146) of foods; 4% (n = 17/462) had misleading protein content. There was a high rate of incomplete, misleading, or inaccurate data affecting the interpretation of the protein content of food items on supermarket websites. This could adversely affect metabolic control of patients with PKU and warrants serious consideration.
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Affiliation(s)
- Dilyana Kraleva
- Faculty of Health, Education & Life Sciences, Birmingham City University City South Campus, Westbourne Road, Edgbaston, Birmingham B15 3TN, UK; (D.K.); (K.P.-B.)
| | - Sharon Evans
- Birmingham Women’s and Children’s NHS Foundation Trust, Steelhouse Lane, Birmingham B4 6NH, UK; (S.E.); (A.P.); (A.D.); (C.A.)
| | - Alex Pinto
- Birmingham Women’s and Children’s NHS Foundation Trust, Steelhouse Lane, Birmingham B4 6NH, UK; (S.E.); (A.P.); (A.D.); (C.A.)
| | - Anne Daly
- Birmingham Women’s and Children’s NHS Foundation Trust, Steelhouse Lane, Birmingham B4 6NH, UK; (S.E.); (A.P.); (A.D.); (C.A.)
| | - Catherine Ashmore
- Birmingham Women’s and Children’s NHS Foundation Trust, Steelhouse Lane, Birmingham B4 6NH, UK; (S.E.); (A.P.); (A.D.); (C.A.)
| | - Kiri Pointon-Bell
- Faculty of Health, Education & Life Sciences, Birmingham City University City South Campus, Westbourne Road, Edgbaston, Birmingham B15 3TN, UK; (D.K.); (K.P.-B.)
| | - Júlio César Rocha
- Nutrition & Metabolism, NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo Mártires da Pátria, 130, 1169-056 Lisbon, Portugal;
- Center for Health Technology and Services Research (CINTESIS), R. Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal
| | - Anita MacDonald
- Birmingham Women’s and Children’s NHS Foundation Trust, Steelhouse Lane, Birmingham B4 6NH, UK; (S.E.); (A.P.); (A.D.); (C.A.)
- Correspondence:
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Kosendiak A, Stanikowski P, Domagała D, Gustaw W. Gluten-Free Diet in Prisons in Poland: Nutrient Contents and Implementation of Dietary Reference Intake Standards. Nutrients 2020; 12:E2829. [PMID: 32947787 PMCID: PMC7551281 DOI: 10.3390/nu12092829] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 09/11/2020] [Accepted: 09/12/2020] [Indexed: 12/16/2022] Open
Abstract
The gluten-free diet (GFD) requires special attention from nutritionists due to the potential risk of nutrient deficiencies in its users. This risk may be greater when this type of nutrition is implemented in prisons due to the limited possibilities of external control, a low catering budget for meals, and insufficiently defined recommendations regulating nutrition for prisoners. The aim of the present study was to assess the nutritional value of GFD and regular diet meals served in some Polish prisons and to compare the values to the dietary reference intake (DRI) standards. Using a specialized computer program, 7-day menus of both types of diet provided in 10 prisons were analyzed. The percentage coverage of the DRI was calculated based on the recommendations of the Polish National Food and Nutrition Institute. GFD was characterized by lower average contents of energy and 11 out of 14 essential nutrients, i.e., protein, carbohydrates, dietary fiber, starch, ash, sodium, calcium, iron, zinc, folate, and vitamin B12. The average content of phosphorus, niacin, and riboflavin in the gluten-free diet was higher than that in the regular diet. It was shown that the meals in GFD and the regular diet did not provide the recommended amounts of calcium (38 and 44% DRI, respectively), vitamin D (29 and 30% DRI), vitamin C (86 and 76% DRI), and folate (51 and 56% DRI). In turn, the supply of sodium, phosphorus, copper, and vitamins A and B6 substantially exceeded the recommended levels. The results indicate a need for greater quality control of GFD meals served in catering facilities. It is also necessary to develop legal provisions that will regulate more specifically the nutrition for prisoners in terms of an adequate supply of minerals and vitamins.
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Affiliation(s)
- Aureliusz Kosendiak
- Study of Physical Education and Sport, Wroclaw Medical University, 51-601 Wroclaw, Poland;
| | - Piotr Stanikowski
- Department of Plant Food Technology and Gastronomy, Faculty of Food Science and Biotechnology, University of Life Sciences in Lublin, 20-704 Lublin, Poland;
| | - Dorota Domagała
- Department of Applied Mathematics and Computer Science, Faculty of Production Engineering, University of Life Sciences in Lublin, 20-612 Lublin, Poland;
| | - Waldemar Gustaw
- Department of Plant Food Technology and Gastronomy, Faculty of Food Science and Biotechnology, University of Life Sciences in Lublin, 20-704 Lublin, Poland;
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Abstract
PURPOSE OF REVIEW Noncoeliac gluten sensitivity (NCGS) can be suspected after exclusion of coeliac disease and wheat allergy. However, poorly understood pathogenesis of the NCGS, lack of gold standard for diagnosis and agreement in the definition for the NCGS condition, open the space for future investigation. This review aims to give an overview on the diagnosis and effective diet composition in the treatment of NCGS symptoms. RECENT FINDINGS It appears that a diet low in fermentable oligo, di, and monosaccharides and polyols (FODMAPs) and gluten-free diet play a prominent role in the strategy of NCGS management. Considering available evidence with respect to diagnostic tools, it is challenging to prepare a standard guideline for NCGS diagnosis and treatment with clear cut-offs for symptom reduction/improvement that could directly be translated into test results. Nutritional support, including the use of pre/probiotics, has to be tailored to the individual situation of NCGS patients. SUMMARY The exclusion of such components of wheat as amylase/trypsin inhibitors, wheat-germ agglutinins, or free of FODMAPs diet can reduce clinical symptoms of NCGS. The further investigation on microbiota changes may strengthen the knowledge in this area, where the major challenge is to develop biomarkers for NCGS investigation.
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Potter MDE, Duncanson K, Jones MP, Walker MM, Keely S, Talley NJ. Wheat Sensitivity and Functional Dyspepsia: A Pilot, Double-Blind, Randomized, Placebo-Controlled Dietary Crossover Trial with Novel Challenge Protocol. Nutrients 2020; 12:nu12071947. [PMID: 32629906 PMCID: PMC7400003 DOI: 10.3390/nu12071947] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/24/2020] [Accepted: 06/27/2020] [Indexed: 02/07/2023] Open
Abstract
Introduction: Functional dyspepsia (FD), characterised by symptoms of epigastric pain or early satiety and post prandial distress, has been associated with duodenal eosinophilia, raising the possibility that it is driven by an environmental allergen. Non-coeliac gluten or wheat sensitivity (NCG/WS) has also been associated with both dyspeptic symptoms and duodenal eosinophilia, suggesting an overlap between these two conditions. The aim of this study was to evaluate the role of wheat (specifically gluten and fructans) in symptom reduction in participants with FD in a pilot randomized double-blind, placebo controlled, dietary crossover trial. Methods: Patients with Rome III criteria FD were recruited from a single tertiary centre in Newcastle, Australia. All were individually counselled on a diet low in both gluten and fermentable oligo-, di-, mono-saccharides, and polyols (FODMAPs) by a clinical dietitian, which was followed for four weeks (elimination diet phase). Those who had a ≥30% response to the run-in diet, as measured by the Nepean Dyspepsia Index, were then re-challenged with ‘muesli’ bars containing either gluten, fructan, or placebo in randomised order. Those with symptoms which significantly reduced during the elimination diet, but reliably reappeared (a mean change in overall dyspeptic symptoms of ≥30%) with gluten or fructan re-challenge were deemed to have wheat induced FD. Results: Eleven participants were enrolled in the study (75% female, mean age 43 years). Of the initial cohort, nine participants completed the elimination diet phase of whom four qualified for the rechallenge phase. The gluten-free, low FODMAP diet led to an overall (albeit non-significant) improvement in symptoms of functional dyspepsia in the diet elimination phase (mean NDI symptom score 71.2 vs. 47.1, p = 0.087). A specific food trigger could not be reliably demonstrated. Conclusions: Although a gluten-free, low-FODMAP diet led to a modest overall reduction in symptoms in this cohort of FD patients, a specific trigger could not be identified. The modified Salerno criteria for NCG/WS identification trialled in this dietary rechallenge protocol was fit-for-purpose. However, larger trials are required to determine whether particular components of wheat induce symptoms in functional dyspepsia.
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Affiliation(s)
- Michael D. E. Potter
- Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia; (M.D.E.P.); (M.P.J.); (M.M.W.); (S.K.); (N.J.T)
- Australian Gastrointestinal Research Alliance (AGIRA), Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Department of Gastroenterology, John Hunter Hospital, New Lambton Heights, NSW 2305, Australia
| | - Kerith Duncanson
- Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia; (M.D.E.P.); (M.P.J.); (M.M.W.); (S.K.); (N.J.T)
- Australian Gastrointestinal Research Alliance (AGIRA), Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Correspondence:
| | - Michael P. Jones
- Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia; (M.D.E.P.); (M.P.J.); (M.M.W.); (S.K.); (N.J.T)
- Australian Gastrointestinal Research Alliance (AGIRA), Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Psychology Department, Macquarie University, Macquarie Park, Sydney, NSW 2109, Australia
| | - Marjorie M. Walker
- Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia; (M.D.E.P.); (M.P.J.); (M.M.W.); (S.K.); (N.J.T)
- Australian Gastrointestinal Research Alliance (AGIRA), Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Simon Keely
- Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia; (M.D.E.P.); (M.P.J.); (M.M.W.); (S.K.); (N.J.T)
- Australian Gastrointestinal Research Alliance (AGIRA), Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Nicholas J. Talley
- Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia; (M.D.E.P.); (M.P.J.); (M.M.W.); (S.K.); (N.J.T)
- Australian Gastrointestinal Research Alliance (AGIRA), Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Department of Gastroenterology, John Hunter Hospital, New Lambton Heights, NSW 2305, Australia
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Arámburo-Gálvez JG, Beltrán-Cárdenas CE, Geralda André T, Carvalho Gomes I, Macêdo-Callou MA, Braga-Rocha ÉM, Mye-Takamatu-Watanabe EA, Rahmeier-Fietz V, Figueroa-Salcido OG, Vergara-Jiménez MDJ, Flores-Mendoza LK, Ontiveros N, Cabrera-Chávez F. Prevalence of Adverse Reactions to Gluten and People Going on a Gluten-Free Diet: A Survey Study Conducted in Brazil. ACTA ACUST UNITED AC 2020; 56:medicina56040163. [PMID: 32260408 PMCID: PMC7231032 DOI: 10.3390/medicina56040163] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 03/29/2020] [Accepted: 04/02/2020] [Indexed: 12/11/2022]
Abstract
Background: The prevalence of gluten-related disorders (GRD) and adherence to a gluten-free diet (GFD) remains unknown in Brazilian population and there is no published information on the scientific literature about the proportion of Brazilians that were diagnosed with a gluten-related disorder. Thus, the aim of this work was to estimate the prevalence of GRDs and adherence to a GFD by self-report in adult Brazilian population. Materials and Methods: A questionnaire-based cross-sectional study was conducted in two Brazilian cities. Results: The response rate was 93.2% (1630/1749). The self-reported prevalence rates were (95% CI): adverse reactions to gluten 10.06% (8.64–11.62); gluten sensitivity 2.33% (1.65–3.18); physician-diagnosed celiac disease 0.3% (0.09–0.71); non-celiac gluten sensitivity 1.71% (1.14–2.47); wheat allergy 0.79% (0.42–1.36); adherence to gluten-free diet 7.48% (6.25–8.87); gluten avoiders 15.21% (13.5–17.05). Among those who were following a GFD (n = 122), 65.6% (n = 80) of them reported that they did not develop symptoms after wheat/gluten ingestion and 50% (n = 61) were following the diet without medical/dietitian advice. The main motivation for following a GFD in the self-reported and non-self-reported gluten sensitivity groups were the symptoms triggered after wheat/gluten ingestion (86.8%) and weight control (57.1%), respectively. Conclusions: Implementation of programs to increase awareness about GRDs among healthcare professionals and giving scientifically sound information to the general population about the risks and benefits for following a GFD are desirable actions in Brazil. The results also add to the growing body of evidence for highlighting the under-diagnosis of GRD and the trend for following a GFD in Latin America.
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Affiliation(s)
- Jesús Gilberto Arámburo-Gálvez
- Postgraduate in Health Sciences, Division of Biological and Health Sciences, University of Sonora, Hermosillo, Sonora 83000, Mexico; (J.G.A.-G.); (O.G.F.-S.)
| | | | - Tatiane Geralda André
- Master of Science Program in Nursing, School of Nursing, Los Mochis, Sinaloa 81220, Mexico; (T.G.A.); (I.C.G.)
| | - Itallo Carvalho Gomes
- Master of Science Program in Nursing, School of Nursing, Los Mochis, Sinaloa 81220, Mexico; (T.G.A.); (I.C.G.)
| | | | - Élida Mara Braga-Rocha
- Faculdade de Juazeiro do Norte, Juazeiro do Norte, Ceará 63010-215, Brazil; (M.A.M.-C.); (É.M.B.-R.)
| | | | - Vivian Rahmeier-Fietz
- Curso de Enfermagem, Universidade Estadual de Mato Grosso do Sul, Dourados, Mato Grosso do Sul 79804-970, Brazil; (E.A.M.-T.-W.); (V.R.-F.)
| | - Oscar Gerardo Figueroa-Salcido
- Postgraduate in Health Sciences, Division of Biological and Health Sciences, University of Sonora, Hermosillo, Sonora 83000, Mexico; (J.G.A.-G.); (O.G.F.-S.)
| | | | - Lilian Karem Flores-Mendoza
- Department of Chemical, Biological, and Agricultural Sciences (DC-QB), Division of Sciences and Engineering, Clinical and Research Laboratory (LACIUS, URS), University of Sonora, Navojoa, Sonora 85880, Mexico;
| | - Noé Ontiveros
- Department of Chemical, Biological, and Agricultural Sciences (DC-QB), Division of Sciences and Engineering, Clinical and Research Laboratory (LACIUS, URS), University of Sonora, Navojoa, Sonora 85880, Mexico;
- Correspondence: (N.O.); (F.C.-C.)
| | - Francisco Cabrera-Chávez
- Faculty of Nutrition Sciences, University of Sinaloa, Culiacán, Sinaloa 80019, Mexico; (C.E.B.-C.); (M.d.J.V.-J.)
- Correspondence: (N.O.); (F.C.-C.)
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Osorio CE, Mejías JH, Rustgi S. Gluten Detection Methods and Their Critical Role in Assuring Safe Diets for Celiac Patients. Nutrients 2019; 11:E2920. [PMID: 31810336 PMCID: PMC6949940 DOI: 10.3390/nu11122920] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 11/20/2019] [Accepted: 11/26/2019] [Indexed: 12/16/2022] Open
Abstract
Celiac disease, wheat sensitivity, and allergy represent three different reactions, which may occur in genetically predisposed individuals on the ingestion of wheat and derived products with various manifestations. Improvements in the disease diagnostics and understanding of disease etiology unveiled that these disorders are widespread around the globe affecting about 7% of the population. The only known treatment so far is a life-long gluten-free diet, which is almost impossible to follow because of the contamination of allegedly "gluten-free" products. Accidental contamination of inherently gluten-free products could take place at any level from field to shelf because of the ubiquity of these proteins/grains. Gluten contamination of allegedly "gluten-free" products is a constant threat to celiac patients and a major health concern. Several detection procedures have been proposed to determine the level of contamination in products for celiac patients. The present article aims to review the advantages and disadvantages of different gluten detection methods, with emphasis on the recent technology that allows identification of the immunogenic-gluten peptides without the use of antibodies. The possibility to detect gluten contamination by different approaches with similar or better detection efficiency in different raw and processed foods will guarantee the safety of the foods for celiac patients.
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Affiliation(s)
- Claudia E. Osorio
- Agriaquaculture Nutritional Genomic Center, CGNA, Las Heras 350, Temuco 4781158, Chile
| | - Jaime H. Mejías
- Centro Regional de Investigación Carillanca, Instituto de Investigaciones Agropecuarias INIA, Temuco 4880000, Chile
| | - Sachin Rustgi
- Department of Crop and Soil Sciences, Washington State University, Pullman, WA 99164, USA
- Department of Plant and Environmental Sciences, School of Health Research, Clemson University Pee Dee Research and Education Center, Florence, SC 29506, USA
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Karakula-Juchnowicz H, Rog J, Juchnowicz D, Łoniewski I, Skonieczna-Żydecka K, Krukow P, Futyma-Jedrzejewska M, Kaczmarczyk M. The study evaluating the effect of probiotic supplementation on the mental status, inflammation, and intestinal barrier in major depressive disorder patients using gluten-free or gluten-containing diet (SANGUT study): a 12-week, randomized, double-blind, and placebo-controlled clinical study protocol. Nutr J 2019; 18:50. [PMID: 31472678 PMCID: PMC6717641 DOI: 10.1186/s12937-019-0475-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 08/16/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Current treatment of major depressive disorder (MDD) often does not achieve full remission of symptoms. Therefore, new forms of treatment and/or adjunct therapy are needed. Evidence has confirmed the modulation of the gut-brain-microbiota axis as a promising approach in MDD patients. The overall purpose of the SANGUT study-a 12-week, randomized, double-blind, and placebo-controlled Study Evaluating the Effect of Probiotic Supplementation on the Mental Status, Inflammation, and Intestinal Barrier in Major Depressive Disorder Patients Using Gluten-free or Gluten-containing Diet - is to determine the effect of interventions focused on the gut-brain-microbiota axis in a group of MDD patients. METHODS A total of 120 outpatients will be equally allocated into one of four groups: (1) probiotic supplementation+gluten-free diet group (PRO-GFD), (2) placebo supplementation+ gluten-free diet group (PLA-GFD), (3) probiotic supplementation+ gluten containing diet group (PRO-GD), and (4) placebo supplementation+gluten containing diet group (PLA-GD). PRO groups will receive a mixture of psychobiotics (Lactobacillus helveticus R0052 and Bifidobacterium longum R0175), and GFD groups will follow a gluten-free diet. The intervention will last 12 weeks. The primary outcome measure is change in wellbeing, whereas the secondary outcome measures include physiological parameters. DISCUSSION Microbiota and its metabolites have the potential to influence CNS function. Probiotics may restore the eubiosis within the gut while a gluten-free diet, via changes in the microbiota profile and modulation of intestinal permeability, may alter the activity of microbiota-gut-brain axis previously found to be associated with the pathophysiology of depression. It is also noteworthy that microbiota being able to digest gluten may play a role in formation of peptides with different immunogenic capacities. Thus, the combination of a gluten-free diet and probiotic supplementation may inhibit the immune-inflammatory cascade in MDD course and improve both psychiatric and gut barrier-associated traits. TRIAL REGISTRATION NCT03877393 .
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Affiliation(s)
- Hanna Karakula-Juchnowicz
- 1st Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Głuska 1, 20-439, Lublin, Poland
- Department of Clinical Neuropsychiatry, Medical University of Lublin, 20-439, Lublin, Poland
| | - Joanna Rog
- 1st Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Głuska 1, 20-439, Lublin, Poland.
| | - Dariusz Juchnowicz
- Department of Psychiatric Nursing, Medical University of Lublin, 20-124, Lublin, Poland
| | - Igor Łoniewski
- Department of Biochemistry and Human Nutrition, Pomeranian Medical University, 71-460, Szczecin, Poland
- Sanprobi sp. z o.o. sp. k, Szczecin, Poland
| | | | - Paweł Krukow
- Department of Clinical Neuropsychiatry, Medical University of Lublin, 20-439, Lublin, Poland
| | - Malgorzata Futyma-Jedrzejewska
- 1st Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Głuska 1, 20-439, Lublin, Poland
| | - Mariusz Kaczmarczyk
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University, 70-111, Szczecin, Poland
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Mansikka E, Hervonen K, Kaukinen K, Ilus T, Oksanen P, Lindfors K, Laurila K, Hietikko M, Taavela J, Jernman J, Saavalainen P, Reunala T, Salmi T. Gluten Challenge Induces Skin and Small Bowel Relapse in Long-Term Gluten-Free Diet-Treated Dermatitis Herpetiformis. J Invest Dermatol 2019; 139:2108-2114. [PMID: 30998982 DOI: 10.1016/j.jid.2019.03.1150] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 03/11/2019] [Accepted: 03/25/2019] [Indexed: 01/20/2023]
Abstract
Dermatitis herpetiformis (DH) is an extraintestinal manifestation of celiac disease causing an itchy, blistering rash. Granular IgA deposits in the skin are pathognomonic for DH, and the treatment of choice is a lifelong gluten-free diet (GFD). Preliminary evidence suggests that there are patients with DH who redevelop gluten tolerance after adherence to a GFD treatment. To evaluate this, we performed a 12-month gluten challenge with skin and small-bowel mucosal biopsy samples in 19 patients with DH who had adhered to a GFD for a mean of 23 years. Prechallenge biopsy was negative for skin IgA and transglutaminase 3 deposits in 16 patients (84%) and indicated normal villous height-to-crypt depth ratios in the small bowel mucosa in all 19 patients. The gluten challenge caused a relapse of the rash in 15 patients (79%) in a mean of 5.6 months; of these 15 patients, 13 had skin IgA and transglutaminase 3 deposits, and 12 had small-bowel villous atrophy. In addition, three patients without rash or immune deposits in the skin developed villous atrophy, whereas one patient persisted without any signs of relapse. In conclusion, 95% of the patients with DH were unable to tolerate gluten even after long-term adherence to a GFD. Therefore, lifelong GFD treatment remains justified in all patients with DH.
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Affiliation(s)
- Eriika Mansikka
- Department of Dermatology, Tampere University Hospital, Tampere, Finland; Celiac Disease Research Center, Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Kaisa Hervonen
- Department of Dermatology, Tampere University Hospital, Tampere, Finland; Celiac Disease Research Center, Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Katri Kaukinen
- Celiac Disease Research Center, Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland; Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Tuire Ilus
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland
| | - Pia Oksanen
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Katri Lindfors
- Celiac Disease Research Center, Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Kaija Laurila
- Celiac Disease Research Center, Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Minna Hietikko
- Celiac Disease Research Center, Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Juha Taavela
- Celiac Disease Research Center, Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland; Department of Internal Medicine, Central Hospital of Central Finland, Jyväskylä, Finland
| | - Juha Jernman
- Department of Pathology, Fimlab Laboratories, Tampere, Finland
| | - Päivi Saavalainen
- Research Programs Unit, Immunobiology, University of Helsinki, Helsinki, Finland; Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland
| | - Timo Reunala
- Department of Dermatology, Tampere University Hospital, Tampere, Finland; Celiac Disease Research Center, Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Teea Salmi
- Department of Dermatology, Tampere University Hospital, Tampere, Finland; Celiac Disease Research Center, Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland.
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do Vale ECS, Dimatos OC, Porro AM, Santi CG. Consensus on the treatment of autoimmune bullous dermatoses: dermatitis herpetiformis and linear IgA bullous dermatosis - Brazilian Society of Dermatology. An Bras Dermatol 2019; 94:48-55. [PMID: 31166403 PMCID: PMC6544034 DOI: 10.1590/abd1806-4841.2019940208] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 01/30/2019] [Indexed: 12/19/2022] Open
Abstract
Dermatitis herpetiformis and linear IgA bullous dermatosis are autoimmune diseases that present with pruritic urticarial papules and plaques, with formation of vesicles and blisters of subepidermal location, mediated by IgA antibodies. Mucosal lesions are present only in linear IgA bullous dermatosis. The elaboration of this consensus consisted of a brief presentation of the different aspects of these dermatoses and, above all, of an updated literature review on the various therapeutic options that were discussed and compared with the authors' experience, aiming at the treatment orientation of these diseases in Brazil. Dermatitis herpetiformis is a cutaneous manifestation of celiac disease, and can be controlled with a gluten-free diet and dapsone. On the other hand, linear IgA bullous dermatosis arises spontaneously or is triggered by drugs, and can be controlled with dapsone, but often requires the association of systemic corticosteroids and eventually immunosuppressants.
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Affiliation(s)
| | - Oscar Cardoso Dimatos
- Dermatology Service, Hospital Universitário Professor
Polydoro Ernani de São Thiago, Universidade Federal de Santa Catarina,
Florianópolis (SC), Brazil
| | - Adriana Maria Porro
- Department of Dermatology, Escola Paulista de Medicina,
Universidade Federal de São Paulo, São Paulo (SP), Brazil
| | - Claudia Giuli Santi
- Department of Dermatology, Hospital das Clínicas, Faculdade
de Medicina, Universidade de São Paulo, São Paulo (SP), Brazil
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Ianiro G, Rizzatti G, Napoli M, Matteo MV, Rinninella E, Mora V, Fanali C, Leonetti A, Benedettelli S, Mele MC, Cammarota G, Gasbarrini A. A Durum Wheat Variety-Based Product Is Effective in Reducing Symptoms in Patients with Non-Celiac Gluten Sensitivity: A Double-Blind Randomized Cross-Over Trial. Nutrients 2019; 11:E712. [PMID: 30934747 PMCID: PMC6521061 DOI: 10.3390/nu11040712] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 03/19/2019] [Accepted: 03/23/2019] [Indexed: 12/12/2022] Open
Abstract
Patients with non-celiac gluten sensitivity (NCGS) do not have celiac disease, but their symptoms improve after a gluten-free diet (GFD). However, to date, it is uncertain if gluten or other components of wheat are responsible for these symptoms. The aim of this study was to compare the effects of an organic durum wheat variety with those of standard commercial wheat in patients with known NCGS. We performed a double-blind randomized cross-over trial of 42 patients (mean age 45 years, 8 men) with NCGS diagnosed according to the Salerno criteria and adherence to GFD for at least 12 weeks from screening. Enrolled subjects were randomly assigned to one the following groups of treatment: (A) a two-week diet with Senatore Cappelli wheat variety pasta; (B) a two-week diet with standard commercial pasta. Then, after a two-week washout period on gluten-free diet, each patient crossed over to the other treatment group. Symptoms were assessed through a modified version of the Gastrointestinal Symptom Rating Scale (GSRS), tailored on NCGS. Between April 2018 and July 2018, 42 patients with NCGS were enrolled in the study (70.6% females), and 34 patients completed the study. Patients reported lower overall symptoms scores after eating Senatore Cappelli pasta than standard pasta (p = 0.03) and also significantly lower scores in several specific gastrointestinal and extra-intestinal symptoms after eating Senatore Cappelli pasta than standard pasta, specifically, bloating (p = 0.04), abdominal distention (p = 0.004), eructation (p = 0.01), flatus (p = 0.02), feeling of incomplete evacuation (p = 0.001), dermatitis (p = 0.01), and limb numbness (p = 0.03). In our study, patients with NCGS experienced lower gastrointestinal and extra-intestinal symptom scores after eating the Senatore Cappelli wheat variety than a standard commercial wheat. Should our preliminary results be confirmed by further studies, new dietary alternatives may be available to patients with NCGS, with consequent health, economic, and social benefits.
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Affiliation(s)
- Gianluca Ianiro
- Digestive Disease Center, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, 00143 Rome, Italy.
| | - Gianenrico Rizzatti
- Digestive Disease Center, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, 00143 Rome, Italy.
| | - Marco Napoli
- Digestive Disease Center, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, 00143 Rome, Italy.
| | - Maria Valeria Matteo
- Digestive Disease Center, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, 00143 Rome, Italy.
| | - Emanuele Rinninella
- Digestive Disease Center, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, 00143 Rome, Italy.
| | - Vincenzina Mora
- Digestive Disease Center, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, 00143 Rome, Italy.
| | - Caterina Fanali
- Digestive Disease Center, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, 00143 Rome, Italy.
| | - Alessia Leonetti
- Digestive Disease Center, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, 00143 Rome, Italy.
| | - Stefano Benedettelli
- Dipartimento di Scienze e Tecnologie Agrarie, Alimentari, Ambientali e Forestali (DAGRI), Università degli Studi di Firenze, 50144 Firenze, Italy.
| | - Maria Cristina Mele
- Digestive Disease Center, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, 00143 Rome, Italy.
| | - Giovanni Cammarota
- Digestive Disease Center, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, 00143 Rome, Italy.
| | - Antonio Gasbarrini
- Digestive Disease Center, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, 00143 Rome, Italy.
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Kraijenhoff GPS, Smit MJM, van Vlerken RHT, Mearin Manrique ML. [Psychiatric symptoms in a child with gluten sensitivity]. Ned Tijdschr Geneeskd 2019; 163:D2900. [PMID: 30945820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Non-celiac gluten sensitivity (NCGS) is a diagnosis that is increasingly being reported. Psychiatric symptoms can be a rare but serious manifestation of this new clinical entity. CASE REPORT A 13-year-old girl consulted the paediatrician with abdominal pain, diarrhoea, bloating, and compulsive thoughts and fears; these disappeared on a gluten-free diet. Celiac disease and wheat allergy were excluded. Double-blind placebo-controlled gluten challenge confirmed the diagnosis NCGS. CONCLUSION Consider a diagnosis of NCGS in patients with psychiatric symptoms in combination with abdominal symptoms.
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Tovoli F, Granito A, Negrini G, Guidetti E, Faggiano C, Bolondi L. Long term effects of gluten-free diet in non-celiac wheat sensitivity. Clin Nutr 2019; 38:357-363. [PMID: 29306516 DOI: 10.1016/j.clnu.2017.12.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 11/20/2017] [Accepted: 12/17/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Information about the clinical outcome of patients with non-celiac wheat sensitivity (NCWS) treated with gluten-free diet (GFD) derive from studies assessing the symptom response in the first few weeks of treatment. We aimed to evaluate the clinical response to the GFD and the quality of life (QoL) of NCWS patients in the long term. METHODS Forty-four NCWS (diagnosed according to the Salerno criteria) participated in the study. Participants rated their symptoms according to a 0-10 scale patients and filled in a QoL questionnaire (CDQ) before the beginning of the GFD and during a follow-up evaluation performed after at least one year. To assess the reliability of the questionnaire we also included a control group of 43 matched patients with celiac disease (CD). RESULTS Upon diagnosis, NCWS patients had a high prevalence of intestinal and extraintestinal symptoms. Also, most symptoms were described as severe and the QoL questionnaire showed high scores. On follow-up, both prevalence and severity of the most common symptoms were significantly reduced. However, persistent intestinal and extraintestinal symptoms of mild severity were found in 65.9 and 72.7% of NCWS patients. In comparison, in the CD group, the prevalence was lower (32.6 and 23.2% respectively) and consistent with previous studies. The analyses of the determinant of QoL showed that, upon diagnosis, NCWS patients had higher scores in the CDQ "gastrointestinal symptoms" (p < 0.001), "emotional aspects" (p < 0.001) and "social problems" (p < 0.001) subclasses compared to CD patients. After the GFD, NCWS and CD patients shared similar scores in all of the subclasses. CONCLUSIONS A significant proportion of NCWS patients still complains of intestinal and extraintestinal symptoms, even if significantly attenuated by the GFD, even years after the diagnosis. A comprehensive nutritional evaluation of these patients is required to further improve their symptoms and their QoL.
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Affiliation(s)
- Francesco Tovoli
- Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy.
| | - Alessandro Granito
- Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy.
| | - Giulia Negrini
- Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy.
| | - Elena Guidetti
- Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy.
| | - Chiara Faggiano
- Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy.
| | - Luigi Bolondi
- Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy.
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Makovický P, Chrenková M, Makovický P, Fľak P, Formelová Z, Novosadová V, Rajský M, Vannucci L. The effect of selected feed mixtures on the duodenal morphology: comparison study. Physiol Res 2018; 67:955-962. [PMID: 30204462 DOI: 10.33549/physiolres.933816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The objective of this work was to compare the effect of selected feed mixtures on the duodenal morphology. One-hundred-four rats of the Wistar strain were divided to thirteen groups per eight rats. The experiment started in 35-day-old rats after birth and lasted for 32 days. The groups (A-M) were fed by commercial diet, 85 % wheat and 15 % oat diet, 85 % wheat and 15 % triticale, 85 % wheat and 15 % barley, 85 % wheat and 15 % amaranth, 85 % wheat and 15 % lantern, 85 % wheat and 15 % buckwheat, 100 % wheat, 100 % white lupine, 100 % flock peas - variety Garden, 100 % native peas - variety Garden, 100 % native peas - variety Zekon or 100 % extruded peas - variety Zekon diet, respectively. Samples from the duodenum were taken. The height of the villi and the depth of the crypts were measured. The tallest villi were measured in group F (474.33+/-114.36 microm) and the shortest villi were observed in group B (294.08+/-88.52 microm). The deepest crypts were measured in group K (166.41+/-35.69 microm) and the shallowest crypts were observed in group E (77.85+/-17.61 microm). The work documents that gluten-free and classical cereals combination can be a better choice for people who want to limit the gluten content of the diet.
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Affiliation(s)
- P Makovický
- Czech Centre for Phenogenomics, Division BIOCEV, Vestec, Czech Republic, Laboratory of Immunotherapy, Institute of Microbiology of the Czech Academy of Sciences, Prague, Czech Republic.
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Drabińska N, Krupa-Kozak U, Abramowicz P, Jarocka-Cyrta E. Beneficial Effect of Oligofructose-Enriched Inulin on Vitamin D and E Status in Children with Celiac Disease on a Long-Term Gluten-Free Diet: A Preliminary Randomized, Placebo-Controlled Nutritional Intervention Study. Nutrients 2018; 10:nu10111768. [PMID: 30445682 PMCID: PMC6266806 DOI: 10.3390/nu10111768] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 10/31/2018] [Accepted: 11/13/2018] [Indexed: 12/18/2022] Open
Abstract
Prebiotics have been shown to improve absorption of some nutrients, including vitamins. This pilot study evaluated the effect of the prebiotic oligofructose-enriched inulin (Synergy 1) on fat-soluble vitamins status, parathormone, and calcium-related elements in pediatric celiac disease (CD) patients (n = 34) on a strict gluten-free diet (GFD). Participants were randomized into a group receiving 10 g of Synergy 1 or placebo (maltodextrin) together with a GFD. At baseline and after 3 months of intervention, 25-hydroxyvitamin D [25(OH)D], parathormone, vitamin E and A, calcium, phosphate, magnesium, total protein, and albumin were determined. Concentration of 25(OH)D increased significantly (p < 0.05) by 42% in CD patients receiving Synergy 1 in GFD, whereas no change was observed in placebo. Vitamin D status reached an optimal level in 46% of patients receiving Synergy 1. No significant difference in parathormone, calcium, and phosphate levels was observed. Concentration of vitamin E increased significantly (p < 0.05) by 19% in patients receiving Synergy 1, but not in the placebo. Vitamin A levels were not changed. Supplementation of GFD with Synergy 1 improved vitamin D and vitamin E status in children and adolescents with CD and could be considered a novel complementary method of management of fat-soluble vitamins deficiency in pediatric CD patients.
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Affiliation(s)
- Natalia Drabińska
- Department of Chemistry and Biodynamics of Food, Institute of Animal Reproduction and Food Research of Polish Academy of Sciences, Tuwima 10 Str., 10-748 Olsztyn, Poland.
| | - Urszula Krupa-Kozak
- Department of Chemistry and Biodynamics of Food, Institute of Animal Reproduction and Food Research of Polish Academy of Sciences, Tuwima 10 Str., 10-748 Olsztyn, Poland.
| | - Paweł Abramowicz
- Department of Pediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Białystok, Waszyngtona 17 Str., 15-274 Białystok, Poland.
| | - Elżbieta Jarocka-Cyrta
- Department of Pediatrics, Gastroenterology and Nutrition, Collegium Medicum, University of Warmia & Mazury, Oczapowskiego 2 Str., 10-719 Olsztyn, Poland.
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Abstract
We performed a systematic review of the literature to determine whether adherence to a gluten-free diet (GFD) leads to improved outcomes for patients with schizophrenia. We searched the AMED (Allied and Complementary Medicine; 1985-June 2016), MEDLINE (1946-June 2016), and Embase (1980-2016 week 24) databases using the terms "wheat" or "glutenin" or "gliadin" or "gluten" AND "schizophrenia." A total of 9 studies met the inclusion criteria for this review: 1 randomized controlled trial, 7 crossover studies, and 1 open-label pilot study. Six of the included studies demonstrated beneficial effects including improved functioning and decreased symptom severity after the course of a GFD, whereas 3 studies found no benefits. All of the included studies found that a GFD is well tolerated and can be adhered to by patients with schizophrenia. The findings of this systematic review should be interpreted with caution due to limitations inherent to nonrandomized trials, as well as the heterogeneity in the study design and the length of the GFD applied in each study. Publication bias is another potential limitation. Further research is required to examine the biomarkers of gluten sensitivity and inflammation to effectively target those patients with schizophrenia who will benefit most from this dietary intervention.
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Affiliation(s)
- Anastasia Levinta
- Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ilya Mukovozov
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Lee RWY, Corley MJ, Pang A, Arakaki G, Abbott L, Nishimoto M, Miyamoto R, Lee E, Yamamoto S, Maunakea AK, Lum-Jones A, Wong M. A modified ketogenic gluten-free diet with MCT improves behavior in children with autism spectrum disorder. Physiol Behav 2018; 188:205-211. [PMID: 29421589 PMCID: PMC5863039 DOI: 10.1016/j.physbeh.2018.02.006] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 01/27/2018] [Accepted: 02/03/2018] [Indexed: 02/08/2023]
Abstract
Purpose The ketogenic diet is a low-carbohydrate, moderate protein, high-fat diet that has emerged as a potential treatment for autism spectrum disorder. Autism spectrum disorder is a neurodevelopmental disorder of social communication, and restricted, repetitive behaviors and interests in need of novel therapies. An open-label clinical trial was done in Honolulu, Hawaii to test a modified ketogenic diet for improvement of core clinical impairments in children with ASD. Intervention A modified ketogenic gluten-free diet regimen with supplemental MCT was completed in 15 children ages 2 to 17 years for 3 months. Clinical (ADOS-2, CARS-2) and biochemical measures were performed at baseline and 3-months on the ketogenic diet. Main outcome Children administered a modified ketogenic gluten-free diet with supplemental MCT significantly improved core autism features assessed from the ADOS-2 after 3 months on diet (P = 0.006). No significant difference was observed in restricted and repetitive behavior score (P = 0.125) after 3 months on the diet protocol. Substantial improvement (> 30% decrease ADOS-2 total score) was observed in six participants, moderate improvement (> 3 units) in two participants, and minor/no improvement in seven participants. Ten participants assessed at a six-month time point sustained improvement in total ADOS-2 and social affect subdomain scores comparing baseline and 6 months (P = 0.019; P = 0.023), but no significant improvement in restricted and repetitive behavior scores were noted (P = 0.197). Significant improvements in CARS-2 items after 3 months of the modified ketogenic protocol were observed in imitation, body use, and fear or nervousness (P = 0.031, P = 0.008, P = 0.039). The percent change on ADOS-2 score from baseline to 3 months was associated with baseline high-density lipoprotein levels (ρ = −0.67, P = 0.007) and albumin levels (ρ = −0.60, P = 0.019). Moreover, the percent change from baseline to 3 months in ADOS-2 scores was significantly associated with percent change in high-density lipoprotein levels (ρ = 0.54, P = 0.049) and albumin levels (ρ = 0.67, P = 0.010). Conclusions A modified gluten-free ketogenic diet with supplemental MCT is a potentially beneficial treatment option to improve the core features of autism spectrum disorder and warrants further investigation. Trial registration Trial Registry: Clinicaltrials.gov Registration Number: NCT02477904 URL: https://www.clinicaltrials.gov/ct2/show/NCT02477904?term=ketogenic+diet&cond=Autism&rank=1
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Affiliation(s)
- Ryan W Y Lee
- Shriners Hospitals for Children, Medical Staff Department, Honolulu, Hawaii, United States; University of Hawaii, John A. Burns School of Medicine, Department of Pediatrics, Honolulu, Hawaii, United States; Shriners Hospitals for Children, Research Department, Honolulu, Hawaii, United States.
| | - Michael J Corley
- University of Hawaii, John A. Burns School of Medicine, Department of Native Hawaiian Health, Honolulu, Hawaii, United States.
| | - Alina Pang
- University of Hawaii, John A. Burns School of Medicine, Department of Native Hawaiian Health, Honolulu, Hawaii, United States.
| | - Gaye Arakaki
- Shriners Hospitals for Children, Rehabilitation Department, Honolulu, Hawaii, United States.
| | - Lisa Abbott
- Shriners Hospitals for Children, Research Department, Honolulu, Hawaii, United States
| | - Michael Nishimoto
- Shriners Hospitals for Children, Medical Staff Department, Honolulu, Hawaii, United States.
| | - Rob Miyamoto
- Shriners Hospitals for Children, Research Department, Honolulu, Hawaii, United States.
| | - Erica Lee
- University of Hawaii, John A. Burns School of Medicine, Department of Native Hawaiian Health, Honolulu, Hawaii, United States.
| | - Susan Yamamoto
- Shriners Hospitals for Children, Research Department, Honolulu, Hawaii, United States.
| | - Alika K Maunakea
- University of Hawaii, John A. Burns School of Medicine, Department of Native Hawaiian Health, Honolulu, Hawaii, United States.
| | - Annette Lum-Jones
- University of Hawaii, John A. Burns School of Medicine, Department of Native Hawaiian Health, Honolulu, Hawaii, United States.
| | - Miki Wong
- Shriners Hospitals for Children, Research Department, Honolulu, Hawaii, United States; Shriners Hospitals for Children, Nutrition Services Department, Honolulu, Hawaii, United States.
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Chen XY, Sun JM, Huang XJ. Idiopathic pulmonary hemosiderosis in adults: review of cases reported in the latest 15 years. Clin Respir J 2017; 11:677-681. [PMID: 26692115 DOI: 10.1111/crj.12440] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 11/24/2015] [Accepted: 12/14/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Idiopathic pulmonary hemosiderosis (IPH) is a rare disorder of unknown etiology which can cause diffuse alveolar hemorrhage. IPH is found primarily in children. In adults, however, it is extremely rare. A systematic review was applied to identify the details of IPH in adults. METHODS Articles of English or Chinese language published between 2000 and 2015 were included. Data were extracted on the clinical features, examinations, treatments and clinical outcome. RESULTS A total of 37 cases of adult-onset IPH were included (13 females and 24 males). IPH combined with coeliac disease was found in five patients, three of whom received gluten-free diet (GFD) only and got full remission. Upon diagnosis, median age was 34 years. The main manifestations were: hemoptysis (n = 30, 81%), dyspnea (n = 23, 64%), anemia (n = 20, 54%). Most patients were treated by corticosteroids initially. The mortality rage was 14% on acute phase. CONCLUSION The adult patients in this study showed some differences from the previously characterized IPH. It is characterized by immunologically mediated, middle-age onset, male dominance, absence of anemia, high mortality on acute phase.
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Affiliation(s)
- Xi-Yuan Chen
- Department of Respiratory Medicine, Zhejiang Provincial People's Hospital, Hangzhou, 310014, China
| | - Jin-Ming Sun
- Department of Respiratory Medicine, The People's No.3 Hospital of Hangzhou Xiaoshan, Hangzhou, 311251, China
| | - Xiao-Jun Huang
- Department of Respiratory Medicine, Zhejiang Provincial People's Hospital, Hangzhou, 310014, China
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Affiliation(s)
- Caren Pichardo
- *Department of Medical Education, Miami Children's Hospital †Department of Pediatric Gastroenterology, Miami Children's Hospital ‡Department of Pathology, Miami Children's Hospital, Miami, FL
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Tomal J, McKiernan D, Guandalini S, Semrad CE, Kupfer S. Celiac patients' attitudes regarding novel therapies. MINERVA GASTROENTERO 2016; 62:275-280. [PMID: 27405659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND The only current treatment for celiac disease (CD) is a gluten-free diet (GFD). Novel therapies are in development to supplement or replace a GFD. Knowledge of patients' attitudes toward these therapies is limited. The aim of this study was to determine attitudes about novel therapies in securely diagnosed patients with CD on a GFD and to correlate factors associated with these attitudes. METHODS A survey was created with two scenarios: a novel therapy that protects against cross contamination while on a GFD and one that allows intentional gluten consumption. The survey also included the Celiac Dietary Adherence Test and the CD Quality of Life (QOL) surveys. RESULTS A total of 182/284 (64%) CD patients completed the survey. Significantly more respondents would take a novel therapy to protect against cross contamination compared with one that allows intentional gluten consumption (87% vs. 65%; P<0.001). This difference was significant among women but not men. In both scenarios, protection against bowel inflammation was significantly more important than symptom control, and side effects were more important than cost. For a novel therapy that would allow intentional gluten consumption, a one-time injection was preferred over a daily pill, and patients willing to take this therapy had significantly lower QOL scores. CONCLUSIONS CD patients on a GFD are interested in novel therapies. There were notable differences in attitudes by gender and QOL. Considering patient preferences, drugs with daily or less frequent dosing that protect against bowel inflammation from gluten cross contamination would be best accepted.
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Affiliation(s)
- Justin Tomal
- Section of Gastroenterology, Department of Medicine, University of Chicago, Chicago, IL, USA -
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Moubax K, Mana F, Reynaert H, Urbain D. Two jenuno-jenunal intussusceptions in a patient with coeliac disease. Acta Gastroenterol Belg 2016; 79:391. [PMID: 27821042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We present a case of a 41-year-old woman with severe abdominal pain caused by two jejuno-jejunal intussusceptions. Further investigation showed coeliac disease as the underlying cause. The patient recovered rapidly on a gluten-free diet. So coeliac disease could be the underlying cause of idiopathic intussusception more often than previously thought and intussusception should be suspected in patients with known coeliac disease presenting with abdominal pain. (Acta gastro-enterol. belg., 2016, 79, 000-000).
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Sherman A, Zamulko A. Burning Tongue as Initial Presentation of Celiac Disease in an Elderly Woman: A Case Report. S D Med 2016; 69:253-255. [PMID: 27443108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
There are few reports in the literature where celiac disease presents with tongue manifestations, although atypical presentations of celiac disease are not uncommon. This case report highlights an atypical presentation of celiac disease in an elderly female. Our patient presented to clinic with complaints of a burning tongue for the past two years as well as occasional loose stools and fatigue. Work-up revealed iron deficiency anemia, zinc deficiency and an abnormal celiac panel. Complete symptom improvement was noted by 10 weeks into the initiation of a gluten free diet. Celiac disease can present at any age and should be considered as a differential in findings of malabsorption and gastrointestinal symptoms.
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Antvorskov JC, Josefsen K, Haupt-Jorgensen M, Fundova P, Funda DP, Buschard K. Gluten-Free Diet Only during Pregnancy Efficiently Prevents Diabetes in NOD Mouse Offspring. J Diabetes Res 2016; 2016:3047574. [PMID: 27642610 PMCID: PMC5014974 DOI: 10.1155/2016/3047574] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 07/05/2016] [Accepted: 07/10/2016] [Indexed: 11/17/2022] Open
Abstract
Studies have documented that the pathogenesis of autoimmune diabetes is influenced by the intake of gluten. Aims. To investigate the importance of gluten exposure during pregnancy and the subsequent development of autoimmune diabetes in offspring. Methods. Nonobese diabetic mice were divided into 7 groups to receive combinations of gluten-free and standard diet before, during, or after pregnancy. Diabetes incidence in offspring was followed in each group (n = 16-27) for 310 days. Insulitis score and intestinal expression of T-cell transcription factors (RT-QPCR) were evaluated in animals from the different diet groups. Results. If mothers were fed a gluten-free diet only during pregnancy, the development of autoimmune diabetes in offspring was almost completely prevented with an incidence reduction from 62.5% in gluten-consuming mice to 8.3% (p < 0.0001) in the gluten-free group. The islets of Langerhans were less infiltrated (p < 0.001) and the intestinal expression of RORγt (Th17) (p < 0.0001) reduced in mice whose mothers were Gluten-free during pregnancy. Conclusion. A gluten-free diet exclusively during pregnancy efficiently prevents autoimmune diabetes development in offspring and reduces insulitis and intestinal expression of RORγt (Th17).
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Affiliation(s)
- Julie C. Antvorskov
- The Bartholin Institute, Rigshospitalet, 2200 Copenhagen, Denmark
- *Julie C. Antvorskov:
| | - Knud Josefsen
- The Bartholin Institute, Rigshospitalet, 2200 Copenhagen, Denmark
| | | | - Petra Fundova
- The Bartholin Institute, Rigshospitalet, 2200 Copenhagen, Denmark
- Laboratory of Specific Cellular Immunity, Institute of Microbiology ASCR, 54922 Prague, Czech Republic
| | - David P. Funda
- The Bartholin Institute, Rigshospitalet, 2200 Copenhagen, Denmark
- Laboratory of Specific Cellular Immunity, Institute of Microbiology ASCR, 54922 Prague, Czech Republic
| | - Karsten Buschard
- The Bartholin Institute, Rigshospitalet, 2200 Copenhagen, Denmark
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Abenavoli L, Delibasic M, Peta V, Turkulov V, De Lorenzo A, Medić-Stojanoska M. Nutritional profile of adult patients with celiac disease. Eur Rev Med Pharmacol Sci 2015; 19:4285-4292. [PMID: 26636515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Celiac disease (CD) is a chronic immune-mediated gluten dependent enteropathy induced by ingestion of gluten, characterized by intestinal malabsorption and subtotals or total atrophy of intestinal villi. The predominant consequence of CD in untreated patients, is malnutrition as a result of malabsorption. Moreover, several and increasing extra-intestinal clinical manifestations have been described in the CD patients. Strict adherence to a gluten-free diet (GFD) improves nutritional status, inducing an increase in fat and bone compartments, but does not completely normalize body composition and nutritional deficiencies. An early and accurate evaluation of nutritional status can be of the pivotal step in the clinical management of the adult CD patients. The aim of this review is to present the most important and recent data on nutritional and metabolic features in the CD adult patients, the related implications and the effects of the GFD on these conditions.
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Affiliation(s)
- L Abenavoli
- Department of Health Sciences, University "Magna Græcia", Catanzaro, Italy.
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Uspenskaia ID, Shabunina EI, Zhukova EA, Erzutova MV, Korkotashvili LV. [Endogenous intoxication and biochemical protection in children with celiac disease: state assesment and correlation-regression analysis]. ACTA ACUST UNITED AC 2015:93-9. [PMID: 25563009 DOI: 10.15690/vramn.v69i7-8.1114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIM The purpose of the study was to determine the characteristics of endogenous intoxication parameters, biochemical protection and reveal their interaction in children with celiac disease. MATERIALS AND METHODS 81 children aged from 1 to 16 years with celiac disease were examined in acute and remission periods. In erythrocytes, blood serum and urine we determined low and moderate molecular weight substances (LMMWS), oligopeptides OP); in erythrocytes--the value of erythrocyte mechanical hemolysis (MH), malondialdehyde (MDA) content, the activity of glutathione reductase GR) and superoxide dismutase (SOD); in blood serum--ceruloplasmin (CP) level, alcohol dehydrogenase (ADH) activity; in erythrocytes and blood serum--glutathione transferase (GT), and calculated intoxication index (II). RESULTS In children with celiac disease in acute and remission periods LMMWS, OP, II levels in blood were statistically significantly high, while LMMWS level in urine was low. In both periods MH activity was high (p < 0.001), and GSR (p < 0.001) and SOD (p < 0.01) levels were low. We revealed the correlation between MDA and II (r = 0.67; p = 0.006), erythrocyte LMMWS and SOD (r = -0.61; p = 0.015), erythrocyte LMMWS and ADH (r = 0.62; p = 0.006), between GT and OP in urine (r = -0.31; p = 0.026), GTand MDA (r = 0.68; p = 0.000), GT and MH (r = -0.46; p = 0.004), between MDA and CP (r = 0.57; p = 0.002) that made it possible to develop the models of dependence of the parameters in relation to each other. CONCLUSION In celiac disease there is endogenous intoxication. The changes of the first and the second phases of biotransformation, antioxidant protection is an essential factor of the disease pathogenesis, since they have an effect on endogenous intoxication formation that should be taken into consideration in therapy.
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Uspenskaya ID, Erzutova MV, Korkotashvili LV, Kolesov SA, Shirokova NY. The significance of increased levels of end nitric oxide metabolites in blood serum of children with celiac disease. ACTA ACUST UNITED AC 2014; 115:712-7. [PMID: 25428541 DOI: 10.4149/bll_2014_138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES The aim of the study was to determine serum nitric oxide (NO) metabolites and correlate them to gluten-free diet (GFD) compliance, the parameters of morphological and functional condition of the small intestine in patients with celiac disease (CD) in a long-term follow-up. PATIENTS AND METHODS The study included 35 children (age median 8.0 years) with previously diagnosed CD, among them 15 - on a strict GFD and 20 - on a semistrict GFD. 32 patients (age median 7.5 years) with functional abdominal pain were recruited as controls. Nitrites (NO(2)), nitrates (NO(3)), total content of nitrites and nitrates (NOx) in serum were determined using the Griess reaction. CD patients underwent small intestine morphometry and absorption D-xylose test. RESULTS Compared to the controls, the CD patients on a strict GFD had no significant differences in NO(2), NO(3), NOx content, while in patients violating GFD these parameters were significantly higher. In comparison with the patients on a strict GFD, the patients on a semistrict GFD had higher median values of NO(3) (p = 0.002) and NOx (p = 0.0000). Serum NOx correlated negatively with the height of villi (p = 0.0001), D-xylose excretion (p = 0.0063), and correlated positively with the depth of crypts (p = 0.0082) and cellular density of villi stroma (p = 0.0067). CONCLUSION CD patients not keeping to a strict GFD have an increased level of nitric oxide metabolites in serum. NOx content is associated with morphometric parameters of the small intestine that proves the participation of NO in the pathogenesis of histological changes in CD (Tab. 3, Ref. 39).
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Mavrinac MA, Ohannessian A, Dowling EP, Dowling PT. Why celiac disease is so easy to miss. J Fam Pract 2014; 63:508-513. [PMID: 25353024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Maureen A Mavrinac
- Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
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Bürgin-Wolff A. Two-step approach. Dtsch Arztebl Int 2014; 111:213. [PMID: 24717309 PMCID: PMC3983702 DOI: 10.3238/arztebl.2014.0213b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Tromm A. Necessary additional points. Dtsch Arztebl Int 2014; 111:213. [PMID: 24717308 PMCID: PMC3983701 DOI: 10.3238/arztebl.2014.0213a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Abendroth K. Osteomalacia rather than osteoporosiss. Dtsch Arztebl Int 2014; 111:212. [PMID: 24717307 PMCID: PMC3983700 DOI: 10.3238/arztebl.2014.0212b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Razeghi S. Practicable only to a degree. Dtsch Arztebl Int 2014; 111:212. [PMID: 24717306 PMCID: PMC3983699 DOI: 10.3238/arztebl.2014.0212a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Zimmer KP, Schuppan D. In reply. Dtsch Arztebl Int 2014; 111:213-214. [PMID: 24717310 PMCID: PMC3983703 DOI: 10.3238/arztebl.2014.0213c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Klaus-Peter Zimmer
- *Department of General Pediatrics and Neonatology, Center for Pediatric and Adolescent Medicine, University Hospital Gießen and Marburg GmbH, Justus Liebig University, Gießen,
| | - Detlef Schuppan
- **Institute of Translational Immunology and Department of Medicine I, Johannes Gutenberg University, Mainz
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