Duodenal Mucosal Immune Cells in Treatment-Naive Adult Patients with Celiac Disease Having Different Histological Grades and Controls

July Alert 2019

1. Indian J Pathol Microbiol. 2019 Jul-Sep;62(3):399-404. doi: 10.4103/IJPM.IJPM_703_18. Duodenal mucosal immune cells in treatment-naive adult patients with celiac disease having different histological grades and controls.

S Gahlot GP1, Das P1, Baloda V1, Singh A2, Vishnubhatla S3, Gupta SD1, Makharia GK2.

Author information: 1. Department of Pathology, AIIMS, New Delhi, India. 2. Department of Gastroenterology and Human Nutritions, AIIMS, New Delhi, India. 3. Department of Biostatistics, AIIMS, New Delhi, India.

Abstract

Background:

It is hypothesized that the duodenal mucosal damage in patients with celiac disease (CeD) is caused by the mucosa-infiltrating lymphoid cells. This study aimed to analyze the immune effective and regulatory T (Treg) cells in duodenal biopsies from treatment-naive adult patients with CeD having different histological grades and controls.

Patients and Methods:

Dual-color immunohistochemical staining was done in a total of 234 duodenal biopsies, including 132 controls and 102 adult patients with CeD using CD20, CD3:CD4, CD3:CD8, CD4:FoxP3, CD8:FoxP3, and TCRαβ:TCRγδ antibodies. The density of these lymphoid cells in lamina propria and mucosal epithelium was compared between controls and CeD, with different modified Marsh grades.

Results: Densities of CD4+ T cells in lamina propria and CD8+γδ intraepithelial lymphocytes (IELs) were significantly more in biopsies from patients with CeD, than in controls. An increasing linear pattern of IELs, CD3+ T cells, and CD20+ B cells was observed with increasing grades of villous abnormalities. Although CD8+ FoxP3+ Treg cells were significantly more in biopsies from patients with CeD, there was no significant difference in CD4+ FoxP3+ Treg cell infiltrate between both the groups.

Conclusion:

Our finding in this observational study generates interest to study the local intestinal mucosal immunity in CeD in detail. A study to prove the failure of CD4+ FoxP3+ Treg cell recruitment in CeD and its direct functional impact may yield valuable information regarding loss of mucosal tolerance. PMID: 31361227 Similar articles

Conflict of interest statement

There are no conflicts of interest 2. Scand J Gastroenterol. 2019 Jul 30:1-4. doi: 10.1080/00365521.2019.1647455. [Epub ahead of print] Two cases of monomorphic epitheliotropic intestinal T-cell lymphoma associated with coeliac disease.

Lenti MV1, Biagi F1,2, Lucioni M3, Di Sabatino A1, Paulli M3, Corazza GR1.

Author information: 1. a Department of Internal Medicine, University of Pavia, Fondazione IRCCS Policlinico San Matteo , Pavia , Italy. 2. b Gastroenterology Unit, ICS Maugeri IRCCS, University of Pavia , Pavia , Italy. 3. c Anatomic Pathology Section, Department of Human Pathology, University of Pavia, Fondazione IRCCS Policlinico San Matteo , Pavia , Italy.

Abstract

Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) is an aggressive type of intestinal lymphoma which affects individuals without evidence of enteropathy. In this single-centre case series, we describe the first two cases of MEITL in Caucasian patients suffering from histologically- proven coeliac disease (CD). Original medical records were retrieved and anonymised. All biopsy and surgical MEITL specimens were reviewed by three haematopathologists. Two patients aged 63- and 55-year old at CD diagnosis, subsequently developed a MEITL. MEITL always involved the ileum and was multifocal. Both patients died from complications after surgery, including gastrointestinal bleeding, septic shock and multiorgan failure, with a mean survival since MEITL diagnosis of 15.5 ± 16.3 months. In one case, array-CGH revealed a large deletion on chromosome nine between 9p13.1 and 9p24.1, and a recurrent chromosome gain at 9q33-q34. Our cases indicate that a subset of MEITL may arise in Caucasian patients suffering from CD. The clinical, pathological and molecular features of these cases show a partial overlap with enteropathy-associated T-cell lymphoma. PMID: 31361171 Similar articles

3. Scand J Gastroenterol. 2019 Jul 30:1-5. doi: 10.1080/00365521.2019.1647283. [Epub ahead of print] Is the double gene dose of DQ2.5 or DQ2.5/DQ2.2 an involved factor in the clinical features of celiac disease?

Cabrera CM1, Sánchez-Godoy L2, Navas-López VM3.

Author information: 1. a Immunology Section, Department of Hematology, Carlos Haya Regional University Hospital , Málaga , Spain. 2. b Clinical Laboratory Service, Carlos Haya Regional University Hospital , Málaga , Spain. 3. c Pediatric Gastroenterology and Nutrition Unit, Carlos Haya Regional University Hospital , Málaga , Spain.

Abstract

Objectives: Celiac disease (CD) is barely known if the quantitative effect of DQB1*02 (DQ2) double dose in antigen presentation to T-cells has translation into the clinic. For this, we have conducted a case-control study in a cohort of two hundred and nineteen patients with CD. Material and methods: For the control group, individuals were enrolled with single dose of DQ2, carrying DQ2.5 heterodimers in heterozygous state (n = 109). The cases with CD were diving into three groups: cases with overall DQ2 double dose (n = 110), DQ2.5 homozygous (n = 33) and DQ2.5/DQ2.2 heterozygous (n = 77). Prevalence and associations of demographic, laboratory, histological and clinical characteristics between the control group and cases were studied. Results: No differences were found for the total of 16 variables analyzed between the control group and overall DQ2 double dose as well as DQ2.5 homozygous cases. In contrast to DQ2.5/DQ2.2, heterozygous cases presented a protection factor for developing allergy to airway allergens regarding the control group (OR = 0.210, p = .019). Conclusions: To date, this negative association has not been described. Further studies will be necessary to elucidate the implication of this protection factor in CD. Since, until now the association between CD and allergic diseases has been poorly studied. PMID: 31361165 Similar articles

4. Postgrad Med. 2019 Jul 30. doi: 10.1080/00325481.2019.1650609. [Epub ahead of print] Small fiber neuropathy in coeliac disease and gluten sensitivity.

Zis P1, Sarrigiannis PG1, Rao DG1, Sanders DS2, Hadjivassiliou M1.

Author information: 1. a Academic Department of Neurosciences, Sheffield Teaching Hospitals NHS Foundation Trust. 2. b Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust.

Abstract

OBJECTIVES:

The commonest types of peripheral neuropathy in the context of Coeliac Disease (CD) and gluten sensitivity (GS) are length dependent symmetrical sensorimotor neuropathies and sensory ganglionopathies. In patients with such neuropathy, (gluten neuropathy), peripheral neuropathic pain is prevalent suggesting involvement of small fibers. The purpose of this report was to describe the clinical characteristics of patients with CD or GS and pure small fiber neuropathy (SFN).

METHODS:

We reviewed the records of all patients that had been referred to the Gluten Related Neurological Disorders clinic who had clinical and neurophysiological evidence of SFN. All patients had serological evidence of gluten sensitivity (GS) prior to commencing GFD. All patients were offered a duodenum biopsy. Patients with comorbidities that could cause SFN were excluded.

RESULTS:

We identified 13 patients (9 males) with SFN and gluten sensitivity. Of 11 patients who underwent duodenal biopsy 10 had evidence of enteropathy (CD). Mean age at onset of pain was 53.5±11.4 years (range 34-72) and mean age of CD/GS diagnosis was 50.8±10.4 years (range 34-68). In 8 patients (61.5%) pain was the presenting feature. Neurophysiological assessment suggested a length dependent small fiber neuropathy in 11 patients, whereas in 2, a non-length dependent pattern was identifying suggesting that the predominant pathology lies in the dorsal root ganglia.

CONCLUSION:

SFN can be a presenting feature of CD and GS and, therefore, screening for CD and GS should be included in the diagnostic work up of patients with idiopathic SFN. PMID: 31359810 Similar articles

5. J Nutr Metab. 2019 Jul 1;2019:2438934. doi: 10.1155/2019/2438934. eCollection 2019. A Gluten-Free Diet, Not an Appropriate Choice without a Medical Diagnosis.

Diez-Sampedro A1, Olenick M1, Maltseva T1, Flowers M1.

Author information: 1. Undergraduate Nursing, NWCNHS, Florida International University, Miami, FL 33199, USA.

Abstract

In the past, only people diagnosed with celiac disease, approximately 1% of the population, avoided gluten consumption through all their meals. However, popular media often now mistakenly present gluten-free foods as being a healthier choice, and more people have now concluded that gluten is a harmful part of the diet. A review of literature on gluten-free diets, gluten sensitivity, celiac disease, and attitudes toward gluten consumption was undertaken to examine the prevalence and consequences of adopting a gluten-free diet and to provide guidance to healthcare practitioners whose patients are now often adopting this diet without medical input. Aside from celiac disease, nonceliac gluten sensitivity (NCGS) occurs in those persons in which gluten ingestion leads to symptomatic manifestations in the absence of celiac disease or wheat allergy but who report a remission of certain symptoms after removing gluten from their diet. However, it was been shown that a large percentage of people who claim NCGS do not feel those manifestations under a double- blind challenge to gluten. Moreover, some parents, believing that ingesting gluten is detrimental for their health, adopt gluten-free diets for their children. A review of existing data shows that there are detrimental effects to going gluten free, including loss of the dietary fiber, deficiencies in dietary minerals and vitamins, and potential heavy metal exposure. Healthcare practitioners should query patients about their dietary choices, and in cases of questionable adoption of gluten-free diet, patients and parents are educated about the detriments of a gluten-free diet, and in cases where patients continue to insist on gluten-free foods, referrals to nutritional counseling are warranted in order to minimize potential harm.

PMCID: PMC6636598 Free Article PMID: 31354988 Similar articles

6. Front Endocrinol (Lausanne). 2019 Jul 12;10:476. doi: 10.3389/fendo.2019.00476. eCollection 2019. Phenotypic Expression of Autoimmunity in Children With Autoimmune Thyroid Disorders.

Aversa T1, Corica D1, Zirilli G1, Pajno GB1, Salzano G1, De Luca F1, Wasniewska M1.

Author information: 1. Department of Human Pathology of Adulthood and Childhood, Unit of Pediatrics, University of Messina, Messina, Italy.

Abstract

Autoimmune thyroid diseases (AITDs), including Hashimoto's thyroiditis (HT) and Graves' disease (GD), tend to aggregate with other non-thyroidal autoimmune diseases (NTADs). Aim of this Mini- review is to report the most recent insights concerning the clustering of NTADs in pediatric patients with either HT or GD, the pathophysiology of AITDs and the metamorphic thyroid autoimmunity. A systematic literature research of the last 15 years, according to EQUATOR statement, was carried out through MEDLINE via PubMed (http://www.ncbi.nlm.nih.gov/pubmed/) Embase, CINAHL, Cochrane Library, based on the following keywords: (autoimmune thyroid disease OR Hashimoto thyroiditis OR Grave's disease) AND (autoimmune comorbidities OR extra-thyroidal autoimmune disorders) AND (children OR adolescents OR pediatrics) AND (celiac disease OR type 1 diabetes mellitus OR arthropathies OR cutaneous diseases) AND (Turner syndrome OR Down syndrome). One-hundred and twenty-eight manuscripts were extrapolated but only seventeen were eligible. On the basis of the available reports it may be inferred that clustering of NTADs can be significantly modified by both patients' age at AITDs presentation and association with Down's syndrome (DS). Particularly, the association of AITDs with celiac disease and type 1 diabetes was most commonly reported in children than in adults. A sequential shifting from HT to GD has been described in children with AITDs, and it seems to be more frequent in children with DS than in those without DS. Coexistence of autoimmune diseases might be the result of a complex interaction among genetics, environment and epigenetic modifications that are able to affect gene expression, immune system response and, finally, the pathogenesis of autoimmune diseases.

PMCID: PMC6640617 Free Article PMID: 31354636 Similar articles

7. Gastroenterology. 2019 Jul 25. pii: S0016-5085(19)41012-3. doi: 10.1053/j.gastro.2019.06.014. [Epub ahead of print] AGA Technical Review on the Evaluation of Functional Diarrhea and Diarrhea- Predominant Irritable Bowel Syndrome in Adults.

Carrasco-Labra A1, Lytvyn L2, Falck-Ytter Y3, Surawicz CM4, Chey WD5.

Author information: 1. Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; Evidence-Based Dentistry Unit, Faculty of Dentistry, University of Chile, Santiago, Chile. 2. Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada. 3. Division of Gastroenterology, Case Western Reserve University, Cleveland, Ohio; Veterans Affairs Medical Center and University Hospitals of Cleveland, Cleveland, Ohio. 4. Division of Gastroenterology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington. 5. Division of Gastroenterology, Department of Medicine, University of Michigan School of Medicine, Ann Arbor, Michigan.

Abstract

BACKGROUND & AIMS:

The evaluation of patients with chronic watery diarrhea represents a diagnostic challenge for clinicians because organic causes, including inflammatory bowel disease, microscopic colitis, and chronic infection, must be differentiated from functional diarrhea and diarrhea-predominant irritable bowel syndrome. The purpose of this review is to summarize the available evidence on the usefulness of diagnostic tests in such patients.

METHODS:

We searched MEDLINE and EMBASE via OVID, from 1978 until April 2017. We included diagnostic test accuracy studies reporting on the use of fecal and blood tests for the evaluation of adult patients with functional diarrhea, including irritable bowel syndrome. We assessed the risk of bias of included studies using a modified version of the Quality Assessment of Diagnostic Accuracy Studies II, and the certainty in the evidence using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. We calculated pooled sensitivity and specificity, and the proportion of patients with true and false positive and negative results. We evaluated the following tests: erythrocyte sedimentation rate, C-reactive protein, fecal lactoferrin, fecal calprotectin, serologic tests for celiac disease, tests for bile acid diarrhea, the commercially available version of anti-cytolethal distending toxin B and anti-vinculin antibodies, and tests for Giardia infection. We did not evaluate breath tests for small intestinal bacterial overgrowth, as they are not part of a standard diarrhea workup.

RESULTS:

Thirty-eight studies proved eligible to evaluate 1 or more of these tests. Erythrocyte sedimentation rate and C-reactive protein were similar at discriminating organic from functional disease, with sensitivity and specificity, respectively, of 0.54-0.78 and 0.46-0.95 for erythrocyte sedimentation rate and 0.73 and 0.78 for C-reactive protein. Among fecal tests, fecal calprotectin in a range of 50-60 μg/g (pooled sensitivity 0.81; 95% confidence interval [CI], 0.75-0.86; pooled specificity 0.87; 95% CI, 0.78-0.92) and fecal lactoferrin in a range of 4.0-7.25 μg/g (pooled sensitivity 0.79; 95% CI, 0.73-0.84; pooled specificity 0.93; 95%CI 0.63-0.99) presented the lowest proportion of false-negative results (low certainty in the evidence). Among tests for celiac disease, IgA tissue transglutaminase presented the best diagnostic test accuracy (sensitivity range, 0.79-0.99; specificity range, 0.90-0.99) with moderate certainty in the evidence. Among tests for bile acid diarrhea, the 75selenium homotaurocholic acid test performed better than serum fibroblast growth factor 19 and 7α-hydroxy- 4-cholesten-3-one, but is not available in the United States. There was insufficient evidence to recommend serologic tests for irritable bowel syndrome at this time. There are several good diagnostic tests for Giardia infection.

CONCLUSIONS:

Moderate to low certainty in the evidence indicates that available fecal and blood tests may play a role in the diagnostic workup of adult patients with functional diarrhea. At the moment, no tests are available to reliably rule in irritable bowel syndrome.

8. Clin Gastroenterol Hepatol. 2019 Jul 24. pii: S1542-3565(19)30776-1. doi: 10.1016/j.cgh.2019.07.032. [Epub ahead of print] Measurements of Duodenal Mucosal Integrity are Altered in Celiac Disease.

Adams DW1, Patel D2, Evers L3, Slaughter JC4, Higginbotham T2, Vaezi M2.

Author information: 1. Department of Internal Medicine, Vanderbilt Medical Center, Nashville, TN, USA. Electronic address: [email protected]. 2. Gastroenterology, Hepatology, and Nutrition, Vanderbilt Medical Center, Nashville, TN, USA. 3. Department of Internal Medicine, Vanderbilt Medical Center, Nashville, TN, USA. 4. Biostatistics, Vanderbilt Medical Center, Nashville, TN, USA. PMID: 31351133 Similar articles

9. Nutrients. 2019 Jul 25;11(8). pii: E1718. doi: 10.3390/nu11081718. Daily Life Restrictions are Common and Associated with Health Concerns and Dietary Challenges in Adult Celiac Disease Patients Diagnosed in Childhood.

Leinonen H1,2, Kivelä L3,4, Lähdeaho ML2, Huhtala H5, Kaukinen K1,6,7, Kurppa K1,2,8.

Author information: 1. Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland. 2. Center for Child Health Research, Tampere University and Department of Pediatrics, Tampere University Hospital, 33014 Tampere, Finland. 3. Center for Child Health Research, Tampere University and Department of Pediatrics, Tampere University Hospital, 33014 Tampere, Finland. [email protected]. 4. Pediatric Research Center, Children's Hospital, University of Helsinki and Helsinki University Hospital, 00029 Helsinki, Finland. [email protected]. 5. Faculty of Social Sciences, Tampere University, 33014 Tampere, Finland. 6. Department of Internal Medicine, Tampere University Hospital, 33014 Tampere, Finland. 7. Celiac Disease Research Center, Tampere University, 33014 Tampere, Finland. 8. The University Consortium of Seinäjoki, 60320 Seinäjoki, Finland.

Abstract

The prevalence and associated factors of daily life restrictions due to a gluten-free diet in adult celiac disease patients diagnosed in childhood are poorly known. We investigated these issues by collecting the medical data of 955 pediatric patients and sending questionnaires evaluating various health outcomes to the 559 patients who had reached adulthood. Of the 231 respondents, 46% reported everyday life restrictions caused by dietary treatment. Compared with those without restrictions, they more often had anemia at diagnosis (37% vs. 22%, p = 0.014), but the groups were comparable in other diagnostic features. In adulthood, patients with restrictions reported more overall symptoms (32% vs. 17%, p = 0.006), although the symptoms measured with the Gastrointestinal Symptom Rating Scale questionnaire were comparable. Despite strict dietary adherence in both groups, the experience of restrictions was associated with dietary challenges (34% vs. 9%, p < 0.001), health concerns (22% vs. 13%, p = 0.050), and lower vitality scores in the Psychological General Well-Being questionnaire. The groups did not differ in their current age, socioeconomic status, family history of celiac disease, general health or health-related lifestyle, the presence of co-morbidities, or regular follow up. Our results encourage healthcare professionals to discuss the possible health concerns and dietary challenges with patients to avoid unnecessary daily life restrictions, especially when young patients start to take responsibility for their treatment.

Free Article PMID: 31349675 Similar articles

10. Pediatr Emerg Care. 2019 Jul 24. doi: 10.1097/PEC.0000000000001894. [Epub ahead of print] What Do Saudi Children Ingest?: A 10-Year Retrospective Analysis of Ingested Foreign Bodies From a Tertiary Care Center.

Ibrahim AH1, Andijani A1, Abdulshakour M1, Algain S1, Abu Thamrah A1, Ali MM1, Marwah H1, Aldaher A1, Bashir S2, Alsaleem B3, Asery A3, Al-Hussaini A3,4,5.

Author information: 1. From the Children's Specialized Hospital, King Fahad Medical City. 2. Department of Biostatistics, Research Services Administration, Research Center, King Fahad Medical City. 3. Division of Pediatric Gastroenterology, Children's Specialized Hospital, King Fahad Medical City. 4. College of Medicine, Alfaisal University. 5. Prince Abdullah Bin Khaled Celiac Disease Research Chair, King Saud University, Riyadh, Kingdom of Saudi Arabia.

Abstract

OBJECTIVES:

Few studies investigated the correlation between foreign body (FB) ingestion and occurrence of complications. The local literature is limited to case reports and small case series on esophageal FBs. We conducted this study to identify the high-risk factors predisposing to complications among Saudi children ingesting FBs.

METHODS:

The medical records of 436 children (boys, 59.6%; mean age, 4.4 ± 2.7 years) presenting to the emergency department (ED) between 2007 and 2016 were retrospectively reviewed. Relative risk analysis of clinical variables was performed between 2 groups: The first group constituted children without FB-related complications (n = 389), and the second group included those with major complications (n = 14). Major complication was defined as any event associated with significant morbidity such as esophageal stricture, esophageal perforation, esophageal fistula, and intestinal perforation or fistula formation.

RESULTS:

Most of the 436 cases presented between ages 2 and 4 years (35.1%). Coin was the most commonly ingested FB (22.9%) followed by button battery (19.5%). Most of the ingested FBs passed spontaneously without intervention (69%). Upper endoscopy was performed in 121 cases (27.7%). By multivariate analysis, the variables that were significantly associated with major complications included the following: very young age group (0-2 years; odds ratio [OR], 11.5), button battery (OR, 4), FB impacted at upper esophagus (OR, 8.7), and longer time duration to visit the ED (OR, 14.7).

CONCLUSION:

Button battery impaction at upper esophagus in very young children and delayed presentation to the ED were the most significant risk factors of FB-related complications. PMID: 31348207 Similar articles

11. Am J Gastroenterol. 2019 Jul 23. doi: 10.14309/ajg.0000000000000331. [Epub ahead of print] Gluten Intake in Early Childhood and Risk of Celiac Disease in Childhood: A Nationwide Cohort Study.

Lund-Blix NA1,2,3,4, Mårild K1,5, Tapia G1, Norris JM3, Stene LC1, Størdal K1,6.

Author information: 1. Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway. 2. Barbara Davis Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. 3. Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. 4. Department of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway. 5. Department of Pediatrics, The Sahlgrenska Academy at University of Gothenburg and Queen Silvia Children's Hospital, Gothenburg, Sweden. 6. Department of Pediatrics, Østfold Hospital Trust, Grålum, Norway.

Abstract OBJECTIVES:

Celiac disease (CD) may occur in genetically predisposed individuals exposed to gluten, but it is unclear whether the amount of gluten influences the risk of disease. We aimed at determining whether the amount of gluten intake at age 18 months predicted later risk of CD.

METHODS:

In an observational nationwide cohort study, the Norwegian Mother and Child Cohort Study (MoBa), we included 67,608 children born during 2000-2009 and followed up for a mean of 11.5 years (range 7.5-15.5) after exclusions for missing data. Information regarding CD diagnosis was obtained from the Norwegian Patient Register 2008-2016 and from parental questionnaires at child age 7 and 8 years. We estimated gluten intake at age 18 months from a prospectively collected parental questionnaire.

RESULTS:

CD was diagnosed in 738 children (1.1%, 62% girls). The mean estimated amount of gluten in the diet at 18 months was 8.8 g/d (SD 3.6). The adjusted relative risk of CD was 1.10 (95% confidence interval 1.03-1.18) per SD increase in daily gluten amount at age 18 months. Children in the upper quartile of gluten intake compared with the lower quartile had an increased risk of CD (adjusted relative risk 1.29, 95% confidence interval 1.06-1.58). The association with gluten amount was independent of the age at introduction of gluten. Gluten introduction ≥6 months was also an independent risk factor for CD.

DISCUSSION:

In this nationwide study, increased gluten intake at 18 months was associated with a modestly increased risk of CD later in childhood. PMID: 31343439 Similar articles

12. Pediatr Gastroenterol Hepatol Nutr. 2019 Jul;22(4):407-412. doi: 10.5223/pghn.2019.22.4.407. Epub 2019 Jun 18. Coexistence of Excessive Weight Gain and Celiac Disease in Children: An Unusual Familial Condition.

Calcaterra V1,2, Regalbuto C1,2, Madè A1,2, Magistrali M1,2, Leonard MM3,4,5, Cena H6,7. Author information: 1. Pediatrics and Adolescentology Unit, Department of Internal Medicine, University of Pavia, Pavia, Italy. 2. Pediatric Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. 3. Mass General Hospital for Children, Harvard Medical School, Boston, MA, United States. 4. Division of Pediatric Gastroenterology and Nutrition, Harvard Medical School, Boston, MA, United States. 5. Center for Celiac Research and Treatment, Mucosal Immunology and Biology Research Center, United States of America Celiac Research Program, Harvard Medical School, Boston, MA, United States. 6. Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, Pavia, Italy. 7. Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.

Abstract

Excessive weight gain in children diagnosed with celiac disease (CD) is becoming more common. We describe 2 siblings (9-year and 6 months-old female and 6-year and 9 months-old male) with obesity showing attenuated gastrointestinal and atypical symptoms in which CD was diagnosed in the absence of a known family history of CD. After children's diagnosis, CD in their parents was also investigated. It was detected in their father affected by overweight. The presentation of patients with CD has changed. While patients with overweight and obesity commonly have symptoms such as abdominal pain, reflux, headache, and constipation due to lifestyle factors, CD should also be considered in patients with or without a family history of CD. Careful nutritional status assessment and follow-up monitoring after the diagnosis of CD are mandatory, especially in subjects who are already overweight at the presentation of this disease.

PMCID: PMC6629591 Free PMC Article PMID: 31338317 Similar articles

Conflict of interest statement

Conflict of Interest: The authors have no financial conflicts of interest. 13. Pediatr Gastroenterol Hepatol Nutr. 2019 Jul;22(4):350-357. doi: 10.5223/pghn.2019.22.4.350. Epub 2019 Jun 20. Tissue Transglutaminase Antibody and Its Association with Duodenal Biopsy in Diagnosis of Pediatric Celiac Disease.

Meena DK1, Akunuri S1, Meena P2, Bhramer A3, Sharma SD4, Gupta R4.

Author information: 1. Pediatric Intensive Care Unit, Great Ormond Street Hospital, London, United Kingdom. 2. Department of Pediatrics, Lady Harding Medical College, New Delhi, India. 3. Department of Pediatrics, Government BDM Hospital, Jaipur, India. 4. Department of Pediatrics, SMS Medical College, Jaipur, India.

Abstract

Purpose:

This study aimed to evaluate a possible association between the anti-tissue transglutaminase antibody (anti-tTG) titer and stage of duodenal mucosal damage and assess a possible cut-off value of anti-tTG at which celiac disease (CD) may be diagnosed in children in conjunction with clinical judgment.

Methods:

This observational study was conducted at a gastroenterology clinic in a tertiary hospital from April 2012 to May 2013. Seventy children between 6-months and 18-years-old with suspected CD underwent celiac serology and duodenal biopsy. Statistical analyses were done using SPSS 16. Diagnostic test values were determined for comparing the anti-tTG titer with duodenal biopsy. An analysis of variance and Tukey-Kramer tests were performed for comparing the means between groups. A receiver operating characteristics curve was plotted to determine various cut-off values of anti-tTG.

Results:

The mean antibody titer increased with severity of Marsh staging (p<0.001). An immunoglobulin (Ig) A-tTG value at 115 AU/mL had 76% sensitivity and 100% specificity with a 100% positive predictive value (PPV) and 17% negative predictive value (NPV) for diagnosis of CD (p<0.001, 95% confidence interval [CI], 0.75-1).

Conclusion:

There is an association between the anti-tTG titer and stage of duodenal mucosal injury in children with CD. An anti-tTG value of 115 AU/mL (6.4 times the upper normal limit) had 76% sensitivity, 100% specificity, with a 100% PPV, and 17% NPV for diagnosing CD (95% CI, 0.75-1). This cut-off may be used in combination with clinical judgment to diagnose CD.

PMCID: PMC6629588 Free PMC Article PMID: 31338310 Similar articles

Conflict of interest statement

Conflict of Interest: The authors have no financial conflicts of interest. 14. J Exp Med. 2019 Jul 23. pii: jem.20190414. doi: 10.1084/jem.20190414. [Epub ahead of print] Resident memory CD8 T cells persist for years in human small intestine.

Bartolomé-Casado R1, Landsverk OJB2, Chauhan SK2,3, Richter L2,4, Phung D2, Greiff V5, Risnes LF6,7, Yao Y5,7, Neumann RS5,7, Yaqub S8, Øyen O9, Horneland R9, Aandahl EM3,9, Paulsen V10, Sollid LM5,6,7, Qiao SW5,7, Baekkevold ES2, Jahnsen FL11.

Author information: 1. Department of Pathology, Oslo University Hospital and University of Oslo, Oslo, Norway [email protected]. 2. Department of Pathology, Oslo University Hospital and University of Oslo, Oslo, Norway. 3. Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway. 4. Core Facility Flow Cytometry, Biomedical Center, Ludwig-Maximilians-University Munich, Munich, Germany. 5. Department of Immunology, Institute of Clinical Medicine, University of Oslo, Oslo, Norway. 6. Department of Immunology, Oslo University Hospital, Rikshospitalet, Oslo, Norway. 7. K.G. Jebsen Coeliac Disease Research Centre, University of Oslo, Oslo, Norway. 8. Department of Gastrointestinal Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway. 9. Department of Transplantation Medicine, Section for Transplant Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway. 10. Department of Gastroenterology, Oslo University Hospital, Rikshospitalet, Oslo, Norway. 11. Department of Pathology, Oslo University Hospital and University of Oslo, Oslo, Norway [email protected].

Abstract

Resident memory CD8 T (Trm) cells have been shown to provide effective protective responses in the small intestine (SI) in mice. A better understanding of the generation and persistence of SI CD8 Trm cells in humans may have implications for intestinal immune-mediated diseases and vaccine development. Analyzing normal and transplanted human SI, we demonstrated that the majority of SI CD8 T cells were bona fide CD8 Trm cells that survived for >1 yr in the graft. Intraepithelial and lamina propria CD8 Trm cells showed a high clonal overlap and a repertoire dominated by expanded clones, conserved both spatially in the intestine and over time. Functionally, lamina propria CD8 Trm cells were potent cytokine producers, exhibiting a polyfunctional (IFN-γ+ IL-2+ TNF-α+) profile, and efficiently expressed cytotoxic mediators after stimulation. These results suggest that SI CD8 Trm cells could be relevant targets for future oral vaccines and therapeutic strategies for gut disorders.

15. Nutrients. 2019 Jul 13;11(7). pii: E1588. doi: 10.3390/nu11071588. Nutritional Deficiencies in Children with Celiac Disease Resulting from a Gluten-Free Diet: A Systematic Review.

Di Nardo G1, Villa MP1, Conti L2, Ranucci G3, Pacchiarotti C1, Principessa L1, Raucci U4, Parisi P5.

Author information: 1. Chair of Pediatrics, School of Medicine and Psychology, NESMOS Department, Sapienza University of Rome, S. Andrea University Hospital, 00189 Rome, Italy. 2. Department of Medical-Surgical Sciences and Translational Medicine, Sant'Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy. 3. Pediatric Unit, AORN Santobono-Pausilipon, 80129 Naples, Italy. 4. Pediatric Emergency Department, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy. 5. Chair of Pediatrics, School of Medicine and Psychology, NESMOS Department, Sapienza University of Rome, S. Andrea University Hospital, 00189 Rome, Italy. [email protected].

Abstract

BACKGROUND:

A strictly gluten-free diet (GFD) is the basis for managing celiac disease (CD). Numerous studies have reported nutritional deficiencies/imbalances ascribable to a GFD. The aim of this review is to describe nutritional deficiencies observed in children with celiac disease on a GFD, to discuss the clinical consequences related to these nutritional imbalances, and to identify strategies that may be adopted to treat them. METHODS:

We reviewed the MEDLINE and EMBASE databases between January 1998 and January 2019.

RESULTS:

Children are, regardless of whether they are on a gluten-free diet or not, at risk of consuming too much fat and insufficient fiber, iron, vitamin D, and calcium. These imbalances may be exacerbated when children are on a gluten-free diet. In particular, the intake of folate, magnesium, zinc, and foods with a high glycemic index in children with CD who are on a GFD is significantly altered.

CONCLUSIONS:

Therapeutic protocols should include nutritional education to help teach subjects affected by disorders such as CD the importance of labels, the choice of foods, and the combination of macro- and micronutrients. Children with CD on a GFD should be encouraged to rotate pseudo-cereals, consume gluten-free commercial products that have been fortified or enriched, and use foods that are local and naturally gluten-free.

Free Article PMID: 31337023 Similar articles

16. Nutrients. 2019 Jul 11;11(7). pii: E1566. doi: 10.3390/nu11071566. Effect of Three Diets (Low-FODMAP, Gluten- free and Balanced) on Irritable Bowel Syndrome Symptoms and Health-Related Quality of Life.

Paduano D1, Cingolani A2, Tanda E3, Usai P2.

Author information: 1. Gastroenterology, Department of Medical Sciences, Policlinico Universitario di Monserrato, University of Cagliari, 09042 Cagliari, Italy. [email protected]. 2. Gastroenterology, Department of Medical Sciences, Policlinico Universitario di Monserrato, University of Cagliari, 09042 Cagliari, Italy. 3. Thoracic Vascular Surgery, Department of Surgical Sciences, Policlinico Universitario di Monserrato, University of Cagliari, 09042 Cagliari, Italy. Abstract

Several studies have reported some efficacy of diets low in fermentable carbohydrates (Fermentable Oligo-, Di-, Monosaccharides and Polyols (FODMAPs)) in Irritable Bowel Syndrome (IBS). There is no evidence of its superiority compared to gluten-free and balanced diets in improving IBS patients' quality of life (QoL). The aim of this study is to assess whether different diets can improve QoL in IBS. Forty-two patients with IBS, according to Rome IV criteria, were enrolled. Low-FODMAP, gluten-free and balanced diets were proposed to each patient in the same succession. Each diet was followed for 4 weeks. The Bristol Stool Scale, the Visual Analogue Scale (VAS) for bloating and abdominal pain, and the SF12 questionnaire for health-related quality of life were applied at the beginning and at the end of each diet. Twenty-eight of the forty-two patients completed all the three diets. All the three diets reduced symptom severity (p < 0.01), bloating (p < 0.01) and abdominal pain (p < 0.01), and improved quality of life (p < 0.05); 3% of patients expressed a preference for the low-FODMAP diet, 11% for the gluten-free and 86% for the balanced diet (p < 0.01). The balanced diet improves QoL and VAS pain, provides an adequate quantity of FODMAPs and is more appreciated by patients. For these reasons, the balanced diet could be recommended to patients with irritable bowel syndrome.

Free Article PMID: 31336747 Similar articles

17. J Pediatr Gastroenterol Nutr. 2019 Jul 22. doi: 10.1097/MPG.0000000000002451. [Epub ahead of print] Celiac Dietary Adherence Test simplifies Determining Adherence to a Gluten-Free Diet in Swedish Adolescents.

Johansson K1, Norström F2, Nordyke K2, Myleus A1,2.

Author information: 1. Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden. 2. Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden.

Abstract

OBJECTIVES: The aims of the study were to ascertain whether the Celiac Dietary Adherence Test (CDAT) could contribute in determining adherence to a gluten-free diet in celiac disease patients and to evaluate the diet adherence and well-being of a study population five years after a celiac disease screening known as "Exploring the Iceberg of Celiacs in Sweden".

METHODS:

Through the screening, 90 adolescents (born 1997) were diagnosed with biopsy-proven celiac disease at twelve-years of age. Of them, 70 (78%) came to a five-year follow-up where anti-tissue transglutaminase antibodies 2 (TG2-IgA) was tested and a questionnaire was filled in, including CDAT, which consists of seven questions related to adherence. Non-parametrical tests were utilized to determine associations between adherence measures.

RESULTS:

Among the adolescents, 86% were adherent to a gluten-free diet five years after screening, 38% reported their general well-being as excellent, 50% very well, and 12% well. Statistically significant associations were seen between TG2-IgA and the CDAT score (p=0.033), and the self-reported adherence question and the CDAT score (p < 0.001).

CONCLUSIONS:

The screening-detected adolescents reported a high level of well-being and adherence to a gluten- free diet five years after screening. We conclude that the CDAT can be used in clinical practice as an estimation of adherence to a gluten-free diet. It would be most suitable to use in conjunction with currently used adherence measures, but can also be used as a stand-alone method when others are not accessible. PMID: 31335839 Similar articles

18. Front Nutr. 2019 Jul 5;6:101. doi: 10.3389/fnut.2019.00101. eCollection 2019. What Is Gluten-Why Is It Special?

Shewry P1.

Author information: 1. Rothamsted Research, Harpenden, Hertfordshire, United Kingdom.

Abstract

Wheat gluten has an immense impact on human nutrition as it largely determines the processing properties of wheat flour, and in particular the ability to make leavened breads, other baked products, pasta and noodles. However, there has been increasing interest in wheat gluten over the past two decades because of its well-established role in triggering coeliac disease, and its perceived role in other adverse reactions to wheat. The literature on wheat gluten is vast and extends back over two centuries, with most studies focusing on the structures of gluten proteins and their role in determining the functional properties of wheat flour and dough. This article provides a concise account of wheat gluten, focusing on properties, and features which are relevant to its role in triggering coeliac disease and, to a lesser extent, other gluten-related disorders. It includes descriptions of the biological role of the gluten proteins, the structures and relationships of gluten protein families, and the presence of related types of protein which may also contribute to functional properties and impacts on health. It therefore provides an understanding of the gluten protein system at the level required by those focusing on its impact on human health.

PMCID: PMC6625226 Free PMC Article PMID: 31334243 Similar articles

19. Front Nutr. 2019 Jul 3;6:98. doi: 10.3389/fnut.2019.00098. eCollection 2019. Lactic Fermentation as a Strategy to Improve the Nutritional and Functional Values of Pseudocereals.

Rollán GC1, Gerez CL1, LeBlanc JG1.

Author information: 1. Centro de Referencia para Lactobacilos (CERELA) - CONICET, San Miguel de Tucumán, Argentina.

Abstract

One of the greatest challenges is to reduce malnutrition worldwide while promoting sustainable agricultural and food systems. This is a daunting task due to the constant growth of the population and the increasing demands by consumers for functional foods with higher nutritional values. Cereal grains are the most important dietary energy source globally; wheat, rice, and maize currently provide about half of the dietary energy source of humankind. In addition, the increase of celiac patients worldwide has motivated the development of gluten-free foods using alternative flour types to wheat such as rice, corn, cassava, soybean, and pseudocereals (amaranth, quinoa, and buckwheat). Amaranth and quinoa have been cultivated since ancient times and were two of the major crops of the Pre-Colombian cultures in Latin- America. In recent years and due to their well- known high nutritional value and potential health benefits, these pseudocereals have received much attention as ideal candidates for gluten-free products. The importance of exploiting these grains for the elaboration of healthy and nutritious foods has forced food producers to develop novel adequate strategies for their processing. Fermentation is one of the most antique and economical methods of producing and preserving foods and can be easily employed for cereal processing. The nutritional and functional quality of pseudocereals can be improved by fermentation using Lactic Acid Bacteria (LAB). This review provides an overview on pseudocereal fermentation by LAB emphasizing the capacity of these bacteria to decrease antinutritional factors such as phytic acid, increase the functional value of phytochemicals such as phenolic compounds, and produce nutritional ingredients such as B-group vitamins. The numerous beneficial effects of lactic fermentation of pseudocereals can be exploited to design novel and healthier foods or grain ingredients destined to general population and especially to patients with coeliac disease.

PMCID: PMC6617224 Free PMC Article PMID: 31334241 Similar articles

20. J Proteome Res. 2019 Jul 23. doi: 10.1021/acs.jproteome.9b00314. [Epub ahead of print] Catcher of the rye - detection of rye, a gluten-containing grain, by LC-MS/MS.

Pasquali D, Blundell M, Howitt CA, Colgrave ML.

Abstract

Rye, wheat and barley contain gluten, proteins that trigger immune-mediated inflammation of the small intestine in people with coeliac disease (CD). The only treatment for CD is a lifelong gluten- free diet. To be classified as gluten-free by the World Health Organisation the gluten content must be below 20 mg/kg, but Australia has a more rigorous standard of no detectable gluten and not made from wheat, barley, rye or oats. The purpose of this study was to devise an LC-MS/MS method to detect rye in food. An MS-based assay could overcome some of the limitations of immunoassays, wherein antibodies often show cross-reactivity and lack specificity due to the diversity of gluten proteins in commercial food and the homology between rye and wheat gluten isoforms. Comprehensive proteomic analysis of 20 rye cultivars originating from 12 countries enabled the identification of a panel of candidate rye-specific peptide markers. The peptide markers were assessed in 16 cereal and pseudo-cereal grains, and in 10 breakfast cereals and 7 snacks foods. One of two spelt flours assessed was contaminated with rye at a level of 2% and trace levels of rye were found in a breakfast cereal that should be gluten-free based on its labelled ingredients. PMID: 31333027 Similar articles

21. Am J Clin Pathol. 2019 Jul 23. pii: aqz091. doi: 10.1093/ajcp/aqz091. [Epub ahead of print] Clinical and Histopathologic Predictors of Disaccharidase Deficiency in Duodenal Biopsy Specimens.

Reed RC1, Pacheco MC2,3,4.

Author information: 1. Department of Laboratory Medicine and Pathology, Children's Hospitals and Clinics of Minnesota, Minneapolis. 2. Department of Pathology, Microbiology & Immunology, Division of Pediatric Pathology, Vanderbilt University Medical Center, Nashville, TN. 3. Department of Laboratories, Seattle Children's Hospital, Seattle, WA. 4. Department of Pathology, University of Washington, Seattle.

Abstract

OBJECTIVES:

Disaccharidase (DS) activity in duodenal biopsy specimens is the gold standard for diagnosing DS deficiency. We investigated strategies to reduce the need for DS testing and whether clinical or histopathologic factors predict DS deficiency.

METHODS:

A retrospective chart review analyzed 1,678 DS results in children, biopsy indication(s), and duodenal histopathology.

RESULTS:

One or more DSs were abnormal in 42.8%. Sufficient lactase predicted sucrase, palatinase, and maltase sufficiency (negative predictive value 97.7%). Three patients had sucrase-isomaltase deficiency (0.2%). DS deficiency was more common in biopsy specimens for positive celiac serology (78.0%). Villous blunting, intraepithelial lymphocytosis, and active inflammation predicted DS deficiency; a combination of any two had an 81.4% positive predictive value.

CONCLUSIONS:

Utilization could be reduced by only testing cases with normal duodenal histopathology and ongoing clinical suspicion for DS deficiency after reviewing pathology. In cases with suspected celiac disease and/or mucosal injury, DS deficiency is common and likely secondary, limiting test utility. © American Society for Clinical Pathology, 2019. All rights reserved. For permissions, please e-mail: [email protected]. PMID: 31332425 Similar articles

22. Trends Mol Med. 2019 Jul 19. pii: S1471-4914(19)30126-1. doi: 10.1016/j.molmed.2019.05.009. [Epub ahead of print] Therapeutic and Diagnostic Implications of T Cell Scarring in Celiac Disease and Beyond.

Christophersen A1, Risnes LF1, Dahal-Koirala S1, Sollid LM2.

Author information: 1. KG Jebsen Coeliac Disease Research Centre, University of Oslo, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Norway; Department of Immunology, University of Oslo, Oslo, Norway. 2. KG Jebsen Coeliac Disease Research Centre, University of Oslo, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Norway; Department of Immunology, University of Oslo, Oslo, Norway; Department of Immunology, Oslo University Hospital, Oslo, Norway. Electronic address: [email protected].

Abstract

Few therapeutic and diagnostic tools specifically aim at T cells in autoimmune disorders, but are T cells a narrow target in these diseases? Lessons may be learned from celiac disease (CeD), one of the few autoimmune disorders where the T cell driving antigens are known, i.e. dietary gluten proteins. T cell clonotypes specific to gluten are expanded, persist for decades and express a distinct phenotype in CeD patients. Cells with this phenotype are increased also in other autoimmune conditions. Accordingly, disease-specific CD4+ T cells form an immunological scar in CeD and probably other autoimmune disorders. We discuss approaches how such T cells may be targeted for better treatment and diagnosis via their antigen specificity or via their expression of characteristic phenotypic markers.

Free Article PMID: 31331739 Similar articles

23. BMC Pediatr. 2019 Jul 22;19(1):247. doi: 10.1186/s12887-019-1564-x. Study of Environmental Enteropathy and Malnutrition (SEEM) in Pakistan: protocols for biopsy based biomarker discovery and validation.

Iqbal NT1,2, Syed S1,3, Sadiq K1, Khan MN3, Iqbal J1,2, Ma JZ4, Umrani F1, Ahmed S1, Maier EA5, Denson LA5, Haberman Y5, McNeal MM6, Setchell KDR7, Zhao X7, Qureshi S1, Shen L8, Moskaluk CA9, Liu TC10, Yilmaz O11,12, Brown DE13, Barratt MJ14, Kung VL14, Gordon JI14, Moore SR15, Ali SA16.

Author information: 1. Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan. 2. Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan. 3. Department of Pediatrics, University of Virginia, Charlottesville, VA, USA. 4. Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA. 5. Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 6. Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 7. Clinical Mass Spectrometry, Division of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 8. Department of Pediatrics, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Houston, TX, USA. 9. Department of Pathology, University of Virginia, Charlottesville, VA, USA. 10. Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA. 11. Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. 12. Koch Institute for Integrative Cancer Research at MIT and Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA. 13. Data Science Institute, University of Virginia, Charlottesville, VA, USA. 14. Center for Genome Sciences and Systems Biology, Washington University School of Medicine, St. Louis, MO, USA. 15. Department of Pediatrics, University of Virginia, Charlottesville, VA, USA. [email protected]. 16. Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan. [email protected].

Abstract

BACKGROUND: Environmental Enteropathy (EE), characterized by alterations in intestinal structure, function, and immune activation, is believed to be an important contributor to childhood undernutrition and its associated morbidities, including stunting. Half of all global deaths in children < 5 years are attributable to under-nutrition, making the study of EE an area of critical priority.

METHODS:

Community based intervention study, divided into two sub-studies, 1) Longitudinal analyses and 2) Biopsy studies for identification of EE features via omics analyses. Birth cohorts in Matiari, Pakistan established: moderately or severely malnourished (weight for height Z score (WHZ) < - 2) children, and well-nourished (WHZ > 0) children. Blood, urine, and fecal samples, for evaluation of potential biomarkers, will be collected at various time points from all participants (longitudinal analyses). Participants will receive appropriate educational and nutritional interventions; non-responders will undergo further evaluation to determine eligibility for further workup, including upper gastrointestinal endoscopy. Histopathological changes in duodenal biopsies will be compared with duodenal biopsies obtained from USA controls who have celiac disease, Crohn's disease, or who were found to have normal histopathology. RNA-Seq will be employed to characterize mucosal gene expression across groups. Duodenal biopsies, luminal aspirates from the duodenum, and fecal samples will be analyzed to define microbial community composition (omic analyses). The relationship between histopathology, mucosal gene expression, and community configuration will be assessed using a variety of bioinformatic tools to gain better understanding of disease pathogenesis and to identify mechanism-based biomarkers. Ethical review committees at all collaborating institutions have approved this study. All results will be made available to the scientific community.

DISCUSSION:

Operational and ethical constraints for safely obtaining intestinal biopsies from children in resource- poor settings have led to a paucity of human tissue-based investigations to understand and reverse EE in vulnerable populations. Furthermore, EE biomarkers have rarely been correlated with gold standard histopathological confirmation. The Study of Environmental Enteropathy and Malnutrition (SEEM) is designed to better understand the pathophysiology, predictors, biomarkers, and potential management strategies of EE to inform strategies to eradicate this debilitating pathology and accelerate progress towards the 2030 Sustainable Development Goals.

TRIAL REGISTRATION:

Retrospectively registered; clinicaltrials.gov ID NCT03588013 .

PMCID: PMC6643315 Free PMC Article PMID: 31331393 Similar articles

24. BMC Med. 2019 Jul 23;17(1):142. doi: 10.1186/s12916-019-1380-z. Celiac disease: a comprehensive current review.

Caio G1,2, Volta U3, Sapone A4,5, Leffler DA5,6, De Giorgio R7, Catassi C4,8, Fasano A4.

Author information: 1. Department of Medical Sciences, University of Ferrara, Via Aldo Moro 8, Cona, 44124, Ferrara, Italy. [email protected]. 2. Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA, 02114, USA. [email protected]. 3. Department of Medical and Surgical Sciences, University of Bologna, 40138, Bologna, Italy. 4. Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA, 02114, USA. 5. Takeda Pharmaceuticals International Co, Cambridge, MA, 02139, USA. 6. Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA, 02115, USA. 7. Department of Medical Sciences, University of Ferrara, Via Aldo Moro 8, Cona, 44124, Ferrara, Italy. 8. Department of Pediatrics, Center for Celiac Research, Università Politecnica delle Marche, 60121, Ancona, Italy.

Abstract

BACKGROUND:

Celiac disease remains a challenging condition because of a steady increase in knowledge tackling its pathophysiology, diagnosis, management, and possible therapeutic options.

MAIN BODY:

A major milestone in the history of celiac disease was the identification of tissue transglutaminase as the autoantigen, thereby confirming the autoimmune nature of this disorder. A genetic background (HLA-DQ2/DQ8 positivity and non-HLA genes) is a mandatory determinant of the development of the disease, which occurs with the contribution of environmental factors (e.g., viral infections and dysbiosis of gut microbiota). Its prevalence in the general population is of approximately 1%, with female predominance. The disease can occur at any age, with a variety of symptoms/manifestations. This multifaceted clinical presentation leads to several phenotypes, i.e., gastrointestinal, extraintestinal, subclinical, potential, seronegative, non-responsive, and refractory. Although small intestinal biopsy remains the diagnostic 'gold standard', highly sensitive and specific serological tests, such as tissue transglutaminase, endomysial and deamidated gliadin peptide antibodies, have become gradually more important in the diagnostic work-up of celiac disease. Currently, the only treatment for celiac disease is a life-long, strict gluten-free diet leading to improvement in quality of life, ameliorating symptoms, and preventing the occurrence of refractory celiac disease, ulcerative jejunoileitis, and small intestinal adenocarcinoma and lymphoma.

CONCLUSIONS:

The present review is timely and provides a thorough appraisal of various aspects characterizing celiac disease. Remaining challenges include obtaining a better understanding of still-unclear phenotypes such as slow-responsive, potential (minimal lesions) and seronegative celiac disease. The identification of alternative or complementary treatments to the gluten-free diet brings hope for patients unavoidably burdened by diet restrictions.

Free Article PMID: 31331324 Similar articles

25. Cells. 2019 Jul 19;8(7). pii: E751. doi: 10.3390/cells8070751. HLA-DQA1 and HLA-DQB1 Alleles, Conferring Susceptibility to Celiac Disease and Type 1 Diabetes, are More Expressed Than Non- Predisposing Alleles and are Coordinately Regulated.

Farina F1, Picascia S2, Pisapia L1, Barba P1, Vitale S2, Franzese A3, Mozzillo E3, Gianfrani C2, Del Pozzo G G4.

Author information: 1. Institute of Genetics and Biophysics "Adriano Buzzati Traverso"-CNR, 80131 Naples, Italy. 2. Institute of Biochemistry and Cell Biology-CNR, 80131 Naples, Italy. 3. Department of Translational Medical Science (DISMET), Section of Pediatrics, University of Naples Federico II, 80131 Naples, Italy. 4. Institute of Genetics and Biophysics "Adriano Buzzati Traverso"-CNR, 80131 Naples, Italy. [email protected].

Abstract

HLA DQA1*05 and DQB1*02 alleles encoding the DQ2.5 molecule and HLA DQA1*03 and DQB1*03 alleles encoding DQ8 molecules are strongly associated with celiac disease (CD) and type 1 diabetes (T1D), two common autoimmune diseases (AD). We previously demonstrated that DQ2.5 genes showed a higher expression with respect to non-CD associated alleles in heterozygous DQ2.5 positive (HLA DR1/DR3) antigen presenting cells (APC) of CD patients. This differential expression affected the level of the encoded DQ2.5 molecules on the APC surface and established the strength of gluten-specific CD4+ T cells response. Here, we expanded the expression analysis of risk alleles in patients affected by T1D or by T1D and CD comorbidity. In agreement with previous findings, we found that DQ2.5 and DQ8 risk alleles are more expressed than non-associated alleles also in T1D patients and favor the self-antigen presentation. To investigate the mechanism causing the high expression of risk alleles, we focused on HLA DQA1*05 and DQB1*02 alleles and, by ectopic expression of a single mRNA, we modified the quantitative equilibrium among the two transcripts. After transfection of DR7/DR14 B-LCL with HLA-DQA1*05 cDNA, we observed an overexpression of the endogenous DQB1*02 allele. The DQ2.5 heterodimer synthesized was functional and able to present gluten antigens to cognate CD4+ T cells. Our results indicated that the high expression of alpha and beta transcripts, encoding for the DQ2.5 heterodimeric molecules, was strictly coordinated by a mechanism acting at a transcriptional level. These findings suggested that, in addition to the predisposing HLA-DQ genotype, also the expression of risk alleles contributed to the establishment of autoimmunity.

Free Article PMID: 31331105 Similar articles

Conflict of interest statement

The authors have no conflicts of interest to declare. 26. Food Chem. 2019 Jul 16;300:125196. doi: 10.1016/j.foodchem.2019.125196. [Epub ahead of print] Development of a novel model dough based on mechanically activated cassava starch and gluten protein: Application in bread.

Liu R1, Sun W2, Zhang Y3, Huang Z4, Hu H5, Zhao M5, Li W5.

Author information: 1. School of Chemistry and Chemical Engineering, Guangxi University, Nanning 530004, China; College of Light Industry and Food Engineering, Guangxi University, Nanning 530004, China; Institute of Electromechanical and Quality Technology Engineering, Nanning University, Nanning 530200, China. 2. College of Light Industry and Food Engineering, Guangxi University, Nanning 530004, China. 3. School of Chemistry and Chemical Engineering, Guangxi University, Nanning 530004, China. Electronic address: [email protected]. 4. School of Chemistry and Chemical Engineering, Guangxi University, Nanning 530004, China. Electronic address: [email protected]. 5. School of Chemistry and Chemical Engineering, Guangxi University, Nanning 530004, China.

Abstract

This study focused on the development of a novel model dough for leavened food production, which was obtained by blending gluten protein with damaged cassava starch (DCS) induced by mechanical activation (MA). The characteristics of model dough and the interaction between DCS and gluten were investigated, and the quality of bread made from the model dough was also evaluated. The results showed that both the addition of gluten and the increased damage of DCS could improve the strength of model dough. The damage of cassava starch prevented the formation of gluten network. The enhanced DCS-gluten interaction had an impact on the performance of dough, attributing to the interaction of hydrogen bonds between both of them. Moderate interaction was required to obtain the bread with desired quality, and MA for moderating structural damage to starch was an effective approach in promoting the interaction between starch and gluten protein.

27. J Vasc Surg. 2019 Jul 18. pii: S0741-5214(19)30352-0. doi: 10.1016/j.jvs.2019.01.078. [Epub ahead of print] Juxtarenal endovascular therapy with fenestrated and branched stent grafts after previous infrarenal repair.

Sveinsson M1, Kristmundsson T2, Dias N3, Sonesson B3, Mani K4, Wanhainen A4, Resch T3.

Author information: 1. Department of Vascular Surgery, Helsingborg Regional Hospital, Helsingborg, Sweden; Vascular Center, Skåne University Hospital Malmö, Malmö, Sweden. Electronic address: [email protected]. 2. Vascular Center, Skåne University Hospital Malmö, Malmö, Sweden. 3. Vascular Center, Skåne University Hospital Malmö, Malmö, Sweden; Department of Clinical Sciences, Lund University, Lund, Sweden. 4. Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.

Abstract BACKGROUND:

The treatment strategy for proximal aortic disease or type I endoleak after previous infrarenal repair has traditionally been open surgery. As endovascular treatment options with fenestrated and branched stent grafts increasingly rival open surgery for juxtarenal and pararenal aortic aneurysms, secondary proximal repair may similarly be performed endovascularly. Fenestrated stent grafts are individually tailored to each patient, whereas a more readily available "off-the-shelf" branched stent graft is often suitable in more urgent settings.

METHODS:

All patients who had been reoperated on with a proximal fenestrated or branched cuff after previous infrarenal endovascular or open repair from two tertiary referral centers between 2002 and 2015 were included in the analysis. Patients were retrospectively enrolled in a digital database. Data were collected from chart review and digital imaging.

RESULTS:

There were 43 patients, 37 (86%) male and six (14%) female, who were treated. The indications for proximal endovascular repair were type I endoleak (58%), proximal aneurysm formation (30%), and stent graft migration (12%). Median follow-up time was 33 months (range, 3-120 months); 34 patients (79%) received a fenestrated cuff, and branched stent grafts were used in 8 (19%) cases. The majority of grafts had three (47%) or four (49%) fenestrations or branches. Technical success was accomplished in 93% of cases. In two cases, the celiac trunk occluded; in one case, the hepatic artery was overstented, and a renal artery could not be cannulated in one case. Median hospital stay was 5 days (range, 2-57 days). The 30-day mortality was 0%, and 1-year mortality was 5%. One patient died of an aneurysm-related cause during the study period.

CONCLUSIONS:

An endovascular approach with fenestrated or branched stent grafts for treatment of proximal endoleak, proximal aneurysm formation, or pseudoaneurysms after previous infrarenal repair seems to be a valid alternative to open surgery.

28. Transfus Apher Sci. 2019 Jul 9. pii: S1473-0502(19)30144-2. doi: 10.1016/j.transci.2019.06.034. [Epub ahead of print] Anti tissue transglutaminase antibody in idiopathic autoimmune haemolytic anemia.

Ghosh K1, Ghosh K2, Agarwal R3, Shah K4, Mishra K4.

Author information: 1. Surat Raktadan Kendra & Research Centre, Udhna Magdalla Road, Nr. Chosath Joganio Mata Temple, Surat 395002, Gujarat, India; Department of Clinical Biochemistry, Tata Medical Centre, Parel, Mumbai 400012, India; Jerbai Wadia Children Hospital, Parel, Mumbai 400012, India. Electronic address: [email protected]. 2. Department of Clinical Biochemistry, Tata Medical Centre, Parel, Mumbai 400012, India. 3. Jerbai Wadia Children Hospital, Parel, Mumbai 400012, India. 4. Surat Raktadan Kendra & Research Centre, Udhna Magdalla Road, Nr. Chosath Joganio Mata Temple, Surat 395002, Gujarat, India; Department of Clinical Biochemistry, Tata Medical Centre, Parel, Mumbai 400012, India; Jerbai Wadia Children Hospital, Parel, Mumbai 400012, India.

Abstract

BACKGROUND:

In idiopathic autoimmune haemolytic anaemia (AIHA haemolytic antibodies are directed to every type of red cellsWestern blot studies have shown antibody positivity towards red cell anion channel complex which also includes band 4.2 a protein with similarities to tissue trans glutaminase.

OBJECTIVE:

Evaluation of AIHA for anti tissue transglutaminase antibody (Anti tTG).

MATERIALS & METHODS:

Twenty three AIHA patients were tested along with routine hamatogical work up, for a series of auto antibodies and red cell eluates and serum from the patents were tested against solubilised group O red cell ghosts on western blot. Other ancillary investigations were done to rule out complications and secondary causes of haemolysis.

RESULTS:

11/23 patients (48%) were positive for anti tTG, Four, 3 and 8,7 patients were positive for anti thyroid, anti b2 glycoprotein, lupus anticoagulant and ANA respectively. One patient with anti tTG had biopsy proven celiac disease. Three patient developed DVT and all of them were lupus anticoagulant as well as b2 gp-1 antibody positive.17 had become Coombs test negative on treatment while 21/23 had positive western blot test. DISCUSSION & CONCLUSION:

There is strong association of anti tTG antibody with idiopathic AIHA. Aetiological association of this finding needs exploration.

29. J Gastrointest Surg. 2019 Jul 19. doi: 10.1007/s11605-019-04324-8. [Epub ahead of print] Efficacy of Neoadjuvant Chemotherapy in Distal Pancreatectomy with En Bloc Celiac Axis Resection (DP-CAR) for Locally Advanced Pancreatic Cancer.

Yoshiya S1,2, Fukuzawa K3, Inokuchi S4,3, Kosai-Fujimoto Y4,3, Sanefuji K3, Iwaki K3, Motohiro A3, Itoh S4, Harada N4, Ikegami T4, Yoshizumi T4, Mori M4.

Author information: 1. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan. [email protected]. 2. Department of Surgery, Oita Red Cross Hospital, Oita, Japan. [email protected]. 3. Department of Surgery, Oita Red Cross Hospital, Oita, Japan. 4. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan.

Abstract

BACKGROUNDS:

Distal pancreatectomy with en bloc celiac axis resection (DP-CAR) is an extended surgical procedure for patients with locally advanced cancer of the pancreatic body and tail. Recently, the usability of neoadjuvant chemotherapy (NAC) in pancreatic cancer was reported. The purpose of this study was to clarify the impact of NAC on surgical outcomes and prognosis in DP-CAR patients.

METHODS: This study retrospectively reviewed 20 consecutive patients who underwent DP-CAR at a single institution.

RESULTS:

Eleven of 20 patients (55.0%) received NAC. Their first regimens were gemcitabine (GEM) plus nab- PTX (n = 7, 63.6%), GEM plus S-1 (n = 3, 27.3%), and GEM (n = 1, 9.1%). Although two patients converted to a second regimen, none abandoned NAC due to adverse effects or could not undergo a planned procedure for disease progression. There were no significant differences in intraoperative variables, morbidity, including pancreatic fistula and delayed gastric emptying, and mortality between patients with and without NAC; however, patients with NAC had a significantly lower proportion of arterial invasion (p = 0.025), lymphatic invasion (p < 0.0001), and vascular invasion (p = 0.035). There were no significant differences in the induction rate of adjuvant chemotherapy (p = 0.201). The recurrence-free survival and overall survival rates in patients with NAC were significantly higher than in patients without NAC (p = 0.041 and p = 0.018, respectively).

CONCLUSION:

DP-CAR following NAC was associated with a preferable prognosis and had no negative effect on surgical outcomes. Therefore, NAC in DP-CAR patients might be a beneficial and safe therapeutic strategy. PMID: 31325134 Similar articles

30. BMC Pediatr. 2019 Jul 19;19(1):243. doi: 10.1186/s12887-019-1621-5. Survey of the initial management of celiac disease antibody tests by ordering physicians.

Potter K1, de Koning L2,3, Butzner JD1, Gidrewicz D4,5.

Author information: 1. Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada. 2. Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada. 3. Calgary Laboratory Services Calgary, Calgary, Alberta, Canada. 4. Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada. [email protected]. 5. Division of Pediatric Gastroenterology, Alberta Children's Hospital, 2888 Shaganappi Trail, Calgary, AB, T3B 6A8, Canada. [email protected]. Abstract

BACKGROUND:

Appropriate interpretation of a positive celiac antibody test by an ordering physician is important in order to institute proper management. We evaluated why children with an initial positive celiac serology were not referred for diagnostic biopsy or followed with serial testing by the ordering physician.

METHODS:

Consecutive celiac serologies in all patients less than 18 years of age were evaluated over 3.5 years and 775 children with a positive tissue transglutaminase antibody (TTG) were identified. If no management of a positive TTG could be identified, a survey was sent to the ordering physician. Responses were categorized as appropriate or inappropriate management.

RESULTS:

Of the 775 patients with a positive TTG, 193 (24.9%, 95% CI 21.9-28.1%) received no follow-up management. We contacted 173 ordering physicians and 120 (69%) responded. Of the 120 responses, 55 patients (45.8%, 95% CI 36.8-55.1%) were managed appropriately and 46 (38.3%, 95% CI 29.7-47.7%) were considered to be inappropriately managed when no repeat TTG was obtained within 18 months. Reasons for inappropriate management included: screen considered to be false positive (44.7%), patient was not experiencing symptoms of celiac disease (31.6%), symptoms had resolved (15.8%), results were not indicative of celiac disease (26.3%) and patients started a gluten- free diet with no evaluation of response (15.8%). In 19 patients the TTG was not acted upon for technical reasons.

CONCLUSIONS:

Positive TTGs require appropriate interventions. These include: subspecialist referral for further evaluation and/or repeat testing to evaluate: 1) treatment response or 2) patients with minimal or no symptoms.

PMCID: PMC6639898 Free PMC Article PMID: 31324159 Similar articles

31. Molecules. 2019 Jul 18;24(14). pii: E2623. doi: 10.3390/molecules24142623. Content of Phenolic Compounds and Antioxidant Activity of New Gluten-Free Pasta with the Addition of Chestnut Flour.

Oniszczuk A1, Widelska G2, Wójtowicz A3, Oniszczuk T3, Wojtunik-Kulesza K4, Dib A5, Matwijczuk A6.

Author information: 1. Department of Inorganic Chemistry, Medical University of Lublin, Chodźki 4a, 20-093 Lublin, Poland. [email protected]. 2. Department of Inorganic Chemistry, Medical University of Lublin, Chodźki 4a, 20-093 Lublin, Poland. 3. Department of Thermal Technology and Food Process Engineering, University of Life Sciences in Lublin, Głęboka 31, 20-612 Lublin, Poland. 4. Department of Inorganic Chemistry, Medical University of Lublin, Chodźki 4a, 20-093 Lublin, Poland. [email protected]. 5. Laboratoire de Nutrition et Technologie Alimentaire, Institut de la Nutrition, de l'Alimentation et des Technologies Agro-Alimentaires, Université des Frères Mentouri, Constantine 1 25000, Algeria. 6. Department of Biophysics, University of Life Sciences in Lublin, Akademicka 13, 20-950 Lublin, Poland.

Abstract

Chestnut fruit abounds in carbohydrates, proteins, unsaturated fatty acids, fiber, polyphenolic compounds, as well as vitamins and micronutrients, that are behind the health-promoting properties of this plant. The purpose of the discussed research was to obtain innovative gluten-free pasta from rice and field bean flour enriched with a various addition of chestnut flour. Regarding the studied pasta, the following were determined: the content of free phenolic acids, total polyphenols, and antioxidant properties. Chromatographic analysis (HPLC-ESI-MS/MS (high-performance liquid chromatography-electrospray ionization tandem mass spectrometry)) revealed a wide variety of phenolic acids. In a sample with 20% and higher content of chestnut flour, as many as 13 acids were detected. Isoferulic acid prevailed. The total content of free phenolic acids and total polyphenols increased along with the increasing chestnut content. Moreover, in most cases, the content of individual acids increased with the addition of chestnut flour. Besides, the antioxidant activity was positively correlated with the addition of chestnut fruit flour, the content of free phenolic acids, and total polyphenols. Our research has demonstrated that our innovative gluten-free pasta, with the addition of chestnut flour, has a potential to be a source of polyphenolic compounds, including free phenolic acids, that are valuable for human health.

Free Article PMID: 31323897 Similar articles

32. Food Chem. 2019 Nov 30;299:125161. doi: 10.1016/j.foodchem.2019.125161. Epub 2019 Jul 9. Quinoa protein: Composition, structure and functional properties.

Dakhili S1, Abdolalizadeh L1, Hosseini SM1, Shojaee-Aliabadi S2, Mirmoghtadaie L3.

Author information: 1. Department of Food Science and Technology, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2. Department of Food Science and Technology, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: [email protected]. 3. Department of Food Science and Technology, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: [email protected].

Abstract

Quinoa (Chenopodium quinoa willd.) is an annual herbaceous flowering plant showing appropriate nutritional and functional properties due to its high quality protein with a wide amino acid spectrum, particularly rich in lysine. The mature quinoa seed predominantly consists of 11S-type globulin called chenopodin, comprising about 37% of the total protein, and also 2S albumin accounting for 35% of the seed protein both stabilized through disulfide bridges. Moreover, quinoa seed contains low concentration of prolamins (0.5-7% of total protein) making it suitable for patients with celiac disease. Different enzymatic, chemical and physical modification methods also can influence the structural and finally nutritional and functional properties of protein isolate. Consequently, considering appropriate nutritional and functional properties of quinoa protein, it can be considered as a good candidate to supply human food products.

33. J Am Coll Nutr. 2019 Jul 19:1-10. doi: 10.1080/07315724.2019.1616003. [Epub ahead of print] Nutritional Intake and Bone Health Among Adults With Probable Undiagnosed, Untreated Celiac Disease: What We Eat in America and NHANES 2009-2014.

Sattgast LH1, Gallo S1, Frankenfeld CL2, Moshfegh AJ3, Slavin M1.

Author information: 1. a Department of Nutrition & Food Studies , George Mason University , Fairfax , Virginia , USA. 2. b Department of Global & Community Health , George Mason University , Fairfax , Virginia , USA. 3. c Food Surveys Research Group, Agricultural Research Service, U.S. Department of Agriculture , Beltsville , Maryland , USA.

Abstract

Objective: The aim was to evaluate differences in nutritional intake of calcium, vitamin D, and phosphorus; serologic indices of these nutrients; and bone health among adults with and without probable, undiagnosed celiac disease (CD). Method: Cross-sectional data from What We Eat in America and the National Health and Nutrition Examination Survey 2009-2014 including self- reported dietary and supplement intake from one day of 24-hour recalls, serologic indicators, and dual x-ray absorptiometry scans were analyzed in adults with probable undiagnosed CD, who tested positive on the immunoglobulin A endomysial antibody assay (n = 48) and controls (n = 13,634). Statistical analysis included multiple linear regression modeling controlled for age, sex, race/ethnicity, energy intake, and poverty income ratio. Results: The prevalence of probable undiagnosed CD was 1 in 285. Probable CD status was associated with a 251.6 mg (95% confidence interval [CI], 72.3-432.9) higher daily total calcium intake. The total dietary and supplement intake of those with probable CD was significantly higher in calcium density (103.4 mg/1,000 kcal; 95% CI, 25.6-181.1) and phosphorus density (46.7 mg/1,000 kcal; 95% CI, 3.1-90.3). Probable CD status was associated with higher dairy consumption by 0.7 cups per day (95% CI, 0.2-1.2) and higher serum phosphorus concentrations (4.0 mg/dL vs 3.8 mg/dL, p = 0.011). No differences in serum calcium, vitamin D, or alkaline phosphatase levels were observed between groups. Probable CD status was also associated with a -0.1 g/cm2 (95% CI, -0.2 to -0.0) lower femur bone mineral density (BMD) and a -0.1 g/cm2 (95% CI, -0.1 to -0.0) lower femoral neck BMD. No differences in total spine BMD were observed. Conclusions: Adults with probable undiagnosed CD had lower bone density than adults without CD, despite also reporting higher total calcium intake and nutritional density of both calcium and phosphorus. PMID: 31322483 Similar articles 34. Curr Allergy Asthma Rep. 2019 Jul 18;19(9):40. doi: 10.1007/s11882-019-0871-5. Genetic and Environmental Contributors for Celiac Disease.

Serena G1, Lima R2, Fasano A2.

Author information: 1. Center for Celiac Research, Mucosal Immunology and Biology Research Center and Division of Pediatric Gastroenterology and Nutrition, Massachusetts General Hospital, 55 Fruit Street, Jackson BLDG, RM 1402, Boston, MA, 02114, USA. [email protected]. 2. Center for Celiac Research, Mucosal Immunology and Biology Research Center and Division of Pediatric Gastroenterology and Nutrition, Massachusetts General Hospital, 55 Fruit Street, Jackson BLDG, RM 1402, Boston, MA, 02114, USA.

Abstract

PURPOSE OF REVIEW:

Celiac disease (CD) is an autoimmune enteropathy triggered by gluten. The purpose of this review is to examine the major genetic and environmental factors that contribute to CD pathogenesis.

RECENT FINDINGS:

We reviewed the current state of knowledge on the genetic and environmental components that play a role in CD onset. A genome-wide association study (GWAS) analysis has highlighted several genes other than HLA involved in CD. Recent studies have shown that HLA haplotype influences the microbiome composition in infants and that dysbiosis in the intestinal microflora, in turn, contributes to loss of tolerance to gluten. Recently, observational studies have discussed the hypothesis stating that breast-feeding had a protective role against CD onset. CD etiology is influenced by genetic and environmental factors. A better understanding of these components would deepen our knowledge on the mechanisms that lead to loss of tolerance and could help in developing a more "personalized medicine." PMID: 31321608 Similar articles

35. Oncotarget. 2019 Jul 8;10(43):4492-4500. doi: 10.18632/oncotarget.27037. eCollection 2019 Jul 8. Cystic fibrosis transmembrane conductance regulator (CFTR) and autophagy: hereditary defects in cystic fibrosis versus gluten- mediated inhibition in celiac disease.

Maiuri L1,2, Raia V3, Piacentini M4,5, Tosco A3, Villella VR2, Kroemer G6,7,8,9,10,11,12.

Author information: 1. Department of Health Sciences, University of Eastern Piedmont, Novara, Italy. 2. European Institute for Research in Cystic Fibrosis, San Raffaele Scientific Institute, Milan, Italy. 3. Department of Translational Medical Sciences, Pediatric Unit, Regional Cystic Fibrosis Center, Federico II University Naples, Naples, Italy. 4. Department of Biology, University of Rome "Tor Vergata", Rome, Italy. 5. National Institute for Infectious Diseases, IRCCS 'L. Spallanzani', Rome, Italy. 6. Equipe 11 labellisée Ligue Nationale contre le Cancer, Centre de Recherche des Cordeliers, Paris, France. 7. INSERM U1138, Centre de Recherche des Cordeliers, Paris, France. 8. Université Paris Descartes/Paris V, Sorbonne Paris Cité, Paris, France. 9. Metabolomics and Cell Biology Platforms, Institut Gustave Roussy, Villejuif, France. 10. Pôle de Biologie, Hôpital Européen Georges Pompidou, AP-HP, Paris, France. 11. Department of Women's and Children's Health, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden. 12. Suzhou Institute for Systems Medicine, Chinese Academy of Sciences, Suzhou, China.

Abstract

Cystic Fibrosis (CF) is the most frequent lethal monogenetic disease affecting humans. CF is characterized by mutations in cystic fibrosis transmembrane conductance regulator (CFTR), a chloride channel whose malfunction triggers the activation of transglutaminase-2 (TGM2), as well as the inactivation of the Beclin-1 (BECN1) complex resulting in disabled autophagy. CFTR inhibition, TGM2 activation and BECN1 sequestration engage in an 'infernal trio' that locks the cell in a pro- inflammatory state through anti-homeostatic feedforward loops. Thus, stimulation of CFTR function, TGM2 inhibition and autophagy stimulation can be used to treat CF patients. Several studies indicate that patients with CF have a higher incidence of celiac disease (CD) and that mice bearing genetically determined CFTR defects are particularly sensitive to the enteropathogenic effects of the orally supplied gliadin (a gluten-derived protein). A gluten/gliadin-derived peptide (P31-43) inhibits CFTR in mouse intestinal epithelial cells, causing a local stress response that contributes to the immunopathology of CD. In particular, P31-43-induced CFTR inhibition elicits an epithelial stress response perturbing proteostasis. This event triggers TGM2 activation, BECN1 sequestration and results in molecular crosslinking of CFTR and P31-43 by TGM2. Importantly, stimulation of CFTR function with a pharmacological potentiator (Ivacaftor), which is approved for the treatment of CF, could attenuate the autophagy-inhibition and pro-inflammatory effects of gliadin in preclinical models of CD. Thus, CD shares with CF a common molecular mechanism involving CFTR inhibition that might respond to drugs that intercept the "infernal trio". Here, we highlight how drugs available for CF treatment could be repurposed for the therapy of CD.

PMCID: PMC6633896 Free PMC Article

PMID: 31321000 Similar articles

Conflict of interest statement

CONFLICTS OF INTEREST No potential conflicts of interest were disclosed. A patent application by LM is pending (filing date, July 26, 2017. N° 102017000085714). 36. J Clin Densitom. 2019 Jul 2. pii: S1094-6950(19)30082-4. doi: 10.1016/j.jocd.2019.06.005. [Epub ahead of print] Celiac Disease and Its Role in the Development of Metabolic Bone Disease.

Micic D1, Rao VL2, Semrad CE2.

Author information: 1. Department of Internal Medicine, Section of Gastroenterology, Hepatology and Nutrition, University of Chicago, Chicago, IL, USA. Electronic address: [email protected]. 2. Department of Internal Medicine, Section of Gastroenterology, Hepatology and Nutrition, University of Chicago, Chicago, IL, USA.

Abstract

Celiac disease (CD) is an immune-mediated enteropathy that occurs in genetically susceptible hosts with the ingestion of gluten-containing products. Ongoing gluten consumption leads to intestinal damage, characterized by villous blunting and increased intraepithelial lymphocytes, resulting in malabsorption. Pertinent to the development of bone disease, malabsorption of calcium and vitamin D leads to secondary hyperparathyroidism and metabolic bone disease among individuals with CD. In this article, we review the pathogenesis of CD and the effects of malabsorption on bone health. Imbalances in bone resorption and formation particularly in individuals with CD and persistent disease activity ultimately lead to a state of bone loss and impaired mineralization. Initiation of a gluten-free diet is critical in the management of CD-related metabolic bone disease, demonstrating improvements in bone mineral density within the first year of dietary adherence.

37. Soft Matter. 2019 Aug 14;15(30):6160-6170. doi: 10.1039/c9sm00966c. Epub 2019 Jul 18. Phase separation dynamics of gluten protein mixtures.

Banc A1, Pincemaille J2, Costanzo S1, Chauveau E1, Appavou MS3, Morel MH4, Menut P5, Ramos L1.

Author information: 1. Laboratoire Charles Coulomb (L2C), Univ. Montpellier, CNRS, Montpellier, France. [email protected]. 2. Laboratoire Charles Coulomb (L2C), Univ. Montpellier, CNRS, Montpellier, France. [email protected] and Ingénierie des Agro-polymères et Technologies Emergentes (IATE), Univ. Montpellier, CIRAD, INRA, Montpellier SupAgro, Montpellier, France. 3. Forschungszentrum Jülich GmbH, Jülich Centre for Neutron Science (JCNS) at Heinz Maier-Leibnitz Zentrum (MLZ) Lichtenbergstr. 1, 85748 Garching, Germany. 4. Ingénierie des Agro-polymères et Technologies Emergentes (IATE), Univ. Montpellier, CIRAD, INRA, Montpellier SupAgro, Montpellier, France. 5. Ingénierie des Agro-polymères et Technologies Emergentes (IATE), Univ. Montpellier, CIRAD, INRA, Montpellier SupAgro, Montpellier, France and Ingénierie Procédés Aliments, AgroParisTech, INRA, Université Paris-Saclay, Massy, France.

Abstract

We investigate by time-resolved synchrotron ultra-small X-ray scattering the dynamics of liquid- liquid phase-separation (LLPS) of gluten protein suspensions following a temperature quench. Samples at a fixed concentration (237 mg ml-1) but with different protein compositions are investigated. In our experimental conditions, we show that fluid viscoelastic samples depleted in polymeric glutenin phase-separate following a spinodal decomposition process. We quantitatively probe the late stage coarsening that results from a competition between thermodynamics that speeds up the coarsening rate as the quench depth increases and transport that slows down the rate. For even deeper quenches, the even higher viscoelasticity of the continuous phase leads to a "quasi" arrested phase separation. Anomalous phase-separation dynamics is by contrast measured for a gel sample rich in glutenin, due to elastic constraints. This work illustrates the role of viscoelasticity in the dynamics of LLPS in protein dispersions. PMID: 31317157 Similar articles

38. United European Gastroenterol J. 2019 Jul;7(6):767-781. doi: 10.1177/2050640619841249. Epub 2019 Mar 27. Vegetarian or gluten-free diets in patients with inflammatory bowel disease are associated with lower psychological well- being and a different gut microbiota, but no beneficial effects on the course of the disease.

Schreiner P1, Yilmaz B2, Rossel JB3, Franc Y3, Misselwitz B1, Scharl M1, Zeitz J4, Frei P5, Greuter T1, Vavricka SR6, Pittet V3, Siebenhüner A7, Juillerat P8, von Känel R9, Macpherson AJ2, Rogler G1, Biedermann L1; Swiss IBD Cohort Study Group.

Author information: 1. Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland. 2. Maurice Müller Laboratories (Department for Biomedical Research), University Clinic of Visceral Surgery and Medicine, University of Bern, Bern, Switzerland. 3. Institute of Social and Preventive Medicine, University of Lausanne, Lausanne, Switzerland. 4. Center of Gastroenterology, Klinik Hirslanden, Zurich, Switzerland. 5. Bethanien, Department of Gastroenterology, Zurich, Switzerland. 6. Center of Gastroenterology and Hepatology, Zurich, Switzerland. 7. Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland. 8. Gastroenterology, University Clinic of Visceral Surgery and Medicine, Inselspital Bern University Hospital, Bern, Switzerland. 9. Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland.

Abstract

Background:

Many inflammatory bowel disease (IBD) patients follow a restrictive diet due to perceived positive effects on their symptoms. We assessed the prevalence of vegetarian (VD) and gluten-free diets (GFDs) in IBD patients, the reasons for following such a diet, and whether nutrition has an impact on disease activity and microbiota composition.

Methods:

We included 1254 patients from the Swiss Inflammatory Bowel Disease Cohort Study with prospective acquisition of clinical data and psychosocial, disease-related and lifestyle factors between 2006 and 2015. Dietary habits were assessed through a self-report questionnaire. In 92 patients, we analysed intestinal mucosa-associated microbial composition using high-throughput sequencing.

Results:

Overall, 4.1% (n = 52) of the patients reported following a VD and 4.7% (n = 54) a GFD. No differences regarding disease activity, fistula, hospitalization or surgery rates were observed. Patients on a VD or GFD had significantly higher levels of post-traumatic stress symptoms. Furthermore, GFD patients had significantly higher anxiety and depression symptom levels. The gut microbiota composition in IBD patients following a VD or GFD was significantly different compared to that of omnivores.

Conclusions:

Although we did not identify a relevant impact of a specific diet on the course of the disease, there was a significant association with lower psychological well-being in VD and GFD patients.

PMCID: PMC6620875 Free PMC Article PMID: 31316781 Similar articles

39. World J Surg Oncol. 2019 Jul 17;17(1):124. doi: 10.1186/s12957-019-1667-8. Is hepatic artery coil embolization useful in distal pancreatectomy with en bloc celiac axis resection for locally advanced pancreatic cancer?

Ueda A1, Sakai N2, Yoshitomi H1, Furukawa K1, Takayashiki T1, Kuboki S1, Takano S1, Suzuki D1, Kagawa S1, Mishima T1, Nakadai E1, Miyazaki M3, Ohtsuka M1.

Author information: 1. Department of General Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan. 2. Department of General Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan. [email protected]. 3. Surgery and Digestive Disease Center, International University of Health and Welfare, Mita Hospital, Tokyo, Japan. Abstract

BACKGROUND:

The exact contribution of preoperative coil embolization in distal pancreatectomy with en bloc celiac axis resection (DP-CAR) for the prevention of ischemic liver complication is not fully elucidated.

METHODS:

From January 2004 to July 2015, 31 patients underwent DP-CAR for the pancreatic body-tail cancer. Twenty-three patients received preoperative coil embolization. The characteristics and operative outcomes were analyzed retrospectively.

RESULTS:

The median survival time and 1- and 3-year overall survival rates were 23.7 months and 74.2% and 34.4%, respectively. No 30-day mortality occurred in any of the patients. Postoperative liver infarction developed only in 8 patients (25.8%) even though 7 of 8 patients had undergone preoperative coil embolization. Tumor contact with the gastroduodenal artery (GDA)/proper hepatic artery (PHA) on preoperative multi-detector computed tomography (MDCT), tumor size, operative time, portal vein resection, and stenosis of the GDA/PHA after DP-CAR are related to liver infarction. Among them, postoperative stenosis of the GDA/PHA on MDCT, which was observed in all 8 patients with liver infarction, was the most closely related factor to postoperative liver infarction. Tumor contact with the GDA/PHA did not worsen the R0 resection rate or overall survival rate.

CONCLUSION:

Our data indicate that preoperative coil embolization of the common hepatic artery is not useful in DP-CAR as long as GDA is completely preserved during surgery.

PMCID: PMC6637588 Free PMC Article PMID: 31315628 Similar articles

40. Indian J Gastroenterol. 2019 Jul 17. doi: 10.1007/s12664-019-00970-7. [Epub ahead of print] Celiac disease in the East and the West: Bridging the gaps between the guidelines and their implementation in daily practice is mandatory.

Dhawan A1, Agarwal A1, Mulder CJ2, Makharia GK3.

Author information: 1. Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, 110 029, India. 2. Department of Gastroenterology, Amsterdam University Medical Centre, Amsterdam, The Netherlands. 3. Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, 110 029, India. [email protected]. PMID: 31313236 Similar articles

41. Expert Opin Drug Discov. 2019 Jul 16:1-12. doi: 10.1080/17460441.2019.1642321. [Epub ahead of print] Challenges to drug discovery for celiac disease and approaches to overcome them.

Vaquero L1, Bernardo D2,3, León F4, Rodríguez-Martín L1,5, Alvarez-Cuenllas B1, Vivas S1,5.

Author information: 1. a Gastroenterology Unit , University Hospital of León , León , Spain. 2. b Mucosal Immunology lab , IBGM (University of Valladolid-CSIC) , Valladolid , Spain. 3. c Gut Immunology Research Lab , Instituto de Investigación Sanitaria Princesa (IIS-IP) & Centro de Investigación Biomédica en Red de Enfermdades Hepáticas y Digestivas (CIBEREHD) , Madrid , Spain. 4. d Celimmune , Bethesda , EE.UU. 5. e Institute of Biomedicina (IBIOMED), University of León , León , Spain.

Abstract

Introduction: The only available effective treatment for celiac disease (CD) is strict and long-term compliance with a gluten-free diet. Dietary gluten restriction must be strict and long term, but is difficult to achieve in many cases and alternative dietary strategies have been investigated in the past few years. Areas covered: This review highlights the progress that has been made in the development of new therapeutics for CD. Detailed information is provided on the targets of drugs for CD as their related mechanisms of action. The therapies are classified in five mechanisms: modification of gluten, intraluminal therapies, immunomodulation, intestinal permeability and modulation of adaptative response. The actual development phase and future approach are also described and discussed. Expert opinion: There are several limitations in each of the treatment targets related either through complications or the lack of complete response to a normal gluten containing diet. It is clear that the most desired therapy for celiac patients would induce gluten tolerance and progress has been made as per the treatments described herein. Therefore, it is shortly expected that curative or complimentary tools to a gluten free diet will be available that will improve the quality of life of CD sufferers. PMID: 31311347 Similar articles

42. Medicina (Kaunas). 2019 Jul 15;55(7). pii: E373. doi: 10.3390/medicina55070373. Hematologic Manifestations in Celiac Disease-A Practical Review.

Balaban DV1,2, Popp A3,4,5, Ionita Radu F6,7, Jinga M3,6.

Author information: 1. "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania. [email protected]. 2. Gastroenterology Department, "Dr. Carol Davila" Central Military Emergency University Hospital, 010825 Bucharest, Romania. [email protected]. 3. "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania. 4. Pediatrics Department, "Alessandrescu-Rusescu" National Institute for Mother and Child Health, 020395 Bucharest, Romania. 5. Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, 33100 Tampere, Finland. 6. Gastroenterology Department, "Dr. Carol Davila" Central Military Emergency University Hospital, 010825 Bucharest, Romania. 7. Faculty of Medicine, Titu Maiorescu University, 004051 Bucharest, Romania.

Abstract

Celiac disease (CD) is a systemic autoimmune disease driven by gluten-ingestion in genetically predisposed individuals. Although it primarily affects the small bowel, CD can also involve other organs and manifest as an extraintestinal disease. Among the extraintestinal features of CD, hematologic ones are rather frequent and consist of anemia, thrombocytosis (thrombocytopenia also, but rare), thrombotic or hemorrhagic events, IgA deficiency, hyposplenism, and lymphoma. These hematologic alterations can be the sole manifestation of the disease and should prompt for CD testing in a suggestive clinical scenario. Recognition of these atypical, extraintestinal presentations, including hematologic ones, could represent a great opportunity to increase the diagnostic rate of CD, which is currently one of the most underdiagnosed chronic digestive disorders worldwide. In this review, we summarize recent evidence regarding the hematological manifestations of CD, with focus on practical recommendations for clinicians.

Free Article PMID: 31311098 Similar articles

43. J Agric Food Chem. 2019 Jul 25. doi: 10.1021/acs.jafc.9b02728. [Epub ahead of print] Gradients of Gluten Proteins and Free Amino Acids along the Longitudinal Axis of the Developing Caryopsis of Bread Wheat.

Shi Z1,2, Wang Y2, Wan Y2, Hassall K3, Jiang D1, Shewry PR2, Hawkesford MJ2.

Author information: 1. National Technology Innovation Center for Regional Wheat Production, Key Laboratory of Crop Physiology, and Ecology and Production in Southern China, Ministry of Agriculture, National Engineering and Technology Center for Information Agriculture , Nanjing Agricultural University , Nanjing 210095 , P.R. China. 2. Plant Sciences Department , Rothamsted Research , Harpenden , Hertfordshire AL5 2JQ , U.K. 3. Computational and Analytical Sciences Department , Rothamsted Research , Harpenden , Hertfordshire AL5 2JQ , U.K.

Abstract

Gradients in the contents and compositions of gluten proteins and free amino acids and the expression levels of gluten protein genes in developing wheat caryopses were determined by dividing the caryopsis into three longitudinal sections, namely, proximal (En1), middle (En2), and distal (En3) to embryo. The total gluten protein content was lower in En1 than in En2 and En3, with decreasing proportions of HMW-GS, LMW GS, and α/β- and γ-gliadins and increasing proportions of ω-gliadins. These differences were associated with the abundances of gluten protein transcripts. Gradients in the proportions of the gluten protein polymers which affect dough processing quality also occurred, but not in total free amino acids. Microscopy showed that the lower gluten protein content in En1 may have resulted, at least in part, from the presence of modified cells in the dorsal part of En1, but the reasons for the differences in composition are not known. PMID: 31310118 Similar articles

44. Clin Transl Sci. 2019 Jul 15. doi: 10.1111/cts.12668. [Epub ahead of print] SiRNA Targeting and Treatment of Gastrointestinal Diseases.

Chevalier R1,2.

Author information: 1. Children's Mercy Kansas City, Kansas City, MO. 2. University of Missouri-Kansas City School of Medicine, Kansas City, MO.

Abstract

RNA interference via siRNA offers opportunities to precisely target genes that contribute to gastrointestinal pathologies such as inflammatory bowel disease, celiac, and esophageal scarring. Delivering the siRNA to the GI tract proves challenging as the harsh environment of the intestines degrades the siRNA before it can reach its target or blocks its entry into its site of action in the cytoplasm. Additionally, the GI tract is large and disease is often localized to specific site. This review discusses polymer and lipid based delivery systems for protection and targeting of siRNA therapies to the GI tract to treat local disease. This article is protected by copyright. All rights reserved.

45. Clin Exp Gastroenterol. 2019 Jul 4;12:303-319. doi: 10.2147/CEG.S210060. eCollection 2019. Potential risk factors for celiac disease in childhood: a case-control epidemiological survey.

Bittker SS1, Bell KR2.

Author information: 1. Interdisciplinary Center for Innovative Theory and Empirics (INCITE), Columbia University, New York, New York, US. 2. Ontario College of Teachers , Toronto, Ontario, Canada. Abstract

Background: Celiac disease (CD) prevalence has increased significantly in recent decades in some developed countries. Yet the environmental factors in the existing literature do not appear to provide a satisfactory explanation for this increase. Objective: To determine whether nine variables are associated with CD in children. These variables are: incidence of ear infection before 2 years old, courses of antibiotics before 2 years old, duration of breastfeeding, vitamin D drop exposure in infancy, vitamin D supplement exposure between 2-3 years old, age at gluten introduction into the diet, fat content of cow's milk consumed between 2-3 years old, quantity of cow's milk consumed between 2-3 years old, and type of water consumed at 2 years old. Methods: An Internet-based survey was conducted among parents living in the US with at least one biological child between 3 and 12 years old. Potential participants were informed about the survey through social media, websites, electronic newsletters, and advertisements. Results: After exclusions, there remained 332 responses associated with children with CD (cases), and 241 responses associated with children who do not have CD (controls). In this data set, skim milk as the primary form of liquid cow's milk consumed between 2-3 years old (adjusted odds ratio [aOR]=3.556, CI=1.430-10.22, P=0.010), vitamin D drops administered for more than 3 months (aOR=1.749, CI=1.079-2.872, P=0.025), courses of antibiotics (aOR=1.133, CI=1.037-1.244, P=0.007), and incidence of ear infection (aOR=1.183, CI=1.041-1.348, P=0.010) are all associated with CD in children. Conclusions: This study is the first to find an association between skim milk consumption and CD and vitamin D drop use for greater than 3 months and CD. It also adds to evidence that early life exposure to antibiotics and early life infection, specifically ear infection, are associated with CD.

PMCID: PMC6615019 Free PMC Article PMID: 31308721 Similar articles

Conflict of interest statement

The authors report no conflicts of interest in this work. 46. Enzyme Microb Technol. 2019 Oct;129:109356. doi: 10.1016/j.enzmictec.2019.05.013. Epub 2019 May 27. Efficient production of gluten hydrolase Kuma030 in E. coli by hot acid treatment without chromatography.

Liu H1, Fan X1, Song H1, Hu X1, Zhang G1, Yu C2, Yi L3.

Author information: 1. State Key Laboratory of Biocatalysis and Enzyme Engineering, Hubei Engineering Research Center for Bio-Enzyme Catalysis, Hubei Key Laboratory of Industrial Biotechnology, Hubei Collaborative Innovation Center for Green Transformation of Bio-Resources, College of Life Sciences, Hubei University, No. 368 Youyi Road, Wuchang District, Wuhan, 430062, China. 2. State Key Laboratory of Biocatalysis and Enzyme Engineering, Hubei Engineering Research Center for Bio-Enzyme Catalysis, Hubei Key Laboratory of Industrial Biotechnology, Hubei Collaborative Innovation Center for Green Transformation of Bio-Resources, College of Life Sciences, Hubei University, No. 368 Youyi Road, Wuchang District, Wuhan, 430062, China. Electronic address: [email protected]. 3. State Key Laboratory of Biocatalysis and Enzyme Engineering, Hubei Engineering Research Center for Bio-Enzyme Catalysis, Hubei Key Laboratory of Industrial Biotechnology, Hubei Collaborative Innovation Center for Green Transformation of Bio-Resources, College of Life Sciences, Hubei University, No. 368 Youyi Road, Wuchang District, Wuhan, 430062, China. Electronic address: [email protected].

Abstract

Kumamolisin from Alicyclobacillus sendaiensis strain NTAP-1 is a serine protease with collagenase activity. After molecular engineering, a kumamolisin mutant, named Kuma030, was obtained with high proteolytic activity against gluten, which might cause celiac disease. Kuma030 exhibited its potential application in industrial and medicine, while challenges remained of its large-scale purification and production. In the studies here, we successfully overexpressed the Kuma030 in E. coli BL21 (DE3) by anchoring a SUMO (Small Ubiquitin-like Modifier) fusion protein at its N-terminal end. In addition, a fast protein purification procedure was developed according to the acidophilic and thermophilic properties of Alicyclobacillus sendaiensis. After a simple acid treatment followed by a heat treatment, a total of 9.9 mg functional Kuma030 was quickly obtained form 1 L LB media culture. This purified Kuma030 was confirmed to be functional to cleave the PQ sequences in a designed protein substrate, and the gluten in actual food samples, such as whole wheat bread and beer, in a fast manner. Our studies provided an efficient strategy for the overexpression and purification of functional Kuma030 in E. coli, which might expand its broad practical applications.

47. Int J Immunogenet. 2019 Aug;46(4):276-277. doi: 10.1111/iji.12428. Response to Letter to the Editor: Relevance of HLA-DQB1*02 allele in predisposing to coeliac disease.

Bajor J1, Szakács Z2, Vincze Á1. Author information: 1. Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary. 2. Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary. PMID: 31304681 Similar articles

48. Surg Radiol Anat. 2019 Jul 13. doi: 10.1007/s00276-019-02286-9. [Epub ahead of print] Unusual anatomical variation: tetrafurcation of the celiac trunk.

Grigoriță L1, Damen NS2, Vaida MA3, Jianu AM1.

Author information: 1. Department of Anatomy and Embryology, "Victor Babeş" University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041, Timisoara, Romania. 2. Pediatric Surgery Clinic of Emergency Children's Hospital "Louis Țurcanu", Doctor Iosif Nemoianu 2, 300011, Timisoara, Romania. 3. Department of Anatomy and Embryology, "Victor Babeş" University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041, Timisoara, Romania. [email protected].

Abstract

The celiac trunk is one of the main sources of vascularization of the supracolic abdominal compartment. It arises from the abdominal aorta, at the level of T12-L1 vertebrae and classically branches into the splenic artery, common hepatic artery, and left gastric artery. We report here an atypical branching pattern of the celiac trunk, found during the dissection of a 60-year-old female's formalin-fixed cadaver. The atypically celiac trunk gave rise to four branches: a common trunk for left and right inferior phrenic arteries, an accessory left gastric artery, the common hepatic artery, and a splenogastric trunk. Knowledge in detail about normal anatomy and variation in the branching pattern of the celiac trunk is important in surgical, oncological, and radiological interventional procedures and must be taken into account to avoid possible complications. PMID: 31302730 Similar articles

49. Lupus. 2019 Jul 12:961203319860580. doi: 10.1177/0961203319860580. [Epub ahead of print] Lupus anticoagulant remission after gluten- free diet in a coeliac pregnant woman.

Tabacco S1, Garufi C2, Giannini A1, Lanzone A3, Benedetti Panici P1, Rizzo F3, Salvi S3, De Carolis S3.

Author information: 1. 1 Department of Gynaecology Obstetrics and Urology, 'Sapienza' University of Rome, Italy. 2. 2 Lupus Clinic, 'Sapienza' University of Rome, Italy. 3. 3 Department of Obstetrics, Gynaecology and Pediatrics, F. Policlinico Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy. PMID: 31299883 Similar articles

50. Thorac Cancer. 2019 Jul 10. doi: 10.1111/1759-7714.13144. [Epub ahead of print] Should the clinical significance of supraclavicular and celiac lymph node metastasis in thoracic esophageal cancer be reevaluated?

Wen J1,2, Chen D3, Zhao T4, Chen J1,2, Zhao Y4, Liu D1,2, Wang W4, Xu X1,2, Fan M1,2, Chen C3, Chen Y4.

Author information: 1. Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China. 2. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China. 3. Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China. 4. Department of Thoracic Surgery, The Second Affiliated Hospital of Soochow University, Medical College of Soochow University, Suzhou, China.

Abstract

BACKGROUND:

Lower thoracic esophageal cancer (LTEC) with celiac node metastasis and upper thoracic esophageal cancer (UTEC) with supraclavicular node metastasis were previously categorized as M1a diseases. Our study aimed to investigate whether the clinical significance of supraclavicular and celiac lymph node metastasis should be reevaluated in thoracic esophageal cancer.

METHODS:

A total of 6178 patients with thoracic esophageal cancer were identified from the Surveillance, Epidemiology, and End Results (SEER) database during 2004-2015. Treatment strategies and outcomes (OS, overall survival; CSS, cancer-specific survival) of patients with different nodal status were reviewed. The Cox proportional hazards regression model was applied to evaluate the prognostic factors. Statistical analyses were performed in all subgroups.

RESULTS:

Multivariate analysis identified supraclavicular node metastasis but not celiac node metastasis as an independent predictor of both OS and CSS in LTEC. However, metastasis to supraclavicular or celiac nodes was not an independent predictor of OS and CSS in UTEC. Surgery was not associated with increased OS and CSS for UTEC with celiac or supraclavicular node metastasis but was favored as a predictor of better OS and CSS for LTEC with celiac or supraclavicular node metastasis. Radiotherapy benefited OS and CSS in LTEC involving celiac or supraclavicular nodes and in UTEC involving celiac nodes, while only OS benefited from radiotherapy in UTEC involving supraclavicular nodes.

CONCLUSIONS:

These results provide preliminary evidence that the clinical significance of supraclavicular and celiac lymph node metastasis should be reevaluated in thoracic esophageal cancer with different prognostic information according to the primary sites.

© 2019 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd. PMID: 31293066 Similar articles 51. Sci Rep. 2019 Jul 10;9(1):10020. doi: 10.1038/s41598-019-46468-2. Combined Analysis of Methylation and Gene Expression Profiles in Separate Compartments of Small Bowel Mucosa Identified Celiac Disease Patients' Signatures. Cielo D1,2, Galatola M3,4, Fernandez-Jimenez N5, De Leo L6, Garcia-Etxebarria K5, Loganes C6, Tommasini A6, Not T5,6, Auricchio R1,2, Greco L1,2, Bilbao JR5.

Author information: 1. Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy. 2. European Laboratory for the Investigation of Food Induced Diseases (ELFID), University of Naples "Federico II", Naples, Italy. 3. Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy. [email protected]. 4. European Laboratory for the Investigation of Food Induced Diseases (ELFID), University of Naples "Federico II", Naples, Italy. [email protected]. 5. Department of Genetics, Physical Anthropology and Animal Physiology, University of the Basque Country (UPV-EHU), BioCruces Health Research Institute, Leioa, Spain. 6. Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy.

Abstract

By GWAS studies on celiac disease, gene expression was studied at the level of the whole intestinal mucosa, composed by two different compartments: epithelium and lamina propria. Our aim is to analyse the gene-expression and DNA methylation of candidate genes in each of these compartments. Epithelium was separated from lamina propria in biopsies of CeD patients and CTRs using magnetic beads. Gene-expression was analysed by RT-PC; methylation analysis required bisulfite conversion and NGS. Reverse modulation of gene-expression and methylation in the same cellular compartment was observed for the IL21 and SH2B3 genes in CeD patients relative to CTRs. Bioinformatics analysis highlighted the regulatory elements in the genomic region of SH2B3 that altered methylation levels. The cREL and TNFAIP3 genes showed methylation patterns that were significantly different between CeD patients and CTRs. In CeD, the genes linked to inflammatory processes are up-regulated, whereas the genes involved in the cell adhesion/integrity of the intestinal barrier are down-regulated. These findings suggest a correlation between gene-expression and methylation profile for the IL21 and SH2B3 genes. We identified a "gene-expression phenotype" of CeD and showed that the abnormal response to dietary antigens in CeD might be related not to abnormalities of gene structure but to the regulation of molecular pathways.

PMCID: PMC6620355 Free PMC Article PMID: 31292504 Similar articles

52. Nutr Hosp. 2019 Jul 11. doi: 10.20960/nh.02633. [Epub ahead of print] [Analysis of the gluten-free menus served in school canteens: are they balanced?]

[Article in Spanish] García Soto L1, Martín-Masot R1, Nestares MT2, Maldonado J1.

Author information: 1. Hospital Universitario Virgen de las Nieves. 2. Departamento de Fisiología. Universidad de Granada.

Abstract

INTRODUCTION AND OBJECTIVES:

the alimentary profile and the nutritional value of the menus adapted for coeliacs in the dining halls of the schools of Granada capital and Metropolitan Area.

MATERIAL AND METHODS:

descriptive study in which we analyzed the menus adapted for children from 41 schools, 5 with their own kitchen and 36 supplied by catering. The information is recognized through the technical sheets of the dishes made with the quantity of each food, in addition to the brands of the gluten-free products. The four-week menus will be analyzed in terms of the distribution of rations, energy, macro and micronutrients for the age group of 10 to 12 years, obtaining average values and standard deviation of 31 parameters. The Odimet program and the CeliacBase database are used. The data will be analyzed using the IBM SPSS 22.0 statistical program.

RESULTS:

gluten-free pasta was the basis of the first course in 31.7% of the menus analyzed. In the second dish, the meat was the main constituent. In all the menus, at least one daily vegetable ration was offered. 80% of the menus did not reach the recommended energy intake, although the distribution of macronutrients was adequate. The average amount of fiber and total carbohydrates was higher than recommended. The amount of calcium and vitamin has not been recommended. It emphasizes a high consumption of sodium, which doubles the amount recommended for the midday meal.

CONCLUSIONS:

school menus adapted for children conform to the recommendations, although they should be limited to intake.

Free Article PMID: 31291737 Similar articles

53. Rev Paul Pediatr. 2019 Jul 4. pii: S0103-05822019005013107. doi: 10.1590/1984- 0462/;2019;37;4;00014. [Epub ahead of print] ADOLESCENT GLUTEN INTAKE: POPULATION- BASED STUDY IN A BRAZILIAN CITY.

[Article in English, Portuguese] Assumpção D1, Capitani CD1, Rocha AC1, Barros MBA1, Barros Filho AA1.

Author information: 1. Universidade Estadual de Campinas, Campinas, SP, Brazil.

Abstract

OBJECTIVE:

To estimate the prevalence of gluten intake according to demographic, socioeconomic, and health- related behavioral variables in adolescents.

METHODS:

This is a population-based cross-sectional study with a two-stage cluster sampling, conducted in Campinas, São Paulo, in 2008-2009. Foods containing gluten were identified using a 24-hour Recall. We calculated the prevalence and adjusted prevalence ratios with multiple Poisson regression.

RESULTS:

The study had a sample of 924 adolescents aged 10 to 19 years. Among the foods assessed, 26.9% (confidence interval of 95% - 95%CI 25.3-28.6) contained gluten. We found a higher prevalence of gluten intake in younger individuals (10 to 14 years), as well as in subgroups of adolescents who had a higher number of household appliances, attended school, consumed fewer beans and vegetables during the week (<4 times), and whose head of the family had better education level (≥12 years of schooling). The main food sources of gluten in their diet were: bread, cakes, and cereals (30.2%), chocolate milk (14%), chicken nuggets (12.3%), and cookies (11%).

CONCLUSIONS:

The results of the study show the epidemiological profile associated with gluten intake in adolescents and could support actions aimed at promoting healthy eating habits and preventing gluten-related diseases.

Free Article PMID: 31291446 Similar articles

54. Saudi Med J. 2019 Jul;40(7):647-656. doi: 10.15537/smj.2019.7.24293. Celiac disease in type 1 diabetes mellitus in the Kingdom of Saudi Arabia. Characterization and meta-analysis.

Safi MA1.

Author information: 1. Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdul-Aziz University, Jeddah, Kingdom of Saudi Arabia. E-mail. [email protected].

Abstract

To characterize and meta-analyze the pertinent studies concerning celiac disease (CD) among patients with type 1 diabetes mellitus (T1DM) in the Kingdom of Saudi Arabia. Methods: Data (from the relevant articles) were analyzed using both the Statistical Package for Social Sciences, version 20 (IBM Corp., Armonk, NY, USA) program and the comprehensive meta-analysis (CMA) program. This study was conducted between March and July 2018 at King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia. Written ethical approval was not obtained because this study was a retrospective literature review and analysis. Results: The prevalence of seropositive-CD was 15.88% with high heterogeneity (I2=84.0), while the prevalence of biopsy-proven CD was 12% with high heterogeneity (I2=82.7). Anti-transglutaminase was used in 7 of the 8 studies; alone in 4; with endomysial antibodies in 2; and with antigliadin antibodies (AGA) in one. In the remaining study, antireticulin antibodies was used with AGA. The age of the involved patients ranged from 8 months to 50 years old. Conclusion: The prevalence of biopsy-proven CD among T1DM patients in Kingdom of Saudi Arabia (12.0%) was double the global prevalence (6.0%), and much higher than the normal Saudi population (1.4%). The female-to-male ratio (2:1) of CD patients in T1DM was the same as in the normal population in Kingdom of Saudi Arabia. No significant difference was detected between the reported serologically-proven rates and the reported biopsy-proven rates (p=0.093).

Free Article PMID: 31287124 Similar articles

55. BMC Med. 2019 Jul 9;17(1):125. doi: 10.1186/s12916-019-1360-3. Landmark models to define the age-adjusted risk of developing stage 1 type 1 diabetes across childhood and adolescence.

Hoffmann VS1, Weiß A1, Winkler C1,2, Knopff A1, Jolink M1,2, Bonifacio E3,4,5, Ziegler AG6,7,8.

Author information: 1. Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstaedter Landstr. 1, 85764, Munich-Neuherberg, Germany. 2. Forschergruppe Diabetes e.V. at Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany. 3. Forschergruppe Diabetes e.V. at Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany. [email protected]. 4. Technische Universität Dresden, DFG Center for Regenerative Therapies Dresden, Fetscherstrasse 105, 01307, Dresden, Germany. [email protected]. 5. Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital Carl Gustav Carus and Faculty of Medicine, Dresden, TU, Germany. [email protected]. 6. Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstaedter Landstr. 1, 85764, Munich-Neuherberg, Germany. anette- [email protected]. 7. Forschergruppe Diabetes e.V. at Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany. [email protected]. 8. Forschergruppe Diabetes, Technical University Munich at Klinikum rechts der Isar, Munich, Germany. [email protected].

Abstract

BACKGROUND:

Autoimmune diseases are often preceded by an asymptomatic autoantibody-positive phase. In type 1 diabetes, the detection of autoantibodies to pancreatic islet antigens in genetically at-risk children is prognostic for future clinical diabetes. Testing for islet autoantibodies is, therefore, performed in a range of clinical studies. Accurate risk estimates that consider the a priori genetic risk and other risk modifiers are an important component of screening. The age of an individual is an under- appreciated risk modifier. The aim of this study was to provide age-adjusted risk estimates for the development of autoantibodies across childhood in genetically at-risk children.

METHODS:

The prospective BABYDIAB and BABYDIET studies included 2441 children from birth who had a first- degree relative with type 1 diabetes. Children were born between 1989 and 2006 and were regularly followed from birth for the development of islet autoantibodies and diabetes. A landmark analysis was performed to estimate the risk of islet autoantibodies at birth and at the age 3.5, 6.5 and 12.5 years. Exponential decay curves were fitted for the risk by the age of 20 years.

RESULTS:

The risk of islet autoantibodies by the age of 20 years was 8%, 4.6%, 2.6% and 0.9%, at the landmark ages of birth, 3.5, 6.5 and 12.5 years, respectively. The short-term risks (within 6 years of follow-up) at these landmark ages were 5.3%, 2.9%, 1.8% and 1%, respectively. The decline in autoantibody risk with age was modelled using a one-phase exponential decay curve (r = 0.99) with a risk half-life of 3.7 years. This risk decay model was remarkably consistent when the outcome was defined as islet autoantibody-positive or multiple islet autoantibody-positive and when the study cohort was stratified by HLA risk genotype. A similar decay model was observed for coeliac disease-associated transglutaminase antibodies in the same cohort. Unlike the risk of developing islet autoantibodies, the rate of developing clinical diabetes in children who were islet autoantibody-positive did not decline with age.

CONCLUSION:

The risk of developing autoantibodies drops exponentially with age in children with a first-degree relative with type 1 diabetes.

PMCID: PMC6615150 Free PMC Article PMID: 31286933 Similar articles

56. Proc Natl Acad Sci U S A. 2019 Jul 23;116(30):15134-15139. doi: 10.1073/pnas.1901561116. Epub 2019 Jul 8. Efficient T cell-B cell collaboration guides autoantibody epitope bias and onset of celiac disease.

Iversen R1,2, Roy B2, Stamnaes J3,2, Høydahl LS3,2, Hnida K2, Neumann RS3,2, Korponay-Szabó IR4, Lundin KEA3,5, Sollid LM1,2.

Author information: 1. KG Jebsen Coeliac Disease Research Centre, University of Oslo, NO-0372 Oslo, Norway; [email protected] [email protected]. 2. Department of Immunology, Oslo University Hospital, NO-0372 Oslo, Norway. 3. KG Jebsen Coeliac Disease Research Centre, University of Oslo, NO-0372 Oslo, Norway. 4. Celiac Disease Center, Heim Pál National Pediatric Institute, HU-1089 Budapest, Hungary. 5. Department of Gastroenterology, Oslo University Hospital, NO-0372 Oslo, Norway.

Abstract

B cells play important roles in autoimmune diseases through autoantibody production, cytokine secretion, or antigen presentation to T cells. In most cases, the contribution of B cells as antigen- presenting cells is not well understood. We have studied the autoantibody response against the enzyme transglutaminase 2 (TG2) in celiac disease patients by generating recombinant antibodies from single gut plasma cells reactive with discrete antigen domains and by undertaking proteomic analysis of anti-TG2 serum antibodies. The majority of the cells recognized epitopes in the N- terminal domain of TG2. Antibodies recognizing C-terminal epitopes interfered with TG2 crosslinking activity, and B cells specific for C-terminal epitopes were inefficient at taking up TG2-gluten complexes for presentation to gluten-specific T cells. The bias toward N-terminal epitopes hence reflects efficient T-B collaboration. Production of antibodies against N-terminal epitopes coincided with clinical onset of disease, suggesting that TG2-reactive B cells with certain epitope specificities could be the main antigen-presenting cells for pathogenic, gluten-specific T cells. The link between B cell epitopes, antigen presentation, and disease onset provides insight into the pathogenic mechanisms of a T cell-mediated autoimmune condition. PMID: 31285344 Similar articles

Conflict of interest statement

The authors declare no conflict of interest. 57. J AOAC Int. 2019 Jul 8. doi: 10.5740/jaoacint.19-0094. [Epub ahead of print] Quantification of Wheat, Rye, and Barley Gluten in Oat and Oat Products by ELISA RIDASCREEN® Total Gluten: Collaborative Study, First Action 2018.15.

Lacorn M1, Weiss T1, Wehling P2, Arlinghaus M2, Scherf K3.

Author information: 1. R-Biopharm AG, An der neuen Bergstraße 17, Darmstadt 64297, Germany. 2. Medallion Labs, 9000 Plymouth Avenue North, Minneapolis, MN 55427. 3. Leibniz-Institute for Food Systems Biology at the Technical University of Munich, Lise-Meitner Str 34, Freising 85354, Germany. Abstract

Background: Since its introduction to the analytical community, the R5 method to quantify gluten led to a strong improvement of the situation for the food industry and celiac patients. During recent years, some questions arose on the use of the Codex Alimentarius factor of two to convert from prolamins to gluten, an overestimation of rye and barley, inadequate detection of glutelins, and the inhomogeneous distribution of gluten in oats. These limitations of the R5 method, especially when measuring oat samples, led to AOAC Standard Method Performance Requirement (SMPR®) 2017.021, which was approved by stakeholders in 2017. Objective: We present a collaborative study of a method for the quantitative analysis of wheat, rye, and barley gluten in oat and oat products using a sandwich ELISA that is based on four different monoclonal antibodies including the R5 monoclonal anitbody. Methods: The sandwich ELISA detects intact gliadins and related prolamins from rye and barley, high-molecular-weight (HMW) glutenin subunits (GS) from wheat, HMW secalins from rye, and low-molecular-weight (LMW) GS from wheat. It does not detect D-hordeins from barley. Samples are extracted by Cocktail solution, subsequently followed by 80% ethanol, and analyzed within 50 min. Results: The measurement range is between 5 and 80 mg/kg gluten using a calibrator made out of a gluten extract from four different wheat cultivars. The results of the collaborative test with 19 participating laboratories showed recoveries ranging from 99 to 137% for all three grain sources. Relative reproducibility SDs for samples >10 mg/kg gluten ranged from 10 to 53%. Conclusions: The collaborative study results confirmed that the method is accurate and suitable to measure gluten from all three grain sources and has demonstrated performance on oat matrices, which meets the criteria as specified in SMPR 2017.021. Data from in-house validation experiments are available as Annex B to this publication. PMID: 31284896 Similar articles

58. Food Chem. 2019 Nov 30;299:125051. doi: 10.1016/j.foodchem.2019.125051. Epub 2019 Jun 20. A multi-spectroscopic study on the interaction of food polyphenols with a bioactive gluten peptide: From chemistry to biological implications.

Dias R1, Brás NF2, Pérez-Gregorio M1, Fernandes I1, Mateus N1, Freitas V3.

Author information: 1. QUINOA-LAQV/REQUIMTE, Departamento de Química e Bioquímica, Faculdade de Ciências da Universidade do Porto, Porto, Portugal. 2. UCIBIO/REQUIMTE, Departamento de Química e Bioquímica, Faculdade de Ciências da Universidade do Porto, Porto, Portugal. 3. QUINOA-LAQV/REQUIMTE, Departamento de Química e Bioquímica, Faculdade de Ciências da Universidade do Porto, Porto, Portugal. Electronic address: [email protected].

Abstract

This study aims to exploit the molecular and cellular mechanisms concerning the functionality of dietary polyphenols (catechin, procyanidin B3, procyanidin C2, epigallocatechin and epigallocatechin gallate) in a nutritional context to prevent Celiac Disease (CD). In that sense, the interaction between the main CD bioactive peptide (32-mer peptide) and some polyphenols was fully characterized at the intestinal level under near physiological conditions by means of different spectroscopic techniques and dynamic simulations. Accordingly, it is proposed that the primarily polyphenol-binding sites on the 32-mer peptide correspond to leucine, tyrosine and phenylalanine containing domains being this interaction entropy-driven. Although procyanidin B3 and trimer C2 had a similar low-affinity constant at 310 K, both procyanidins were able to reduce the 32-mer peptide apical-to-basolateral translocation in in vitro simulated intestinal epithelial barrier thus prospecting the occurrence of additional and still unexplored regulatory mechanisms by which dietary polyphenols might modulate the transepithelial transport of CD bioactive peptides.

59. Clin Nucl Med. 2019 Jul 5. doi: 10.1097/RLU.0000000000002693. [Epub ahead of print] 18F-Fluciclovine Uptake in Celiac Ganglia: A Pitfall in Prostate Cancer PET Imaging.

Wo S1, Matesan MC.

Author information: 1. From the Department of Radiology, University of Washington, Seattle, WA.

Abstract

We present 4 cases of patients who underwent F-fluciclovine PET for prostate cancer demonstrating physiologic uptake in the celiac ganglia, which could be mistaken for metastatic lymphadenopathy if the celiac ganglia have a nodular configuration and uptake higher than bone marrow. Uptake in celiac, cervical, and sacral ganglia has been reported previously as an important pitfall in Ga-PSMA- HBED-CC PET for prostate cancer. In our patients, only celiac ganglion uptake was visualized. Advances in PET scanner technology may cause physiologic uptake of F-fluciclovine in celiac ganglia to become more visually distinguishable from muscular uptake in adjacent diaphragmatic crura. PMID: 31283598

Similar articles

60. J Agric Food Chem. 2019 Jul 17;67(28):7886-7897. doi: 10.1021/acs.jafc.9b01015. Epub 2019 Jul 8. Role of Gluten in Surface Chemistry: Nanometallic Bioconjugation of Hard, Medium, and Soft Wheat Protein.

Mandial D1, Khullar P1, Gupta V2, Kumar H3, Singh N4, Ahluwalia GK5, Bakshi MS6.

Author information: 1. Department of Chemistry , B.B.K. D.A.V. College for Women , Amritsar 143005 , Punjab , India. 2. Department of Biotechnology , DAV College , Amritsar 143005 , Punjab , India. 3. Department of Chemistry , Dr. B. R. Ambedkar National Institute of Technology , Jalandhar 144011 , Punjab , India. 4. Department of Food Science and Technology , Guru Nanak Dev University , Amritsar 143005 , Punjab , India. 5. Nanotechnology Research Laboratory , College of North Atlantic , Labrador City , NL A2V 2K7 , Canada. 6. Department of Chemistry, Natural and Applied Sciences , University of Wisconsin - Green Bay , 2420 Nicolet Drive , Green Bay , Wisconsin 54311-7001 , United States.

Abstract

Hard, medium, and soft wheat proteins, based on gluten content, were studied for their important roles in nanometallic surface chemistry. In situ synthesis of Au nanoparticles (NPs) was followed to determine the surface adsorption behavior of wheat protein based on the gluten contents. A greater amount of gluten contents facilitated the nucleation to produce Au NPs. X-ray photoelectron spectroscopy (XPS) surface analysis clearly showed the surface adsorption of protein on nanometallic surfaces which was almost equally prevalent for the hard, medium, and soft wheat proteins. Wheat protein conjugated NPs were highly susceptible to phase transfer from aqueous to organic phase that was entirely related to the amount of gluten contents. The presence of higher gluten content in hard wheat protein readily enabled the hard wheat protein conjugated NPs to move across the aqueous-organic interface followed by medium and soft wheat protein conjugated NPs. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS page) analysis allowed us to determine molar masses of nanometallic surface adsorbed protein fractions. Only two protein fractions of high molar masses (74 and 85 kDa) from SDS solubilized hard, medium, and soft wheat proteins preferred to adsorb on nanometallic surfaces out of more than 15 protein fractions of pure wheat protein. This made the surface adsorption of wheat protein highly selective and closely related to gluten content. Cetyltrimethylammonium bromide (CTAB) solubilized wheat protein conjugated NPs demonstrated their strong antimicrobial activities against both Gram negative and Gram positive bacteria making them suitable for their applications in food industry.

PMID: 31283218 Similar articles

61. Frontline Gastroenterol. 2019 Jul;10(3):222-228. doi: 10.1136/flgastro-2018-101088. Epub 2018 Oct 15. Are gluten-free food staples accessible to all patients with coeliac disease?

Hanci O1, Jeanes YM2.

Author information: 1. Department of Paediatrics, Royal Surrey County Hospital, Guildford, UK. 2. Department of Life Sciences, Health Sciences Research Centre, University of Roehampton, London, UK.

Abstract

Introduction:

Within England the removal of prescribed gluten-free (GF) foods from many Clinical Commissioning Groups has resulted in a greater reliance on commercially available GF food by adults and children with coeliac disease (CD). High cost and limited availability of GF foods are associated with poorer dietary adherence in people with CD.

Aim:

To assess if the rise in popularity of GF diets globally has improved the cost or availability of cereal- based GF foods over the past 6 years.

Design:

Observational study where data were collected on cereal-based GF foods from 50 stores and 10 internet retailers. The number of GF foods within each food category and the cost per 100 g of GF and gluten-containing (GC) foods were compared by store type.

Results:

GF food availability has increased in premium stores and online. The majority (82%) of GF food categories were significantly more expensive online compared with regular supermarkets. On average, GF breads were 400% more expensive compared with GC breads (p<0.001); no narrowing in cost difference over time observed. Convenience stores did not stock any GF bread nor GF pasta and only one of the budget supermarkets stocked them, similar to data reported 6 years ago.

Conclusions:

GF food availability has increased, predominately in premium markets. The GF food desert within convenience and budget stores will continue to disproportionately impact poor socioeconomic cohorts, the elderly and physically disabled. A lack of accessibility to GF foods impacts GF dietary adherence, increasing related comorbidities and healthcare costs.

PMCID: PMC6583765 Free PMC Article PMID: 31281622 Similar articles

Conflict of interest statement

Competing interests: YMJ has previously received funding from Dr Shar. 62. Scand J Gastroenterol. 2019 Jul 7:1-6. doi: 10.1080/00365521.2019.1636132. [Epub ahead of print] Risk of fractures in dermatitis herpetiformis and coeliac disease: a register-based study.

Pasternack C1, Koskinen I2, Hervonen K1,3, Kaukinen K1,4, Järvelin J5, Reunala T1,3, Collin P6, Huhtala H7, Mattila VM8, Salmi T1,3.

Author information: 1. a Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University , Tampere , Finland. 2. b Department of Internal Medicine , Central Finland Central Hospital , Jyväskylä , Finland. 3. c Department of Dermatology , Tampere University Hospital , Tampere , Finland. 4. d Department of Internal Medicine , Tampere University Hospital , Tampere , Finland. 5. e National Institute for Health and Welfare , Helsinki , Finland. 6. f Department of Gastroenterology and Alimentary Tract Surgery , Tampere University Hospital , Tampere , Finland. 7. g Faculty of Social Sciences , Tampere University , Tampere , Finland. 8. h Division of Orthopaedics and Traumatology, Department of Trauma , Musculoskeletal Surgery and Rehabilitation, Tampere University Hospital , Tampere , Finland.

Abstract

Objectives: Dermatitis herpetiformis (DH) is a cutaneous manifestation of coeliac disease. Bone fracture risk is increased in coeliac disease, but little knowledge exists about bone complications in DH. This study aimed to evaluate the risk of hip and other hospital-treated fractures in DH and coeliac disease in a high prevalence area with good adherence to a gluten-free diet. Materials and methods: Hip, proximal humerus, wrist and ankle fractures in 368 treated DH and 1076 coeliac disease patients between 1970 and 2015 were reviewed from the National Hospital Discharge Register. Hip fracture incidence rates for DH and coeliac disease patients were compared to those for the general population. The overall fracture risk for DH was compared to coeliac disease. Results: The hip fracture incidence rates for DH and coeliac disease patients did not differ from the general population. In females aged 80-89, the hip fracture incidence was higher in DH than in coeliac disease, but the risk for any hospital-treated fracture was lower in DH compared to coeliac disease (adjusted HR 0.620, 95% CI 0.429-0.949). The DH and coeliac disease patients with hospital- treated fractures were diagnosed at an older age, but the degree of small bowel mucosal damage did not significantly differ between patients with and without fractures. Conclusion: The incidence of hip fracture is not increased in treated DH or coeliac disease in an area with high awareness and dietary compliance rates. However, patients with DH seem to have a lower risk for fractures overall compared to coeliac disease. PMID: 31280614 Similar articles

63. Clin Gastroenterol Hepatol. 2019 Jul 4. pii: S1542-3565(19)30732-3. doi: 10.1016/j.cgh.2019.06.041. [Epub ahead of print] Do Alterations in Bone Mineral Density Go Beyond Borders In Adults With Celiac Disease?

Galli G1, Lahner E2, Annibale B2.

Author information: 1. Medical-surgical department of clinical sciences and translational medicine, Sapienza University, Sant'Andrea Hospital, Rome, Italy. Electronic address: [email protected]. 2. Medical-surgical department of clinical sciences and translational medicine, Sapienza University, Sant'Andrea Hospital, Rome, Italy. PMID: 31279951 Similar articles

64. Clin Immunol. 2019 Jul 4;207:10-17. doi: 10.1016/j.clim.2019.07.001. [Epub ahead of print] Clinical manifestations and gastrointestinal pathology in 40 patients with autoimmune enteropathy.

Villanacci V1, Lougaris V2, Ravelli A3, Buscarini E4, Salviato T5, Lionetti P6, Salemme M1, Martelossi S7, De Giacomo C8, Falchetti D9, Pelizzo G10, Bassotti G11.

Author information: 1. Institute of Pathology, Spedali Civili Brescia, Italy. 2. Pediatrics Clinic and Institute for Molecular Medicine A. Nocivelli, Department of Clinical and Experimental Sciences, University of Brescia and ASST-Spedali Civili of Brescia, Italy. Electronic address: [email protected]. 3. Gastroenterology and GI Endoscopy Unit, University Department of Pediatrics, Children's Hospital, Brescia, Italy. 4. Gastroenterology and Endoscopy Department, Maggiore Hospital, ASST Crema, Crema, Italy. 5. Pathology Institute, Azienda Ospedaliera Universitaria, Ospedali Riuniti di Trieste, Italy. 6. Meyer Children Hospital, University of Firenze, Italy. 7. Marenal and Infantile Department of Pediatrics, Ospedale Ca' Foncello, Treviso, Italy. 8. Maternal and Infantile Department of Pediatrics ASST Grande Ospedale Metropolitano Niguarda Milano, Italy. 9. Pediatric Surgery, Maternal and Infantile Department ASST Grande Ospedale Metropolitano Niguarda Milano, Italy. 10. Pediatric Surgery Department, Children's Hospital G. Di Cristina, ARNAS Civico-Di Cristina- Benfratelli, Palermo, Italy. 11. Gastroenterology and Hepatology Section, Department of Medicine, University of Perugia Medical School, Perugia, Italy.

Abstract

Autoimmune enteropathy (AIE) is a rare condition that may affect pediatric and adult patients, frequently associated with primary immunodeficiencies. We performed a retrospective study on clinical and histological findings from 40 AIE patients. Histological presentation showed a prevalent celiac disease pattern (50%), followed by the mixed pattern (35%), independently of age, chronic active duodenitis (10%), and GVHD-like pattern (5%). Patients with primary immunodeficiencies (24/40) presented mainly with the celiac disease pattern (72.2% versus 22.2%; p < .0001), while patients without primary immunodeficiencies presented with a mixed histological pattern (61.1% versus 13.6%; p < .0001). Our study shows that the prevalent histological presentation is the celiac disease-like pattern, independently of age, and, for the first time, that the histological presentation of AIE differs significantly between patients with and without primary immunodeficiencies. These findings may be helpful for more precise and timely diagnosis and management of this rare disorder.

PMID: 31279857 Similar articles

65. J AOAC Int. 2019 Jul 5. doi: 10.5740/jaoacint.19-0081. [Epub ahead of print] Preparation of Validation Materials for Estimating Gluten Recovery by ELISA According to SMPR 2017.021.

Wehling P1, Scherf KA2.

Author information: 1. Medallion Labs, 9000 Plymouth Ave North, Minneapolis, MN 55427. 2. Leibniz-Institute for Food Systems Biology at the Technical University of Munich, Lise-Meitner Str. 34, 85354 Freising, Germany.

Abstract

Background: In September 2017, the AOAC INTERNATIONAL Stakeholder Panel for Alternative Methods adopted Standard Method Performance Requirement (SMPR®) 2017.021, "Quantitation of Wheat, Rye, and Barley Gluten in Oats," as guidance for the validation of methods for measuring gluten in oat products. The SMPR requires prospective methods to demonstrate adequate recovery (50-200%) based on the analysis of a set of reference samples. Objective: This document provides specific methods and data on the preparation of such validation materials and their analysis by an R5 ELISA kit to demonstrate the SMPR recovery estimation procedure. Methods: Seven reference samples were made by spiking wheat, rye, and barley into gluten-free oat flour at two levels, 10 and 20 mg/kg. The levels of gluten were determined by a wet chemical method based on the Codex Alimentarius definition of gluten. Results: The recoveries for wheat, rye, and barley were 122, 425, and 349%, respectively, for the R5 ELISA kit. The wet chemical method for estimating gluten in a sample of pure grain demonstrated repeatability relative SDs ranging from 1.40 to 2.75%. Conclusions: The reference materials are suitable to estimate ELISA kit responses to wheat, rye, and barley and calculate recoveries. Highlights: A series of oat flours spiked with wheat, rye, and barley flours were developed to be used as reference materials. A wet chemical method was established to estimate gluten contents based on the Codex definition. The reference materials are available for purchase to support further method development and validation. PMID: 31277725 Similar articles

66. Medicina (Kaunas). 2019 Jul 3;55(7). pii: E337. doi: 10.3390/medicina55070337. Micronutrients Dietary Supplementation Advices for Celiac Patients on Long-Term Gluten-Free Diet with Good Compliance: A Review.

Rondanelli M1,2, Faliva MA3, Gasparri C3, Peroni G3, Naso M3, Picciotto G3, Riva A4, Nichetti M3, Infantino V5, Alalwan TA6, Perna S7.

Author information: 1. IRCCS Mondino Foundation, 27100 Pavia, Italy. 2. Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy. 3. Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona "Istituto Santa Margherita", University of Pavia, 27100 Pavia, Italy. 4. Research and Development Unit, Indena, 20139 Milan, Italy. 5. University of Bari, Department of Biomedical Science and Human Oncology, 70121 Bari, Italy. 6. Department of Biology, College of Science, University of Bahrain, Sakhir Campus P. O. Box 32038, Bahrain. 7. Department of Biology, College of Science, University of Bahrain, Sakhir Campus P. O. Box 32038, Bahrain. [email protected].

Abstract

Background and objective: Often micronutrient deficiencies cannot be detected when patient is already following a long-term gluten-free diet with good compliance (LTGFDWGC). The aim of this narrative review is to evaluate the most recent literature that considers blood micronutrient deficiencies in LTGFDWGC subjects, in order to prepare dietary supplementation advice (DSA). Materials and methods: A research strategy was planned on PubMed by defining the following keywords: celiac disease, vitamin B12, iron, folic acid, and vitamin D. Results: This review included 73 studies. The few studies on micronutrient circulating levels in long-term gluten-free diet (LTGFD) patients over 2 years with good compliance demonstrated that deficiency was detected in up to: 30% of subjects for vitamin B12 (DSA: 1000 mcg/day until level is normal, then 500 mcg), 40% for iron (325 mg/day), 20% for folic acid (1 mg/day for 3 months, followed by 400-800 mcg/day), 25% for vitamin D (1000 UI/day or more-based serum level or 50,000 UI/week if level is <20 ng/mL), 40% for zinc (25-40 mg/day), 3.6% of children for calcium (1000-1500 mg/day), 20% for magnesium (200- 300 mg/day); no data is available in adults for magnesium. Conclusions: If integration with diet is not enough, starting with supplements may be the correct way, after evaluating the initial blood level to determine the right dosage of supplementation.

Free Article PMID: 31277328

Similar articles

Conflict of interest statement

The authors declare no conflict of interest. 67. Foods. 2019 Jul 3;8(7). pii: E240. doi: 10.3390/foods8070240. Gluten-Free Bread with Cricket Powder- Mechanical Properties and Molecular Water Dynamics in Dough and Ready Product.

Kowalczewski PŁ1, Walkowiak K2, Masewicz Ł2, Bartczak O3, Lewandowicz J4, Kubiak P5, Baranowska HM2.

Author information: 1. Institute of Food Technology of Plant Origin, Poznań University of Life Sciences, 60-624 Poznań, Poland. [email protected]. 2. Department of Physics and Biophysics, Poznań University of Life Sciences, 60-637 Poznań, Poland. 3. Students' Scientific Club of Food Technologists, Poznań University of Life Sciences, 60-624 Poznań, Poland. 4. Chair of Production Engineering and Logistics, Poznan University of Technology, 60-965 Poznań, Poland. 5. Department of Biotechnology and Food Microbiology, Poznań University of Life Sciences, 60-627 Poznań, Poland.

Abstract

Published data indicate that cricket powder (CP) is a good source of not only protein, fat and fiber, but also minerals. Due to the fact that this product naturally does not contain gluten, it is an interesting addition to the enrichment of gluten-free foods. This paper is a report on the results of starch substitution with CP (at 2%, 6% and 10%) on the properties of dough and bread. The rheology of dough and the texture of the final product were studied. While the changes caused in the dough by the introduction of CP were not pronounced, the bread obtained from it was characterized by significantly increased hardness and improved consistency. Analyses of water behavior at the molecular level with the use of 1H Nuclear Magnetic Resonance (NMR) indicated that CP altered both the bound and bulk water fractions. Moreover, examination of water activity revealed a decreased rate of water transport in samples of bread that contained CP. These results indicate improved availability of water to the biopolymers of bread, which likely plays a role in shaping the textural properties of the product.

Free Article

PMID: 31277294 Similar articles

68. J Food Sci Technol. 2019 Jul;56(7):3380-3390. doi: 10.1007/s13197-019-03822-6. Epub 2019 Jun 8. Effect of ultrasound-assisted freezing on the textural characteristics of dough and the structural characterization of wheat gluten.

Li Y#1,2,3, Zhang Y#1,2,3, Liu X1,2,3, Wang H1,2,3, Zhang H1,2,3.

Author information: 1. 1College of Food and Biological Engineering, School of Food and Biological Engineering, Zhengzhou University of Light Industry, 5 Dongfeng Road, Zhengzhou, 450002 People's Republic of China. 2. Henan Collaborative Innovation Center of Food Production and Safety, 5 Dongfeng Road, Zhengzhou, 450002 People's Republic of China. 3. Henan Key Laboratory of Cold Chain Food Quality and Safety Control, 5 Dongfeng Road, Zhengzhou, 450002 People's Republic of China. #. Contributed equally

Abstract

To better understand the effects of ultrasonic treatment in the whole freezing process (UWF) and the maximum ice crystal formation zone (UMF) on the quality of frozen dough, the textural properties of dough and the structure of gluten were investigated. The results showed that the UWF and UMF treatments improved the textural properties of frozen dough and obtain the best effect at the 60 W/L power densities. Ultrasound-assisted freezing reduced the destructive effect of disulfide bonds on dough, and led to a state of dynamic equilibrium of hydrophobic groups. UWF treatment at 80 W/L and UMF treatment at 40 W/L had positive effects prevented the secondary structure from destruction by freezing. The network of gluten treated by ultrasound-assisted freezing was more uniform and smaller than that of traditional freezing samples, which was similar to the network structure of fresh protein. According to Pearson's correlation analysis, there was a high correlation between SH, α-helix content and springiness. There was a significant positive correlation between β-turn and G', G″, and there was a significant negative correlation between β-turn and hardness. These results suggest that ultrasound-assisted freezing improved the process quality of dough though reducing the damage to gluten structure caused by freezing.

PMCID: PMC6582094 [Available on 2020-07-01] PMID: 31274906 Similar articles

Conflict of interest statement

Conflict of interestWe declare that there is no conflict of interest regarding the publication of this paper. 69. Clin Nucl Med. 2019 Jul 2. doi: 10.1097/RLU.0000000000002688. [Epub ahead of print] Celiac Disease on FDG PET/CT.

Cardin AJ1, Patel M, Ma D.

Author information: 1. From the Barwon Medical Imaging, University Hospital Geelong, Geelong, Victoria, Australia.

Abstract

An FDG PET with diagnostic CT was performed on a 52-year-old man for investigation of lymphocytosis and the clinical suspicion of lymphoma. The PET/CT demonstrated diffuse small bowel uptake, prominent mesenteric lymph nodes without significant FDG uptake, and other features suggestive of celiac disease. Subsequently, the patient was found to have markedly elevated celiac disease antibodies (deamidated gliadin IgG and tissue transglutaminase IgA) and to be HLA DQ2 and DQ8 allele positive on genotyping for celiac disease. Gastroscopy and duodenal biopsy also confirmed the diagnosed. PMID: 31274556 Similar articles

70. Am J Gastroenterol. 2019 Jul 4. doi: 10.14309/ajg.0000000000000310. [Epub ahead of print] A Clinician's Guide to Celiac Disease HLA Genetics.

Brown NK1, Guandalini S2, Semrad C2, Kupfer SS2.

Author information: 1. Department of Pathology, University of Chicago, Chicago, Illinois, USA. 2. Celiac Disease Center, University of Chicago, Chicago, Illinois, USA.

Abstract

Celiac disease is a common inflammatory disease triggered by dietary gluten in genetically susceptible individuals. The strongest and best-characterized genetic susceptibilities in celiac disease are class II human leukocyte antigen (HLA) genes known as HLA-DQ2 and DQ8. HLA genetic testing is available through a number of commercial and academic laboratories and is used in the evaluation of celiac disease and to identify at-risk family members. Importantly, HLA genetic testing has a high negative predictive value for celiac disease, but a low positive predictive value. Therefore, for a practicing clinician, it is important to understand when to order HLA genetic testing, what test to order, and how to interpret the result. This review provides a practical primer on HLA genetics in celiac disease. PMID: 31274511 Similar articles

71. Adv Anat Pathol. 2019 Jul 3. doi: 10.1097/PAP.0000000000000242. [Epub ahead of print] Celiac Disease: Updates on Pathology and Differential Diagnosis.

Dai Y1, Zhang Q2, Olofson AM3, Jhala N4, Liu X3.

Author information: 1. Department of Pathology, Second Xiangya Hospital of Central South University, Changsha. 2. Department of Pathology, the Third Central Hospital of Tianjin, Tianjin, China. 3. Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL. 4. Department of Pathology and Laboratory Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, PA.

Abstract

Celiac disease is a gluten-triggered immune-mediated disorder, characterized by inflammation of the enteric mucosa following lymphocytic infiltration and eventually resulting in villous blunting. There have been many developments in refining diagnostic laboratory tests for celiac disease in the last decade. Biopsy-sparing diagnostic guidelines have been proposed and validated in a few recent prospective studies. However, despite these developments, histologic evaluation of duodenal mucosa remains one of the most essential diagnostic tools as it helps in the diagnosis of celiac disease in individuals who do not fulfill the biopsy-sparing diagnostic criteria and in those not responding to a gluten-free diet. Histologic evaluation also allows for the assessment of mucosal recovery after treatment and in the identification of concurrent intestinal diseases. Therefore, pathologists should be familiar with the histologic spectrum of celiac disease and need to be aware of other disorders with similar symptoms and histopathology that may mimic celiac disease. This review aims to provide pathologists with updates on celiac laboratory testing, biopsy-sparing diagnostic criteria, histopathology, complications, and differential diagnoses of celiac disease. PMID: 31274508 Similar articles

72. Adv Nutr. 2019 Jul 3. pii: nmz061. doi: 10.1093/advances/nmz061. [Epub ahead of print] Negative Effects of a High-Fat Diet on Intestinal Permeability: A Review.

Rohr MW1, Narasimhulu CA1, Rudeski-Rohr TA1, Parthasarathy S1.

Author information: 1. Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL, USA.

Abstract

The intestinal tract is the largest barrier between a person and the environment. In this role, the intestinal tract is responsible not only for absorbing essential dietary nutrients, but also for protecting the host from a variety of ingested toxins and microbes. The intestinal barrier system is composed of a mucus layer, intestinal epithelial cells (IECs), tight junctions (TJs), immune cells, and a gut microbiota, which are all susceptible to external factors such as dietary fats. When components of this barrier system are disrupted, intestinal permeability to luminal contents increases, which is implicated in intestinal pathologies such as inflammatory bowel disease, necrotizing enterocolitis, and celiac disease. Currently, there is mounting evidence that consumption of excess dietary fats can enhance intestinal permeability differentially. For example, dietary fat modulates the expression and distribution of TJs, stimulates a shift to barrier-disrupting hydrophobic bile acids, and even induces IEC oxidative stress and apoptosis. In addition, a high-fat diet (HFD) enhances intestinal permeability directly by stimulating proinflammatory signaling cascades and indirectly via increasing barrier-disrupting cytokines [TNFα, interleukin (IL) 1B, IL6, and interferon γ (IFNγ)] and decreasing barrier-forming cytokines (IL10, IL17, and IL22). Finally, an HFD negatively modulates the intestinal mucus composition and enriches the gut microflora with barrier-disrupting species. Although further research is necessary to understand the precise role HFDs play in intestinal permeability, current data suggest a stronger link between diet and intestinal disease than was first thought to exist. Therefore, this review seeks to highlight the various ways an HFD disrupts the gut barrier system and its many implications in human health.

Published by Oxford University Press on behalf of the American Society for Nutrition 2019. PMID: 31268137 Similar articles

73. Ugeskr Laeger. 2019 Jul 1;181(27). pii: V12180869. [Folate deficiency as a differential diagnosis to severe pre-eclampsia].

[Article in Danish] Sisman Y1, Thomsen RH, Vestermark V, Krebs L.

Author information: 1. [email protected].

Abstract

In this case report, a 26-year-old pregnant woman presented with headache, visual disturbances, mega-loblastic anaemia, thrombocytopenia and proteinuria in her third trimester. These symptoms were initially misinterpreted as HELLP-syndrome, but due to normal blood pressure and liver function the patient was diagnosed with severe folate deficiency despite her daily supplements of folate to avoid neural tube defects and deficiency. The reason was onset of coeliac disease during pregnancy. Careful examination may help discriminate HELLP-syndrome from folate deficiency and thus avoid preterm delivery. PMID: 31267942 Similar articles

74. Clin Rev Allergy Immunol. 2019 Jul 2. doi: 10.1007/s12016-019-08756-7. [Epub ahead of print] The Epidemiology and Clinical Manifestations of Autoimmunity in Selective IgA Deficiency.

Odineal DD1, Gershwin ME2.

Author information: 1. Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis School of Medicine, 451 Health Sciences Drive, Suite 6510, Davis, CA, 95616, USA. [email protected]. 2. Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis School of Medicine, 451 Health Sciences Drive, Suite 6510, Davis, CA, 95616, USA.

Abstract Selective immunoglobulin A deficiency (SIgAD) is the most common primary immunodeficiency, defined as an isolated deficiency of IgA (less than 0.07 g/L). Although the majority of people born with IgA deficiency lead normal lives without significant pathology, there is nonetheless a significant association of IgA deficiency with mucosal infection, increased risks of atopic disease, and a higher prevalence of autoimmune disease. To explain these phenomena, we have performed an extensive literature review to define the geoepidemiology of IgA deficiency and particularly the relative risks for developing systemic lupus erythematosus, hyperthyroidism, hypothyroidism, type 1 diabetes mellitus, Crohn's disease, ulcerative colitis, rheumatoid arthritis, juvenile idiopathic arthritis, ankylosing spondylitis, and vitiligo; these diseases have strong data to support an association. We also note weaker associations with scleroderma, celiac disease, autoimmune hepatitis, immune thrombocytopenic purpura, and autoimmune hemolytic anemia. Minimal if any associations are noted with myasthenia gravis, lichen planus, and multiple sclerosis. Finally, more recent data provide clues on the possible immunologic mechanisms that lead to the association of IgA deficiency and autoimmunity; these lessons are important for understanding the etiology of autoimmune disease. PMID: 31267472 Similar articles

75. Ann Gastroenterol. 2019 Jul-Aug;32(4):338-345. doi: 10.20524/aog.2019.0378. Epub 2019 Apr 22. The role of mast cells in pediatric gastrointestinal disease.

Ravanbakhsh N1, Kesavan A2.

Author information: 1. Department of Pediatrics (Naseem Ravanbakhsh). 2. Section of Pediatric Gastroenterology (Anil Kesavan), Rush University Children's Hospital, Chicago, IL, USA.

Abstract

Mast cells are granulocytes derived from CD34+ pluripotent progenitor cells that demonstrate plasticity in their development, leaving the bone marrow and differentiating in the tissue where they ultimately reside. They are best known for their role in the allergic response, but also play a prominent immunoregulatory role in other processes, including immune tolerance, the innate immune response, angiogenesis, wound healing and tissue remodeling. Mast cells are found throughout the gastrointestinal tract; their metabolic products influence and regulate intestinal epithelial and endothelial function, gastrointestinal secretion, intestinal motility and absorption, and contribute to host defense. They also play an important role in the development of visceral hypersensitivity through bidirectional interaction with the enteric nervous system. Mast cells have been found to have an increasingly important role in the pathophysiology of a number of pediatric gastrointestinal diseases. This review summarizes the current understanding of the role that mast cells play in the development of pediatric gastrointestinal disorders, including eosinophilic esophagitis, functional dyspepsia, irritable bowel syndrome, celiac disease, inflammatory bowel disease, histologically negative appendicitis, Hirschsprung's disease, intestinal neuronal dysplasia, and food protein-induced enterocolitis syndrome.

PMCID: PMC6595934 Free PMC Article PMID: 31263355 Similar articles

Conflict of interest statement

Conflict of Interest: None 76. Food Chem. 2019 Nov 15;298:125068. doi: 10.1016/j.foodchem.2019.125068. Epub 2019 Jun 24. Transformation of polyphenols found in pigmented gluten-free flours during in vitro large intestinal fermentation.

Rocchetti G1, Lucini L2, Giuberti G3, Bhumireddy SR4, Mandal R4, Trevisan M3, Wishart DS5.

Author information: 1. Department of Animal Science, Food and Nutrition, Università Cattolica del Sacro Cuore, Piacenza 29122, Italy; Department for Sustainable Food Process, Università Cattolica del Sacro Cuore, Piacenza 29122, Italy; Department of Biological Sciences, University of Alberta, Edmonton, AB T6G 2E9, Canada. 2. Department for Sustainable Food Process, Università Cattolica del Sacro Cuore, Piacenza 29122, Italy. Electronic address: [email protected]. 3. Department for Sustainable Food Process, Università Cattolica del Sacro Cuore, Piacenza 29122, Italy. 4. Department of Biological Sciences, University of Alberta, Edmonton, AB T6G 2E9, Canada. 5. Department of Biological Sciences, University of Alberta, Edmonton, AB T6G 2E9, Canada; Department of Computing Science, University of Alberta, Edmonton, AB T6G 2E8, Canada.

Abstract

In this work, 18 gluten-free flours (prepared from cereals, pseudocereals and legumes), differing in pigmentation, were screened for their phenolic profiles, cooked and, then, subjected to digestion and large intestinal fermentation in vitro. A combined targeted/untargeted metabolomic approach was used to elucidate the microbial biotransformation processes of polyphenols following digestion. This preliminary work demonstrated an increase in 3,5-dihydroxybenzoic acid (on average from 0.67 up to 1.30 μmol/g dry matter) throughout large intestinal fermentation of pseudocereals (esp. quinoa), due to their high alkylresorcinol contents. Isoflavones were converted into equol- or O- desmethylangolensin- derivatives, whereas anthocyanins were degraded into lower-molecular- weight phenolics (i.e., protocatechuic aldehyde and 4-hydroxybenzoic acid, with the latter exhibiting the highest increase over time). A decreasing trend was observed for antioxidant activities (i.e., FRAP and ORAC values) moving from digested to faecal fermented samples. These findings highlight that gluten-free flours are able to deliver bioaccessible polyphenols to the colon.

77. Food Chem. 2019 Nov 15;298:125085. doi: 10.1016/j.foodchem.2019.125085. Epub 2019 Jun 27. Physicochemical, microstructural and digestibility analysis of gluten-free spaghetti of whole unripe plantain flour.

Patiño-Rodríguez O1, Agama-Acevedo E2, Pacheco-Vargas G2, Alvarez-Ramirez J3, Bello-Pérez LA2.

Author information: 1. CONACyT-Instituto Politécnico Nacional, CEPROBI, Km. 6.5 Carr. Yautepec-Jojutla Col. San Isidro, Calle CEPROBI No. 8, Yautepec, Morelos, Mexico. Electronic address: [email protected]. 2. Instituto Politécnico Nacional, CEPROBI, Km. 6.5 Carr. Yautepec-Jojutla Col. San Isidro, Calle CEPROBI No. 8, Yautepec, Morelos, Mexico. 3. Departamento de Ingeniería de Procesos e Hidráulica, Universidad Autónoma Metropolitana- Iztapalapa, Apartado Postal 55-534, CDMX 09340, Mexico.

Abstract

Plantain is a climacteric fruit having economic relevance in several tropical regions. Unripe plantain is an alternative source of indigestible carbohydrates (dietary fibre) and undigestible starch fraction. Unripe plantain flour was explored in this work as an alternative ingredient (whole and pulp) in spaghetti formulations. Chemical composition, cooking quality, texture analysis, and microstructure of spaghetti formulations were analyzed. The microstructure results showed that the presence of fiber in the food matrix helped the reduction of the starch granule swelling in the cooking process. Spaghetti made with whole plantain flour exhibited lower rapidly starch fraction, with increased resistant starch fractions. Overall, the whole unripe plantain flour exhibited good potential for gluten-free spaghetti having highest content of fiber and lower starch digestion rates.

Similar articles

78. Gastroenterology. 2019 Aug;157(2):293-294. doi: 10.1053/j.gastro.2019.06.012. Epub 2019 Jun 29. When Is Celiac Disease Celiac Disease?

Green PHR1, Guandalini S2.

Author information: 1. Celiac Disease Center, Columbia University Medical Center, New York, New York. Electronic address: [email protected]. 2. Celiac Disease Center, University of Chicago, Chicago, Illinois; Section of Pediatric Gastroenterology, Hepatology and Nutrition, University of Chicago, Chicago, Illinois. PMID: 31260660 Similar articles

79. Hum Reprod Update. 2019 Jul 1;25(4):486-503. doi: 10.1093/humupd/dmz014. The association between endometriosis and autoimmune diseases: a systematic review and meta-analysis.

Shigesi N1,2, Kvaskoff M3,4, Kirtley S5, Feng Q1, Fang H2, Knight JC2, Missmer SA6,7,8,9, Rahmioglu N2, Zondervan KT1,2, Becker CM1.

Author information: 1. Oxford Endometriosis CaRe Centre, Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK. 2. Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK. 3. CESP, Faculté de médecine, Université Paris-Sud, Faculté de médecine, UVSQ, INSERM, Université Paris-Saclay, Villejuif Cedex, France. 4. Gustave Roussy, Espace Maurice Tubiana, Villejuif Cedex, France. 5. Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK. 6. Division of Adolescent and Young Adult Medicine, Department of Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA. 7. Boston Center for Endometriosis, Boston Children's and Brigham and Women's Hospitals, Boston, MA, USA. 8. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 9. Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA.

Abstract

BACKGROUND:

Endometriosis is a chronic gynaecological disorder that affects 2-10% of women of reproductive age. The aetiology of endometriosis is largely under-explored, yet abnormalities in the immune system have been suggested to explain the origin of ectopic endometrial tissues, and an association between endometriosis and autoimmune diseases has been proposed. Evaluation of current evidence investigating the association between endometriosis and autoimmune diseases from population-based studies will facilitate our understanding of the causes and consequences of endometriosis and provide a reference for better healthcare practices population-wide.

OBJECTIVE AND RATIONALE:

The aim of this study was to systematically review the literature on population-based studies investigating an association between endometriosis and autoimmune diseases and to conduct a meta-analysis of combinable results to investigate the extent and robustness of evidence.

SEARCH METHODS:

Four electronic databases were searched (MEDLINE, Embase, Web of Science, and CINAHL) from each database inception date until 7 April 2018. Search terms included a combination of database- specific controlled vocabulary terms and free-text terms relating to 'endometriosis' and 'autoimmune diseases'. Study inclusion criteria focused on peer-reviewed published articles that reported an association between endometriosis and autoimmune diseases, excluding case reports/series, review papers, meta-analyses, organizational guidelines, editorial letters, expert opinions, and conference abstracts. Quality assessment of included studies was performed based on GRADE criteria. Key information of eligible studies was abstracted into a standard form. Meta- analysis was performed for autoimmune diseases with combinable study results from at least three studies investigating an association with endometriosis. For cross-sectional studies and case-control studies, raw data from each study were documented to calculate a Mantel-Haenszel odds ratio with 95% CIs. For cohort studies, an inverse variance probability weighted model was used to pool study results to calculate a rate ratio (a hazard ratio or a standardized incidence rate) with 95% CIs.

OUTCOMES:

A total of 26 published population-based cross-sectional, case-control, and cohort studies that investigated the association between endometriosis and autoimmune diseases met all eligible criteria and were included in the review. The studies quantified an association between endometriosis and several autoimmune diseases, including systemic lupus erythematosus (SLE), Sjögren's syndrome (SS), rheumatoid arthritis (RA), autoimmune thyroid disorder, coeliac disease (CLD), multiple sclerosis (MS), inflammatory bowel disease (IBD), and Addison's disease. However, the quality of the evidence was generally poor due to the high risk of bias in the majority of the chosen study designs and statistical analyses. Only 5 of the 26 studies could provide high-quality evidence, and among these, 4 supported a statistically significant association between endometriosis and at least 1 autoimmune disease: SLE, SS, RA, CLD, MS, or IBD.

WIDER IMPLICATIONS:

The observed associations between endometriosis and autoimmune diseases suggest that clinicians need to be aware of the potential coexistence of endometriosis and autoimmune diseases when either is diagnosed. Scientists interested in research studies on endometriosis or autoimmune diseases should consider the likelihood of comorbidity when studying these two types of health conditions. Well-designed large prospective cohort studies with confounding control and mediation quantification, as well as genetic and biological studies, are needed to generate further insights into whether endometriosis is a risk factor for, or a consequence of, autoimmune diseases, and whether these two types of disorders share pathophysiological mechanisms even if they arise independently. Such insights may offer opportunities for the development of novel non-hormonal medications such as immuno-modulators or repurposing of existing immunomodulatory therapies for endometriosis.

PMCID: PMC6601386 Free PMC Article PMID: 31260048 Similar articles

80. Food Chem. 2019 Nov 1;297:124902. doi: 10.1016/j.foodchem.2019.05.176. Epub 2019 Jun 6. Effect of dietary fiber-rich fractions on texture, thermal, water distribution, and gluten properties of frozen dough during storage.

Jiang Y1, Zhao Y1, Zhu Y1, Qin S1, Deng Y2, Zhao Y3.

Author information: 1. Department of Food Science and Technology, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China. 2. Department of Food Science and Technology, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China. Electronic address: [email protected]. 3. Department of Food Science and Technology, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China; Department of Food Science and Technology, 100 Wiegand Hall, Oregon State University, Corvallis, OR, USA.

Abstract

The effect of dietary fiber-rich fractions on the texture, thermal, water distribution, and gluten properties of frozen dough during storage was investigated. These fractions could greatly improve retention of the texture properties, which was mainly related to water loss, and changes in freezable water proportion (FW) and gluten secondary structure. Kinetic studies showed that the fractions could change the nucleation type and ice crystal growth rate, with konjac flour significantly decreasing the ice growth rate from 0.0177 to 0.0048. These fractions could decrease FW by 15%- 27% and restrict water mobility during storage. Moreover, gluten β-sheets shifted toward β-turns, while the β-sheet values of potato and okara flours showed no significant change during storage. SEM confirmed that okara flour could suppress the deterioration of gluten. Generally, the potato, okara, and konjac flours represent excellent fortification materials that could improve the texture, reduce water mobility, and suppress deterioration of frozen dough during storage.

81. Food Chem. 2019 Nov 1;297:124956. doi: 10.1016/j.foodchem.2019.124956. Epub 2019 Jun 6. Use of agricultural by-products in extruded gluten-free breakfast cereals.

Alonso Dos Santos P1, Caliari M2, Soares Soares Júnior M2, Soares Silva K3, Fleury Viana L4, Gonçalves Caixeta Garcia L5, Siqueira de Lima M6.

Author information: 1. Institute Federal Goiano, Department of Food Engineering, Campus Rio Verde, Rod. Sul Goiana, 75901-970 Rio Verde, Goiás, Brazil. Electronic address: [email protected]. 2. Federal University of Goiás, Department of Food Technology, Campus Samambaia, Rod. Goiânia/Nova Veneza, 74690-900 Goiânia, Goiás, Brazil. 3. São Paulo State University "Júlio de Mesquita Filho", Department of Engineering and Food Science, São José do Rio Preto Campus, 15054-000 São Paulo, Brazil. 4. Institute Federal Goiano, Department of Food Engineering, Campus Rio Verde, Rod. Sul Goiana, 75901-970 Rio Verde, Goiás, Brazil. Electronic address: [email protected]. 5. Institute Federal Goiano, Department of Food Engineering, Campus Rio Verde, Rod. Sul Goiana, 75901-970 Rio Verde, Goiás, Brazil. 6. Institute Federal Goiano, Department of Food Engineering, Campus Rio Verde, Rod. Sul Goiana, 75901-970 Rio Verde, Goiás, Brazil. Electronic address: [email protected]. Abstract

The objective of this study was to evaluate the effect of the extrusion moisture and temperature on the physical characteristics of breakfast cereals. The chemical composition, microbiological risk and acceptance of the selected breakfast cereal with the best physical quality were assessed to determine the technological viability of the use of these by-products by the food industry. The response surface method and a rotatable central composite design were used, and a desirability test was performed based on adjusted regression models. The breakfast cereal produced under these conditions had protein, lipid and dietary fiber contents of 7.55, 0.97 and 6.12 g 100 g-1, respectively. In regards to the sensory analysis, the evaluated breakfast cereal received average acceptance scores ranging from "neither like or dislike" to "like moderately". The use of rice, passion fruit and milk by-products was shown to be an alternative for the production of extruded breakfast cereal.

82. Food Chem. 2019 Nov 1;297:124986. doi: 10.1016/j.foodchem.2019.124986. Epub 2019 Jun 11. How microwave treatment of gluten affects its toxicity for celiac patients? A study on the effect of microwaves on the structure, conformation, functionality and immunogenicity of gluten.

Mahroug H1, Ribeiro M2, Rhazi L3, Bentallah L1, Zidoune MN1, Nunes FM4, Igrejas G5.

Author information: 1. Laboratoire de Nutrition et de Technologies Alimentaires LNTA - Institut de Nutrition, de l'Alimentation et des Technologies Agroalimentaires, Université Frères Mentouri Constantine 1, Algeria. 2. CQ-VR, Chemistry Research Center, Vila Real, Food and Wine Chemistry Lab, Chemistry Department, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal; Functional Genomics and Proteomics Unit, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal; Department of Genetics and Biotechnology, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal; LAQV-REQUIMTE, Faculty of Science and Technology, University Nova of Lisbon, Lisbon, Portugal. 3. UniLaSalle, Unité de recherche "Transformations & Agro-Ressources", 19 rue Pierre Waguet - BP 30313, F-60026 Beauvais Cedex, France. 4. CQ-VR, Chemistry Research Center, Vila Real, Food and Wine Chemistry Lab, Chemistry Department, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal. Electronic address: [email protected]. 5. Functional Genomics and Proteomics Unit, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal; Department of Genetics and Biotechnology, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal; LAQV-REQUIMTE, Faculty of Science and Technology, University Nova of Lisbon, Lisbon, Portugal. Electronic address: [email protected].

Abstract

The microwave heating of wheat kernels, flour, and gluten, has attracted attention lately because it has been claimed to abolish gluten toxicity for celiac patients. Nevertheless, contradictory results have been reported regarding the effect on gluten celiac-immunotoxicity. In order to better understand the effect of the microwave treatment on gluten structure, conformation, functionality and celiac-immunotoxicity, a central composite design with two factors, power level, and treatment time, was used to investigate a possible quadratic and interaction effects between both factors. Extractable gliadins content was affected by the power and time in a linear and quadratic fashion; extractable glutenins were not affected. Gluten secondary structure was affected by the microwave treatment and related to the polymer's disaggregation phenomenon observed. In fact, the microwave treatment increased the amount of potentially toxic epitopes released after peptic and tryptic digestion, showing inefficiency as a treatment to detoxify the gluten for celiac disease patients.

83. Mayo Clin Proc. 2019 Jul;94(7):1253-1260. doi: 10.1016/j.mayocp.2018.11.036. Micronutrient Deficiencies Are Common in Contemporary Celiac Disease Despite Lack of Overt Malabsorption Symptoms.

Bledsoe AC1, King KS2, Larson JJ2, Snyder M3, Absah I4, Choung RS1, Murray JA5.

Author information: 1. Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN. 2. Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN. 3. Division of Clinical Biochemistry, Mayo Clinic, Rochester, MN. 4. Division of Pediatric Gastroenterology, Mayo Clinic, Rochester, MN. 5. Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN; Department of Pediatrics, University of Southern Denmark, Odense. Abstract

OBJECTIVE:

To evaluate micronutrient deficiencies in a contemporary cohort of adult patients with newly diagnosed celiac disease (CD).

PATIENTS AND METHODS:

This is a retrospective study of prospective adults newly diagnosed with CD from January 1, 2000, through October 31, 2014, at Mayo Clinic. Micronutrient data were collected for tissue transglutaminase IgA, zinc, 25-hydroxy vitamin D, ferritin, albumin, copper, vitamin B12, and serum folate. Data were analyzed for absolute number of deficiencies and associations with age, sex, body mass index, presenting symptoms, and tissue transglutaminase IgA; each deficiency was assessed using logistic regression. Deficiencies were compared with age- and sex-matched controls from the National Health and Nutrition Examination Survey.

RESULTS:

In total, 309 patients with CD (196 women and 113 men; mean age, 46.1±15.1 years; mean body mass index, 25.9 kg/m2) were included. Weight loss was seen in only 25.2% (78/309) of patients. Zinc was deficient in 59.4% (126/212) of patients with CD compared with 33.2% (205/618) of controls (P<.001). Albumin was low in 19.7% (24/122) compared with 1.1% of controls (P<.001). Copper was low in 6.4% (13/204) compared with 2.1% (13/618) of controls (P=.003). Vitamin B12 was low in 5.3% (13/244) compared with 1.8% (11/618) of controls (P=.004). Folate was low in 3.6% (6/159) compared with 0.3% (2/618) of controls (P=.002). 25-Hydroxy vitamin D was low in 19.0% (44/213) compared with 18% (111/618) of controls (P=.72). Ferritin was low in 30.8% (66/214) of patients; no NHANES controls were available for comparison for ferritin.

CONCLUSION:

Micronutrient deficiencies remain common in adults with CD despite increased nonclassic presentation. This study provides support for micronutrient assessment at the time of CD diagnosis.

84. J Pediatr Gastroenterol Nutr. 2019 Jul;69(1):39-44. doi: 10.1097/MPG.0000000000002293. HLA-DQ Genotyping, Duodenal Histology, and Response to Exclusion Diet in Autistic Children With Gastrointestinal Symptoms.

Alessandria C1, Caviglia GP2, Campion D1, Nalbone F1, Sanna C1, Musso A1, Abate ML2, Rizzetto M1, Saracco GM1,2, Balzola F1.

Author information: 1. Division of Gastroenterology and Hepatology, Città Della Salute e Della Scienza di Torino Hospital. 2. Department of Medical Sciences, University of Turin, Turin, Italy.

Abstract

OBJECTIVES:

A correlation between autism spectrum disorders (ASDs) and gastrointestinal (GI) problems, and a possible link between gluten consumption and ASD have been increasingly reported. Gluten/casein- free diet (GCFD) is often undertaken, with conflicting results. This study aimed at evaluating the distribution of human leukocyte antigen (HLA)-DQ2/DQ8 typing among patients with ASD with GI symptoms, together with its correlation with duodenal histology and response to GCFD.

METHODS:

Between 2002 and 2015 all patients with ASD with GI symptoms referred to our outpatient clinic, displaying clinical, laboratory, or ultrasound findings suggestive of organic disease, underwent endoscopy, celiac disease (CD) serum antibodies testing and HLA-DQ2/DQ8 genotyping. Patients were prescribed a 6-month GCFD, and then clinically reassessed.

RESULTS:

Among 151 enrolled patients, 134 (89%) were negative for CD-specific antibodies; 72 (48%) were positive for HLA-DQ2/DQ8; and 56 (37%) showed duodenal microscopic inflammation. Clinical improvement was observed in non-CD patients irrespective of the rigorous or partial adherence to the diet, being the difference nonstatistically significant. Response to diet was related to the presence of histological duodenal alterations at baseline (odds ratio 11.323, 95% confidence interval 1.386-92.549 for Marsh 2 pattern), but not to HLA-DQ2/DQ8 positivity (odds ratio 1.120, 95% confidence interval 0.462-2.716).

CONCLUSIONS:

Our data suggest that children with ASD with GI symptoms have a high prevalence of duodenal intraepithelial lymphocytic infiltration, which seems to be linked to a mechanism other than autoimmune response to gluten consumption. Alteration of duodenal histology, but not the HLA- DQ2/DQ8 status, was associated with clinical response to the diet. PMID: 31232884 Similar articles

85. Clin Gastroenterol Hepatol. 2019 Jul;17(8):1509-1514. doi: 10.1016/j.cgh.2018.10.035. Epub 2018 Oct 26. Prevalence of and Risk Factors for Low Bone Mineral Density in Children With Celiac Disease.

Webster J1, Vajravelu ME2, Choi C3, Zemel B4, Verma R5.

Author information: 1. Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. Electronic address: [email protected]. 2. Division of Endocrinology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. 3. Perelman School of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. 4. Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. 5. Section of Gastroenterology, Hepatology, and Nutrition, University of Chicago, Chicago, Illinois.

Abstract

BACKGROUND & AIMS:

Celiac disease can reduce bone mineral density. We sought to determine the prevalence and risk factors for low areal bone mineral density (aBMD) in children with celiac disease.

METHODS:

We performed a retrospective cohort study of 673 children with celiac disease (63% female; median age at diagnosis, 10.6 y; interquartile range, 7.8-13.9) who underwent dual x-ray absorptiometry (DXA) from 2009 through 2016 at the Children's Hospital of Philadelphia. We collected demographic, clinical, and laboratory data from medical records. We performed logistic regression analysis to identify factors associated with low (Z less than -2) lumbar spine aBMD Z (aBMD-Z) scores at initial and subsequent tests. RESULTS:

The time between diagnosis of celiac disease and first DXA was 0 days (interquartile range, -11 to 31 d). The mean aBMD-Z score at the children's initial scan was -0.4 ± 1.2; 46 children had aBMD-Z scores less than -2 (6.8%; 95% CI, 5.2%-9.0%). Those who had a second DXA analysis (n = 108; 16.0%) had a significant increase in aBMD-Z score (mean change, 0.29; P = .0005). Higher body mass index (BMI) was associated with lower odds of a low aBMD-Z score at the initial DXA analysis (odds ratio, 0.46, 95% CI, 0.35-0.50). BMI-Z scores greater than -0.4 identified children with a low aBMD-Z at their initial DXA analysis with a 95% negative predictive value.

CONCLUSIONS:

Approximately 7% of subjects with celiac disease had a low aBMD-Z score, determined by DXA, at the time of diagnosis; this value was nearly 3-fold higher than expected from a population of children of this age and sex distribution. BMI-Z scores could be used to identify children with celiac disease at risk for low BMD who should receive DXA screening.

86. EBioMedicine. 2019 Jul;45:456-463. doi: 10.1016/j.ebiom.2019.06.015. Epub 2019 Jun 20. Transcriptomic analysis of enteropathy in Zambian children with severe acute malnutrition.

Chama M1, Amadi BC1, Chandwe K1, Zyambo K1, Besa E1, Shaikh N2, Ndao IM2, Tarr PI2, Storer C3, Head R3, Kelly P4.

Author information: 1. Tropical Gastroenterology and Nutrition group, University of Zambia School of Medicine, Nationalist Road, Lusaka, Zambia. 2. Department of Pediatrics, Washington University School of Medicine, St Louis, MO, United States. 3. Department of Genetics, Washington University School of Medicine, St Louis, MO, United States. 4. Tropical Gastroenterology and Nutrition group, University of Zambia School of Medicine, Nationalist Road, Lusaka, Zambia; Blizard Institute, Barts & The London School of Medicine, Queen Mary University of London, 4 Newark Street, London, UK. Electronic address: [email protected].

Abstract BACKGROUND:

Children with severe acute malnutrition (SAM), with or without diarrhoea, often have enteropathy, but there are few molecular data to guide development of new therapies. We set out to determine whether SAM enteropathy is characterised by specific transcriptional changes which might improve understanding or help identify new treatments.

METHODS:

We collected intestinal biopsies from children with SAM and persistent diarrhoea. mRNA was extracted from biopsies, sequenced, and subjected to a progressive set of complementary analytical approaches: NOIseq, Gene Set Enrichment Analysis (GSEA), and correlation analysis of phenotypic data with gene expression.

FINDINGS:

Transcriptomic profiles were generated for biopsy sets from 27 children of both sexes, under 2 years of age, of whom one-third were HIV-infected. NOIseq analysis, constructed from phenotypic group extremes, revealed 66 differentially expressed genes (DEGs) out of 21,386 mapped to the reference genome. These DEGs include genes for mucins and mucus integrity, antimicrobial defence, nutrient absorption, C-X-C chemokines, proteases and anti-proteases. Phenotype - expression correlation analysis identified 1221 genes related to villus height, including increased cell cycling gene expression in more severe enteropathy. Amino acid transporters and ZIP zinc transporters were specifically increased in severe enteropathy, but transcripts for xenobiotic metabolising enzymes were reduced.

INTERPRETATION:

Transcriptomic analysis of this rare collection of intestinal biopsies identified multiple novel elements of pathology, including specific alterations in nutrient transporters. Changes in xenobiotic metabolism in the gut may alter drug disposition. Both NOIseq and GSEA identified gene clusters similar to those differentially expressed in pediatric Crohn's disease but to a much lesser degree than those identified in coeliac disease. FUND: Bill & Melinda Gates Foundation OPP1066118. The funding agency had no role in study design, data collection, data analysis, interpretation, or writing of the report.

PMCID: PMC6642221 Free PMC Article PMID: 31229436 Similar articles

87. Pancreas. 2019 Jul;48(6):e53-e54. doi: 10.1097/MPA.0000000000001326. Autoimmune Pancreatitis Masquerading as Celiac Disease.

Patel BJ1, Cantor M, Retrosi G, Gheorghe R, Wrogemann J, Mujawar Q.

Author information: 1. Department of Pediatrics Max Rady College of Medicine University of Manitoba Winnipeg, Canada Section of Gastroenterology Department of Internal Medicine Health Sciences Centre University of Manitoba Winnipeg, Canada Section of Pediatric Surgery Department of Surgery Health Sciences Centre University of Manitoba Winnipeg, Canada Department of Pathology University of Manitoba Winnipeg, Canada Section of Pediatric Radiology Department of Radiology Health Sciences Centre University of Manitoba Winnipeg, Canada Section of Pediatric Gastroenterology Department of Pediatrics Health Sciences Centre University of Manitoba Winnipeg, Canada [email protected]. PMID: 31206470 Similar articles

88. J Biomech. 2019 Jul 19;92:146-154. doi: 10.1016/j.jbiomech.2019.05.043. Epub 2019 Jun 1. Computational simulation of flow-induced arterial remodeling of the pancreaticoduodenal arcade associated with celiac artery stenosis.

Yuhn C1, Hoshina K2, Miyahara K2, Oshima M3.

Author information: 1. Department of Mechanical Engineering, The University of Tokyo, Tokyo, Japan. Electronic address: [email protected]. 2. Department of Vascular Surgery, The University of Tokyo, Tokyo, Japan. 3. Interfaculty Initiative in Information Studies, The University of Tokyo, Tokyo, Japan.

Abstract

Arterial remodeling of the pancreaticoduodenal arcade, which enables collateral flow to the liver, spleen, and stomach, is a well-recognized clinical sign of celiac artery (CA) stenosis. However, the hemodynamic changes due to remodeling are poorly understood, despite their importance in surgical procedures such as pancreaticoduodenectomy. In this study, a framework to simulate remodeling of the arterial network following pathological flow alterations was developed and applied to investigate the hemodynamic characteristics of patients with CA stenosis. A one- dimensional-zero-dimensional cardiovascular model was used for blood flow simulation. After introducing CA stenosis into the normal network, arterial remodeling was simulated by iteratively changing the diameter of each artery until time-averaged wall shear stress reached its value under normal conditions. A representative case was simulated to validate the present framework, followed by simulation cases to investigate the impact of stenosis severity on remodeling outcome. A markedly dilated arcade was observed whose diameter agreed well with the corresponding values measured in subjects with CA stenosis, confirming the ability of the framework to predict arterial remodeling. A series of simulations clarified how the geometry and hemodynamics after remodeling change with stenosis severity. In particular, the arterial remodeling and resulting blood flow redistribution were found to maintain adequate organ blood supply regardless of stenosis severity. Furthermore, it was suggested that flow conditions in patients with CA stenosis could be estimated from geometric factors, namely, stenosis severity and arcade diameter, which can be preoperatively and non-invasively measured using diagnostic medical images.

89. Am J Physiol Gastrointest Liver Physiol. 2019 Aug 1;317(2):G161-G170. doi: 10.1152/ajpgi.00099.2019. Epub 2019 Jun 12. Celiac disease: should we care about microbes?

Caminero A1, Verdu EF1.

Author information: 1. Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada.

Abstract

The prevalence of celiac disease (CeD) has increased in the last decades, suggesting a role for environmental factors in addition to gluten. Several cohort studies have shown that different gastrointestinal infections increase CeD risk. However, the mechanisms by which microbes participate in CeD have remained elusive. Recently, with the use of animal models, both viral and bacterial opportunistic pathogens were shown to induce immune activation relevant for CeD. The hypothesis that viral and/or bacterial infections can contribute to immune activation and breakdown of tolerance toward gluten in genetically susceptible individuals is therefore reinforced. Here, we discuss the evidence regarding the role of microbes in promoting CeD and the specific pathways triggered by microbes that could participate in CeD pathogenesis. Understanding these pathways will allow us to develop optimal microbiota-modulating strategies to help prevent CeD. PMID: 31188640 Similar articles

90. Chin Med J (Engl). 2019 Jul 5;132(13):1513-1515. doi: 10.1097/CM9.0000000000000305. Insufficient awareness of celiac disease in China: population-based screening is needed.

Chen CY1, Li JN.

Author information: 1. Department of Gastroenterology, Key Laboratory of Gut Microbiota Translational Medicine Research, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.

PMCID: PMC6616242 Free PMC Article PMID: 31188159 Similar articles

91. Aliment Pharmacol Ther. 2019 Jul;50(1):107-108. doi: 10.1111/apt.15304. Editorial: faecal gluten immunogenic peptides in coeliac children.

Guandalini S1.

Author information: 1. Department of Pediatrics, University of Chicago, Chicago, Illinois. PMID: 31184396 Similar articles

92. Am J Med Genet A. 2019 Aug;179(8):1426-1431. doi: 10.1002/ajmg.a.61258. Epub 2019 Jun 10. Gastrointestinal disorders in Down syndrome.

Bermudez BEBV1, de Oliveira CM2, de Lima Cat MN1, Magdalena NIR1, Celli A1.

Author information: 1. Down Syndrome Outpatient Clinic, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Paraná, Brazil. 2. Preventive Medicine & Epidemiology, Boston University School of Medicine, Boston, Massachusetts.

Abstract

Down syndrome is the most common human chromosomal disorder. Among clinical findings, one constant concern is the high prevalence of gastrointestinal system alterations. The aim of this study was to determine the prevalence of gastrointestinal disorders at a Down syndrome outpatient clinic during a 10-year follow-up period. Data from medical files were retrospectively reviewed from 1,207 patients. Gastrointestinal changes occurred in 612 (50.7%). The most prevalent disorder was chronic intestinal constipation. Intestinal parasite occurred in 22% (mainly giardiasis), gastroesophageal reflux disease in 14%, digestive tract malformations occurred in 5%: 13 cases of duodenal atresia, 8 of imperforate anus, 4 annular pancreases, 2 congenital megacolon, 2 esophageal atresias, 2 esophageal compression by anomalous subclavian and 1 case of duodenal membrane. We had 38/1,207 (3.1%) patients with difficulty in sucking and only three with dysphagia that resolved before the second year of life. Peptic ulcer disease, celiac disease, and biliary lithiasis were less prevalent with 3% each. Awareness of the high prevalence of gastrointestinal disorders promotes outstanding clinical follow-up as well as adequate development and greater quality of life for patients with Down syndrome and their families.

93. Mol Med Rep. 2019 Jul;20(1):787-794. doi: 10.3892/mmr.2019.10284. Epub 2019 May 23. Overlapping of irritable bowel syndrome with erosive esophagitis and the performance of Rome criteria in diagnosing IBS in a clinical setting.

El-Salhy M1, Gilja OH2, Hatlebakk JG2.

Author information: 1. Section for Gastroenterology, Department of Medicine, Stord Hospital, 5416 Stord, Norway. 2. Department of Clinical Medicine, University of Bergen, 5007 Bergen, Norway.

Abstract

Irritable bowel syndrome (IBS) and gastroesophageal reflux disease (GERD) overlap. It is not clear whether GERD is caused by non-erosive esophagitis, or erosive esophagitis. The Rome criteria are not widely used for the diagnosis of IBS in the clinic. In total, 1,489 IBS patients without red flags were included in the present retrospective study. They comprised of 1,331 females and 158 males with a mean age of 51 years. The diagnosis of IBS was verified by endoscopic and histopathological examinations. Whereas erosive esophagitis occurred in 97% of patients, only 66% had GERD symptoms. Endoscopy and histopathological examinations revealed that 1.4% of the IBS patients with diarrhea as the predominant symptom had other organic gastrointestinal diseases: 0.3% with celiac disease, 0.2% with Crohn's disease, 0.07% with ulcerative colitis, 0.6% with microscopic colitis, and 0.2% with colon cancer. Applying the Rome III criteria produced a sensitivity of 100% [95% confidence intervals (CI)=99.8-100.0%] a specificity of 98.7% (95% CI=98.0-99.2%), a positive likelihood ratio of 76.9%, and a negative likelihood ratio of 0%. IBS is associated with erosive esophagitis. Applying Rome III criteria without red flags and history, was effective in diagnosing IBS. Celiac disease and microscopic colitis should be considered as alternative diagnoses.

PMCID: PMC6580027 Free PMC Article PMID: 31180516 Similar articles

94. Food Chem. 2019 Oct 15;295:599-606. doi: 10.1016/j.foodchem.2019.05.161. Epub 2019 May 24. Impact of aqualysin 1 peptidase from Thermus aquaticus on molecular scale changes in the wheat gluten network during bread baking.

Verbauwhede AE1, Lambrecht MA2, Fierens E3, Shegay O4, Brijs K5, Delcour JA6. Author information: 1. KU Leuven, Laboratory of Food Chemistry and Biochemistry, Leuven Food Science and Nutrition Research Centre (LFoRCe), Kasteelpark Arenberg 20, B-3001 Leuven, Belgium. Electronic address: [email protected]. 2. KU Leuven, Laboratory of Food Chemistry and Biochemistry, Leuven Food Science and Nutrition Research Centre (LFoRCe), Kasteelpark Arenberg 20, B-3001 Leuven, Belgium. Electronic address: [email protected]. 3. KU Leuven, Laboratory of Food Chemistry and Biochemistry, Leuven Food Science and Nutrition Research Centre (LFoRCe), Kasteelpark Arenberg 20, B-3001 Leuven, Belgium. Electronic address: [email protected]. 4. Competence Center for Fermentation, Puratos Group, Rue Bourrie 12, B-5300 Andenne, Belgium. Electronic address: [email protected]. 5. KU Leuven, Laboratory of Food Chemistry and Biochemistry, Leuven Food Science and Nutrition Research Centre (LFoRCe), Kasteelpark Arenberg 20, B-3001 Leuven, Belgium. Electronic address: [email protected]. 6. KU Leuven, Laboratory of Food Chemistry and Biochemistry, Leuven Food Science and Nutrition Research Centre (LFoRCe), Kasteelpark Arenberg 20, B-3001 Leuven, Belgium. Electronic address: [email protected].

Abstract

The impact of Aqualysin 1 (Aq1), the thermo-active peptidase of Thermus aquaticus, on wheat albumin, globulin, gliadin and glutenin proteins during heat treatment of wheat dough and bread baking was examined. The level of protein extractable in sodium dodecyl sulfate containing medium under non-reducing conditions (SDS-EP-NR) from wheat dough decreases upon heating to a lesser extent when Aq1 is used than in control experiments. The higher SDS-EP-NR level is caused by the release by Aq1 of peptides from the repetitive gluten protein domains during baking. These peptides are also extractable from bread crumb with salt solution. The resultant thermoset gluten network in bread crumb is mainly made up by protein from non-repetitive gluten domains.

95. Food Chem. 2019 Oct 15;295:189-197. doi: 10.1016/j.foodchem.2019.05.066. Epub 2019 May 11. Sugar beet and apple fibres coupled with hydroxypropylmethylcellulose as functional ingredients in gluten-free formulations: Rheological, technological and sensory aspects.

Djordjević M1, Šoronja-Simović D2, Nikolić I1, Djordjević M1, Šereš Z1, Milašinović-Šeremešić M3.

Author information: 1. University of Novi Sad, Faculty of Technology Novi Sad, Department of Carbohydrate Food Engineering, Bul. cara Lazara 1, 21000 Novi Sad, Serbia. 2. University of Novi Sad, Faculty of Technology Novi Sad, Department of Carbohydrate Food Engineering, Bul. cara Lazara 1, 21000 Novi Sad, Serbia. Electronic address: [email protected]. 3. Maize Research Institute, Department of Technology, Zemun Polje, Slobodana Bajića 1, 11080 Belgrade, Serbia.

Abstract

The presented study examined the influence of hydroxypropylmethylcellulose (HPMC), sugar beet fibre (SBF) and apple fibre (AF) incorporation coupled with adequate water levels on gluten-free (GF) batter rheology, bread quality and sensory characteristics. A Box-Behnken experimental design with independent variables: HPMC quantity (2-4 g/100 g), SBF and AF quantity (3-7 g/100 g) and water quantity (180-230 g/100 g depending on the fibre type) based on a maize flour/starch mixture was applied. GF breads with 4 g/100 g HPMC coupled with 3 g/100 g SBF and 7 g/100 g AF reached the highest specific volumes (2.44 cm3/g and 3.97 cm3/g) accompanied with the lowest crumb hardness (2.29 and 2.10 N, respectively). Appealing crust and crumb colour and good sensory characteristics were achieved in GF breads with 4 g/100 g HPMC and 3, 5 and 7 g/100 g SBF or AF. The corresponding GF breads showed enhanced fibre content (4.56-6.07 g/100 g).

96. Diabetes Care. 2019 Aug;42(8):1489-1495. doi: 10.2337/dc18-2376. Epub 2019 Jun 4. Abnormal Cortical and Trabecular Bone in Youth With Type 1 Diabetes and Celiac Disease.

Pham-Short A1,2, Donaghue KC1,2, Ambler G1,2, Briody J2,3, Garnett S1,2, Munns CF1,2, Craig ME4,2,5. Author information: 1. Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia. 2. Children's Hospital Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia. 3. Department of Nuclear Medicine, The Children's Hospital at Westmead, Westmead, New South Wales, Australia. 4. Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia [email protected] [email protected]. 5. School of Women's and Child's Health, University of New South Wales, Sydney, New South Wales, Australia.

Abstract

OBJECTIVE:

This study compared bone health in youth with type 1 diabetes and celiac disease (CD) versus type 1 diabetes alone.

RESEARCH DESIGN AND METHODS:

This was a case-control study of 42 youth with coexisting type 1 diabetes and CD and 40 with type 1 diabetes matched for age, sex, diabetes duration, and HbA1c. Bone mineral density (BMD), bone mineral content (BMC), and BMC-to-lean tissue mass (LTM) ratio were measured using DXA and reported as z-scores for height. Total, trabecular, and cortical bone and muscle parameters were measured using peripheral quantitative computed tomography (pQCT) and reported as z-scores for age.

RESULTS:

Mean age at assessment was 14.3 ± 3.1 years; diabetes duration, 8.0 ± 3.5 years; HbA1c, 8.2 ± 1.5% (66 ± 5 mmol/mol); and 25-hydroxy vitamin D, 71 ± 21 nmol/L. Comparing youth with coexisting CD versus type 1 diabetes alone, DXA showed lower BMC-to-LTM ratio (0.37 ± 1.12 vs. 0.73 ± 2.23, P = 0.007) but no difference in total BMD. Youth with coexisting CD also had lower BMC-to-LTM ratio versus the general population (P = 0.04). Radial pQCT showed lower total BMC (-0.92 ± 1.40 vs. -0.26 ± 1.23, P = 0.03) despite similar bone and muscle cross-sectional area. In multivariable linear regression, lower BMC was associated with higher insulin dose (P = 0.03) but not HbA1c.

CONCLUSIONS:

Youth with both type 1 diabetes and CD have lower BMC relative to LTM and lower BMC, indicating abnormal trabecular and cortical bone development despite similar bone and muscle size. These findings suggest that the two conditions confer a lower bone turnover state. We recommend further examination of bone health in this population; future research should examine early interventions to improve bone health. © 2019 by the American Diabetes Association. PMID: 31167891 Similar articles

97. Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2019 Aug;36(8):1151-1162. doi: 10.1080/19440049.2019.1616830. Epub 2019 Jun 4. Detection of gluten in a pilot-scale barley- based beer produced with and without a prolyl endopeptidase enzyme.

Fiedler KL1, Cao W2, Zhang L2, Naziemiec M2, Bedford B3, Yin L1, Smith N4, Arbuckle M4, Lopez- Hernandez A4, Jackson LS3.

Author information: 1. a Center for Food Safety and Applied Nutrition, US FDA , College Park , MD , USA. 2. b Institute for Food Safety and Health, Illinois Institute of Technology , Bedford Park , IL , USA. 3. c Center for Food Safety and Applied Nutrition, US FDA , Bedford Park , IL , USA. 4. d Department of Food Science, University of Wisconsin , Madison , WI , USA.

Abstract

Immunochemical and mass spectrometric methods were used to examine the gluten composition of a gluten-reduced beer produced by brewing with barley malt in the presence of prolyl endopeptidase (PEP) and a final filtration treatment with diatomaceous earth and perlite. The competitive ELISA is generally considered appropriate for the analysis of hydrolysed gluten, but it is not considered a scientifically valid method for the quantification of gluten in fermented or hydrolysed foods due to the lack of an appropriate reference standard. As no single analytical method can capture the spectrum of gluten-derived products in beer, a comprehensive approach was employed to analyse the intact and hydrolysed fractions of gluten with complementary methods. The combination of PEP addition and diatomaceous earth/perlite filtration was more effective at reducing the concentration of detectable gluten than each of the treatments alone. However, gluten proteins and/or polypeptides were observed in filtered, PEP-treated beers using sandwich ELISA methods, western blot, and bottom-up mass spectrometry. In addition, mass spectrometry results showed that the number of hydrolysed gluten peptides was almost unaffected by the filtration process. Gluten peptides that contained potentially immunopathogenic sequences were identified in the filtered PEP-containing beers by MS. Variability in gluten composition was observed between three replicate pilot-scale productions, suggesting that the gluten profile in beer could differ from batch to batch. As there is uncertainty in the detection and quantification of gluten in hydrolysed and fermented foods, characterisation of hydrolysed gluten by complementary analytical methodologies is recommended.

PMID: 31161918 Similar articles

98. Anal Bioanal Chem. 2019 Aug;411(20):5159-5174. doi: 10.1007/s00216-019-01893-0. Epub 2019 Jun 3. Western blot analysis of fermented- hydrolyzed foods utilizing gluten-specific antibodies employed in a novel multiplex competitive ELISA.

Panda R1, Garber EAE2.

Author information: 1. Division of Bioanalytical Chemistry, Office of Regulatory Science, Center for Food Safety and Applied Nutrition (CFSAN), FDA, 5001 Campus Drive, College Park, MD, 20740, USA. [email protected]. 2. Division of Bioanalytical Chemistry, Office of Regulatory Science, Center for Food Safety and Applied Nutrition (CFSAN), FDA, 5001 Campus Drive, College Park, MD, 20740, USA.

Abstract

Horseradish peroxidase (HRP) conjugated gluten-specific antibodies (G12, R5, 2D4, MIoBS, and Skerritt), from nine commercial gluten ELISA test kits, previously utilized in the development of a multiplex competitive ELISA for the detection of fermented-hydrolyzed gluten, were utilized in western blot analyses of 59 fermented-hydrolyzed foods from four food groups (beer, soy-based sauces, vinegar, and sourdough bread). The protein/peptide profiles generated by the nine gluten- specific antibodies varied in size distribution and intensity dependent on the type of food, with minor differences between related products. Cluster analysis of the estimated gluten concentration values (based on western blot band intensities relative to intact gluten standards at 2.5 μg/mL and 100 μg/mL) and that of the relative response of the nine gluten-specific antibodies to different gluten proteins/peptides, distinguished among the different categories of fermented-hydrolyzed foods; comparable to what was observed in the multiplex competitive ELISA. Further, unlike the competitive ELISA, the western blot analyses distinguished between the presence of antigenic proteinaceous materials and false positives due to the presence of binding inhibitors (as observed with four soy-based sauces and one vinegar). Limitations of western blot analysis often include lower sensitivity than the comparable competitive ELISA and problems quantitating gluten-derived peptides and proteins. As a result, western blot analysis provides an orthogonal approach that can be used to both confirm the multiplex competitive ELISA while also providing additional insight into the protein/peptide profile of fermented-hydrolyzed foods. Graphical abstract.

PMID: 31161323 [Indexed for MEDLINE] Similar articles

99. Hautarzt. 2019 Jul;70(7):547-549. doi: 10.1007/s00105-019-4436-2. [Follicular hyperkeratosis in coeliac disease].

[Article in German] Ullrich N1, Metze D2, Luger TA2, Böhm M2.

Author information: 1. Klinik für Hautkrankheiten - Allgemeine Dermatologie und Venerologie, Universitätsklinikum Münster, Von-Esmarch-Str. 58, 48149, Münster, Deutschland. [email protected]. 2. Klinik für Hautkrankheiten - Allgemeine Dermatologie und Venerologie, Universitätsklinikum Münster, Von-Esmarch-Str. 58, 48149, Münster, Deutschland. PMID: 31161237 [Indexed for MEDLINE] Similar articles

100. Rev Med Interne. 2019 Aug;40(8):536-544. doi: 10.1016/j.revmed.2019.05.010. Epub 2019 May 31. [Mesenteric lymph node cavitation in celiac disease: Report of four cases and literature review].

[Article in French] Ruch Y1, Labidi A2, Martin A3, Weingertner N4, Hansmann Y3, Lefebvre N3, Andres E5, Argemi X3, Dieudonné Y6.

Author information: 1. Service de maladies infectieuses et tropicales, NHC, CHU de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France. Electronic address: [email protected]. 2. Service de gastro-entérologie, université de Tunis el Manar, hôpital universitaire La Rabta, Tunis, Tunisie. 3. Service de maladies infectieuses et tropicales, NHC, CHU de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France. 4. Service d'anatomie pathologique, hôpital de Hautepierre, CHU de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France. 5. Service de médecine interne et maladies métaboliques, médicale B, CHU de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France. 6. Service d'immunologie clinique, NHC, CHU de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France.

Abstract

INTRODUCTION:

Mesenteric lymph node cavitation is an exceptional complication of celiac disease. We report four original observations of this syndrome, completed by a literature review.

DISCUSSION:

The analysis of 38 cases showed that this complication occurred exclusively in adults, with a mean age at diagnosis of 54 years. It revealed the celiac disease in the majority of cases. Hyposplenism was almost systematically associated. The risk of lymphoma appeared higher, especially enteropathy-associated T-cell lymphoma. The prognosis was poor with nearly 50% mortality and seemed related to the clinical response to the gluten-free diet.

CONCLUSION:

The severity of this complication deserves to be known and should lead to its research in celiac patients, especially in cases diagnosed in adulthood or in case of refractory disease.

101. J Pediatr Gastroenterol Nutr. 2019 Aug;69(2):e25-e33. doi: 10.1097/MPG.0000000000002407. Psychological Comorbidities in Childhood Celiac Disease: A Systematic Review.

Coburn SS1,2, Puppa EL3, Blanchard S3.

Author information: 1. Department of Gastroenterology, Children's National Health System. 2. George Washington University School of Medicine, Washington, DC. 3. University of Maryland Medical Center, Baltimore, MD.

Abstract OBJECTIVES:

Mental health disorders comorbid to chronic illness are associated with higher medical care utilization and costs for adults and children. Celiac disease (CD) has a substantial perceived treatment burden and is associated with higher rates of psychopathology in adults. However, establishing the risk for psychological comorbidities in children with CD is still needed. This study aimed to review existing research on mental health concerns in pediatric CD and propose an initial psychosocial research and clinical agenda.

METHODS:

Databases, including Scopus and PubMed. Additional publications were accessed and reviewed from the references provided by initially identified publications. Two investigators screened studies using predetermined criteria (peer-reviewed, published in English, electronically available, inclusive of child participants, and examining CD). One investigator initially extracted data, with subsequent review by the second investigator.

RESULTS:

Twenty-six publications met criteria for the current review (16 case-control, 9 observational, and 1 clinical trial). Publications were heterogeneous in symptoms examined, methodology, and population characteristics. Several studies found elevated risk for psychological comorbidities and poorer quality of life in children with CD. However, many studies were limited by small sample sizes and inconsistent or nonvalidated approaches to measuring psychological symptoms.

CONCLUSIONS:

Many existing studies have found increased prevalence of comorbid CD and psychological symptoms or diagnoses. Therefore, screening for psychological symptoms in CD and also screening for CD in psychological clinic populations is needed. We have identified the importance for further study of mechanisms and risk, and identify preliminary priorities for psychosocial research and clinical care in pediatric CD. PMID: 31149937 Similar articles

102. Dig Liver Dis. 2019 Jul;51(7):934-943. doi: 10.1016/j.dld.2019.04.015. Epub 2019 May 25. Device-assisted enteroscopy: An update on techniques, clinical indications and safety.

Pennazio M1, Venezia L2, Cortegoso Valdivia P2, Rondonotti E3. Author information: 1. University Division of Gastroenterology, Department of Medical Sciences, University of Turin, City of Health and Science, Italy. Electronic address: [email protected]. 2. University Division of Gastroenterology, Department of Medical Sciences, University of Turin, City of Health and Science, Italy. 3. Gastroenterology Unit, Valduce Hospital, Italy.

Abstract

After more than 15 years since its introduction into clinical practice, indications for device-assisted enteroscopy have greatly expanded. Alongside the consolidated indications such as the diagnosis and treatment of small bowel bleeding, Crohn's disease, hereditary polyposis, small-bowel tumors and complicated celiac disease, device-assisted enteroscopy is nowadays largely used to perform endoscopic retrograde cholangiopancreatography in patients with altered anatomy, stent placement, retrieval of foreign bodies, direct insertion of jejunal feeding tubes, and in selected cases of incomplete colonoscopy. This has been made possible by the technical improvements of the enteroscopes and accessories and by the widespread use of the method. Device-assisted enteroscopy endotherapy currently offers a safe and effective alternative to major surgery and often represents the preferred option for treatment of small-bowel pathology. Its safety profile is favourable even in the elderly patient, provided that it is performed in high-volume and experienced centers. The evolution of the enteroscopy technique is a challenge for the future and could be facilitated by the new enteroscopes models. These prototypes need a thorough clinical and safety assessment especially for the complex therapeutic procedures. Large prospective, multicenter studies should be performed to assess whether the use of device-assisted enteroscopy leads to improved patients' long-term outcomes.

103. J Clin Immunol. 2019 Jul;39(5):470-475. doi: 10.1007/s10875-019-00647-y. Epub 2019 May 25. Clinical and Laboratory Features of 184 Italian Pediatric Patients Affected with Selective IgA Deficiency (SIgAD): a Longitudinal Single-Center Study. Lougaris V1, Sorlini A2, Monfredini C2, Ingrasciotta G2, Caravaggio A2, Lorenzini T2, Baronio M2, Cattalini M2, Meini A3, Ruggeri L3, Salpietro A3, Pilotta A3, Grazzani L3, Prandi E3, Felappi B3, Gualdi G4, Fabiano A4, Fuoti M3, Ravelli A3, Villanacci V5, Soresina A3, Badolato R2, Plebani A2.

Author information: 1. Pediatrics Clinic and Institute for Molecular Medicine A. Nocivelli, Department of Clinical and Experimental Sciences, University of Brescia and ASST-Spedali Civili of Brescia, Brescia, Italy. [email protected]. 2. Pediatrics Clinic and Institute for Molecular Medicine A. Nocivelli, Department of Clinical and Experimental Sciences, University of Brescia and ASST-Spedali Civili of Brescia, Brescia, Italy. 3. Pediatrics Clinic, ASST-Spedali Civili of Brescia, Brescia, Italy. 4. Department of Dermatology, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy. 5. Institute of Pathology, ASST-Spedali Civili of Brescia, Brescia, Italy.

Abstract

PURPOSE:

Selective IgA deficiency (SIgAD) is the most common humoral primary immunodeficiency. Long- term follow-up data in large cohort of pediatric patients are scarce.

METHODS:

We report on a single-center cohort of 184 pediatric patients affected with selective IgA deficiency and describe the characteristics at diagnosis and during follow-up.

RESULTS:

Respiratory infections were the most common clinical finding leading to the initial diagnosis (62%). Positive family history for antibody deficiencies (selective IgA deficiency, common variable immunodeficiency) led to SIgAD diagnosis in 16% of cases. During follow-up, while the incidence of respiratory infections was not particularly high, gastrointestinal symptoms were reported in 27% of patients. Allergic manifestations were found in 23% at diagnosis and an additional 16% of patients during follow-up, leading to a prevalence of atopy of 39% among SIgAD patients. Autoimmune manifestations, excluding celiac disease, were found in 9% of affected patients during follow-up. Celiac disease was found in a high prevalence (14%). Increase of serum IgA levels to partial deficiency (9%) and normal serum levels for age (4%) was observed during follow-up. A small percentage of patients (2%) progressed to common variable immunodeficiency (CVID).

CONCLUSIONS:

In conclusion, this is the first study to describe a large single-center pediatric cohort of patients affected with SIgAD, revealing that overall most patients do well with regard to infections. Many develop CD, at a rate much higher than the general population. A few normalize their IgA levels. A few progress to CVID. Thus, careful follow-up is suggested to diagnose and treat potential complications earlier for avoiding potential morbidities.

PMID: 31129864 Similar articles

104. Food Chem. 2019 Oct 1;294:87-95. doi: 10.1016/j.foodchem.2019.05.037. Epub 2019 May 8. Effect of quinoa flour on baking performance, antioxidant properties and digestibility of wheat bread.

Xu X1, Luo Z2, Yang Q3, Xiao Z3, Lu X4.

Author information: 1. School of Food Science and Engineering, South China University of Technology, Guangzhou 510640, China. 2. School of Food Science and Engineering, South China University of Technology, Guangzhou 510640, China; College of Grain Science and Technology, Shenyang Normal University, Shenyang 110034, China; Overseas Expertise Introduction Center for Discipline Innovation of Food Nutrition and Human Health (111 Center), Guangzhou 510640, China. Electronic address: [email protected]. 3. College of Grain Science and Technology, Shenyang Normal University, Shenyang 110034, China. 4. Department of Food Science, Rutgers, The State University of New Jersey, 65 Dudley Rd, New Brunswick, NJ 08901, USA.

Abstract

Quinoa flour (QF) was added in wheat flour to make nutritionally fortified wheat bread (WB). Effects of QF on baking performance, antioxidant activity and digestibility of WB were studied. The results indicated that with an addition of a small amount of QF (5%) would not affect the baking performance of WB, while higher amounts of QF (10% and 15%) resulted in smaller specific volume, increased hardness and coarse porosity, since QF changed gluten secondary structure and disrupted gluten network. However, sensory evaluation showed that the flavor of WB enhanced significantly with increasing QF addition. More importantly, WB containing QF exhibited improved antioxidant activity and reduced in vitro digestibility with lower estimated glycemic index (eGI) and higher content of slowly digestible starch (SDS) and resistant starch (RS). Our findings indicate that QF-fortified bread is promising to be developed as a functional food with relatively lower eGI and more effective antioxidant properties.

105. Eur J Obstet Gynecol Reprod Biol. 2019 Jul;238:90-94. doi: 10.1016/j.ejogrb.2019.05.015. Epub 2019 May 15. Reproductive complications in celiac disease patients in Slovenia.

Pogačar MŠ1, Vlaisavljević V2, Turk E3, Mičetić-Turk D3.

Author information: 1. University of Maribor, Faculty of Medicine, Department of Pediatrics, Taborska ulica 8, 2000 Maribor, Slovenia. Electronic address: [email protected]. 2. IVF Adria Consulting, Ljubljanska ul. 9, 2000 Maribor, Slovenia. 3. University of Maribor, Faculty of Medicine, Department of Pediatrics, Taborska ulica 8, 2000 Maribor, Slovenia.

Abstract

OBJECTIVE:

Celiac disease is associated with higher risk of infertility, recurrent abortions, and adverse outcomes in pregnancy and in puerperium. The aim of the study was to analyse the association between celiac disease and reproductive disorders in the group of celiac patients and compare these to healthy controls.

METHODS:

A retrospective case-control matched study. The association between celiac disease and menstrual cycle, gyneco-obstetrical complications was assessed with a questionnaire specifically developed for the study. 144 celiac women and 61 celiac men, members of Slovenian Celiac Society, together with 71 healthy women and 31 healthy men participated in the study.

RESULTS:

A higher percentage of celiac women (27.1%) had difficulties in conception of the first child when compared to healthy controls (12.7%) (p = 0.042). In addition, celiac women experienced more complications than healthy controls during the pregnancy, such as abortions or intrauterine growth retardation (p < 0.005). In our study, the prevalence of reproductive problems was not the same in celiac males and females. Altogether 2 celiac men (3.3%) reported having fertility problems, however, the difference between male cases and controls was not statistically significant (p = 0.548). CONCLUSION:

Physicians should examine women with unexplained infertility, recurrent abortions or intrauterine growth retardation for undiagnosed celiac disease. Compared with healthy women, women with celiac disease have increased risk of spontaneous abortions, preterm delivery and fewer successful pregnancies.

106. Comput Biol Med. 2019 Jul;110:40-41. doi: 10.1016/j.compbiomed.2019.05.005. Epub 2019 May 7. Honored papers 2018.

Ciaccio EJ1.

Author information: 1. Department of Medicine, Division of Cardiology and Celiac Disease Center, Columbia University, New York, NY 10032, USA. Electronic address: [email protected]. PMID: 31121505 Similar articles

107. Adv Ther. 2019 Jul;36(7):1672-1683. doi: 10.1007/s12325-019-00964-z. Epub 2019 May 17. Risk of Developing Additional Immune- Mediated Manifestations: A Retrospective Matched Cohort Study.

Aletaha D1, Epstein AJ2, Skup M3, Zueger P3, Garg V3, Panaccione R4.

Author information: 1. Medical University of Vienna, Vienna, Austria. [email protected]. 2. Medicus Economics, LLC, Boston, USA. 3. AbbVie Inc., North Chicago, IL, USA. 4. University of Calgary, Calgary, Canada. Abstract

INTRODUCTION:

Immune-mediated inflammatory diseases (IMIDs) cause significant impairment in quality of life. Although they share similar genetic factors, environmental precipitants, and pathophysiological mechanisms, there is little evidence on the risk of developing subsequent IMIDs after an initial IMID diagnosis. We sought to assess the risk of developing subsequent IMIDs among patients diagnosed with an initial IMID.

METHODS:

This retrospective matched cohort study used a large US commercial health insurance claims database (01/01/2006-09/30/2015). The risks of developing secondary IMIDs among patients aged 18-64 years with a diagnosis of one of nine IMIDs of interest (ankylosing spondylitis, celiac disease, hidradenitis suppurativa [HS], inflammatory bowel disease, lupus, psoriatic arthritis [PsA], psoriasis, rheumatoid arthritis, and uveitis) as identified from diagnosis codes on medical claims were compared with up to 1000 matched controls without the primary IMID using Cox proportional hazards models.

RESULTS:

Across the nine IMIDs of interest, there were 398,935 unique case patients matched to 256,795,796 non-unique control patients. Case patients with an initial IMID had higher risks of developing each, any one, and any two of the other eight secondary IMIDs compared to their matched controls. Hazard ratios [95% confidence intervals] for the risk of developing any one secondary IMID ranged from 5.4 [5.0, 5.8] (initial IMID: HS) to 62.2 [59.9, 64.6] (initial IMID: PsA), and hazard ratios for developing any two secondary IMIDs ranged from 3.0 [2.3, 3.8] (HS) to 75.2 [69.3, 81.7] (PsA).

CONCLUSIONS:

This study demonstrates that the risk of developing a second IMID is significantly higher for individuals who have already experienced a first IMID in a large and contemporary US claims database. Certain pairs of IMIDs co-occur more frequently than others. The risk of developing subsequent IMIDs may be an important consideration for clinicians when selecting treatment strategies.

FUNDING:

Abbvie. PMID: 31102202 Similar articles

108. Dig Dis Sci. 2019 Jul;64(7):1740-1747. doi: 10.1007/s10620-019-05663-x. Going Against the Grains: Gluten-Free Diets in Patients Without Celiac Disease- Worthwhile or Not?

Lerner BA1, Green PHR1, Lebwohl B2,3.

Author information: 1. Department of Medicine, Celiac Disease Center, Columbia University Medical Center, New York, NY, 10032, USA. 2. Department of Medicine, Celiac Disease Center, Columbia University Medical Center, New York, NY, 10032, USA. [email protected]. 3. Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, NY, 10032, USA. [email protected].

Abstract

While the gluten-free diet (GFD) is the only known effective therapy for celiac disease, in recent years it has become increasingly popular in the USA and worldwide, with many believing it to be more "healthful" and others claiming that it has beneficial effects for health conditions, many extraintestinal, other than celiac disease. This review examines the evidence for use of the GFD in patients without celiac disease who self-report intestinal and/or extraintestinal symptoms (nonceliac gluten sensitivity), as well as for enhancement of athletic performance and treatment of autism, rheumatoid arthritis, and psychiatric disorders. Overall, the evidence for use of GFDs in conditions other than celiac disease is poor. Though non-celiac gluten sensitivity may ultimately emerge as a biomarker-defined condition, a large proportion of patients with apparent non-celiac gluten sensitivity have, after careful investigation, an alternative diagnosis. In light of this, and coupled with the potential physical and psychological harms associated with the avoidance of gluten, initiating a GFD should not be encouraged for people who have these other conditions or are seeking physical/athletic enhancement. PMID: 31102129 Similar articles

109. Anal Biochem. 2019 Aug 1;578:36-44. doi: 10.1016/j.ab.2019.05.007. Epub 2019 May 11. Profiling of VOCs released from different salivary bacteria treated with non-lethal concentrations of silver nitrate.

Milanowski M1, Monedeiro F2, Złoch M1, Ratiu IA3, Pomastowski P1, Ligor T1, De Martinis BS4, Buszewski B5.

Author information: 1. Department of Environmental Chemistry and Bioanalytics, Faculty of Chemistry, Nicolaus Copernicus University, 7 Gagarina Str, 87-100, Toruń, Poland; Interdisciplinary Centre of Modern Technologies, Nicolaus Copernicus University, 4 Wileńska Str, 87-100, Toruń, Poland. 2. Department of Environmental Chemistry and Bioanalytics, Faculty of Chemistry, Nicolaus Copernicus University, 7 Gagarina Str, 87-100, Toruń, Poland; Interdisciplinary Centre of Modern Technologies, Nicolaus Copernicus University, 4 Wileńska Str, 87-100, Toruń, Poland; Department of Chemistry, Faculty of Philosophy, Science and Letters of Ribeirão Preto, University of São Paulo, CEP 14040-901, Ribeirão Preto, Brazil. 3. Department of Environmental Chemistry and Bioanalytics, Faculty of Chemistry, Nicolaus Copernicus University, 7 Gagarina Str, 87-100, Toruń, Poland; Interdisciplinary Centre of Modern Technologies, Nicolaus Copernicus University, 4 Wileńska Str, 87-100, Toruń, Poland; (d)Babeş- Bolyai University, Faculty of Chemistry and Chemical Engineering, 11 Arany Janos, RO-400028, Cluj- Napoca, Romania. 4. Department of Chemistry, Faculty of Philosophy, Science and Letters of Ribeirão Preto, University of São Paulo, CEP 14040-901, Ribeirão Preto, Brazil. 5. Department of Environmental Chemistry and Bioanalytics, Faculty of Chemistry, Nicolaus Copernicus University, 7 Gagarina Str, 87-100, Toruń, Poland; Interdisciplinary Centre of Modern Technologies, Nicolaus Copernicus University, 4 Wileńska Str, 87-100, Toruń, Poland. Electronic address: [email protected].

Abstract

Considering the shortcomings related to antibiotics usage, the introduction of other bacteriostatic and bactericidal agents that present synergetic effects or standalone properties is urgently needed. AgNO3 is an important bactericidal agent, which imparts various functions on bacteria dependent on its concentration. Therefore, an understanding of its mechanisms of action in infinitesimal concentrations plays an important role which can ultimately lead to AgNO3 involvement in the pharmaceutical industry. The monitoring of VOC (volatile organic compound) profiles emitted by bacteria is a simple method to assess changes occurring in bacterial metabolism. In this study, VOCs of Hafnia alvei, Pseudomonas luteola and Staphylococcus warneri cultures were analyzed both in the absence and in the presence of three concentrations of AgNO3. Headspace solid-phase microextraction gas chromatography/mass spectrometry (HS-SPME-GC/MS) was employed for extraction and analysis. After supplementation with AgNO3, changes in the emitted fingerprints were investigated. Odorants associated with mouth-related and systemic diseases, like dimethyl trisulfide, indole (halitosis) and 2-hexanone (celiac disease), were also affected by addition of AgNO3. Statistical tests proved discrimination between obtained profiles with more that 90% variability. Moreover, physiological states of bacteria after dosage with various concentration of stressing agent were investigated and explained by the mechanisms of action.

110. Food Chem Toxicol. 2019 Jul;129:466-475. doi: 10.1016/j.fct.2019.05.011. Epub 2019 May 10. Prolyl endopeptidase-degraded low immunoreactive wheat flour attenuates immune responses in Caco-2 intestinal cells and gluten-sensitized BALB/c mice.

Mohan Kumar BV1, Vijaykrishnaraj M1, Kurrey NK2, Shinde VS2, Prabhasankar P3.

Author information: 1. Flour Milling, Baking and Confectionery Technology Department, India; Academy of Scientific and Industrial Research, CFTRI Campus, CSIR-Central Food Technological Research Institute, Mysuru, 570020, Karnataka, India. 2. Department of Biochemistry, India. 3. Flour Milling, Baking and Confectionery Technology Department, India; Academy of Scientific and Industrial Research, CFTRI Campus, CSIR-Central Food Technological Research Institute, Mysuru, 570020, Karnataka, India. Electronic address: [email protected].

Abstract

Targeted degrading Aspergillus niger-derived prolyl endopeptidase (AN-PEP) is promising in gluten hydrolysis because it specifically cleaves the proline-rich sites in gluten. The current study aims to understand the safety aspects of AN-PEP hydrolysed low immunoreactive wheat flours by testing immune responses using cell line and animal models. In the AN-PEP hydrolysed wheat flour (AN- PEP HWF) gliadin extract, there was no increase in the levels of zonulin-1 (Zo-1) and pro- inflammatory cytokines (IL-6 and IL-8) but a significant increase was noted in the control wheat flour (CWF) gliadin-treated Caco-2 cells. The Zo-1 localization in Caco-2 cells was significantly noted in the reacted positive fluorescence cells that were treated with the control wheat flour. Further, a safety evaluation of HWF was carried out in gluten-sensitized BALB/c mice. Mouse anti-gliadin (IgG, IgA and IgE) antibodies were significantly generated in the CWF treated animals rather than the AN-PEP HWF groups. The serum pro-inflammatory (IL-1β, IL-4, IL-6, IL-15, TNF-α and IFN-γ) markers were observed in significant levels in CWF challenged mice and a similar trend was observed in ex- vivo splenocyte cells. A small intestine histopathological sectioning revealed that there are no abnormalities or structural changes in AN-PEP HWF challenged mice.

111. DNA Cell Biol. 2019 Jul;38(7):708-717. doi: 10.1089/dna.2018.4561. Epub 2019 May 13. microRNAs: Novel Markers in Diagnostics and Therapeutics of Celiac Disease.

Chamani E1,2, Sargolzaei J3, Tavakoli T1,4, Rezaei Z5.

Author information: 1. 1 Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran. 2. 2 Department of Biochemistry, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran. 3. 3 Department of Biology, Faculty of Sciences, Arak University, Arak, Iran. 4. 4 Gastroenterology Section, Department of Internal Medicine, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran. 5. 5 Department of Biology, University of Sistan and Baluchestan, Zahedan, Iran.

Abstract

microRNAs (miRNAs) are a novel class of single-stranded RNAs with a key role in the regulation of gene expression. miRNA main mechanism of action involves interaction with the mRNA transcribed from the genes, leading to the target mRNA silencing and degradation. Indeed, it is easy to conceive that a defective miRNA-based mRNA regulation may compromise normal cell function and cause genetic diseases. A wide spectrum of studies has focused on the identification and introduction of regulatory diseases-specific miRNAs for the past decade. Overexpression or downregulation of several miRNAs can potentially stimulate or inhibit pathways related to the pathogenesis of celiac disease (CD). CD is a chronic inflammatory disease characterized by small intestinal mucosal injury and nutrient malabsorption in genetically susceptible individuals after the dietary ingestion of gluten. The disease is characterized by villous atrophy, intraepithelial lymphocyte infiltration, and chronic inflammation and activation of lamina propria T cells. The common genetic background in CD is the presence of heterodimeric human leukocyte antigen class II molecules DQ2 or DQ8 that account for 40% of the genetic predisposition in this disease. In fact, by minute identification of these miRNAs and related targets and mechanisms, specific therapeutics can be developed to suppress∼ these pathophysiological pathways through the enhancement or inhibition of miRNAs. This development can open a new prospect for personalized medicine. PMID: 31081687 [Indexed for MEDLINE]

Similar articles

112. Dig Dis Sci. 2019 Jul;64(7):1748-1758. doi: 10.1007/s10620-019-05646-y. Breaking Down Barriers: How Understanding Celiac Disease Pathogenesis Informed the Development of Novel Treatments.

Valitutti F1, Fasano A2,3.

Author information: 1. Pediatric Gastroenterology and Liver Unit, Department of "Maternal-and-Child Health" and Urology, Sapienza University of Rome, Rome, Italy. 2. Mucosal Immunology and Biology Research Center, Center for Celiac Research and Treatment and Division of Pediatric Gastroenterology and Nutrition, MassGeneral Hospital for Children, 175 Cambridge Street, CPZS - 574, Boston, MA, 02114, USA. [email protected]. 3. European Biomedical Research Institute of Salerno, Salerno, Italy. [email protected].

Abstract

For decades, the pathogenesis of a variety of human diseases has been attributed to increased intestinal paracellular permeability even though scientific evidence supporting this hypothesis has been tenuous. Nevertheless, during the past decade, there have been a growing number of publications focused on human genetics, the gut microbiome, and proteomics, suggesting that loss of mucosal barrier function, particularly in the gastrointestinal tract, may substantially affect antigen trafficking, ultimately causing chronic inflammation, including autoimmunity, in genetically predisposed individuals. The gut mucosa works as a semipermeable barrier in that it permits nutrient absorption and also regulates immune surveillance while retaining potentially harmful microbes and environmental antigens within the intestinal lumen. Celiac disease (CD), a systemic, immune-mediated disorder triggered by gluten in genetically susceptible individuals, is associated with altered gut permeability. Pre-clinical and clinical studies have shown that gliadin, a prolamine component of gluten that is implicated in CD pathogenesis, is capable to disassembling intercellular junctional proteins by upregulating the zonulin pathway, which can be inhibited by the zonulin antagonist larazotide acetate. In this review, we will focus on CD as a paradigm of chronic inflammatory diseases in order to outline the contribution of gut paracellular permeability toward disease pathogenesis; moreover, we will summarize current evidence derived from available clinical trials of larazotide acetate in CD.

PMCID: PMC6586517 [Available on 2020-07-01]

PMID: 31076989 Similar articles

113. J Pediatr Gastroenterol Nutr. 2019 Jul;69(1):e23-e24. doi: 10.1097/MPG.0000000000002378. Response to: In Screening for Celiac Disease, Deamidated Gliadin Rarely Predicts Disease When Tissue Transglutaminase Is Normal. J Pediatr Gastroenterol Nutr. 2019;68(1):20- 25.

Gould MJ1, Brill H2, Marcon MA1, Walsh CM1.

Author information: 1. Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada. 2. McMaster University, Hamilton, Ontario, Canada and William Osler Health System, Brampton, Ontario, Canada. PMID: 31058774 Similar articles

114. J Pediatr Gastroenterol Nutr. 2019 Jul;69(1):e23. doi: 10.1097/MPG.0000000000002377. Can We Ignore the Utility of Deamidated Gliadin Peptide in the Diagnosis of Celiac Disease in Children?

Mataya L1, Silvester J2, Jericho H1.

Author information: 1. University of Chicago Celiac Disease Center, Chicago, IL. 2. Harvard Celiac Disease Program, Boston Children's Hospital, Boston, MA. PMID: 31058773 Similar articles

115. Food Chem. 2019 Sep 15;292:304-313. doi: 10.1016/j.foodchem.2019.04.074. Epub 2019 Apr 22. Healthy novel gluten-free formulations based on beans, carob fruit and rice: Extrusion effect on organic acids, tocopherols, phenolic compounds and bioactivity.

Arribas C1, Pereira E2, Barros L2, Alves MJ2, Calhelha RC2, Guillamón E3, Pedrosa MM4, Ferreira ICFR5.

Author information: 1. Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal; Food Tecnhology Department, SGIT-INIA, Crta. De La Coruña, Km 7.5, 28040 Madrid, Spain. 2. Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal. 3. Centre for the Food Quality, INIA, C/Universidad s/n, 42004 Soria, Spain. 4. Food Tecnhology Department, SGIT-INIA, Crta. De La Coruña, Km 7.5, 28040 Madrid, Spain. 5. Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal. Electronic address: [email protected].

Abstract

Rice and legumes have great potential in the development of novel gluten-free snacks that are healthier than traditional snacks. Novel gluten-free extruded foods (composed of rice: 50-80%, beans: 20-40% and carob: 5-10%) were analysed and the extrusion effects regarding organic acids, tocopherols, phenolic compounds and bioactive properties were evaluated. The total concentration of organic acids was not significantly affected by extrusion, while tocopherols showed a significant reduction. Extrusion did not produce an increase of the total phenolic content. For the bioactivity assays, commercial extruded rice, carob and most of the extruded samples showed anti-proliferative activity, which was higher than in the non-extruded samples, while for the anti-inflammatory activity, the extrusion process did not show a significant effect. Regarding the antimicrobial activity, low potential was observed with extruded and non-extruded samples showing high values of MIC and MBC as the microorganisms tested were multi-resistant isolated clinical strains.

PMID: 31054679 [Indexed for MEDLINE] Similar articles

116. Eur J Gastroenterol Hepatol. 2019 Aug;31(8):941-947. doi: 10.1097/MEG.0000000000001432. How to best measure quality of life in coeliac disease? A validation and comparison of disease-specific and generic quality of life measures.

Burger JPW1, van Middendorp H2, Drenth JPH3, Wahab PJ1, Evers AWM2.

Author information: 1. Department of Gastroenterology and Hepatology, Rijnstate Hospital, Arnhem. 2. Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden. 3. Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands.

Abstract

OBJECTIVE:

Health-related quality of life (HRQoL) is an important outcome in chronic disease. Generic HRQoL questionnaires may not adequately reflect disease-specific challenges in coeliac disease. We investigated whether disease-specific HRQoL questionnaires add relevant information to generic measures that will better help to identify patients experiencing problems.

PATIENTS AND METHODS:

We performed a cross-cultural validation of the Celiac Disease Quality Of Life-survey (CD-QOL), next we developed and validated a new disease-specific HRQoL questionnaire, and finally compared their predictive validity with the disease-generic RAND SF-36/SF-12 in 825 patients (mean age: 56.1±15.8 years) with (reported) biopsy-proven coeliac disease. Internal consistency and convergent, discriminative and predictive validity of the questionnaires was determined.

RESULTS:

Two Dutch versions of the CD-QOL were validated, consisting of 14 and six items, respectively (CD- QOL-14-NL, CD-QOL-6-NL). We developed and validated the CeliacQ-27, which has 27-items across three subscales (Limitations, Worries and Impact on daily life), and a short seven-item version, the CeliacQ-7. All questionnaires had excellent psychometric properties and differentiated well between active disease and clinical remission and strict versus poor dietary adherence. The added value of the disease-specific questionnaires to the generic HRQoL measure to the explained variance of symptom burden and dietary adherence was limited.

CONCLUSION:

HRQoL in patients with coeliac disease can easily be assessed by brief generic as well as disease- specific measures. Disease-specific questionnaires, however, provide more explicit information on disease-relevant areas of functioning. PMID: 31045631 Similar articles

117. Vasc Endovascular Surg. 2019 Aug;53(6):497-500. doi: 10.1177/1538574419846711. Epub 2019 May 1. Renal Autotransplant and Celiac Artery Bypass for Aneurysmal Degeneration Related to Neurofibromatosis Type 1.

Drucker NA1, Blaibel MF2, Nagaraju S1,3, Wang SK4, Goggins W1,3, Fajardo A4.

Author information: 1. 1 Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA. 2. 2 Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA. 3. 3 Division of Transplant Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA. 4. 4 Division of Vascular Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.

Abstract

We present a case of an 18-year-old female with neurofibromatosis type 1 who presented with abdominal pain and weight loss secondary to chronic mesenteric ischemia due to celiac axis occlusion and was subsequently found to have multiple visceral artery aneurysms. Of clinical significance, 2 aneurysms of the right renal artery were noted at the hilum, with the larger one having a diameter of 2.4 cm. After initial endovascular treatment with stenting of a concurrent pancreaticoduodenal artery pseudoaneurysm, staged aorto-hepatic bypass and right nephrectomy with renal autotransplantation after back table resection of the aneurysmal segments were successfully completed. PMID: 31043138 [Indexed for MEDLINE]

Similar articles

118. Cell Microbiol. 2019 Aug;21(8):e13035. doi: 10.1111/cmi.13035. Epub 2019 May 20. Celiac disease-associated Neisseria flavescens decreases mitochondrial respiration in CaCo-2 epithelial cells: Impact of Lactobacillus paracasei CBA L74 on bacterial-induced cellular imbalance.

Labruna G1, Nanayakkara M2, Pagliuca C3, Nunziato M3,4, Iaffaldano L4, D'Argenio V3,4,5, Colicchio R3, Budelli AL6, Nigro R7, Salvatore P3, Barone MV2, Sacchetti L4,5.

Author information: 1. IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) SDN, Naples, Italy. 2. Dipartimento di Scienze Mediche Traslazionali and European Laboratory for the Investigation of Food Induced Disease (ELFID), Università degli Studi di Napoli Federico II, Naples, Italy. 3. Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Naples, Italy. 4. CEINGE-Biotecnologie Avanzate SCarl, Naples, Italy. 5. Task Force on Microbiome Studies, Università degli Studi di Napoli Federico II and CEINGE- Biotecnologie Avanzate SCarl, Naples, Italy. 6. Kraft Heinz Innovation Center, Nijmegen, Netherlands. 7. Dipartimento di Ingegneria Chimica, dei Materiali e della Produzione Industriale, Università di Napoli Federico II, Naples, Italy.

Abstract

We previously identified a Neisseria flavescens strain in the duodenum of celiac disease (CD) patients that induced immune inflammation in ex vivo duodenal mucosal explants and in CaCo-2 cells. We also found that vesicular trafficking was delayed after the CD-immunogenic P31-43 gliadin peptide-entered CaCo-2 cells and that Lactobacillus paracasei CBA L74 (L. paracasei-CBA) supernatant reduced peptide entry. In this study, we evaluated if metabolism and trafficking was altered in CD-N. flavescens-infected CaCo-2 cells and if any alteration could be mitigated by pretreating cells with L. paracasei-CBA supernatant, despite the presence of P31-43. We measured CaCo-2 bioenergetics by an extracellular flux analyser, N. flavescens and P31-43 intracellular trafficking by immunofluorescence, cellular stress by TBARS assay, and ATP by bioluminescence. We found that CD-N. flavescens colocalised more than control N. flavescens with early endocytic vesicles and more escaped autophagy thereby surviving longer in infected cells. P31-43 increased colocalisation of N. flavescens with early vesicles. Mitochondrial respiration was lower (P < .05) in CD-N. flavescens-infected cells versus not-treated CaCo-2 cells, whereas pretreatment with L. paracasei-CBA reduced CD-N. flavescens viability and improved cell bioenergetics and trafficking. In conclusion, CD-N. flavescens induces metabolic imbalance in CaCo-2 cells, and the L. paracasei- CBA probiotic could be used to correct CD-associated dysbiosis.

PMCID: PMC6618323 Free PMC Article PMID: 31042331 Similar articles

119. Eur J Epidemiol. 2019 Jul;34(7):637-649. doi: 10.1007/s10654-019-00522-5. Epub 2019 Apr 29. Smoking in pregnancy, cord blood cotinine and risk of celiac disease diagnosis in offspring.

Mårild K1,2,3, Tapia G4, Midttun Ø5, Ueland PM6,7, Magnus MC4,8,9, Rewers M10, Stene LC4, Størdal K4,11.

Author information: 1. Division for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway. [email protected]. 2. Department of Pediatrics, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. [email protected]. 3. Department of Pediatrics, Queen Silvia Children's Hospital, 41678, Gothenburg, Sweden. [email protected]. 4. Division for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway. 5. Bevital AS, Bergen, Norway. 6. Department of Clinical Science, University of Bergen, Bergen, Norway. 7. Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway. 8. MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK. 9. Department of Population Health Sciences, Bristol Medical School, Bristol, UK. 10. Barbara Davis Center, University of Colorado, Aurora, CO, USA. 11. Department of Pediatrics, Østfold Hospital Trust, Grålum, Norway.

Abstract

Ecological observations suggest an inverse relationship between smoking in pregnancy and celiac disease (CD) in offspring. While individual-level analyses have been inconsistent, they have mostly lacked statistical power or refined assessments of exposure. To examine the association between pregnancy-related smoking and CD in the offspring, as well as its consistency across data sets, we analyzed: (1) The Norwegian Mother and Child Cohort (MoBa) of 94,019 children, followed from birth (2000-2009) through 2016, with 1035 developing CD; (2) a subsample from MoBa (381 with CD and 529 controls) with biomarkers; and (3) a register-based cohort of 536,861 Norwegian children, followed from birth (2004-2012) through 2014, with 1919 developing CD. Smoking behaviors were obtained from pregnancy questionnaires and antenatal visits, or, in the MoBa- subsample, defined by measurement of cord blood cotinine. CD and potential confounders were identified through nationwide registers and comprehensive parental questionnaires. Sustained smoking during pregnancy, both self-reported and cotinine-determined, was inversely associated with CD in MoBa (multivariable-adjusted [a] OR = 0.61 [95%CI, 0.46-0.82] and aOR = 0.55 [95%CI, 0.31-0.98], respectively); an inverse association was also found with the intensity of smoking. These findings differed from those of our register-based cohort, which revealed no association with sustained smoking during pregnancy (aOR = 0.97 [95%CI, 0.80-1.18]). In MoBa, neither maternal smoking before or after pregnancy, nor maternal or paternal smoking in only early pregnancy predicted CD. In a carefully followed pregnancy cohort, a more-detailed smoking assessment than oft-used register-based data, revealed that sustained smoking during pregnancy, rather than any smoking exposure, predicts decreased likelihood of childhood-diagnosed CD.

PMCID: PMC6548867 Free PMC Article PMID: 31037572 Similar articles

120. J Chromatogr A. 2019 Aug 30;1600:55-64. doi: 10.1016/j.chroma.2019.04.043. Epub 2019 Apr 17. Targeted proteomics to monitor the extraction efficiency and levels of barley α- amylase trypsin inhibitors that are implicated in non-coeliac gluten sensitivity.

Bose U1, Byrne K2, Howitt CA3, Colgrave ML4.

Author information: 1. CSIRO Agriculture and Food, 306 Carmody Rd, St Lucia, QLD, 4067, Australia. Electronic address: [email protected]. 2. CSIRO Agriculture and Food, 306 Carmody Rd, St Lucia, QLD, 4067, Australia. Electronic address: [email protected]. 3. CSIRO Agriculture and Food, GPO Box 1700, Canberra, ACT, 2601, Australia. Electronic address: [email protected]. 4. CSIRO Agriculture and Food, 306 Carmody Rd, St Lucia, QLD, 4067, Australia. Electronic address: [email protected]. Abstract

Plant defense protein α-amylase trypsin inhibitors (ATIs) have been proposed as one of the triggers of non-coeliac gluten sensitivity, however there have been no focused studies on their optimal extraction and quantitation from cereal grains. The efficiency of extraction is of utmost interest for the downstream detection and characterisation. In the present study, three extraction buffers and two modified protocols were investigated using LC-MRM-MS in order to examine their ability to efficiently and repeatably extract ATIs from selected barley cultivars. Initially, three extraction buffers IPA/DTT, urea and Tris-HCl were used to extract ATIs from two selected barley cultivars, Commander and Hindmarsh. The results obtained from the preliminary study showed that IPA/DTT and urea-based buffer extraction could yield 70% and 45% more ATIs, respectively than a buffer based on Tris-HCl extraction, with all methods showing high repeatability (CV < 15%). A multi-step protocol, employing IPA/DTT and urea improved∼ the extraction∼ efficiency in comparison to the single buffer extraction protocols (p<0.0001). When solutions from parallel extractions using IPA/DTT and urea were combined, the results were comparable (p = 0.99) with a sequential multi- step IPA/DTT-urea protocol. However, the repeatability of the combined process was compromised, as discerned by greater variation (CV>30%). The optimised sequential two-step extraction protocol was successfully used to extract and quantify ATIs from 12 barley cultivars. LC- MS analysis revealed that cv Yagan and cv Scope contain the higher levels ( 143% relative to the average barley ATI content), whereas cultivars Fleet (61%), Baudin (77%) and Commander (79%) contained the lowest levels. The libraries of ATIs identified and the quantitative∼ methods described here provide a foundation for the future application of MS-based quantitative methodologies to detect and quantify ATIs in barley varieties and in food products.

121. Trends Biotechnol. 2019 Aug;37(8):796-800. doi: 10.1016/j.tibtech.2019.03.010. Epub 2019 Apr 17. Safety Assessment of Immune-Mediated Adverse Reactions to Novel Food Proteins.

Fernandez A1, Mills ENC2, Koning F3, Moreno FJ4.

Author information: 1. European Food Safety Authority (EFSA), via Carlo Magno 1A, 43021 Parma, Italy. Electronic address: [email protected]. 2. Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Manchester Institute of Biotechnology, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, UK. 3. Department of Immunohematology and Blood Transfusion, Leiden University Medical Centre, Leiden 2333, ZA, The Netherlands. 4. Instituto de Investigación en Ciencias de la Alimentación, CIAL (CSIC-UAM), C/ Nicolás Cabrera, 9, Campus de la Universidad Autónoma de Madrid, 28049 Madrid, Spain.

Abstract

Current international guidelines for the risk assessment of biotechnology-derived foods date back to 2003. We present new strategies and directions for assessing immune adverse reactions to novel food proteins. Understanding genetic factors involved in food allergy and the role of the gastrointestinal tract will streamline risk assessment strategies.

122. Int J Immunogenet. 2019 Aug;46(4):274-275. doi: 10.1111/iji.12427. Epub 2019 Apr 19. Relevance of HLA-DQB1*02 allele in predisposing to coeliac disease.

Poddighe D1.

Author information: 1. Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan City, Kazakhstan. PMID: 31001909 Similar articles

123. Neurol Sci. 2019 Aug;40(8):1611-1617. doi: 10.1007/s10072-019-03899-z. Epub 2019 Apr 18. Causes of chronic neuropathies: a single- center experience.

Ricci L1, Luigetti M2,3, Florio L4, Capone F4, Di Lazzaro V4.

Author information: 1. Unit of Neurology, Neurobiology, Department of Medicine, University Campus Bio-Medico of Rome, via Álvaro del Portillo, 21, 00128, Rome, Italy. [email protected]. 2. IRCCS, UOC Neurologia, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy. 3. Università Cattolica del Sacro Cuore, Sede di Roma, Rome, Italy. 4. Unit of Neurology, Neurobiology, Department of Medicine, University Campus Bio-Medico of Rome, via Álvaro del Portillo, 21, 00128, Rome, Italy.

Abstract

OBJECTIVES:

Chronic neuropathies are a common cause of neurological disability worldwide. However, few reports have evaluated, in real life, the prevalence of the several conditions which can cause it.

PATIENTS AND METHODS:

The authors reviewed informatic database for outpatient office to confirm identification of chronic neuropathy in a 3-year interval period.

RESULTS:

Among the 100 selected patients with chronic neuropathies, almost one fifth (19%) remained idiopathic. The most common etiologies were diabetes (17%), dysimmune neuropathies (38%), and vitamin B12 deficiency (9%). In the "dysimmune neuropathies" group, we distinguished various etiologies, including dysimmune neuropathies associated or not with systemic autoimmune diseases (7 and 3%, respectively), chronic inflammatory polyneuropathy (CIDP) (8%), multifocal motor neuropathy (MMN) (3%), paraproteinemic (8%), celiac disease-related (6%), and paraneoplastic (3%) neuropathies.

CONCLUSIONS:

In this report from a single neurological center, treatable causes of chronic neuropathies, such as dysimmune neuropathies, including CIDP, and celiac disease-associated neuropathy, were common. These findings suggest the utility of routine screening with blood testing for dysimmune neuropathy and celiac disease for all patients presenting with idiopathic chronic polyneuropathy in whom primary diagnostic testings had failed to identify an etiology for the disease.

SIGNIFICANCE:

Our results indicate that patients with peripheral neuropathy could receive a benefit from being evaluated routinely in a specialized neurological center, as many of the conditions that were discovered represented potentially treatable causes of neuropathy. PMID: 31001716 Similar articles

124. Food Chem. 2019 Aug 30;290:64-71. doi: 10.1016/j.foodchem.2019.03.016. Epub 2019 Mar 8. Impact of altered starch functionality on wheat dough microstructure and its elongation behaviour.

Hackenberg S1, Vogel C2, Scherf KA2, Jekle M3, Becker T1.

Author information: 1. Technical University of Munich, Brewing and Beverage Technology, Research Group Cereal Technology and Process Engineering, Weihenstephaner Steig 20, 85354 Freising, Germany. 2. Leibniz-Institute for Food Systems Biology at the Technical University of Munich, Lise-Meitner- Str. 34, D-85354 Freising, Germany. 3. Technical University of Munich, Brewing and Beverage Technology, Research Group Cereal Technology and Process Engineering, Weihenstephaner Steig 20, 85354 Freising, Germany. Electronic address: [email protected].

Abstract

The effect of kneading on dough microstructure development, dough elongation and bread volume was investigated using wheat flour with a high mechanical starch modification (MSM) level. The resistance to extension (Rmax) of dough produced from wheat flour with a high MSM level increased by 52.5% because of higher protein network connectivity with prolonged kneading time. The improved network structure was caused by an increased protein branching rate (+14.8%), a decreased protein end-point rate (-24.3%) and a decreased mean lacunarity (-64%). Rmax was highly correlated with specific bread volume (r = 0.97, P < 0.05) only if the dough was not over-kneaded. Kneading time adaptation of the dough produced from high MSM flour significantly increased specific bread volume by 24.4%. Differences compared with the standard can be attributed to weakened network connectivity because of weakened protein interfacial interactions and larger cavities within the gluten network, both caused by starch swelling.

125. Intest Res. 2019 Jul;17(3):387-397. doi: 10.5217/ir.2018.00167. Epub 2019 Apr 22. Quantitative histology-based classification system for assessment of the intestinal mucosal histological changes in patients with celiac disease.

Das P1, Gahlot GP1, Singh A2, Baloda V1, Rawat R2, Verma AK2, Khanna G1, Roy M1, George A1, Singh A1, Nalwa A1, Ramteke P1, Yadav R1, Ahuja V2, Sreenivas V3, Gupta SD1, Makharia GK2.

Author information: 1. Departments of Pathology, All India Institute of Medical Sciences, New Delhi, India. 2. Departments of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India. 3. Departments of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.

Abstract

BACKGROUND/AIMS:

The existing histological classifications for the interpretation of small intestinal biopsies are based on qualitative parameters with high intraobserver and interobserver variations. We have developed and propose a quantitative histological classification system for the assessment of intestinal mucosal biopsies.

METHODS:

We performed a computer-assisted quantitative histological assessment of digital images of duodenal biopsies from 137 controls and 124 patients with celiac disease (CeD) (derivation cohort). From the receiver-operating curve analysis, followed by multivariate and logistic regression analyses, we identified parameters for differentiating control biopsies from those of the patients with CeD. We repeated the quantitative histological analysis in a validation cohort (105 controls and 120 patients with CeD). On the basis of the results, we propose a quantitative histological classification system. The new classification was compared with the existing histological classifications for interobserver and intraobserver agreements by a group of qualified pathologists.

RESULTS:

Among the histological parameters, intraepithelial lymphocyte count of ≥25/100 epithelial cells, adjusted villous height fold change of ≤0.7, and crypt depth-to-villous height ratio of ≥0.5 showed good discriminative power between the mucosal biopsies from the patients with CeD and those from the controls, with 90.3% sensitivity, 93.5% specificity, and 96.2% area under the curve. Among the existing histological classifications, our quantitative histological classification showed the highest intraobserver (69.7%-85.03%) and interobserver (24.6%-71.5%) agreements.

CONCLUSIONS: Quantitative assessment increases the reliability of the histological assessment of mucosal biopsies in patients with CeD. Such a classification system may be used for clinical trials in patients with CeD. (Intest Res, Published online).

Free Article PMID: 30996219 Similar articles

126. Eur J Gastroenterol Hepatol. 2019 Jul;31(7):893-895. doi: 10.1097/MEG.0000000000001421. Anaphylaxis after wheat ingestion in a patient with coeliac disease: two kinds of reactions and the same culprit food.

Mennini M1, Fiocchi A1, Trovato CM2, Ferrari F3, Iorfida D2, Cucchiara S2, Montuori M2.

Author information: 1. Department of Pediatrics, Division of Allergy. 2. Pediatric Gastroenterology and Liver Unit, Department of Pediatrics, Sapienza University of Rome, Rome, Italy. 3. Hepatology, Gastroenterology and Nutrition, Pediatrics Department, Bambino Gesù Children's Hospital.

Abstract

In recent years, the role of atopic dermatitis epidermal skin barrier defects in inducing a transcutaneous allergic sensitization is highly debated, possibly explaining why some children with eczema are sensitized to foods they have never eaten. In our specific situation, the association between coeliac disease and wheat allergy might be particularly harmful owing to unavoidable strict food avoidance. We describe the case of a young boy affected by coeliac disease who, after an occasional unexpected ingestion of gluten, experienced a complete anaphylactic reaction characterized by urticarial, labial angioedema, wheezing, and hypotension. To better investigate the state of allergic sensitization to wheat in our patient, we then performed the component resolved diagnosis, which showed Tri a19 2 kU/l and Tri a14 0.3 kU/l. These results demonstrated the association of IgE-mediated allergy to wheat and coeliac disease. The natural course of specific IgE in allergic patients who are on a food-free diet needs further investigation, such as the possible influence that the increasing popularity of gluten-free diets may have on the epidemiology of wheat allergy in westernized societies. National and International registers of cases of anaphylaxis may improve the still limited knowledge in this field. The final message of our contribution is that the decision to eliminate a food should to take into account a patient's awareness of possible consequences.

PMID: 30994495 Similar articles

127. Drug Dev Ind Pharm. 2019 Aug;45(8):1292-1305. doi: 10.1080/03639045.2019.1607868. Epub 2019 May 17. Design and development of a self- microemulsifying drug delivery system of olmesartan medoxomil for enhanced bioavailability.

Komesli Y1, Burak Ozkaya A2, Ugur Ergur B3, Kirilmaz L1, Karasulu E1.

Author information: 1. a Department of Pharmaceutical Technology, Faculty of Pharmacy , Ege University , Izmir , Turkey. 2. b Department of Medical Biochemistry, Faculty of Medicine , Izmir University of Economics , Izmir , Turkey. 3. c Department of Basic Medicine Sciences, Faculty of Medicine , Dokuz Eylul University , Izmir , Turkey.

Abstract

Olmesartan medoxomil (OM) is a hydrophobic antihypertensive drug with low bioavailability (26%) and is known to have adverse effects such as celiac disease and enteropathy. The purpose of this study was to develop SMEDDS to increase bioavailability and decrease potential side effects of OM. Hydrophilic lipophilic balance was calculated by testing solubility of OM in different oils, surfactants, and cosurfactants to obtain the most suitable combination of SMEDDS. Pseudoternary phase diagram was used to select the better oil/water formulation of SMEDDS. After a test for 3- month stability, dissolution tests and parallel artificial membrane permeability assay (PAMPA) were conducted to investigate drug solubility and permeability. Biodistribution of fluorescent marked SMEDDS was observed by using in vivo imaging system. The pharmacodynamics of the drug were determined by measuring blood pressure from tails of rats. At the end of the experiment, intestines were examined for adverse effects of OM. Compared with tablet formulation according to the dissolution study, SMEDDS formulation showed 1.67 times improvement in solubility of OM. PAMPA studies suggested a much faster permeability rate for OM SMEDDS compared to the suspension form. Labeled SMEDDS gave 3.96 times stronger fluorescent emission than control dye administered mice in in vivo imaging system (IVIS®) studies, indicating an increased bioavailability. Treating effect of SMEDDS was 3.1 times more efficient compared to suspension in hypertensive rats. It caused neither celiac-like enteropathy nor diarrhea, during 21-day noninvasive blood pressure system (NIBP) assay. Our results suggest that SMEEDS formulation improves dissolution and oral bioavailability of OM while reducing its adverse effects. PMID: 30986085 Similar articles

128. Pediatr Diabetes. 2019 Aug;20(5):567-573. doi: 10.1111/pedi.12857. Epub 2019 May 2. Role of HLA-DQ typing and anti-tissue transglutaminase antibody titers in diagnosing celiac disease without duodenal biopsy in type 1 diabetes: A study of the population-based pediatric type 1 diabetes cohort of Western Australia.

Joshi KK1, Haynes A2, Davis EA1,2,3, D'Orsogna L4,5, McLean-Tooke A6,7.

Author information: 1. Department of Endocrinology and Diabetes, Princess Margaret Hospital, Perth, WA, Australia. 2. Telethon Kids Institute, University of Western Australia, Perth, WA, Australia. 3. School of Paediatrics and Child Health, University of Western Australia, Perth, WA, Australia. 4. Department of Clinical Immunology and PathWest, Fiona Stanley Hospital, Murdoch, WA, Australia. 5. School of Biomedical Science, University of Western Australia, Perth, WA, Australia. 6. Department of Clinical Immunology, Sir Charles Gairdner Hospital, Perth, WA, Australia. 7. Department of Laboratory Immunology, PathWest QEII Medical Centre, Perth, WA, Australia.

Abstract

AIM:

The primary aim of the present study was to determine if it is cost effective to use human leukocyte antigen (HLA) typing as a first-line screening test for celiac disease (CD) in children with type 1 diabetes (T1D), as recommended by the European Society of Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN). The second aim was to investigate whether anti-tissue transglutaminase IgA (anti-tTGA) antibodies can be used to diagnose CD without the need for a confirmatory duodenal biopsy in T1D. METHODS:

Data for all T1D patients aged <18 years, who attended the diabetes clinics in Western Australia up to June 2017, were extracted from the Western Australian Children's Diabetes Database (WACDD) and analyzed for their demographic data and CD permissive HLA alleles (DQ2, DQ8, and DQ7). For T1D patients already diagnosed with CD, the mode of diagnosis of CD, anti-tTGA titers, and CD permissive HLA alleles were analyzed.

RESULTS:

Of the 936 eligible T1D patients identified, HLA-DQ typing was available for 551 (59%). Of these 551 patients, 504 (91.2%) were positive for celiac permissive HLA alleles. Eight percent (n = 75) of the T1D patients had a co-diagnosis of CD. High anti-tTGA titers were observed in those who were diagnosed with a positive duodenal biopsy.

CONCLUSION:

HLA-DQ typing is not cost effective as a first-line screening test for CD in T1D patients because of over-representation of CD permissive HLA alleles in this group. Anti-tTGA titers may be useful in diagnosing CD in T1D without duodenal biopsy, as high levels were found to be strongly predictive of CD.

129. Eur Ann Allergy Clin Immunol. 2019 Jul;51(4):159-164. doi: 10.23822/EurAnnACI.1764-1489.90. Epub 2019 Apr 15. Circulating microRNAs as potential noninvasive biomarkers in pediatric patients with celiac disease.

Amr KS1, Bayoumi FS2, Eissa E3, Abu-Zekry M4.

Author information: 1. Medical molecular genetics Department, National Research Centre, Cairo, Egypt. 2. Immunogenetics Department, National Research Centre, Cairo, Egypt; Microbiology and Immunology Department, MSA University, Egypt. 3. Immunogenetics Department, National Research Centre, Cairo, Egypt. 4. Abu El Reesh Children's Hospital, Cairo University, Cairo, Egypt.

Abstract

Celiac disease is an enteropathy induced by ingestion of gluten triggering an immune response in genetically predisposed individuals. MiRNAs are small non-coding RNAs that have a role as regulators of gene expression at the post transcriptional level. The aim of this study is to evaluate the possibility of using circulating miRNAs as non-invasive biomarkers in pediatric patients with celiac disease. In addition, we examine the effect of a gluten-free diet on the expression of these miRNAs in serum of CD patients. The expression pattern of miR-21 and miR-31 was estimated in serum of 25 untreated CD patients (recently diagnosed), 25 treated CD patients (on gluten-free diet) and 20 healthy controls using qRT-PCR. Our results demonstrated the significant up- regulation of microRNA-21 in the untreated celiac patients in comparison with the treated group and healthy controls. Moreover, miR-31 expression was significantly under-expressed in the untreated celiac patients in comparison with the treated group and healthy controls. Furthermore, the results showed that miR-21 expression level was significantly positively correlated with the tTG IgA auto-antibodies. In conclusion, circulating miRNA-21 and miRNA-31 could serve as potential non-invasive biomarkers for pediatric CD patients.

Free Article PMID: 30983306 Similar articles

130. Vasc Endovascular Surg. 2019 Jul;53(5):424-428. doi: 10.1177/1538574419839547. Epub 2019 Apr 14. A Rare Case of Ischemia-Reperfusion Injury After Mesenteric Revascularization.

Robles-Martín ML1, Reyes-Ortega JP1, Rodríguez-Morata A1.

Author information: 1. 1 Department of Angiology and Vascular Surgery, Quirónsalud Málaga Hospital, Málaga, Spain.

Abstract

Endovascular treatment of chronic mesenteric ischemia is currently the treatment of choice, regardless of the number of involved vessels. Unlike other anatomic areas, the hyperperfusion produced by revascularization and the consecutive reperfusion syndrome is only described in cases of acute bowel ischemia, which is usually resolved with traditional surgery. We present a case of severe hyperperfusion syndrome secondary to endovascular correction with stents of a critical ischemia affecting the celiac trunk and superior mesenteric artery. PMID: 30982410 [Indexed for MEDLINE] Similar articles

131. Gastroenterology. 2019 Aug;157(2):413-420.e3. doi: 10.1053/j.gastro.2019.04.004. Epub 2019 Apr 9. Progression of Celiac Disease in Children With Antibodies Against Tissue Transglutaminase and Normal Duodenal Architecture.

Auricchio R1, Mandile R2, Del Vecchio MR2, Scapaticci S2, Galatola M2, Maglio M2, Discepolo V3, Miele E2, Cielo D2, Troncone R2, Greco L2.

Author information: 1. Department of Translation Medical Science, Section of Pediatrics, and European Laboratory for the Investigation of Food Induced Disease (ELFID), University Federico II, Naples, Italy. Electronic address: [email protected]. 2. Department of Translation Medical Science, Section of Pediatrics, and European Laboratory for the Investigation of Food Induced Disease (ELFID), University Federico II, Naples, Italy. 3. Department of Medicine, University of Chicago, Chicago, Illinois.

Abstract

BACKGROUND & AIMS:

Potential celiac disease is characterized by positive results from serologic tests for tissue transglutaminase antibodies (anti-TG2) but normal duodenal architecture (Marsh stages 0-1). There is controversy over the best way to manage these patients. We investigated risk factors associated with the development of villous atrophy in children with potential celiac disease.

METHODS:

We performed a prospective study of 280 children (ages 2-18 years) in Italy with suspected celiac disease, followed for up to 12 years (range, 18-150 months; median 60 months). The subjects had 2 consecutive positive results from tests for anti-TG2, tested positive for the endomysial antibody (anti-EMA), had total serum levels of immunoglobulin A in the normal range, normal duodenal architecture (Marsh stages 0-1) in 5 biopsies, and HLA DQ2- or DQ8-positive haplotypes. The children underwent serologic tests and clinical analyses every 6 months and a small bowel biopsy was taken every 2 years. A total of 210 patients of the original cohort were assessed at the 9-year follow-up evaluation. We performed multivariate analyses of clinical, genetic, and histologic data to identify factors associated with progression to villous atrophy.

RESULTS:

During the follow-up period, 42 (15%) of 280 children developed villous atrophy, whereas 89 (32%) children no longer tested positive for anti-TG2 or anti-EMA. The cumulative incidence of progression to villous atrophy was 43% at 12 years. In multivariate analysis, the baseline factors most strongly associated with development of villous atrophy were numbers of γδ intraepithelial lymphocyte cells followed by age and homozygosity for the HLA DQB1*02. In discriminant analysis, these baseline factors identified 80% of the children who developed baseline atrophy.

CONCLUSIONS:

In a long-term study of 280 children with suspected celiac disease (based on anti-TG2 and anti- EMA) on gluten-containing diets, the cumulative incidence of progression to villous atrophy was 43% over a 12-year period. We identified factors that can be used to identify children at highest risk for villous atrophy. This approach might be used to determine whether children with suspected celiac disease should immediately start a gluten-free diet or be monitored on their regular diet.

132. Am J Reprod Immunol. 2019 Jul;82(1):e13127. doi: 10.1111/aji.13127. Epub 2019 Apr 29. Comparison of celiac disease markers in women with early recurrent pregnancy loss and normal controls.

Kutteh MA1, Abiad M2, Norman GL3, Kutteh WH4.

Author information: 1. University of Oklahoma College of Medicine, Oklahoma City, Oklahoma. 2. American University of Beirut School of Medicine, Beirut, Lebanon. 3. INOVA Diagnostics, Inc, San Diego, California. 4. Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Vanderbilt University School of Medicine, Fertility Associates of Memphis, Memphis, Tennessee. Abstract

PROBLEM:

Celiac disease (CD) is an autoimmune intestinal inflammatory disease triggered by gluten in the diet. Untreated CD has been associated with pregnancy loss and infertility. The purpose of this study was to screen unselected women with recurrent pregnancy loss (RPL) for markers of CD to determine whether a correlation exists between RPL and CD serum markers.

METHOD OF STUDY:

Frequencies of three serum markers of CD [tissue transglutaminase (TTG) IgA, endomysial (EMA) IgA, and deaminated gliadin peptide (DGP) IgA] were determined by enzyme-linked immunoassay (ELISA). Seven hundred and eight women who had two or more failed clinical pregnancies (cases) and one hundred women with at least one live birth and no miscarriages (controls) were included in this study. All cases had a full workup for RPL based on the American Society for Reproductive Medicine 2013 guidelines. Antiphospholipid antibodies (aPL) were correlated with CD markers based on their potential prothrombotic role. Results The results show no significant difference in the prevalence of CD autoantibodies when comparing the RPL patients with the controls. Over half of the patients who tested positive for serum markers for CD also had positive aPL. Conclusion Screening unselected women with RPL who are asymptomatic for CD is not supported based on these data. Women who test positive for CD may be candidates for aPL testing based on the association of adverse pregnancy outcomes.

133. Gastroenterology. 2019 Jul;157(1):27-28. doi: 10.1053/j.gastro.2019.04.001. Epub 2019 Apr 5. Dyspepsia and Increased Levels of Liver Enzymes in a 24-Year-Old Man.

Kumar S1, Prenner S1.

Author information: 1. Division of Gastroenterology, University of Pennsylvania, Philadelphia, Pennsylvania. PMID: 30959034 [Indexed for MEDLINE] Similar articles

134. Food Chem. 2019 Aug 15;289:121-129. doi: 10.1016/j.foodchem.2019.03.030. Epub 2019 Mar 11. Adlay starch-gluten composite gel: Effects of adlay starch on rheological and structural properties of gluten gel to molecular and physico-chemical characteristics.

Li C1, Chen G2, Ran C3, Liu L4, Wang S2, Xu Y2, Tan Y2, Kan J5.

Author information: 1. College of Food Science, Southwest University, 2 Tiansheng Road, Beibei, Chongqing 400715, PR China; Department of Public Health and Management, Chongqing Three Gorges Medical College, 366 Tianxing Road, Wanzhou, Chongqing 404120, PR China. 2. College of Food Science, Southwest University, 2 Tiansheng Road, Beibei, Chongqing 400715, PR China. 3. Department of Public Health and Management, Chongqing Three Gorges Medical College, 366 Tianxing Road, Wanzhou, Chongqing 404120, PR China. 4. College of Safety Engineering, Chongqing University of Science & Technology, Chongqing 401331, PR China. 5. College of Food Science, Southwest University, 2 Tiansheng Road, Beibei, Chongqing 400715, PR China; Laboratory of Quality & Safety Risk Assessment for Agro-products on Storage and Preservation (Chongqing), Ministry of Agriculture, Chongqing 400715, PR China; Chinese-Hungarian Cooperative Research Centre for Food Science, Chongqing 400715, PR China. Electronic address: [email protected].

Abstract

Effects of adlay starch on the rheological and conformational changes in wheat gluten gel were investigated in this study. Rheological measurement showed that adlay starch-gluten composite gels exhibited higher storage modulus G' and loss modulus G″ compared with pure gluten gels. This result was also confirmed through morphological analysis. As the addition of adlay starch increased from 0% to 40%, the surface hydrophobicity of gluten protein gel decreased from 16,660 to 11,931 and the free thiol content increased from 3.11 to 4.30 µmol/g. In addition, the β-sheet structure in the gluten protein gel increased at the expense of the α-helical structure with increasing adlay starch fraction. This study revealed that besides acting as an inert filler, adlay starch could participate in hydrogen bonding and induce the enhancement of hydrophobic interaction to modify gluten protein association, altering the rheological and structural properties of gluten protein gels.

135. J Clin Gastroenterol. 2019 Aug;53(7):549-550. doi: 10.1097/MCG.0000000000001208. Duodenal Biopsy Rate Differences Among Endoscopists and its Impact on Celiac Disease Diagnosis and Management.

Lasa J1, Rausch A, Zubiaurre I.

Author information: 1. Gastroenterology DepartmentBuenos Aires British Hospital Buenos Aires, Argentina. PMID: 30950922 Similar articles

136. J Sci Food Agric. 2019 Aug 30;99(11):4922-4931. doi: 10.1002/jsfa.9722. Epub 2019 May 13. Effects of extrusion types, screw speed and addition of wheat gluten on physicochemical characteristics and cooking stability of meat analogues.

Samard S1, Gu BY1, Ryu GH1.

Author information: 1. Department of Food Science and Technology, Food and Feed Extrusion Research Center, Kongju National University, Daehakro 54, Yesan, Chungnam, Republic of Korea.

Abstract

BACKGROUND:

Plant protein-based products such as meat analogues have been receiving attention over the years. However, comparisons of product properties and mechanisms applied in the production of low- and high-moisture meat analogues have not been reported. In this study, the effects of extrusion types (low- and high-moisture extrusion cooking), absence or presence of added wheat gluten, as well as screw speed (150 and 200 rpm) on the physicochemical properties of meat analogues were evaluated. The mechanism of protein texturization of low- and high-moisture meat analogues was studied.

RESULTS:

Extrusion types and addition of wheat gluten had a major influence on physicochemical characteristics which were critical in controlling the fibrous texture of the final product, while screw speed had a minor impact on springiness only (P < 0.001). All high-moisture meat analogues (HMMAs) were associated with a higher integrity index and greater stability of springiness and cutting strength than low-moisture meat analogues (LMMAs) using the same formula and screw speed, while the nitrogen solubility index of HMMAs was lower. Based on the physicochemical properties determined, the higher cross-link formation in HMMAs is proposed to occur in the cooling die section.

CONCLUSION:

Our findings show that the utilization of high-moisture extrusion cooking and the incorporation of wheat gluten into the formula at 400 g kg-1 could impart a fibrous and compact structure to extrudates similar to that of actual muscle meat, with a greater integrity index and texture stability. © 2019 Society of Chemical Industry.

137. J Cell Physiol. 2019 Nov;234(11):19866-19874. doi: 10.1002/jcp.28585. Epub 2019 Apr 2. Synergistic antitumor effect of anti-PD-L1 combined with oxaliplatin on a mouse tumor model.

Golchin S1, Alimohammadi R1, Rostami Nejad M2, Jalali SA1.

Author information: 1. Department of Immunology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2. Celiac Disease Department, Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Abstract

Oxaliplatin (OXP) can change tumor microenvironment from immune-suppressive toward the immune-favorable condition. Almost all of the antitumor agents cannot totally cure cancer as monotherapy. So the current focus of cancer research became combining therapy using different treatment regimen, especially chemotherapy with checkpoint blockers. In this study, we assessed the activity of combining regimen using anti-PD-L1 with OXP in CT26 tumor-bearing BALB/c mice. We further analyzed the immune cell phenotypes in tumor site, lymph nodes, and spleen by flow cytometry analysis. Our study showed that combination therapy with OXP and anti-PD-L1 significantly increased survival in vivo and inhibited tumor growth of tumor-bearing mice. Inconsistent with better antitumor activity, our combination therapy led to an increase in tumor- infiltrating activated CD8+ T cells. In draining lymph nodes and spleen, regulatory T cells decreased significantly. Mice receiving either anti-PD-L1 or OXP alone had a larger tumor and lower survival rate in comparison with combination therapy receiving group. The time and order of administration of each component of the combination therapy affected antitumor response.

138. J Psychiatry Neurosci. 2019 Jul 1;44(4):269-276. Randomized controlled trial of a gluten-free diet in patients with schizophrenia positive for antigliadin antibodies (AGA IgG): a pilot feasibility study

Kelly DL1, Demyanovich HK1, Rodriguez KM1, Ciháková D1, Talor MV1, McMahon RP1, Richardson CM1, Vyas G1, Adams HA1, August SM1, Fasano A1, Cascella NG1, Feldman SM1, Liu F1, Sayer MA1, Powell MM1, Wehring HJ1, Buchanan RW1, Gold JM1, Carpenter WT1, Eaton WW1.

Author information: 1. From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer).

Abstract

Background:

Approximately one-third of people with schizophrenia have elevated levels of anti-gliadin antibodies of the immunoglobulin G type (AGA IgG) — a higher rate than seen in healthy controls. We performed the first double-blind clinical trial of gluten-free versus gluten-containing diets in a subset of patients with schizophrenia who were positive for AGA IgG.

Methods:

In this pilot feasibility study, 16 participants with schizophrenia or schizoaffective disorder who had elevated AGA IgG (≥ 20 U) but were negative for celiac disease were admitted to an inpatient unit for a 5-week trial. All participants received standardized gluten-free meals and were randomized in a double-blind fashion to receive a shake containing 10 g of gluten flour or 10 g of rice flour each day. Participants were rated for psychiatric, cognitive and gastrointestinal symptoms at baseline and endpoint.

Results:

Of the 16 participants, 14 completed the 5-week trial (2 discontinued early for administrative reasons). Compared with participants on the gluten-containing diet, participants on the gluten-free diet showed improvement on the Clinical Global Impressions scale (Cohen d = –0.75) and in negative symptoms (Cohen d = –0.53). We noted no improvement in positive or global cognitive symptoms, but did observe an improvement in attention favouring the gluten-free diet (Cohen d = 0.60). Robust improvements in gastrointestinal adverse effects occurred in the gluten-free group relative to the glutencontaining group. Adverse effects were similar between groups.

Limitations:

This study was limited by its small sample size; larger studies are needed.

Conclusion:

This feasibility study suggests that removal of gluten from the diet is associated with improvement in psychiatric and gastrointestinal symptoms in people with schizophrenia or schizoaffective disorder.

PMCID: PMC6606425 Free PMC Article PMID: 30938127 Similar articles

Conflict of interest statement

D. Kelly served as an advisor to Lundbeck and HLS Therapeutics. A. Fasano is the founder and a stock holder of Alba Therapeutics. R. Buchanan served on the advisory boards for Astellas Pharma, Avanir, Boehringer Ingelheim-RCV, ITI, Inc., Lundbeck and Roche. He was a consultant for Takeda and Upsher-Smith Laboratories and on the DSMB for Pfizer. W. Carpenter has served as an advisor to Boehringer Ingelheim, Allergan, Health Analytics and Teva. All other authors have nothing to disclose. 139. J Pediatr Gastroenterol Nutr. 2019 Aug;69(2):e43-e48. doi: 10.1097/MPG.0000000000002343. Pediatric Celiac Disease and Eosinophilic Esophagitis: Outcome of Dietary Therapy.

Patton T1, Chugh A2, Padhye L3, DeGeeter C4, Guandalini S1.

Author information: 1. Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Comer Children's Hospital, University of Chicago Medical Center, Chicago, IL. 2. Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Medical College of Wisconsin, Milwaukee, WI. 3. Division of Allergy and Immunology, Rush University Medical Center, Chicago, IL. 4. Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Stead Family Children's Hospital, University of Iowa, Iowa City, IA.

Abstract

OBJECTIVE:

The coexistence of celiac disease (CeD) and eosinophilic esophagitis (EoE) in pediatric patients has been increasingly recognized. In the current study, we have aimed to assess the outcomes of therapeutic dietary interventions in a cohort of pediatric patients with CeD and EoE.

METHODS:

Pediatric patient records obtained from the University of Chicago Celiac Center Database from August 2008 to July 2013 were reviewed. Information was collected on patients with concomitant CeD and EoE regarding age, sex, dates of diagnoses, presenting symptoms, length of symptoms before diagnosis, familial and personal atopic history, dietary therapy, and esophageal histologic response to dietary therapy. RESULTS:

A total of 350 records of patients with CeD were reviewed. Twenty-two (6.3%) had a confirmed diagnosis of CeD and EoE, 17 had repeat biopsies. Four of 17 (23.5%) had resolution of esophageal eosinophilia on an exclusive gluten-free diet, 10 of 17 (59%) required additional eliminations to show histologic resolution, 1 of 17 (6%) had not reached histological remission, and 2 of 17 (12%) were lost to follow-up. Success rates of single food reintroductions were: soy 5 of 5 (100%), eggs 3 of 5 (60%), dairy 3 of 7 (43%), nuts 2 of 4 (50%), and fish 2 of 4 (50%).

CONCLUSIONS:

To our knowledge, this is the largest pediatric study to assess the histologic outcome of EoE- associated esophageal eosinophilia in response to dietary management of pediatric patients with concomitant CeD and EoE. We demonstrate that soy is well tolerated in this cohort, and suggest that reintroducing this food first, or trialing a soy-inclusive elimination diet is a viable strategy. PMID: 30921260 Similar articles

140. J Pediatr Gastroenterol Nutr. 2019 Aug;69(2):200-205. doi: 10.1097/MPG.0000000000002335. Pediatric Nonceliac Gluten Sensitivity: A Gluten-related Disorder Treatment Center Experience.

Camhi SS1,2, Sangal K3, Kenyon V2, Lima R2, Fasano A2,4, Leonard MM2,4.

Author information: 1. Miller School of Medicine, University of Miami, Miami, FL. 2. Center for Celiac Research and Treatment, Pediatric Gastroenterology and Nutrition, Mass General Hospital for Children. 3. Boston University School of Medicine. 4. Celiac Research Program, Harvard Medical School, Boston, MA.

Abstract

OBJECTIVE:

The aim of the study was to identify the prevalence and clinical characteristics of children with nonceliac gluten sensitivity (NCGS) presenting to a tertiary care center specialized for evaluation of gluten-related disorders. METHODS:

The medical records of all patients aged 0 to 18 years who presented to our center over a 4-year period (July 2013-June 2018) and consented to participate in our research registry were reviewed. Patients meeting the clinical criteria for NCGS were reviewed in detail.

RESULTS:

Among 500 pediatric patients who volunteered to participate in the registry during the study period, we identified 26 (5.2%) with NCGS. Both gastrointestinal and extraintestinal symptoms associated with gluten ingestion were common with abdominal pain (57.7%), bloating (53.9%), rash (53.9%), diarrhea/loose stool (42.3%), and emotional/behavioral issues (42.3%) emerging as the predominant complaints. In addition, children with NCGS demonstrated a high personal history (61.5%) and family history (61.5%) of concomitant allergic/atopic disease.

CONCLUSIONS:

Even within our highly specialized population of patients with a suspected gluten-related disorder, pediatric NCGS is relatively uncommon. The estimated prevalence and clinical features mirror those previously reported in a similarly highly selective population of adults. In the absence of celiac disease, clinical suspicion for NCGS should arise in a child with gastrointestinal and/or extraintestinal complaints alleviated with gluten removal and considered in symptomatic patients with associated allergic/atopic disease. Proper and adequate exclusion of celiac disease and other potential causes of the clinical complaints is essential to justify adoption of the gluten-free diet according to an appropriate stringency and with dietitian supervision to avoid nutritional deficiencies. PMID: 30908383 Similar articles

141. Clin Chem Lab Med. 2019 Jul 26;57(8):1207-1217. doi: 10.1515/cclm-2019-0088. Diagnostic accuracy of a fully automated multiplex celiac disease antibody panel for serum and plasma.

Terryberry J1, Tuomi J2, Perampalam S3, Peloquin R3, Brouwer E3, Schuppan D4,5, Guandalini S6.

Author information: 1. SQI Diagnostics Systems Inc., 36 Meteor Dr. Toronto, ON M9W 1A4, Canada, Phone: +416-674- 9500. 2. Microdrop LLC., Houston, TX, USA. 3. SQI Diagnostics Systems Inc., Toronto, ON, Canada. 4. Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. 5. Institute of Translational Immunology, University Medical Center, Johannes-Gutenberg University, Mainz, Germany. 6. Department of Pediatrics, Section of Gastroenterology, Hepatology and Nutrition, University of Chicago Celiac Disease Center-Comer Children's Hospital, Chicago, IL, USA.

Abstract

Background An automated multiplex platform using capillary blood can promote greater throughput and more comprehensive studies in celiac disease (CD). Diagnostic accuracy should be improved using likelihood ratios for the post-test probability of ruling-in disease. Methods The Ig_plex™ Celiac Disease Panel on the sqidlite™ automated platform measured IgA and IgG antibodies to tTG and DGP in n = 224 CD serum or plasma samples. Diagnostic accuracy metrics were applied to the combined multiplex test results for several CD populations and compared to conventional single antibody ELISA tests. Results With multiple positive antibody results, the post- test probability for ruling-in untreated and treated CD increased to over 90%. The number of samples positive for more than one antibody also increased in untreated CD to ≥90%. Measurement of all four CD antibodies generate cut-off dependent accuracy profiles that can monitor response to treatment with the gluten-free diet (GFD). Higher positive tTG and DGP antibodies are seen more frequently in confirmed CD without (81%-94%) than with GFD treatment (44%-64%). In CD lacking biopsy confirmation, overall agreement of plasma to serum was ≥98% for all antibodies, and 100% for venous to capillary plasma. Conclusions The Ig_plex Celiac Disease Panel increases the likelihood of confirming CD based on the post-test probability of disease results for multi-reactive markers. Specific positivity profiles and cut-off intervals can be used to monitor GFD treatment and likely disease progression. Using serum, venous and capillary plasma yield comparable and accurate results. PMID: 30903755 Similar articles

142. J Oral Facial Pain Headache. 2019 Summer;33(3):294–300. doi: 10.11607/ofph.2079. Epub 2019 Mar 20. Headache in Patients with Celiac Disease and Its Response to the Gluten-Free Diet.

Ameghino L, Farez MF, Wilken M, Goicochea MT.

Abstract AIMS:

To describe headache characteristics among celiac disease (CD) patients and to analyze the relationship between CD and headache.

METHODS:

An online survey analyzing the characteristics of headache and its response to the gluten-free diet (GFD) in celiac patients was published on Argentinean Celiac social networks, open to the public to complete. The results were analyzed using chi-square test or Mann-Whitney test accordingly.

RESULTS:

A total of 1,517 subjects completed the survey, and 866 (55.2%) met the inclusion criteria (headache and CD confirmed with positive biopsy). The subjects were predominantly female (94.5%) and had a median age of 39 ± 11.27 years. Tension-type headache was the most prevalent headache type (52%), followed by migraine without (32.5%) and with aura (15.4%), respectively. Of the included participants, 24% reported headache as the main symptom that resulted in the diagnosis of CD. Following initiation of GFD, headache frequency and intensity improved significantly more in participants with migraine than tension-type headache (P = .02 and P = .013, respectively). Compliance to GFD was higher among subjects with severe manifestations (77% vs 66%, P = .05), and compliant individuals showed a 48% improvement in headache frequency (P = .049). An association between food transgressions and headache was better recognized by migraineurs (P = .02).

CONCLUSION:

These results suggest that strict compliance to the GFD could improve headache in celiac patients with headache, even in those without gastrointestinal symptoms. This observation could provide an additional factor when convincing patients to follow a GFD, thus reducing the morbidity related to CD. PMID: 30893404 Similar articles

143. J Hum Nutr Diet. 2019 Aug;32(4):525-530. doi: 10.1111/jhn.12622. Epub 2019 Mar 20. Coeliac disease in Caucasian and South Asian patients in the North West of England.

Adam UU1, Melgies M1, Kadir S1, Henriksen L2, Lynch D1. Author information: 1. Gastroenterology Department, Royal Blackburn Hospital, Blackburn, UK. 2. Dietetics Department, Royal Blackburn Hospital, Blackburn, UK.

Abstract

BACKGROUND:

Coeliac disease is an autoimmune enteropathy characterised by mucosal inflammation subsequent to gluten exposure, leading to malabsorption. Treatment is strict dietary control, relying on the patient's ability to maintain lifestyle modifications. The present study aimed to compare clinical presentation and adherence to a gluten-free diet between South Asian and Caucasian patients with coeliac disease in East Lancashire METHODS: In total, 33 South Asian and 113 Caucasian adult patients diagnosed with coeliac disease under the care of the Dietetics Department at East Lancashire Hospitals NHS Trust were selected using a convenience sampling method and then allocated to the South Asian or Caucasian group. A subjective assessment of dietetic notes from follow-up visits within 1 year of the first appointment was undertaken by two investigators who subsequently allocated the patients to one of the three categories: (i) fully-adherent; (ii) partly- adherent; and (iii) non-adherent. Presenting complaint, vitamin D, vitamin B12 , folate and ferritin levels were also compared.

RESULTS:

There was a significant difference in adherence to gluten-free diet between the groups, with a larger proportion of Caucasian patients being fully adherent to gluten-free diet compared to South Asian patients (64.6% versus 12.1%, P < 0.001). In addition, a significantly higher proportion of South Asian patients were vitamin D deficient compared with Caucasian patients (70.8% versus 32.8%, P = 0.002).

CONCLUSIONS:

The rates of strict adherence to gluten-free diet and vitamin D levels were significantly lower in South Asian patients with coeliac disease compared to the Caucasian coeliac population. Further studies are required to investigate the causes and improve adherence in the South Asian population.

144. Nutr Diet. 2019 Jul;76(3):305-312. doi: 10.1111/1747-0080.12521. Epub 2019 Mar 14. Thinking about going wheat-free? Evidence of nutritional inadequacies in the dietary practices of wheat avoiders.

Golley S1, Baird D1, Hendrie GA1, Mohr P2.

Author information: 1. CSIRO Health and Biosecurity, Adelaide, South Australia, Australia. 2. School of Psychology, Faculty of Health Sciences, University of Adelaide, Adelaide, South Australia, Australia.

Abstract

AIM:

To assess dietary intake and nutritional adequacy amongst self-identified symptomatic wheat- avoiders.

METHODS:

Thirty-four self-identified symptomatic avoiders of wheat-based products without a diagnosis of coeliac disease or wheat allergy were recruited to participate in a dietary assessment study. Dietary intake was assessed via a three-day weighed food record. Participants were aged 33 to 83 years, were predominantly women (n = 30) and had been avoiding wheat for a mean of six years. Nutrient intakes were compared with Nutrient Reference Values. Food group intakes were assessed and consumption of wheat-containing and wheat-free cereal-based foods described.

RESULTS:

Inadequate intakes of key protective nutrients such as fibre and calcium were common; many participants reported avoiding dairy as well as wheat. Intakes of total and saturated fat exceeded recommendations. Although 85% of the sample reported avoiding all wheat products, at least one third of cereal products and dishes consumed in this group, comprising mostly discretionary-type foods, were wheat based.

CONCLUSIONS:

Dietary intake patterns and resulting nutrient imbalances in individuals restricting or eliminating wheat to manage symptoms are cause for concern. The situation is likely exacerbated by the tendency for many wheat avoiders to report also avoiding other foods, especially dairy products. A bi-disciplinary approach from medical practitioners and dietitians to individuals experiencing unexplained gastro-intestinal symptoms and strategies to support informed food choice is needed to combat longer-term health consequences of a diet with this nutritional profile.

© 2019 Dietitians Association of Australia. PMID: 30873744 Similar articles 145. Trop Doct. 2019 Jul;49(3):192-196. doi: 10.1177/0049475519835732. Epub 2019 Mar 14. Reliability of coeliac serology in monitoring dietary adherence in children with coeliac disease on a gluten-free diet.

Jain R1, Kumar P2, Kapoor S3, Basu S4, Lomash A5, Rohatgi S6.

Author information: 1. 1 Post Graduate Student, Department of Pediatrics, Lady Hardinge Medical College & Associated Hospitals, New Delhi, India. 2. 2 Director Professor at Department of Pediatrics, Lady Hardinge Medical College & Associated Hospitals, New Delhi, India. 3. 3 Director Professor at Department of Pediatrics, Division of Genetics, Maulana Azad Medical College and Associated Hospitals, New Delhi, India. 4. 4 Professor at Department of Pediatrics, Lady Hardinge Medical College & Associated Hospitals, New Delhi, India. 5. 5 PHD Student in Genetics Division, Department of Pediatrics, Maulana Azad Medical College and Associated Hospitals, New Delhi, India. 6. 6 Nutritionist, NNRRTC, Kalawati Saran Children Hospital, New Delhi, India.

Abstract

This study aimed to determine the utility of coeliac serology for monitoring dietary adherence in coeliac disease. Serum anti-tTg IgA and anti-DGP IgG levels of 42 newly diagnosed patients were measured at diagnosis and at intervals of three, six and 12 months after starting a gluten-free diet. Both anti-tTg and anti-DGP antibodies decreased in all patients. The decline in the former was significantly greater at 3-12 months throughout, while in the latter the decline was seen only at three months but not subsequently. Serial measurement of coeliac serology may help in monitoring adherence to a gluten-free diet. PMID: 30871417 Similar articles

146. J Sci Food Agric. 2019 Jul;99(9):4391-4396. doi: 10.1002/jsfa.9673. Epub 2019 Apr 1. Sensory profile and quality of chemically leavened gluten-free sorghum bread containing different starches and hydrocolloids.

Ari Akin P1, Miller R1, Jaffe T2, Koppel K2, Ehmke L1.

Author information: 1. Department of Grain Science and Industry, Kansas State University, Manhattan, KS, USA. 2. Center for Sensory Analysis and Consumer Behavior, Department of Food, Nutrition, Dietetics and Health, Kansas State University, Manhattan, KS, USA.

Abstract PMID: 30859568 Similar articles

147. Eur J Surg Oncol. 2019 Aug;45(8):1410-1416. doi: 10.1016/j.ejso.2019.02.018. Epub 2019 Feb 19. Prognostic impact of celiac lymph node involvement in patients after frontline treatment for advanced ovarian cancer.

Angeles MA1, Ferron G2, Cabarrou B3, Balague G4, Martínez-Gómez C5, Gladieff L6, Pomel C7, Martinez A8.

Author information: 1. Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse (IUCT), Oncopole, Toulouse, France. 2. Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse (IUCT), Oncopole, Toulouse, France; INSERM CRCT 19, Toulouse, France. 3. Biostatistics Unit, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse (IUCT), Oncopole, Toulouse, France. 4. Department of Radiology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse (IUCT), Oncopole, Toulouse, France. 5. Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse (IUCT), Oncopole, Toulouse, France; INSERM CRCT 1, Toulouse, France. 6. Department of Medical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse (IUCT), Oncopole, Toulouse, France. 7. Department of Surgical Oncology, CRLCC Jean Perrin, Clermont-Ferrand, France. 8. Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse (IUCT), Oncopole, Toulouse, France; INSERM CRCT 1, Toulouse, France. Electronic address: [email protected].

Abstract

INTRODUCTION:

Completeness of cytoreduction is the most important prognostic factor in patients with advanced ovarian cancer (OC). Extensive upper abdominal surgery has allowed to increase the rate complete cytoreduction and the feasibility of resection of celiac lymph nodes (CLN) and porta hepatis disease in these patients has been demonstrated. The aim of our study was to assess the prognostic impact of CLN involvement in patients with primary advanced OC undergoing a complete cytoreductive surgery (CRS).

MATERIAL AND METHODS:

We designed a retrospective unicentric study. We reviewed data from patients who underwent CLN resection with or without porta hepatis disease resection, within upfront or interval complete CRS in the frontline treatment of advanced epithelial OC between January 2008 and December 2015. Patients were classified in two groups according to CLN status. Univariate and multivariate analyses were conducted. Survival rates were estimated using Kaplan-Meier method.

RESULTS:

Forty-three patients were included and positive CLN were found in 39.5% of them. The median disease-free survival in the group of patients with positive and negative CLN were 11.3 months and 25.8 months, respectively. In multivariable analysis, both CLN involvement and high peritoneal cancer index were independently associated with decreased disease-free survival. Computed tomography re-reading by an expert radiologist has good sensitivity for detection of positive CLN.

CONCLUSION:

CLN involvement and high preoperative tumor burden are independently associated with decreased survival after complete cytoreduction for OC. CLN involvement is a marker of diffuse disease and an independent risk factor for early recurrent disease.

148. Food Chem. 2019 Jul 30;287:11-19. doi: 10.1016/j.foodchem.2019.02.084. Epub 2019 Feb 23. Inhibiting effect of low-molecular weight polyols on the physico-chemical and structural deteriorations of gluten protein during storage of fresh noodles.

Ma M1, Han CW2, Li M3, Song XQ2, Sun QJ2, Zhu KX4.

Author information: 1. School of Food Science and Engineering, Qingdao Agricultural University, Qingdao 266109, Shandong Province, PR China; State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi 214122, Jiangsu Province, PR China. 2. School of Food Science and Engineering, Qingdao Agricultural University, Qingdao 266109, Shandong Province, PR China. 3. School of Food Science and Engineering, Qingdao Agricultural University, Qingdao 266109, Shandong Province, PR China. Electronic address: [email protected]. 4. State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi 214122, Jiangsu Province, PR China.

Abstract

In this study, the inhibiting effects of low-molecular weight polyols on the deterioration of gluten network and noodle texture were systematically investigated, based on dough rheological properties, and the macroscopic, structural and water status changes of gluten protein during storage of fresh noodles. Both glycerol and propylene glycol significantly restrained the decrease of GMP gel weight, LA-SRC value, hardness and springiness, and the increase of cooking loss. SEM showed that polyols retarded the collapse of gluten network, with still continuous gluten fibrils. The inner structure of polyol noodles was much less damaged after 2 days, with more uniform moisture distribution in MRI images. Potential dynamic depolymerization and repolymerization interactions were detected for protein components during processing and cooking, which might contribute to the textural changes. Low-molecular weight polyols inhibited the collapse of gluten network and deterioration of noodle texture although they showed no inhibiting effect on microbial growth.

149. Am J Dermatopathol. 2019 Jul;41(7):511-513. doi: 10.1097/DAD.0000000000001380. A Case of Dermatitis Herpetiformis With Fibrillar Immunoglobulin A Deposition: A Rare Pattern Not to Be Missed.

Lilo MT1, Yan S1, Chapman MS2, Linos K1.

Author information: 1. Department of Pathology and Laboratory Medicine, Geisel School of Medicine, Dartmouth- Hitchcock Medical Center, Lebanon, NH. 2. Section of Dermatology, Department of Surgery, Geisel School of Medicine, Dartmouth- Hitchcock Medical Center, Lebanon, NH.

Abstract

Dermatitis herpetiformis is a rare, chronic autoimmune disorder characterized by intense pruritic papules and vesicles, which can be associated with celiac disease and other autoimmune disorders. Its histologic characteristic is the accumulation of neutrophils within the papillary dermis with granular deposition of immunoglobulin A (IgA) observed under direct immunofluorescence. Herein, we report a 58-year-old woman who presented with a vesicular rash on the buttocks. The patient reported a recent history of genital herpes, Entamoeba histolytica colitis, recurrent hives, and eczema. A representative biopsy demonstrated features of spongiotic dermatitis and focal papillary dermal neutrophilic aggregates. Direct immunofluorescence revealed fibrillary IgA deposition in the papillary dermis, granular C3 deposition at the dermal-epidermal junction, and dermal papillae. The overall clinical, histologic, and DIF findings were consistent with those of dermatitis herpetiformis. The fibrillar IgA pattern is rare and easily overlooked by the unwary. Pathologists should be aware of this rare pattern, especially when the histologic findings are not classic. PMID: 30839342 Similar articles

150. Epidemiology. 2019 Jul;30(4):e23-e24. doi: 10.1097/EDE.0000000000001006. Changes in Testing for and Incidence of Celiac Disease in the United Kingdom: A Population-based Cohort Study.

West J1, Otete H, Sultan AA, Crooks CJ. Author information: 1. Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom, [email protected], NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham, United Kingdom School of Pharmacy, University of Nottingham, Nottingham, United Kingdom, School of Medicine and Dentistry, University of Central Lancashire, Preston, United Kingdom Research Institute for Primary Care & Health Sciences, Primary Care Sciences, Keele University, Staffordshire, United Kingdom NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham, United Kingdom, Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham. PMID: 30829833 Similar articles

151. Psychol Health. 2019 Aug;34(8):943-962. doi: 10.1080/08870446.2019.1579912. Epub 2019 Mar 4. The roles of autonomous motivation and self-control lapses in concurrent adherence to a gluten-free diet and a self-chosen weight loss plan in adults with coeliac disease.

Voi S1, Sainsbury K2.

Author information: 1. a School of Psychology , Newcastle University , Newcastle Upon Tyne , UK. 2. b Institute of Health and Society, Faculty of Medical Sciences , Newcastle University , Newcastle Upon Tyne , UK.

Abstract

Objective: Examine the correspondence between autonomous motivation, self-control lapses, and adherence, to a gluten-free diet (GFD) and weight loss plan in adults with coeliac disease; and assess the impact of the interaction of motivation style and self-control lapses on adherence to both diets. Design: Cross-sectional survey in 519 adults with coeliac disease, 238 of whom were also attempting weight loss. Main outcome measures: Adherence, motivation style, frequency of temptation and self-control lapses (e.g. when tired, stressed, happy) for GFD and weight loss plan. Results: Autonomous motivation was higher, and amotivation lower, for the GFD than weight loss; adherence to the two diets was unrelated. Similar circumstances led to temptation and self-control lapses across diets; both were less frequent for the GFD than weight loss. Motivation and self- control lapses explained 21% and 35% of the variance in adherence, respectively; the interaction between motivation and lapse frequency did not explain additional variance for either diet. Conclusions: There are clear benefits to developing autonomous motivations and strategies to resist temptation for both the GFD and weight loss. Understanding how these processes differ and interact across diets may lead to the design of interventions to improve adherence and weight outcomes in coeliac disease. PMID: 30829064 Similar articles 152. Dig Dis Sci. 2019 Aug;64(8):2095-2106. doi: 10.1007/s10620-019-05528-3. Epub 2019 Mar 1. Diagnosis and Treatment Patterns in Celiac Disease.

Cichewicz AB1, Mearns ES2, Taylor A3, Boulanger T1, Gerber M4, Leffler DA4, Drahos J4, Sanders DS5, Thomas Craig KJ1, Lebwohl B6.

Author information: 1. IBM Watson Health, 75 Binney Street, Cambridge, MA, 02142, USA. 2. IBM Watson Health, 75 Binney Street, Cambridge, MA, 02142, USA. [email protected]. 3. Takeda Development Centre Europe, 61 Aldwych, London, WC2B 4AE, UK. 4. Takeda Pharmaceuticals International Co, 35 Landsdowne Street, Cambridge, MA, 02139, USA. 5. Royal Hallamshire Hospital and University of Sheffield, Glossop Road, Sheffield, S10 2FJ, UK. 6. Department of Medicine, Celiac Disease Centre, Columbia University Medical Center, 180 Fort Washington Avenue, Suite 936, New York, NY, 10032, USA.

Abstract

Celiac disease (CD) is an immune-mediated gastrointestinal (GI) disorder driven by innate and adaptive immune responses to gluten. Presentation of CD has changed over time, with non-GI symptoms, such as anemia and osteoporosis, presenting more commonly. With improved screening and diagnostic methods, the reported prevalence of CD has increased globally, and there is considerable global variation in diagnostic and treatment practices. The objective of this study was to describe the current state of CD diagnosis and treatment patterns. A targeted review of literature from MEDLINE, Embase, the Cochrane Library, and screening of relevant conference abstracts was performed. The generally recommended diagnostic approach is GI endoscopy with small bowel biopsy; however, in selected patients, biopsy may be avoided and diagnosis based on positive serology and clinical symptoms. Diagnosis often is delayed; the average diagnostic delay after symptom onset is highly variable and can last up to 12 years. Barriers to accurate and timely diagnosis include atypical presentation, lack of physician awareness about current diagnostic criteria, misdiagnosis, and limited access to specialists. Currently, strict adherence to a gluten-free diet (GFD) is the only recommended treatment, which is not successful in all patients. Only one- third of patients are monitored regularly following diagnosis. Unmet needs for CD include improvements in the accuracy and timeliness of diagnosis, and the development of treatments for both refractory CD and GFD nonresponsive CD. Further research should investigate the impact of education about gluten-free eating and the availability of gluten-free foods support adherence and improve outcomes in patients with CD. PMID: 30820708 Similar articles

153. Dis Esophagus. 2019 Jul 1;32(7). pii: doy107. doi: 10.1093/dote/doy107. Stenosis of the celiac trunk is associated with anastomotic leak after Ivor-Lewis esophagectomy.

Brinkmann S1, Chang DH2, Kuhr K3, Hoelscher AH4, Spiro J2, Bruns CJ1, Schroeder W1.

Author information: 1. Department of General, Visceral and Cancer Surgery, University of Cologne, Germany. 2. Department of Radiology, University of Cologne, Germany. 3. Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Germany. 4. Department of Surgery, AGAPLESION Markus Krankenhaus, Frankfurt, Germany.

Abstract

Transthoracic esophagectomy with gastric tube formation is the surgical treatment of choice for esophageal cancer. The surgical reconstruction induces changes of gastric microcirculation, which are recognized as potential risk factors of anastomotic leak. This prospective observational study investigates the association of celiac trunk (TC) stenosis with postoperative anastomotic leak. One hundred fifty-four consecutive patients with esophageal cancer scheduled for Ivor-Lewis esophagectomy were included. Preoperative staging computed tomography (CT) was used to identify TC stenosis. Any narrowing of the lumen due to atherosclerotic changes was classified as stenosis. Percentage of stenotic changes was calculated using the North American Symptomatic Carotid Endarterectomy Trial formula. Multivariable analysis was used to identify possible risk factors for leak. The overall incidence of TC stenosis was 40.9%. Anastomotic leak was identified in 15 patients (9.7%). Incidence of anastomotic leak in patients with stenosis was 19.4% compared to 2.3% in patients without stenosis. Incidence of stenosis in patients with leak was 86.7% (13 of 15 patients) and significantly higher than 38.8% (54 of 139 patients) in patients without leak (P < 0.001). There was a significant difference in median degree of TC stenosis (50.0% vs 39.4%; P = 0.032) in patients with and without leak. In the multivariable model, TC stenosis was an independent risk factor for anastomotic leak (odds ratio: 5.98, 95% CI: 1.58-22.61). TC stenosis is associated with postoperative anastomotic leak after Ivor-Lewis esophagectomy. Routine assessment of TC for possible stenosis is recommended to identify patients at risk. © The Author(s) 2019. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. PMID: 30820543 Similar articles

154. J AOAC Int. 2019 Jul 1;102(4):1162-1173. doi: 10.5740/jaoacint.19-0005. Epub 2019 Feb 26. The Validation of the Wheat Gluten ELISA Kit.

Saito E1, Doi H1, Kurihara K1, Kato K1, Aburatani K1, Shoji M1, Naka Y1, Koerner T2, Poepping B3, Boison J4.

Author information: 1. Morinaga Institute of Biological Science, Inc., Sahiura 2-1-16, Kanazawa-Ku, Yokohama-Shi 236- 0003, Japan. 2. Health Canada, Bureau of Chemical Safety, 251 Sir Frederick Banting Driveway, Ottawa, ON, Canada. 3. FOCOS GBr Food Consultants, Zum Kälterhaus 6b, 63755 Alzenau, Germany. 4. Retired Canadian Food Inspection Agency, 116 Veterinary Rd, Saskatoon, SK, Canada.

Abstract

Background: It is important to analyze the presence of wheat/gluten in food to avoid wheat allergy or celiac disease. Objective: The Wheat/Gluten ELISA kit was developed to measure total wheat protein or gluten content in wheat, barley, and rye cereals as raw materials, and processed foods. Validation as to whether this kit is suitable for quantifying total wheat protein/gluten was carried out. Methods: The Wheat/Gluten ELISA kit was designed as a sandwich ELISA based on antigliadin polyclonal antibody. Selectivity, interference study, matrix study including incurred food, robustness, stability, and lot-to-lot consistency studies were conducted for the Wheat/Gluten ELISA kit. Incurred matrix studies were also conducted in an independent laboratory. Results: The analysis of 38 different substances revealed no cross-reactivity above the LOQ except for oats. Recoveries of the spiked samples were mostly in the range of 75-140%, including an independent laboratory result. The LOD of the ELISA was found to be 0.02-0.16 mg/kg. Robustness testing proved that extraction time and incubation time of first reaction and enzyme reaction had no significant influence on quantified value. The stability at 2-8°C was found to exceed 12 months. Good lot-to-lot consistency was observed. Conclusions: The Wheat/Gluten ELISA kit showed good analytical performance in the quantitative analysis of total wheat protein/gluten in the identified food products using the AOAC Performance Tested Method(s)SM program. Highlights: The Wheat/Gluten ELISA kit was validated and showed good analytical performance in the quantitative analysis of total wheat protein/gluten in food. PMID: 30808436

Similar articles

155. Hum Immunol. 2019 Jul;80(7):523-532. doi: 10.1016/j.humimm.2019.02.012. Epub 2019 Feb 23. Prevalence of autoimmune diseases and clinical significance of autoantibody profile: Data from National Institute of Hygiene in Rabat, Morocco.

Missoum H1, Alami M2, Bachir F3, Arji N3, Bouyahya A4, Rhajaoui M3, El Aouad R5, Bakri Y4.

Author information: 1. Laboratory of Human Pathologies Biology, Department of Biology, Faculty of Sciences, and Genomic Center of Human Pathologies, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco; Laboratory Autoimmunity, Department of Immunology, National Institute of Hygiene, Rabat, Morocco. Electronic address: [email protected]. 2. Laboratory of Microbiology and Molecular Biology, Faculty of Science, Mohammed V University, Rabat, Morocco. 3. National Institute of Hygiene, Rabat, Morocco. 4. Laboratory of Human Pathologies Biology, Department of Biology, Faculty of Sciences, and Genomic Center of Human Pathologies, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco. 5. Hassan II Academy of Science and Technology Rabat, Morocco.

Abstract

AIM:

The objective of this study was to explore the prevalence of various autoimmune diseases (AIDs) in a large cohort of patients and to characterize the autoantibody profile in the patients with and without AIDs to confirm the diagnosis and to refine the Moroccan databases.

PATIENTS AND METHOD:

Retrospective study was conducted in the Laboratory of autoimmunity National Institute of Hygiene (NIH) of Rabat in Morocco. A total of 3182 consecutive Moroccan patients (2183 females and 999 males) whose sera were tested for 14 autoantibody profile between 2010 and 2016.

RESULTS: Only 944 (29.7%) patients were diagnosed with AIDs of those suspected. The prevalence of systemic lupus erythematosus (SLE), intestinal malabsorption (IM) and arthritis polyarthralgia (AP) were the highest (4.2, 4.1 and 4%), subsequently followed by rheumatoid arthritis (RA) (2.8%), cholestatic syndrome (CS) (1.8%), interstitial lung disease (ILD) (1.6%).In females IM, AP and SLE also showed the highest prevalence (5.4%, 5.3% and 4.9% respectively), while of male, SLE showed the highest prevalence (1.9%). The prevalence of ANA was increased in most patients with systemic especially in neuropathy (NP), hemolytic anemia (HA), primary Sjogren's syndrome (pSS), dermatomyositis (DM), thrombocytopenia (Tb), systemic sclerosis (SSc), ANCA-associated vasculitis (AAV), AP, Renal impairment (RI), SLE, and mixed connective tissue disease (MCTD). Anti-dsDNA antibodies were higher in SLE and ENA showed the highest titers in MCTD. Others are relatively specific for certain disease, such as anti β2GP1 for thrombosis syndrome, anti ANCA for primary sclerosing cholangitis (PSC), AAV, ILD and RI, anti CCP2 for RA, ILD and AP. the prevalence of anti AMA was higher in primary biliary cirrhosis (PBC), followed in CS, also, ANA have been identified in up to 25% of patients with primary biliary cirrhosis. The prevalence of anti-SMA was higher in PBC, treated patients for Chronic hepatitis C (HCV), and autoimmune hepatitis (AIH) and anti-PCA was higher in biermer anemia patients with vitamin B12 deficiency (BA/Def vit B12). The prevalence of IgA EMA, IgA tTG and IgA AGA were higher in patients IM and celiac disease (CD). The prevalence of anti thyroperoxidase (TPO) was significantly increased in the autoimmune thyroiditis (AIT).

CONCLUSION:

Our study shows the diagnostic value of auto antibodies in AIDs. It would be interesting to carry out prospective studies on each pathology separately, in order to fill the classic vagaries of the retrospective study and objectively estimate the prevalence in different AIDs. These data on the prevalence of each autoimmune disease are valuable for the public health system.

156. J Clin Gastroenterol. 2019 Jul;53(6):474-475. doi: 10.1097/MCG.0000000000001196. Gamma-Delta T lymphocytes in the Diagnostic Approach of Celiac Disease.

Fernández-Bañares F1, Esteve M.

Author information: 1. Department of Gastroenterology, Hospital Universitari Mutua Terrassa, and Center for Biomedical Research in the Network (CIBER) of Hepatic and Digestive Diseases Terrassa (Barcelona), Spain. PMID: 30807402 Similar articles

157. Food Chem. 2019 Jul 1;285:290-295. doi: 10.1016/j.foodchem.2019.01.137. Epub 2019 Jan 31. Changes in digestibility of proteins from chickpeas (Cicer arietinum L.) germinated in presence of selenium and antioxidant capacity of hydrolysates.

Serrano-Sandoval SN1, Guardado-Félix D2, Gutiérrez-Uribe JA3.

Author information: 1. Tecnologico de Monterrey, Centro de Biotecnología FEMSA, Escuela de Ingeniería y Ciencias, Av. Eugenio Garza Sada 2501 Sur, C.P. 64849 Monterrey, NL, Mexico. 2. Tecnologico de Monterrey, Centro de Biotecnología FEMSA, Escuela de Ingeniería y Ciencias, Av. Eugenio Garza Sada 2501 Sur, C.P. 64849 Monterrey, NL, Mexico; Programa Regional de Posgrado en Biotecnología, Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Sinaloa, FCQB-UAS, AP 1354, CP 80000 Culiacán, Sinaloa, Mexico. 3. Tecnologico de Monterrey, Centro de Biotecnología FEMSA, Escuela de Ingeniería y Ciencias, Av. Eugenio Garza Sada 2501 Sur, C.P. 64849 Monterrey, NL, Mexico; Tecnologico de Monterrey, Escuela de Ingeniería y Ciencias, Campus Puebla, Vía Atlixcáyotl 5718, Reserva Territorial Atlixcáyotl, C.P. 72453 Puebla, Pue, Mexico. Electronic address: [email protected].

Abstract

Germination in the presence of selenium (Se) is an alternative to increase the healthy properties of seeds. This study aimed to compare the Se accumulation in different protein fractions from germinated chickpea (Cicer arietinum L.) and the effect on digestibility and cellular antioxidant activity (CAA) of protein hydrolysates. Chickpeas were germinated during four days after soaking with sodium selenite (0, 1, or 2 mg/100 g seeds). Total protein (TP) and glutelin (Glu), albumin (Alb) and globulin (Glo) fractions were digested and ultrafiltrated through a 10 kDa membrane. Se accumulated in the order of Glu > Alb > Glo. Ultrafiltrated Glu hydrolysate of four days germinated chickpeas treated with 2 mg Na2SeO3/100 g increased CAA (51.47%), demonstrating the potential health benefits of selenization. The intensity of vicilin bands (34-37 kDa) increased from the second to the fourth day compared with the control samples. Glo digestibility was higher in selenized chickpea sprouts.

158. J Am Coll Nutr. 2019 Jul;38(5):433-440. doi: 10.1080/07315724.2018.1541426. Epub 2019 Feb 22. A Peptide from Kiwifruit Exerts Anti- Inflammatory Effects in Celiac Disease Mucosa.

Russo I1, Del Giorno C1, Giangrieco I2, Hajji N1, Ciardiello MA2, Iovino P1, Ciacci C1.

Author information: 1. a Gastrointestinal Unit, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana , University of Salerno , Baronissi , SA , Italy. 2. b Institute of Biosciences and BioResources , CNR , Naples , Italy.

Abstract

Objective: Celiac disease is an immune-mediated disease of the intestine triggered by gluten. Gluten elicits, in genetically susceptible individuals, cytokine responses that are then transmitted to the immunocompetent cells. Vegetables and fruit have anti-inflammatory and antioxidant properties with a protective effect on intestinal epithelium. Kiwifruit is known to have beneficial effects on the intestinal tissues, and it is the only plant food containing the peptide kissper, with anti-inflammatory properties. The aim of this study was the evaluation of the kissper effect on the gluten-induced inflammation in celiac disease. Methods: We used an in vitro model of intestinal culture explant from celiac disease patients and non-celiac disease patients, cultured for 24 hours with the toxic gliadin peptide P31-43 and kissper preincubation. Results: Our data showed HLA-DR and TG2 reduction in the celiac disease mucosa pretreated with kissper, as well as a reduction of COX-2 in two patients. No differences we observed for the TGF-b1 and IL-15 levels in supernatants upon kissper pretreatment. Conclusions: The preliminary results suggest that kissper has a potential anti-inflammatory role in celiac disease. PMID: 30794064 Similar articles 159. J Crohns Colitis. 2019 Jul 25;13(7):894-904. doi: 10.1093/ecco-jcc/jjz012. Identification of Chitinase-3-Like Protein 1 as a Novel Neutrophil Antigenic Target in Crohn's Disease. Deutschmann C1, Sowa M1,2, Murugaiyan J3,4, Roesler U3, Röber N5, Conrad K5, Laass MW6, Bogdanos D7, Sipeki N8, Papp M8, Rödiger S1, Roggenbuck D1,2, Schierack P1.

Author information: 1. Institute of Biotechnology, Faculty Environment and Natural Sciences, Brandenburg University of Technology Cottbus-Senftenberg, Universitätsplatz, Senftenberg, Germany. 2. Medipan/GA Generic Assays GmbH, Ludwig-Erhard-Ring, Dahlewitz, Berlin, Germany. 3. Institute for Animal Hygiene and Environmental Health, Freie Universität Berlin, Centre for Infectious Medicine, Robert-von-Ostertag-Str., Berlin, Germany. 4. Department of Biotechnology, SRM University-AP, Amaravati, India. 5. Institute of Immunology, Medical Faculty Carl Gustav Carus, Technical University Dresden, Fetscherstraße, Dresden, Germany. 6. Children's Hospital, Medical Faculty Carl Gustav Carus, Technical University Dresden, Fetscherstraße, Dresden, Germany. 7. Department of Rheumatology, School of Health Sciences, University of Thessaly, Larissa, Greece. 8. Department of Internal Medicine, Division of Gastroenterology, Faculty of Medicine, University of Debrecen, Nagyerdei krt., Debrecen, Hungary.

Abstract

BACKGROUND AND AIMS:

There is an increasing incidence of inflammatory bowel disease [IBD]. Autoimmune responses are involved in the pathophysiology of IBD, but their underlying pathways and target antigens have not yet been fully elucidated.

METHODS:

Autoantigenic targets in IBD were identified after separation of whole cell proteins isolated from neutrophils using two-dimensional electrophoresis and matrix assisted laser desorption ionization - time of flight mass spectrometry-based protein identification of the spots that displayed Western blotting signals with anti-neutrophil cytoplasmic antibody-positive sera. The prevalence of IgG, IgA and secretory IgA [sIgA] to chitinase 3-like protein 1 [CHI3L1] was analysed by enzyme-linked immunosorbent assays using recombinant CHI3L1 in 110 patients with Crohn's disease [CD], 95 with ulcerative colitis [UC], 126 with coeliac disease [CeD] and 86 healthy controls [HCs].

RESULTS:

The 18-glycosylhydrolase family member CHI3L1 was identified as a neutrophil autoantigenic target. CD patients displayed significantly higher levels of IgG to CHI3L1 than patients with UC and CeD (p < 0.0001, respectively). IgA and sIgA to CHI3L1 was significantly higher in CD than in UC, CeD and HCs [p < 0.0001, respectively]. IgA and sIgA to CHI3L1 demonstrated the highest prevalence in CD [25.5%, 28/110; and 41.8%%, 46/110] compared to HCs [2.3%, 2/86; and 4.7%%, 4/86; p = 0.0015 and p < 0.0001] and are associated with a more complicated progression of CD.

CONCLUSION: CHI3L1 is a novel neutrophil autoantigenic target in CD. IgA and sIgA to CHI3L1 may serve as novel markers for CD and may facilitate the serological diagnosis of IBD.

160. J Pediatr Gastroenterol Nutr. 2019 Jul;69(1):13-17. doi: 10.1097/MPG.0000000000002292. Magnetically Controlled Capsule Endoscopy in Children: A Single-center, Retrospective Cohort Study.

Gu Z1, Wang Y, Lin K, Wang X, Cheng W, Wang L, Zhang T, Liu H.

Author information: 1. Department of Gastroenterology, Hepatology and Nutrition, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China.

Abstract

OBJECTIVE:

Capsule endoscopy (CE) is a noninvasive diagnostic tool for the digestive tract. We aim to investigate the feasibility and safety of newly developed magnetically controlled capsule endoscopy (MCE) in children.

METHODS:

A total of 129 children who underwent MCE in Shanghai Children's Hospital were retrospectively recruited between March 2016 and August 2018. The feasibility, positive findings, and safety of MCE were evaluated and systematically analyzed.

RESULTS:

Of all those children, 68 were boys, and 61 were girls with a mean age of 9.8 ± 1.9 years (6-14 years). The MCE procedure was feasible in all children. The mean esophageal transit time was 6.0 ± 4.6 seconds. The mean gastric examination time was 14.4 ± 3.9 minutes, and the average gastric transit time was 83.9 ± 59.1 minutes. Positive findings were detected in 82 children (82/129, 63.6%), 1 had esophageal lesions, 30 had superficial gastritis, 14 had superficial gastritis with bile reflux, 18 had nodular gastritis, 1 had ulcers, and 2 had heterotopic pancreas. There were 5 patients who had duodenal bulbar ulcers. One had lymphatic follicle, 1 had celiac disease, 1 had blue rubber bleb nevus syndrome, and 2 polyps were detected in 16 patients who were examined the small bowel. No serious adverse event was reported during the MCE examination and follow- up, and all subjects excreted the capsules spontaneously within 2 weeks.

CONCLUSIONS:

We showed that MCE is feasible and safe in children above 6 years. More studies are needed to further investigate the efficacy of MCE in children. PMID: 30747810 Similar articles

161. Food Sci Technol Int. 2019 Jul;25(5):414-428. doi: 10.1177/1082013219828269. Epub 2019 Feb 2. Optimization of hot-air drying conditions for cassava flour for its application in gluten- free pasta formulation.

Ramírez M1, Tenorio MJ1, Ramírez C2, Jaques A2, Nuñez H2, Simpson R2,3, Vega O1,4.

Author information: 1. 1 BIOALI Research Group, Department of Food, Faculty of Pharmaceutical Sciences and Food, Universidad de Antioquia, Medellín, Colombia. 2. 2 Chemical and Environmental Engineering Department, Universidad Técnica Federico Santa María, Valparaíso, Chile. 3. 3 Centro Regional de Estudios en Alimentos y Salud (CREAS), Conicyt Regional Gore Valparaíso (R06I1004), Valparaíso, Chile. 4. 4 Corporación Universitaria Americana, Medellín, Colombia.

Abstract

The design and development of gluten-free foods requires a comprehensive understanding of the behavior of the raw materials to attain the same cooking and nutritional quality as gluten-based food. The objective of this study was to determine the optimal hot-air drying conditions for elaboration of cassava flour to be used in a gluten-free pasta formulation. The results showed that the operational conditions to minimize the hot-air drying time (57 min) to produce cassava flour with higher water holding capacity was 57 at 3 m/s. Then, the optimal formulation for the pasta was found to be cassava (26 g/100 g), amaranth flour (12 g/100 g), and carboxymethyl cellulose (0.23 g/100 g), which maximized the Aw (0.160),℃ moisture content (3.10 g/100 g), hardness (5.02 N), and protein content (9.30 g/100 g), and it is used for the sensorial analysis, which showed that an earthy taste was the main problem with consumer satisfaction.

PMID: 30714395 Similar articles

162. Int J Food Sci Nutr. 2019 Aug;70(5):562-569. doi: 10.1080/09637486.2018.1551336. Epub 2019 Jan 8. Analysis of ingredient and nutritional labeling of commercially available gluten- free bread in Brazil.

Santos FG1, Aguiar EV1, Capriles VD1.

Author information: 1. a Departamento de Biociências , Universidade Federal de São Paulo , Santos , Brasil.

Abstract

This study aimed at evaluating the ingredients and nutritional information of commercially- available gluten-free bread (GFB) in Brazil. A total of 128 products were studied, of which 87% presented the sandwich loaf shape. Traditional GFBs (n = 114) had as main ingredient the refined rice flour and starches, whereas alternative ones (n = 14) presented whole rice flour. Raw materials suggested by science to improve nutrients and bioactive compounds of gluten-free foodstuffs were observed in the ingredient list of most products (n = 86); however, they were used in lower levels, thus no significant differences were observed for nutritional information between the different categories of GFB. No products with added vitamins or minerals were found, though 77% of them included hydrocolloids in their formulations - other food additives were also observed. Despite the increased gluten-free food market, there is still a gap between science and market, especially regarding the approaches to improve the GFB diversity and nutritional quality. PMID: 30616431 Similar articles

163. J Vasc Surg. 2019 Jul;70(1):15-22. doi: 10.1016/j.jvs.2018.10.052. Epub 2018 Dec 24. Outcomes and complications after fenestrated-branched endovascular aortic repair.

Motta F1, Crowner JR1, Kalbaugh CA1, Marston WA1, Pascarella L1, McGinigle KL1, Kibbe MR1, Farber MA2.

Author information: 1. Division of Vascular Surgery, Department of Surgery, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC. 2. Division of Vascular Surgery, Department of Surgery, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC. Electronic address: [email protected].

Abstract

OBJECTIVE:

To report the outcomes of patients enrolled in a physician-sponsored investigational device exemption trial for endovascular treatment of complex thoracoabdominal aortic aneurysms with fenestrated and/or branched devices.

METHODS:

This study represents a retrospective analysis of a prospectively maintained database of patients enrolled in a physician-sponsored investigational device exemption trial for endovascular treatment of complex thoracoabdominal aneurysms between July 2012 and July 2017. Subjects included high-risk patients for open repair and patients with unsuitable anatomy for either standard endovascular aneurysm repair or Zenith (Cook Medical, Bloomington, Ind) fenestrated device. Aneurysm classification was based upon Crawford classification. We included the pararenal and paravisceral aneurysms in the type IV aneurysm group, because the repair of these aneurysms usually involved treatment of all four visceral branches. The endografts implanted were custom manufactured devices or off-the-shelf devices based on the Cook Zenith platform. Variables analyzed included preoperative demographics and comorbidities, anatomic aneurysmal characteristics, procedural details, and perioperative complications.

RESULTS:

One -hundred fifty patients with a mean age of 71 ± 7.9 years were treated; 69% were male. Tobacco use (93%) and hypertension (91%) were the most common risk factors. Fifty-seven patients (38%) had a history of previous aortic repair. The mean aneurysm diameter was 62 ± 12 mm and 14 (9%) aneurysms were associated with chronic dissection. A total of 573 visceral vessels were incorporated (celiac artery/superior mesenteric artery [287 vessels], renal arteries [275 vessels], and 11 additional vessels) and 539 were stented. The celiac artery/superior mesenteric artery received a fenestrated design in 76.1% of cases. Branch designs were used in the renal artery in 13.2%, with the remainder treated with fenestrations. Spinal cord drainage was used in 51% of patients (76/150). The mean operative time, fluoroscopy time, and estimated blood loss were 283 ± 89 minutes, 83 ± 38 minutes, and 417 ± 404 mL, respectively. There were five patients (3.3%) with intraoperative complications, resulting in one intraoperative death. The early mortality was 2.7% (4/150). Major complications included respiratory failure in 7% (10/150), stroke and myocardial infarction in 0.7% each (1/150), and paraplegia in 2.7% (4/150). Acute kidney injury occurred in 4.7% of patients (7/150), two of whom required temporary dialysis. Thirty-nine percent of patients experienced at least one complication. Early branch vessel patency was 99.8% (525/526). Survival, primary, and primary-assisted branch patency at 2 years of follow-up were 79%, 97%, and 99%, respectively.

CONCLUSIONS:

Endovascular repair of complex aneurysms is safe and effective when performed in a high-volume center experienced in aortic disease management. Branch vessels patency and the low incidence of paraplegia and mortality support expanded use to treat most complex thoracoabdominal aortic aneurysms.

Published by Elsevier Inc. PMID: 30591293 Similar articles

164. Gut. 2019 Aug;68(8):1396-1405. doi: 10.1136/gutjnl-2018-317371. Epub 2018 Nov 17. NKp46 is a diagnostic biomarker and may be a therapeutic target in gastrointestinal T-cell lymphoproliferative diseases: a CELAC study.

Cheminant M#1,2,3, Bruneau J#2,3,4, Malamut G#3,5,6, Sibon D1,2,3, Guegan N6, van Gils T7, Cording S6, Trinquand A3,8,9, Verkarre V3,4, Lhermitte L3,8,9, Brousse N3,4, Jannot AS10, Khater S3,5, Frenzel L1,2,3, Delarue R1,3, Suarez F1,2,3, Marçais A1,3, Mulder CJ7, Macintyre E3,8,9, Asnafi V3,8,9, Pouyet L11, Bonnafous C12, Lhospice F12, Molina TJ3,4, Meresse B3,6, Cellier C#3,5,6, Cerf-Bensussan N#3,6, Hermine O#1,2,3; CELAC network°. Collaborators: (70) Bouhnik Y, Cuenod CA, Brechignac S, Allez M, Cosnes J, Fourmestraux A, Delchier JC, Dupuis J, Haioun C, Gnaoui TE, Lerebours E, Savoye G, Tilly H, Flourie B, Coiffier B, Hebuterne X, Arab N, Filippi J, Schneider S, Zerbib F, Milpied N, Bouabdallah K, Tabrizi R, Vigouroux S, Pigneux A, Leguay T, Dilhuydy MS, Dauriac C, Bologna S, Hulin C, Bonmati C, Magnin F, Ranta D, Matysiakbudnik T, Deconinck E, Pouderoux P, Bonaz B, Gressin R, Carbonnel F, Gornet JM, Branche J, Saint-Georges G, Reimund JM, Nancey S, Nachury M, Viennot S, Zallot C, Fabiani B, Marthey L, Juvin K, Baleur YL, Kwiatek S, Saillard E, Louvel D, Roblin X, Beau P, Feugier P, Peyrin-Biroulet L, Zanaldi H, Brixi- Benmansour H, Cadiot G, Lecomte T, Bretagne JF, Casasnovas O, Caillot D, Bedenne L, Bay JO, Bouteloup C, Duclos B, Foucaud C.

Author information: 1. Clinical Haematology, Necker-Enfants Malades University Hospital, AP-HP, Paris, France. 2. INSERM UMR1163 & CNRS URL 8254, Imagine Institute, Paris, France. 3. Paris Descartes University-Sorbonne Paris Cité, Paris, France. 4. Pathology Department, Necker-Enfants Malades University Hospital, AP-HP, Paris, France. 5. Department of Gastroenterology, HEGP Hospital, AP-HP, Paris, France. 6. INSERM UMR1163, Laboratory of Intestinal Immunity, Imagine Institute, Paris, France. 7. Department of Gastroenterology, VU University Medical Center, Amsterdam, The Netherlands. 8. Biological Haematology, Necker-Enfants Malades University Hospital, AP-HP, Paris, France. 9. INSERM UMR1151, Necker-Enfants Malades Institute, Paris, France. 10. Biomedical Informatics and Public Health Department, HEGP Hospital, AP-HP, Paris, France. 11. MI-mAbs, Marseille, France. 12. Innate Pharma, Marseille, France. #. Contributed equally

Abstract

OBJECTIVES:

Primary GI T-cell lymphoproliferative diseases (T-LPD) are heterogeneous entities, which raise difficult diagnosis and therapeutic challenges. We have recently provided evidences that lymphomas complicating coeliac disease (CD) arise from innate-like lymphocytes, which may carry NK receptors (NKRs).

DESIGN:

NKRs expression was compared by flow cytometry in intraepithelial lymphocytes (IEL) from CD, type I or type II refractory CD (RCD). NKp46 was next assessed by immunohistochemistry in paraffin-embedded biopsies from 204 patients with CD, RCDI, RCDII or GI T-cell lymphomas and from a validation cohort of 61 patients. The cytotoxic properties of an anti-NKp46 monoclonal antibody conjugated to pyrrolobenzodiazepine (PBD) was tested ex vivo in human primary tumour cells isolated from fresh duodenal biopsies.

RESULTS:

NKp46 (but not CD94, NKG2A, NKG2C, NKG2D) was significantly more expressed by malignant RCDII IEL than by normal IEL in CD and RCDI. In paraffin biopsies, detection of >25 NKp46+ IEL per 100 epithelial cells discriminated RCDII from CD and RCDI. NKp46 was also detected in enteropathy-associated T-cell lymphomas (EATL, 24/29) and in monomorphic epitheliotropic intestinal T-cell lymphomas (MEITL, 4/4) but not in indolent T-LPD (0/15). Treatment with anti- NKp46-PBD could efficiently and selectively kill human NKp46+ primary IEL ex vivo. CONCLUSION:

NKp46 is a novel biomarker useful for diagnosis and therapeutic stratification of GI T-LPD. Strong preclinical rationale identifies anti-NKp46-PBD as a promising therapy for RCDII, EATL and MEITL.

Conflict of interest statement

Competing interests: FL and CB are senior directors and have ownership interest (including patents) in Innate Pharma. MC, JB and OH received research grants from Innate Pharma. 165. Inflammopharmacology. 2019 Aug;27(4):781-797. doi: 10.1007/s10787-018-0543-4. Epub 2018 Nov 16. Inhibitory effects of Clematis orientalis aqueous ethanol extract and fractions on inflammatory markers in complete Freund's adjuvant-induced arthritis in Sprague- Dawley rats.

Hasan UH1, Alamgeer2, Shahzad M3, Jahan S4, Niazi ZR5, Bukhari IA6, Assiri AM7, Riaz H8.

Author information: 1. Laboratory of Cardiovascular Research and Integrative Pharmacology, College of Pharmacy, University of Sargodha, Sargodha, Pakistan. 2. Laboratory of Cardiovascular Research and Integrative Pharmacology, College of Pharmacy, University of Sargodha, Sargodha, Pakistan. [email protected]. 3. Department of Pharmacology, University of Health Sciences, Lahore, 54600, Pakistan. 4. Department of Immunology, University of Health Sciences, Lahore, 54600, Pakistan. 5. Department of Biomedical Sciences, Faculty of Pharmacy, Gomal University, DI Khan, Khyber Pakhtunkhwa, Pakistan. 6. Department of Pharmacology, College of Medicine, King Saud University, Riyadh, Saudi Arabia. 7. Prince Abdullah Ben Khaled Celiac Disease Research Chair, Department of Pediatrics, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia. 8. Laboratory Rashid Latif College of Pharmacy, Lahore, Pakistan. Abstract

Clematis orientalis Linn has long been used as ethnopharmacy for the treatment of arthritis. This study is intended to evaluate the curative efficacy of Clematis orientalis in treating polyarthritis in rats. Aqueous ethanolic extract and fractions (hexane, butanol and aqueous) were administered orally at 200 mg/kg for 28 days after CFA immunization. Paw swelling, paw diameter, arthritic score, body weight, hematological parameters, radiographic and histological analysis of ankle joints were evaluated. Moreover, levels of various inflammatory markers through RT-PCR and ELISA were measured. DPPH and reducing power assays were used to appraise antioxidant capacity. Qualitative phytochemical analysis, determination of total phenolic and flavonoid contents were also carried out. Aqueous ethanolic extract and fractions significantly (p < 0.001) reduced paw volume, paw thickness and arthritic score and considerably prevented decrease in body weight along with anomalous alterations in hematological parameters in comparison with arthritic control. X-ray and histological examination revealed no significant structural changes in ankle joints of treated rats. Expression levels of IL-1β, TNF-α, IL-6, COX-2 and NF-Kβ were significantly (p < 0.05-0.001) suppressed as well as noteworthy increase in the levels of IL-4 and IL- 10 among treated animals has been detected. Overproduction of TNF-α and PGE2 was substantially prevented in animals given different treatments. Aqueous ethanol extract and its fractions demonstrated significant and concentration-dependent antioxidant potential. In general, among fractions aqueous fraction exhibited a greater anti-arthritic effect. Phytochemical analysis of aqueous fraction confirmed the presence of flavonoids and glycosides, 215.29 mgGAE/ml phenolic content and 633.03 μgQE/ml flavonoid content. Thus, we suggest Clematis orientalis as a potent strategy for the treatment of rheumatoid arthritis. PMID: 30446927 Similar articles 166. Clin Gastroenterol Hepatol. 2019 Aug;17(9):1780-1787.e5. doi: 10.1016/j.cgh.2018.09.032. Epub 2018 Sep 26. Low Sensitivity of Simtomax Point of Care Test in Detection of Celiac Disease in a Prospective Multicenter Study.

Tangermann P1, Branchi F1, Itzlinger A1, Aschenbeck J2, Schubert S3, Maul J3, Liceni T3, Schröder A4, Heller F5, Spitz W6, Möhler U6, Graefe U6, Radke M7, Trenkel S7, Schmitt M8, Loddenkemper C9, Preiß JC1, Ullrich R1, Daum S1, Siegmund B1, Bojarski C1, Schumann M10.

Author information: 1. Department of Gastroenterology, Infectious Diseases and Rheumatology, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin and Berlin Institute of Health, Berlin, Germany. 2. Praxis Dr. Aschenbeck, Berlin, Germany. 3. Praxis für Gastroenterologie am Bayerischen Platz, Berlin, Germany. 4. Gemeinschaftspraxis Hohenzollerndamm, Berlin, Germany. 5. Praxis Heller/Mayr, Berlin, Germany. 6. Gastroenterologie am Mexikoplatz, Berlin, Germany. 7. Ernst von Bergmann Klinikum, Potsdam, Germany. 8. Evangelisches Krankenhaus Ludwigsfelde-Teltow, Ludwigsfelde, Germany. 9. PathoTres Praxis für Pathologie und Neuropathologie, Berlin, Germany. 10. Department of Gastroenterology, Infectious Diseases and Rheumatology, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin and Berlin Institute of Health, Berlin, Germany. Electronic address: [email protected].

Abstract

BACKGROUND & AIMS:

Point of care tests (POCTs) might be used to identify patients with undiagnosed celiac disease who require further evaluation. We performed a large multicenter study to determine the performance of a POCT for celiac disease and assessed celiac disease prevalence in endoscopy centers.

METHODS:

We performed a prospective study of 1055 patients (888 adults; median age, 48 yrs and 167 children; median age, 10 yrs) referred to 8 endoscopy centers in Germany, for various indications, from January 2016 through June 2017. Patients were tested for celiac disease using Simtomax, which detects immunoglobulin (Ig)A and IgG antibodies against deamidated gliadin peptides (DGP). Results were compared with findings from histologic analyses of duodenal biopsies (reference standard). The primary aim was to determine the accuracy of this POCT for the detection of celiac disease, to identify candidates for duodenal biopsy. A secondary aim was to determine the prevalence of celiac disease in adult and pediatric populations referred for outpatient endoscopic evaluation.

RESULTS:

The overall prevalence of celiac disease was 4.1%. The POCT identified individuals with celiac disease with 79% sensitivity (95% CI, 64%-89%) and 94% specificity (95% CI, 93%-96%). Positive and negative predictive values were 37% and 99%. When we analyzed the adult and pediatric populations separately, we found the test to identify adults with celiac disease (prevalence 1.2%) with 100% sensitivity and 95% specificity. In the pediatric population (celiac disease prevalence 19.6%), the test produced false-negative results for 9 cases; the test therefore identified children with celiac disease with 72% sensitivity (95% CI 53%-86%). Analyses of serologic data revealed significantly lower DGP titers in the false-negative vs the true-positive group.

CONCLUSIONS:

In a study of more than 1000 adults and children, we found the Simtomax POCT to detect celiac disease with lower overall levels of sensitivity than expected. Although the test identifies adults with celiac disease with high levels of sensitivity and specificity, the prevalence of celiac disease was as low as 1.2% among adults. The test's lack of sensitivity might be due to the low intensity of the POCT bands and was associated with low serum DGP titers. Study ID no: DRKS00012499. Copyright © 2019 AGA Institute. Published by Elsevier Inc. All rights reserved. PMID: 30267867 Similar articles

167. Asian J Endosc Surg. 2019 Jul;12(3):315-317. doi: 10.1111/ases.12650. Epub 2018 Sep 26. Laparoscopic decompression of a stricture of the celiac artery caused by the median arcuate ligament in a gastric cancer patient: A case of report.

Asaumi Y1, Sakatoku M1, Okamoto J1, Hayashi S1, Ota N1, Yoshida K1, Sugahara H1, Tabata S1, Kaneki M1, Ietsugu K1, Kiyohara K1.

Author information: 1. Department of Surgery, Tonami General Municipal Hospital, Toyama, Japan.

Abstract

Stricture of the celiac artery caused by the median arcuate ligament induces abdominal ischemic symptoms and aneurysm near the pancreatic head. However, the need to treat asymptomatic patients is unclear. We safely performed surgical decompression of a stricture of the celiac artery by MAL in an asymptomatic patient at the same time as gastrectomy for gastric cancer. After surgery, the stricture of the celiac artery had disappeared as demonstrated by CT scan and 3-D CT angiography.

168. J Child Psychol Psychiatry. 2019 Jul;60(7):803-812. doi: 10.1111/jcpp.12958. Epub 2018 Sep 3. Bidirectional relationship between eating disorders and autoimmune diseases. Hedman A1, Breithaupt L1,2, Hübel C1,3, Thornton LM4, Tillander A1,5, Norring C6, Birgegård A6, Larsson H1,7, Ludvigsson JF1,8, Sävendahl L9, Almqvist C1,10, Bulik CM1,4,11.

Author information: 1. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. 2. Department of Psychology, George Mason University, Fairfax, VA, USA. 3. Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK. 4. Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 5. Department of Computer and Information Science, Linköping University, Linköping, Sweden. 6. Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden. 7. School of Medical Sciences, Örebro University, Örebro, Sweden. 8. Department of Pediatrics, Örebro University Hospital, Örebro, Sweden. 9. Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden. 10. Pediatric Allergy and Pulmonology Unit, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden. 11. Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Abstract

BACKGROUND:

Immune system dysfunction may be associated with eating disorders (ED) and could have implications for detection, risk assessment, and treatment of both autoimmune diseases and EDs. However, questions regarding the nature of the relationship between these two disease entities remain. We evaluated the strength of associations for the bidirectional relationships between EDs and autoimmune diseases.

METHODS:

In this nationwide population-based study, Swedish registers were linked to establish a cohort of more than 2.5 million individuals born in Sweden between January 1, 1979 and December 31, 2005 and followed up until December 2013. Cox proportional hazard regression models were used to investigate: (a) subsequent risk of EDs in individuals with autoimmune diseases; and (b) subsequent risk of autoimmune diseases in individuals with EDs.

RESULTS:

We observed a strong, bidirectional relationship between the two illness classes indicating that diagnosis in one illness class increased the risk of the other. In women, the diagnoses of autoimmune disease increased subsequent hazards of anorexia nervosa (AN), bulimia nervosa (BN), and other eating disorders (OED). Similarly, AN, BN, and OED increased subsequent hazards of autoimmune diseases.Gastrointestinal-related autoimmune diseases such as, celiac disease and Crohn's disease showed a bidirectional relationship with AN and OED. Psoriasis showed a bidirectional relationship with OED. The previous occurence of type 1 diabetes increased the risk for AN, BN, and OED. In men, we did not observe a bidirectional pattern, but prior autoimmune arthritis increased the risk for OED.

CONCLUSIONS:

The interactions between EDs and autoimmune diseases support the previously reported associations. The bidirectional risk pattern observed in women suggests either a shared mechanism or a third mediating variable contributing to the association of these illnesses.

169. J Neurol. 2019 Jul;266(7):1557-1565. doi: 10.1007/s00415-018-9025-2. Epub 2018 Aug 23. Gluten sensitivity and epilepsy: a systematic review.

Julian T1, Hadjivassiliou M2, Zis P2.

Author information: 1. Sheffield Institute for Translational Neuroscience, University of Sheffield, 385a Glossop Rd, Sheffield, S10 2HQ, UK. [email protected]. 2. Academic Department of Neurosciences, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK.

Abstract

OBJECTIVE:

The aim of this systematic review was to establish the prevalence of epilepsy in patients with coeliac disease (CD) or gluten sensitivity (GS) and vice versa and to characterise the phenomenology of the epileptic syndromes that these patients present with.

METHODOLOGY:

A systematic computer-based literature search was conducted on the PubMed database. Information regarding prevalence, demographics and epilepsy phenomenology was extracted.

RESULTS:

Epilepsy is 1.8 times more prevalent in patients with CD, compared to the general population. CD is over 2 times more prevalent in patients with epilepsy compared to the general population. Further studies are necessary to assess the prevalence of GS in epilepsy. The data indicate that the prevalence of CD or GS is higher amongst particular epileptic presentations including in childhood partial epilepsy with occipital paroxysms, in adult patients with fixation off sensitivity (FOS) and in those with temporal lobe epilepsy (TLE) with hippocampal sclerosis. A particularly interesting presentation of epilepsy in the context of gluten-related disorders is a syndrome of coeliac disease, epilepsy and cerebral calcification (CEC syndrome) which is frequently described in the literature. Gluten-free diet (GFD) is effective in the management of epilepsy in 53% of cases, either reducing seizure frequency, enabling reduced doses of antiepileptic drugs or even stopping antiepileptic drugs.

CONCLUSION:

Patients with epilepsy of unknown aetiology should be investigated for serological markers of gluten sensitivity as such patients may benefit from a GFD.

PMCID: PMC6586915 Free PMC Article PMID: 30167878 Similar articles

170. Exp Clin Endocrinol Diabetes. 2019 Jul;127(7):417-422. doi: 10.1055/a-0653-7108. Epub 2018 Jul 30. The Effect of Gluten-Free Diet on Thyroid Autoimmunity in Drug-Naïve Women with Hashimoto's Thyroiditis: A Pilot Study.

Krysiak R1, Szkróbka W1, Okopień B1.

Author information: 1. Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.

Abstract

BACKGROUND:

Autoimmune thyroid disease is often accompanied by celiac disease.

OBJECTIVE: The purpose of this study was to investigate whether a gluten-free diet affects thyroid autoimmunity, hypothalamic-pituitary-thyroid axis activity and thyroid function tests in women with Hashimoto's thyroiditis and incidentally found positive anti-tissue transglutaminase antibodies.

METHODS:

The study included 34 women with autoimmune thyroiditis divided into two group. The patients belonging to the first one (group A, n=16) complied with the gluten-free diet for 6 months, while the remaining patients (group B, n=18) remained without any dietary treatment. Serum titers of thyroid peroxidase and thyroglobulin antibodies, as well as serum levels of thyrotropin, free thyroid hormones and 25-hydroxyvitamin D were measured at the beginning of the study and 6 months later. Based on thyrotropin and free thyroid hormone levels, Jostel's thyrotropin index, the SPINA-GT index and the SPINA-GD index were calculated.

RESULTS:

All patients completed the study protocol. In group B, serum thyrotropin and free thyroid hormones levels, serum 25-hydroxyvitamin D levels as well as the calculated indices remained at the similar levels. The gluten-free diet reduced thyroid antibody titers, as well as slightly increased 25-hydroxyvitamin D levels and the SPINA-GT index. In group A, the impact on TPOAb and TgAb titers correlated with the changes in the SPINA-GT index, whereas the impact on TPOAb with the changes in 25-hydroxyvitamin D levels.

CONCLUSIONS:

The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease.

Conflict of interest statement

The authors declare that they have no conflict of interest. 171. J Clin Gastroenterol. 2019 Aug;53(7):535-542. doi: 10.1097/MCG.0000000000001081. Diagnostic Accuracy of Point of Care Tests for Diagnosing Celiac Disease: A Systematic Review and Meta-Analysis.

Singh P1, Arora A2, Strand TA3, Leffler DA1,4, Mäki M5, Kelly CP1, Ahuja V6, Makharia GK6.

Author information: 1. Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston. 2. Lady Hardinge Medical College. 3. Innlandet Hospital Trust, Lillehammer, Norway. 4. Takeda Pharmaceuticals Inc, Cambridge, MA. 5. Tampere Centre for Child Health Research, University of Tampere and Tampere University Hospital, Finland. 6. Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India.

Abstract

GOALS:

To perform a systematic review and meta-analysis to estimate the overall diagnostic accuracy of point of care tests (POCTs) for diagnosing celiac disease (CD).

BACKGROUND:

Recently, POCTs for CD have been developed and are commercially available. Studies have reported significant variability in their sensitivity (70% to 100%) and specificity (85% to 100%).

STUDY:

We searched MEDLINE, EMBASE databases, and the Cochrane library through June 2017. Positive reference test was defined as villous atrophy along with positive celiac-specific serology and/or clinical improvement after gluten-free diet. Normal duodenal biopsy was defined as negative reference test. Bivariate random-effect model was used to present the summary estimates of sensitivities and specificities along with 95% confidence regions We assessed methodologic quality using the quality assessment of diagnostic accuracy studies-2 tool.

RESULTS:

The pooled sensitivity and specificity of all POCTs (based on tTG or DGP or tTG+Anti-gliadin antibodies) for diagnosing CD were 94.0% [95% confidence interval (CI), 89.9-96.5] and 94.4% (95% CI, 90.9-96.5), respectively. The pooled positive and negative likelihood ratios for POCTs were 16.7 and 0.06, respectively. The pooled sensitivity and specificity for IgA-tTG-based POCTs were 90.5% (95% CI, 82.3-95.1) and 94.8% (95% CI, 92.5-96.4), respectively.

CONCLUSIONS:

The pooled sensitivity and specificity of POCTs in diagnosing CD are high. POCTs may be used to screen for CD, especially in areas with limited access to laboratory-based testing. Further research assessing the diagnostic accuracy of individual POCTs and comparing it with other available POCTs is needed. PMID: 29912751 Similar articles

172. Int J Food Microbiol. 2019 Aug 2;302:103-113. doi: 10.1016/j.ijfoodmicro.2018.05.018. Epub 2018 May 18. Novel insights on the functional/nutritional features of the sourdough fermentation.

Gobbetti M1, De Angelis M2, Di Cagno R3, Calasso M2, Archetti G4, Rizzello CG2.

Author information: 1. Faculty of Science and Technology, Free University of Bolzano, Piazza Università 5, 39100 Bolzano, Italy. Electronic address: [email protected]. 2. Department of Soil, Plant and Food Sciences, University of Bari Aldo Moro, via Amendola 165/a, 70126 Bari, Italy. 3. Faculty of Science and Technology, Free University of Bolzano, Piazza Università 5, 39100 Bolzano, Italy. 4. Department of Modern and Contemporary History, Catholic University of the Sacred Heart, Largo A. Gemelli, 1, 20123 Milano, Italy.

Abstract

As one of the most traditional biotechnologies, sourdough fermentation has deep effects on rheology, sensory and shelf life attributes of baked goods. The most recent literature has also highlighted the effects of sourdough fermentations on several functional/nutritional features of baked goods. While some aspects such as the potential to lower glycemic index, increase mineral bioavailability and decrease the gluten content have been proven almost definitively, others potentialities are emerging, which deserve novel insights. This reviews reports the main evidence on the use of sourdough fermentation for salt reduction in baked goods, management of irritable bowel syndrome (IBS), synthesis/release of bioactive compounds, especially the metabolism of phenolic compounds, and exploitation of the potential of non-conventional flours (legumes and pseudo-cereals) and milling by-products (bran and germ). A brief description on the spiritual, cultural and functional/nutritional significance of leavened bread throughout centuries has also given.

173. J Clin Gastroenterol. 2019 Aug;53(7):514-522. doi: 10.1097/MCG.0000000000001033. Link Between Celiac Disease and Inflammatory Bowel Disease.

Shah A1, Walker M2, Burger D1, Martin N1, von Wulffen M1, Koloski N1,2, Jones M3, Talley NJ2, Holtmann GJ1.

Author information: 1. Department of Gastroenterology and Hepatology, Faculties of Medicine and Health and Behavioral Sciences, Translational Research Institute, Princess Alexandra Hospital, University of Queensland, Brisbane, Qld. 2. Faculty of Health and Medicine, University of Newcastle, Newcastle. 3. Department of Psychology, Macquarie University, Sydney, NSW, Australia.

Abstract

GOAL:

The aim of this analysis was to assess in patients with inflammatory bowel disease (IBD) the risk of celiac disease and in celiac disease patients the risk of IBD.

BACKGROUND:

Previous studies report a possible association between IBD and celiac disease; however, this link is controversial.

STUDY:

Using the search terms "inflammatory bowel disease" and "celiac disease," we identified initially 1525 publications. In total 27 studies met inclusion criteria. Proportions and 95% confidence intervals (CIs) for the prevalence of IBD in celiac disease and vice versa were compared with published prevalence rates for the respective geographic regions. RESULTS:

We included 41,482 adult IBD patients (20,357 with Crohn's disease; 19,791 with ulcerative colitis; and 459 patients with celiac disease). Overall, in IBD patients the prevalence of celiac disease was 1110/100,000 (95% CI, 1010-1210/100,000) as compared with a prevalence of 620/100,000 (95% CI, 610-630/100,000) in the respective populations (odds ratio, 2.23; 95% CI, 1.99-2.50). In contrast, in patients with celiac disease, 2130/100,000 had IBD (95% CI, 1590-2670/100,000) as compared with 260/100,000 (95% CI, 250/100,000-270/100,000) in the respective populations (odds ratio, 11.10; 95% CI, 8.55-14.40). This effect was not different for ulcerative colitis and Crohn's disease. Although there was no evidence for publication bias for celiac disease in IBD, the funnel plot suggested that the association between IBD in celiac disease might be influenced by publication bias.

CONCLUSIONS:

The data are consistent with the notion that celiac disease is a risk factor for IBD and to lesser degree patients with IBD have an increased risk of celiac disease. PMID: 29762265 Similar articles

174. J Clin Gastroenterol. 2019 Jul;53(6):e221-e226. doi: 10.1097/MCG.0000000000001032. Alterations of Inflammatory and Matrix Production Indices in Celiac Disease With Low Bone Mass on Long-term Gluten-free Diet.

Di Stefano M1, Bergonzi M1, Benedetti I1, De Amici M2, Torre C2, Brondino N3, Miceli E1, Pagani E1, Marseglia GL2, Corazza GR1, Di Sabatino A1.

Author information: 1. Departments of Internal Medicine. 2. Pediatrics, IRCCS "S. Matteo" Hospital Foundation. 3. Department of Psychiatry, University of Pavia, Pavia, Italy.

Abstract

BACKGROUND: A clinically meaningful impairment of bone mass secondary to malabsorption is frequent in untreated celiac disease. In adult patients, a rigorous gluten-free diet (GFD) significantly improves, but does not always normalize, bone mineral density (BMD). The reason for this marginal response is unclear. Accordingly, we evaluated the role of both local and systemic factors for bone loss in celiac patients on long-term GFD.

STUDY:

In a prospective cohort, 22 patients with low lumbar and/or femoral BMD and 22 with normal BMD underwent bone and mineral metabolism evaluation: we tested calcium, phosphate, parathyroid hormone, and vitamin D; telopeptide of type I collagen, a bone resorption index; propeptide of type I procollagen, a bone neoformation index; receptor antagonist of NF-kB ligand, an osteoclast- stimulating factor; osteoprotegerin (OPG), a decoy receptor for RANKL. Sunlight exposure and physical exercise were measured.

RESULTS:

Patients with bone loss showed prevalently osteopenia, severe osteoporosis was rare. In comparison with normal BMD patients, they showed higher serum OPG, telopeptide, and lower serum propeptide, suggesting an increased bone turnover. Lumbar T-score was negatively correlated with OPG, telopeptide and RANKL and positively with propeptide. Propeptide was negatively correlated with OPG and telopeptide. OPG was positively correlated with telopeptide.

CONCLUSIONS:

The persistent activation of inflammation should be considered the main pathophysiological mechanism for bone defect in celiac disease patients with bone loss on long-term GFD. High levels of OPG, an attempt at protective mechanism, and low levels of propeptide of type I procollagen, reflecting an insufficient matrix production, characterize this subgroup of patients. PMID: 29672438 Similar articles

175. J Eval Clin Pract. 2019 Aug;25(4):543-549. doi: 10.1111/jep.12923. Epub 2018 Apr 3. Perception, attitude, and satisfaction of paediatric physicians and nurses towards clinical practice guidelines at a university teaching hospital.

Amer YS1,2,3, Al Nemri A4, Osman ME4, Saeed E5, Assiri AM4,5, Mohamed S4,5,6. Author information: 1. Quality Management Department, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia. 2. Research Chair for Evidence-Based Health Care and Knowledge Translation, Deanship of Scientific Research, King Saud University, Riyadh, Saudi Arabia. 3. Alexandria Centre for Evidence-Based Clinical Practice Guidelines, Alexandria University Medical Council, Alexandria University, Alexandria, Egypt. 4. Department of Paediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia. 5. Prince Abdullah Bin Khalid Celiac Disease Research Chair, Deanship of Scientific Research, King Saud University, Riyadh, Saudi Arabia. 6. Department of Paediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.

Abstract

RATIONALE, AIMS, AND OBJECTIVES:

To explore perception, attitude, and satisfaction of paediatric clinicians, trainees, and nurses at King Khalid University Hospital towards clinical practice guidelines (CPGs) including the locally adapted diabetic ketoacidosis CPG (DKA-CPG).

METHODS:

A cross-sectional survey was distributed to 260 doctors and nurses working in the paediatrics department.

RESULTS:

The response rate was 95.4%. The respondents had a positive perception and attitude towards general CPGs and specifically for the DKA-CPG; 98.7% thought CPGs were useful sources of advice, improved safety, and decreased risk, and reduced variation in practice. A total of 99.2% thought CPGs were good clinical tools, 98.3% satisfied with, had confidence in well-developed CPGs, and would recommend them to their colleagues to use, and 94.6% agreed they were cost-effective. The preferred format for CPGs was paper (46.6%) and electronic (42.9%). The DKA-CPG helped in managing patients and respondents were all satisfied and had confidence with it (100%). The rationale and objectives of the DKA-CPG were clear for 99.25%; 98.5% thought the layout was clear and well organized and user-friendly (96.2%). Compared with nurses, physicians had a higher perception towards CPGs in general (P < .05) and the DKA-CPG (P < .05).

CONCLUSIONS:

The paediatric doctors, and nurses have a great perception and satisfaction and positive attitude towards CPGs in general, towards the paediatric diabetic ketoacidosis CPG in particular, which in turn had a positive impact on the acceptability and implementation of the CPGs. These findings could help in sustaining a safe and high-quality health care environment through implementation of evidence-based CPGs. © 2018 John Wiley & Sons, Ltd. PMID: 29611621 Similar articles

176. J Clin Gastroenterol. 2019 Aug;53(7):507-513. doi: 10.1097/MCG.0000000000001013. Dietary Factors and Mucosal Immune Response in Celiac Disease Patients Having Persistent Symptoms Despite a Gluten-free Diet.

Laurikka P1,2, Lindfors K1, Oittinen M3, Huhtala H4, Salmi T5, Lähdeaho ML3, Ilus T6, Mäki M3, Kaukinen K1,7, Kurppa K3.

Author information: 1. Celiac Disease Research Center, Faculty of Medicine and Life Sciences. 2. Seinäjoki Central Hospital, Seinäjoki, Finland. 3. Tampere Centre for Child Health Research, University of Tampere and Tampere University Hospital. 4. Faculty of Social Sciences. 5. Departments of Dermatology. 6. Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere. 7. Internal Medicine, Tampere University Hospital, Faculty of Medicine and Life Sciences, University of Tampere.

Abstract

GOALS:

The aim of this study was to investigate the role of dietary factors, distinct small-bowel mucosal immune cell types, and epithelial integrity in the perpetuation of gastrointestinal symptoms in treated celiac disease patients.

BACKGROUND:

For unexplained reasons, many celiac disease patients suffer from persistent symptoms, despite a strict gluten-free diet (GFD) and recovered intestinal mucosa. STUDY:

We compared clinical and serological data and mucosal recovery in 22 asymptomatic and 25 symptomatic celiac patients on a long-term GFD. The density of CD3 and γδ intraepithelial lymphocytes (IELs), CD25 and FOXP3 regulatory T cells, and CD117 mast cells, and the expression of tight junction proteins claudin-3 and occludin, heat shock protein 60, interleukin 15, and Toll-like receptor 2 and 4 were evaluated in duodenal biopsies.

RESULTS:

All subjects kept a strict GFD and had negative celiac autoantibodies and recovered mucosal morphology. The asymptomatic patients had higher mean fiber intake (20.2 vs. 15.2 g/d, P=0.028) and density of CD3 IELs (59.3 vs. 45.0 cell/mm, P=0.045) than those with persistent symptoms. There was a similar but nonsignificant trend in γδ IELs (17.9 vs. 13.5, P=0.149). There were no differences between the groups in other parameters measured.

CONCLUSIONS:

Low fiber intake may predispose patients to persistent symptoms in celiac disease. There were no differences between the groups in the markers of innate immunity, epithelial stress or epithelial integrity. A higher number of IELs in asymptomatic subjects may indicate that the association between symptoms and mucosal inflammation is more complicated than previously thought. PMID: 29505551 Similar articles

177. Clin Rev Allergy Immunol. 2019 Aug;57(1):23-38. doi: 10.1007/s12016-016-8557-4. Transglutaminase 2 and Transglutaminase 2 Autoantibodies in Celiac Disease: a Review.

Rauhavirta T1, Hietikko M1, Salmi T2,3, Lindfors K4.

Author information: 1. Pediatric Research Center, University of Tampere and Tampere University Hospital, Finn Medi 3, 33520, Tampere, Finland. 2. School of Medicine, University of Tampere, Tampere, Finland. 3. Department of Dermatology, Tampere University Hospital, Tampere, Finland. 4. Pediatric Research Center, University of Tampere and Tampere University Hospital, Finn Medi 3, 33520, Tampere, Finland. [email protected].

Abstract Celiac disease is a common inflammatory disorder with a prevalence of 1-2 % in which a distinct dietary wheat, rye, and barley component, gluten, induces small-bowel mucosal villous atrophy, crypt hyperplasia, and inflammation. The small-bowel mucosal damage can be reversed by a strict lifelong gluten-free diet, which is currently the only effective treatment for the condition. A key player in the pathogenetic process leading to the enteropathy is played by a protein called transglutaminase 2 (TG2), which is able to enzymatically modify gluten-derived gliadin peptides. The TG2-catalyzed deamidation of the gliadin peptides results in their increased binding affinity to the disease-predisposing human leukocyte antigen (HLA) DQ2 and DQ8 molecules, thus enabling a strong immune response to be launched. Blocking the enzymatic activity of TG2 has thus been suggested as a suitable novel pharmacological approach to treat celiac disease. By virtue of its transamidation capacity, TG2 is also able to cross-link gliadin peptides to itself, this resulting in the generation of TG2-gliadin peptide complexes whose presence might provide an explanation for the generation of the TG2 autoantibodies characteristic of celiac disease. Due to their excellent specificity for the disorder, the TG2-targeted autoantibodies are widely used in the diagnostics as a first-line test to select patients for gastrointestinal endoscopy. More recently, it has come to be appreciated that these autoantibodies and also the TG2-specific B cells might play an active role in the disease pathogenesis. In this review, we assess the role of TG2, TG2-specific B cells, and autoantibodies in celiac disease. PMID: 27263022 Similar articles