August 2020 Alert

Items 1-199

1. The effects of gluten protein substation on chemical structure, crystallinity, and Ca in vitro digestibility of wheat-cassava snacks

Food Chem. 2020 Aug 20;339:127875. doi: 10.1016/j.foodchem.2020.127875. Online ahead of print.

Authors

Asad Nawaz 1 , Ali Hussein Taher Alhilali 2 , Engpeng Li 3 , Ibrahim Khalifa 4 , Sana Irshad 5 , Noman Walayat 6 , Lei Chen 6 , Peng-Kai Wang 6 , Zhi Yuan Tan 7

Affiliations

• 1 Jiangsu Key Laboratory of Crop Genetics and Physiology, Key Laboratory of Plant Functional Genomics of the Ministry of Education, College of Agriculture, Yangzhou University, Yangzhou 225009, PR China. Electronic address: [email protected]. • 2 Provincial Key Laboratory of Plant Molecular Breeding, College of Agriculture, South China Agricultural University, Guangzhou 510642, China. • 3 Jiangsu Key Laboratory of Crop Genetics and Physiology, Key Laboratory of Plant Functional Genomics of the Ministry of Education, College of Agriculture, Yangzhou University, Yangzhou 225009, PR China. • 4 Food Technology Department, Faculty of Agriculture, 13736, Moshtohor, Benha University, Egypt. • 5 School of Environmental Studies, China University of Geo Sciences, Wuhan 430074, PR China. • 6 College of Food Science and Technology, Huazhong Agricultural University, Hubei, Wuhan 430070, PR China. • 7 Provincial Key Laboratory of Plant Molecular Breeding, College of Agriculture, South China Agricultural University, Guangzhou 510642, China. Electronic address: [email protected].

• PMID: 32866701 • DOI: 10.1016/j.foodchem.2020.127875

Abstract

Gluten protein based snacks have been a major concern for allergen, low nutrition and physio-chemical properties. In this study, wheat flour (WF) was replaced with cassava starch (CS) at different levels [10, 20, 30, 40 and 50%(w/w)] to prepare fried snacks. The addition of CS significantly (P < 0.05) increased hardness and pasting properties while gluten network, oil uptake, water holding capacity, and expansion were decreased. Fourier transform infrared spectroscopy revealed that the secondary structure of amide I, α-helix (1650-1660 cm-1), along with amide II region (1540 cm-1) changed when CS was added. Starch-protein complex was identified by X-ray diffraction analysis while no starch-protein-lipid complex was observed. The micrographs from scanning electron microscopy showed that starch-protein matrix was interrupted when ≥40%(w/w) CS was added. Furthermore, in vitro calcium bioavailability was decreased slightly with the addition of CS. The results suggest the feasibility of adding 40% CS as an alternative to WF in snacks.

Keywords: Cassava starch; Chemical structure; Fried snacks; Starch-protein matrix; Wheat flour.

Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. 2. Maternal Influenza A(H1N1) Immunization During Pregnancy and Risk for Autism Spectrum Disorder in Offspring : A Cohort Study

Ann Intern Med. 2020 Sep 1. doi: 10.7326/M20-0167. Online ahead of print.

Authors

Jonas F Ludvigsson 1 , Henric Winell 2 , Sven Sandin 3 , Sven Cnattingius 4 , Olof Stephansson 5 , Björn Pasternak 6

Affiliations

• 1 Karolinska Institutet, Stockholm, and Örebro University Hospital, Örebro, Sweden; School of Medicine, University of Nottingham, Nottingham, United Kingdom; and Celiac Disease Center, Columbia University College of Physicians and Surgeons, New York, New York (J.F.L.). • 2 Karolinska Institutet, Stockholm, and Uppsala University, Uppsala, Sweden (H.W.). • 3 Karolinska Institutet, Stockholm, Sweden, and Icahn School of Medicine at Mount Sinai and Seaver Autism Center for Research and Treatment at Mount Sinai, New York, New York (S.S.). • 4 Karolinska Institutet, Stockholm, Sweden (S.C.). • 5 Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden (O.S.). • 6 Karolinska Institutet, Stockholm, Sweden, and Statens Serum Institut, Copenhagen, Denmark (B.P.).

• PMID: 32866418 • DOI: 10.7326/M20-0167 Abstract

Background: There are concerns that influenza vaccine exposure during pregnancy may be associated with increased risk for autism spectrum disorder (ASD).

Objective: To examine the risk for ASD in offspring of mothers who were vaccinated against influenza A(H1N1)pdm09 ("swine flu") during pregnancy.

Design: Population-based cohort study using nationwide registers.

Setting: Seven health care regions in Sweden.

Participants: Live births between October 2009 and September 2010, with follow-up through December 2016. In total, 39 726 infants were prenatally exposed to H1N1 vaccine (13 845 during the first trimester) and 29 293 infants were unexposed.

Measurements: Cox regression was used to estimate hazard ratios (HRs) for the primary outcome, ASD, before and after adjustment for potential confounders. The secondary outcome was autistic disorder (AD).

Results: Mean follow-up was 6.7 years in both unexposed and exposed children. During follow-up, 394 (1.0%) vaccine-exposed and 330 (1.1%) unexposed children had a diagnosis of ASD. In adjusted analyses, prenatal exposure to H1N1 vaccination was not associated with a later diagnosis of ASD (adjusted HR [aHR], 0.95 [95% CI, 0.81 to 1.12]) or AD (aHR, 0.96 [CI, 0.80 to 1.16]). The 6-year standardized cumulative incidence difference between the unexposed and exposed children was 0.04% (CI, -0.09% to 0.17%) for ASD and 0.02% (CI, -0.09% to 0.14%) for AD. Restricting the analysis to vaccination in the first trimester of pregnancy did not influence risk estimates (aHR, 0.92 [CI, 0.74 to 1.16] for ASD and 0.91 [CI, 0.70 to 1.18] for AD).

Limitation: Data on H1N1 influenza infection are lacking.

Conclusion: This large cohort study found no association between maternal H1N1 vaccination during pregnancy and risk for ASD in the offspring.

Primary funding source: Swedish Research Council. 3. Celiac disease and reproductive failures: an update on pathogenic mechanisms

Am J Reprod Immunol. 2020 Aug 31;e13334. doi: 10.1111/aji.13334. Online ahead of print.

Authors

Nicoletta Di Simone 1 2 , Matteo Gratta 2 , Roberta Castellani 2 , Silvia D'Ippolito 1 2 , Monia Specchia 2 , Giovanni Scambia 2 3 , Chiara Tersigni 1 2

Affiliations

• 1 U.O.C. di Ostetricia e Patologia Ostetrica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. • 2 Istituto di Clinica Ostetrica e Ginecologica Università Cattolica del Sacro Cuore, Rome, Italy. • 3 U.O.C. di Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy.

• PMID: 32865829 • DOI: 10.1111/aji.13334

Abstract

Celiac disease (CD) is an autoimmune disorder that occurs in genetically predisposed people in which the ingestion of gluten leads to damage in the small intestine that clinically presents with malabsorption-related symptoms. CD can also be the underlying cause of several non-gastrointestinal symptoms. This review summarizes evidence on the relationship between CD and gynecological/obstetric disorders like reproductive failures. Although much has been reported on such a linkage, the pathogenic mechanisms remain unclear, especially those underlying extra-gastrointestinal clinical manifestations. Studies conducted on celiac subjects presenting gynecological/obstetric disorders have pointed to intestinal malabsorption, coagulation alterations, immune-mediated tissue damage, and endometrial inflammation as the main responsible pathogenic mechanisms. Currently, however, the knowledge of such mechanisms is insufficient, and further studies are needed to gain a more thorough understanding of the matter.

Keywords: Autoimmunity; Celiac disease; Personalized medicine; Pregnancy; Reproductive failures.

4. A prediction model of sepsis-associated acute kidney injury based on antithrombin III

Clin Exp Med. 2020 Aug 31. doi: 10.1007/s10238-020-00656-x. Online ahead of print.

Authors

Yun Xie 1 , Yi Zhang 2 , Rui Tian 1 , Wei Jin 1 , Jiang Du 1 , Zhigang Zhou 1 , Ruilan Wang 3

Affiliations

• 1 Department of Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 650 New Songjiang Road, Songjiang, 201600, Shanghai, People's Republic of China. • 2 Department of Rheumatology, The Second Affiliated Hospital of Soochow University, Suzhou, China. • 3 Department of Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 650 New Songjiang Road, Songjiang, 201600, Shanghai, People's Republic of China. [email protected].

• PMID: 32865720 • DOI: 10.1007/s10238-020-00656-x

Abstract

The incidence of sepsis-associated acute kidney injury (AKI) is on the rise. Recent studies have found a correlation between antithrombin III and AKI. We established a predictive model for sepsis-associated AKI based on plasma ATIII levels. A prospective study (March 2018-January 2020) was conducted in sepsis patients admitted to the Critical Care Medicine Department at Shanghai General Hospital. ATIII levels were obtained within 48 h after admission to the ICU and before the diagnosis of sepsis-associated AKI was recorded. Renal function was assessed by measuring serum creatinine levels and urine volume. Male sex, other cardiovascular disease, and low ATIII levels were identified as independent risk factors for AKI. Age, immune disease, and low ATIII levels were identified as independent risk factors for death. Plasma ATIII levels in the non-AKI group were higher than those in the AKI group, plasma ATIII levels were higher in the survival group than in the non-survival group, plasma ATIII levels in the non-CRRT group were higher than those in the CRRT group, and plasma ATIII levels in the non-CKD group were higher than those in the CKD group. ATIII was significantly higher in the group with pulmonary infection than in the group without pulmonary infection. ATIII was significantly lower in the celiac infection group than in the nonceliac infection group. There was no statistically significant difference between the ATIII in the gram-positive group and the gram-negative group. ATIII was significantly higher in medical patients than in surgical patients. The predictive model of sepsis-associated AKI established based on ATIII was ln[P/(1 - p)] = -1.211 × sex - 0.017 × ATIII + 0.022 × Cr + 0.004 × BUN - 2.8192. The model goodness-of-fit test (p = 0.000) and the area under the ROC curve of the model (0.9862) suggested that the model has a high degree of discrimination and calibration. ATIII reduction was closely related to the prognosis of patients with sepsis. ATIII reduction was an independent risk factor for sepsis-associated AKI and an independent risk factor for mortality in patients with sepsis. ATIII reduction could predict sepsis- associated AKI. Low ATIII predicted a poor prognosis.

Keywords: Acute kidney injury; Antithrombin III; Sepsis.

5. Effect of Celiac Axis Compression on Target Vessel-Related Outcomes During Fenestrated-Branched Endovascular Aortic Repair

J Vasc Surg. 2020 Aug 27;S0741-5214(20)31885-1. doi: 10.1016/j.jvs.2020.07.092. Online ahead of print. Authors

Francesco Squizzato 1 , Gustavo S Oderich 1 , Emanuel R Tenorio 1 , Bernardo C Mendes 1 , Randall R De Martino 2

Affiliations

• 1 Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN, United States. • 2 Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN, United States. Electronic address: [email protected].

• PMID: 32861863 • DOI: 10.1016/j.jvs.2020.07.092

Abstract

Objective: To report the effect of median arcuate ligament (MAL) compression on outcomes and technical aspects of celiac artery (CA) stenting during fenestrated-branched endovascular aneurysm repair (F-BEVAR) for thoracoabdominal (TAAA) or pararenal (PRAA) aortic aneurysms.

Methods: We retrospectively reviewed the clinical and anatomical data on 300 consecutive patients enrolled in a prospective non-randomized physician- sponsored investigational device exemption study from 2013 to 2018. From this group, 230 Patients with CA incorporation by fenestration or directional branch were included. MAL compression was defined by preoperative computed tomography angiogram as a J-hook narrowing of the proximal CA at the level of the ligament; the shift angle between the downward and upward segments within the CA was measured. Endpoints were technical success, rates of intraoperative or early (30-days) CA branch revision, and freedom from target vessel instability, defined by any death or rupture due to target vessel complication, occlusion, or reintervention for stenosis, endoleak or disconnection.

Results: CA incorporation was performed using fenestrations in 118 patients (51%) and directional branch in 112 (49%). MAL compression was present in 97 patients (42%), resulting in a stenosis >50% in 48 (49%). MAL compression was more often present in patients with Extent I-III TAAAs compared to Extent IV TAAA-PRAAs (56% vs 31%; P<.001). Technical success was 99%. Patients with MAL compression more often received a directional branch (65% vs 37%; P<.001), self-expanding bridging stent-grafts (32% vs 16%; P=.007), adjunctive bare-metal stents (46% vs 24%; P=.001), and coverage of the gastric artery (44% vs 22%; P<.001). An intraoperative (n=6, 2.6%) or early (n=1, 0.4%) revision of the CA branch was required in 7 patients (3%) due to dissection/occlusion (n=2, 0.9%), kinking/stenosis (n=3, 1.3%), stent dislodgement (n=1, 0.4%), or type I-C endoleak (n=1, 0.4%). A shift angle <120º was the most significant factor associated with CA branch revision (OR 10.9, 95%CI 2.3-88.9; P=.013). Freedom from CA branch instability was 97±2% at 4 years, and this was not associated with MAL compression (HR 0.83, 95%CI 0.14-5.02; P=.588) or any other predictor.

Conclusion: MAL compression was more common in Extent I-III TAAAs, and related to additional challenges for CA stenting in F-BEVAR. This may include bare-metal stenting, gastric artery coverage, or early revision, especially in presence of an angulation <120º. However, durable results can be achieved for CA incorporation despite these difficulties.

Keywords: Fenestrated and branched endovascular aortic repair; Pararenal aortic aneurysm; Thoracoabdominal aortic aneurysm; aortic aneurysm; celiac artery; median arcuate ligament syndrome.

6. Gastric cancer

Lancet. 2020 Aug 29;396(10251):635-648. doi: 10.1016/S0140-6736(20)31288- 5.

Authors

Elizabeth C Smyth 1 , Magnus Nilsson 2 , Heike I Grabsch 3 , Nicole Ct van Grieken 4 , Florian Lordick 5

Affiliations

• 1 Department of Oncology, Cambridge University Hospitals National Health Service Foundation Trust, Hill's Road, Cambridge, UK. Electronic address: [email protected]. • 2 Division of Surgery, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden; Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, Sweden. • 3 Department of Pathology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, Netherlands; Pathology and Data Analytics, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK. • 4 Department of Pathology, Amsterdam University Medical Centre, Cancer Center Amsterdam, VU University, Amsterdam, Netherlands. • 5 University Cancer Center Leipzig, Leipzig University Medical Center, Leipzig, Germany.

• PMID: 32861308 • DOI: 10.1016/S0140-6736(20)31288-5

Abstract

Gastric cancer is the fifth most common cancer and the third most common cause of cancer death globally. Risk factors for the condition include Helicobacter pylori infection, age, high salt intake, and diets low in fruit and vegetables. Gastric cancer is diagnosed histologically after endoscopic biopsy and staged using CT, endoscopic ultrasound, PET, and laparoscopy. It is a molecularly and phenotypically highly heterogeneous disease. The main treatment for early gastric cancer is endoscopic resection. Non-early operable gastric cancer is treated with surgery, which should include D2 lymphadenectomy (including lymph node stations in the perigastric mesentery and along the celiac arterial branches). Perioperative or adjuvant chemotherapy improves survival in patients with stage 1B or higher cancers. Advanced gastric cancer is treated with sequential lines of chemotherapy, starting with a platinum and fluoropyrimidine doublet in the first line; median survival is less than 1 year. Targeted therapies licensed to treat gastric cancer include trastuzumab (HER2-positive patients first line), ramucirumab (anti- angiogenic second line), and nivolumab or pembrolizumab (anti-PD-1 third line).

• Review

7. Distal pancreatectomy with multivisceral resection: A retrospective multicenter study - Case series

Int J Surg. 2020 Aug 26;S1743-9191(20)30627-0. doi: 10.1016/j.ijsu.2020.08.024. Online ahead of print.

Authors

Jose M Ramia 1 , Juan V Del Río-Martín 2 , Gerardo Blanco-Fernández 3 , Miguel Cantalejo- Díaz 4 , Fernando Rotellar Sastre 5 , Luis Sabater Ortí 6 , Alberto Carabias Hernández 7 , Alba Manuel-Vázquez 8 , Pedro J Hernández-Rivera 9 , Isabel Jaén-Torrejimeno 3 , Helga K Kälviäinen Mejía 4 , Sara Esteban Gordillo 5 , Elena Muñoz-Forner 6 , Roberto De la Plaza 8 , Texell Longoria-Dubocq 9 , Noelia De Armas-Conde 3 , Fernando Pardo Sánchez 5 , Marina Garcés- Albir 6 , Mario Serradilla-Martín 10

Affiliations

• 1 Department of Surgery, Hospital General Universitario de Alicante; ISABIAL: Instituto de Investigación Sanitaria y Biomédica de Alicante. Electronic address: [email protected]. • 2 Department of Surgery, Hospital Auxilio Mutuo, San Juan, Puerto Rico. • 3 Department of Surgery, Hospital Universitario Infanta Cristina, Badajoz, Spain. • 4 Department of Surgery, Hospital Universitario Miguel Servet, Zaragoza, Spain. • 5 Department of Surgery, Clínica Universitaria de Navarra, Pamplona, Spain. • 6 Department of Surgery, Hospital Clínico, University of Valencia. Biomedical Research Institute, Valencia, Spain. • 7 Hospital Universitario de Getafe, Getafe, Spain. • 8 Hospital Universitario de Guadalajara, Guadalajara, Spain. • 9 University of Puerto Rico School of Medicine, Department of Surgery. • 10 Instituto de Investigación Sanitaria Aragón, Department of Surgery, Hospital Universitario Miguel Servet, Zaragoza, Spain.

• PMID: 32860956 • DOI: 10.1016/j.ijsu.2020.08.024

Abstract

Background: Multivisceral resection (MVR) is sometimes necessary to achieve disease-free margins in cancer surgery. In certain patients with pancreatic tumors that invade neighboring organs these must be removed to perform an appropriate oncological surgery. In addition, there is an increasing need to perform resections of other organs like liver not directly invaded by the tumor but which require synchronous removal. The results of MVR in pancreatic surgery are controversial.

Material and methods: A distal pancreatectomy retrospective multicenter observational study using prospectively compiled data carried out at seven HPB Units. The period study was January 2008 to December 2018. We excluded DP with celiac trunk resection.

Results: 435 DP were performed. In 62 (14.25%) an extra organ was resected (82 organs). Comparison of the preoperative data of MVR and non-MVR patients showed that patients with MVR had lower BMI, higher ASA and larger tumor size. In the MVR group, the approach was mostly laparotomic and spleen preservation was performed only in 8% of the cases, Blood loss and the percentage of intraoperative transfusion were higher in MVR group. Major morbidity rates (Clavien>IIIa) and mortality (0.8vs.4.8%) were higher in the MVR group. Pancreatic fistula rates were practically the same in both groups. Mean hospital stay was twice as long in the MVR group and the readmission rate was higher in the MVR group. Histology study confirmed a much higher rate of malignant tumors in MVR group.

Conclusions: In order to obtain free margins or treat pathologies in several organs we think that DP + MVR is a feasible technique in selected patients; the results obtained are not as good as those of DP without MVR but are acceptable nonetheless. CLINICALTRIALS.

Gov identifier: NCT04317352. Keywords: cancer; distal pancreatectomy; multivisceral; pancreas; review; surgery.

Conflict of interest statement

Declaration of Competing Interest None.

Associated data

• ClinicalTrials.gov/NCT04317352

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8. Retinoic Acid Accelerates the Specification of Enteric Neural Progenitors from In-Vitro- Derived Neural Crest

Stem Cell Reports. 2020 Aug 11;S2213-6711(20)30301-5. doi: 10.1016/j.stemcr.2020.07.024. Online ahead of print.

Authors

Thomas J R Frith 1 , Antigoni Gogolou 2 , James O S Hackland 3 , Zoe A Hewitt 2 , Harry D Moore 2 , Ivana Barbaric 2 , Nikhil Thapar 4 , Alan J Burns 5 , Peter W Andrews 2 , Anestis Tsakiridis 6 , Conor J McCann 7

Affiliations

• 1 University of Sheffield, Department of Biomedical Science, Sheffield, UK. Electronic address: [email protected]. • 2 University of Sheffield, Department of Biomedical Science, Sheffield, UK. • 3 The Center for Stem Cell Biology, Memorial Sloan Kettering Cancer Center, New York, USA. • 4 Stem Cells and Regenerative Medicine, UCL Great Ormond Street Institute of Child Health, London, UK; Neurogastroenterology and Motility Unit, Great Ormond Street Hospital, London, UK; Department of Gastroenterology, Hepatology and Liver Transplant, Queensland Children's Hospital, Brisbane, Australia; Prince Abdullah Ben Khalid Celiac Research Chair, College of Medicine, King Saud University, Riyadh, KSA. • 5 Stem Cells and Regenerative Medicine, UCL Great Ormond Street Institute of Child Health, London, UK; Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands. • 6 University of Sheffield, Department of Biomedical Science, Sheffield, UK. Electronic address: [email protected]. • 7 Stem Cells and Regenerative Medicine, UCL Great Ormond Street Institute of Child Health, London, UK. Electronic address: [email protected].

• PMID: 32857978 • DOI: 10.1016/j.stemcr.2020.07.024

Free article Abstract

The enteric nervous system (ENS) is derived primarily from the vagal neural crest, a migratory multipotent cell population emerging from the dorsal neural tube between somites 1 and 7. Defects in the development and function of the ENS cause a range of enteric neuropathies, including Hirschsprung disease. Little is known about the signals that specify early ENS progenitors, limiting progress in the generation of enteric neurons from human pluripotent stem cells (hPSCs) to provide tools for disease modeling and regenerative medicine for enteric neuropathies. We describe the efficient and accelerated generation of ENS progenitors from hPSCs, revealing that retinoic acid is critical for the acquisition of vagal axial identity and early ENS progenitor specification. These ENS progenitors generate enteric neurons in vitro and, following in vivo transplantation, achieved long-term colonization of the ENS in adult mice. Thus, hPSC-derived ENS progenitors may provide the basis for cell therapy for defects in the ENS. Keywords: Hirschsprung disease; cell transplantation; embryonic stem cells; enteric nervous system; human; neural crest; pluripotent stem cells; retinoic acid.

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9. Effect of poly-γ-glutamic acid on hydration and structure of wheat gluten

J Food Sci. 2020 Aug 28. doi: 10.1111/1750-3841.15400. Online ahead of print.

Authors

Xinhua Xie 1 , Xiuyuan Wu 1 2 , Yue Shen 1 , Miao Song 1 , Chao Xu 1 , Bei Zhang 1 , Usman Aziz 3 , Xinjun Xu 1

Affiliations

• 1 College of Food Science and Technology, Henan Agricultural University, Zhengzhou, Henan, 450002, P. R. China. • 2 Henan Grain, oil and feed products Quality Inspection Supervision Center, Zhengzhou, Henan, 450002, P. R. China. • 3 College of Agronomy, Northwest A&F University, Yangling, 712100, P. R. China.

• PMID: 32857865 • DOI: 10.1111/1750-3841.15400

Abstract

In recent years, hydrocolloids have been used extensively as enhancers in dough products. However, studies on the effect of hydrophilic polymers on wheat gluten (WG) within the dough are scarce. In the present study, poly-γ- glutamic acid (γ-PGA), a new and healthy food additive, was added to the WG to investigate its effect on hydration, rheological properties, and structures of WG. Results showed that with the addition of γ-PGA, the water-holding capacity (WHC) of WG and the content of bound water increased, whereas the content of immobilized water decreased. In addition, γ-PGA changed the rheological properties of WG. The elastic properties of WG gradually weakened and the viscous properties gradually increased. Furthermore, scanning electron microscopy (SEM) results showed that with the addition of γ-PGA, the structure of the WG network became more uniform and the pore size was smaller. A change also occurred in the secondary structure of WG, in which the α-helix content was significantly reduced while the contents of β- turn angles were significantly increased, thereby suggesting that γ-PGA not only functions as a filler in the WG system, but also interacts with WG. From the present study, we conclude that γ-PGA can interact with WG and water to change the WG secondary structure. γ-PGA can also restrict moisture migration and enhance the WHC of WG, thereby changing the WG microstructure and improving its functional properties. This condition provides the basis for γ-PGA to be recommended as WG enhancer for addition in WG-containing products such as bread, seitan (meat replacement), and others. PRACTICAL APPLICATION: WG performance plays a key role in the quality of flour products. Thus, many studies have been conducted to improve the WG quality to produce highly popular flour products. The results of this study showed that γ-PGA can interact with WG and water, and had a good effect on improving the WHC of WG, which means that γ-PGA has potential usefulness in improving the quality of WG and WG-containing products such as bread, seitan (meat replacement), and others.

Keywords: functional properties; poly-γ-glutamic acid (γ-PGA); water-holding capacity (WHC); wheat gluten (WG).

• 27 references

Grant support

• 182102210305/Natural Science Foundation of Henan Province

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10. Brain fog and non-coeliac gluten sensitivity: Proof of concept brain MRI pilot study

PLoS One. 2020 Aug 28;15(8):e0238283. doi: 10.1371/journal.pone.0238283. eCollection 2020.

Authors

Iain D Croall 1 , Nigel Hoggard 1 , Imran Aziz 2 , Marios Hadjivassiliou 3 , David S Sanders 2

Affiliations

• 1 Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield/INSIGENO, Sheffield, United Kingdom. • 2 Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, United Kingdom. • 3 Academic Departments of Neurosciences and Neuroradiology, Sheffield Teaching Hospitals NHS Trust, Sheffield, United Kingdom.

• PMID: 32857796 • DOI: 10.1371/journal.pone.0238283

Free article Abstract

Aims: Non-Coeliac Gluten Sensitivity (NCGS) is poorly understood, particularly in terms of its neurological outcomes. We initially conducted a prospective postal survey to investigate its neurological presentation and symptom course. Results from this then motivated a follow-up pilot study utilising brain MRI to characterise potential diagnostic biomarkers for future research.

Methods: Patients with NCGS were recruited from a specialist centre and completed a prospective postal questionnaire (N = 125). This summarised symptoms experienced, their severity and their course. Onset time was compared by Chi-squared analysis to data from the same centre concerning coeliac disease patients (N = 224). Five respondents on a strict gluten-free diet who self-reported brain fog then attended a pilot study, completing MR brain imaging/questionnaires before/after a gluten challenge. "Baseline" data were assessed for abnormalities, while symptom severity and cerebral blood flow (CBF) were compared before/after challenge.

Results: Survey participants were aged 47 (85% female). Prevalence of neurological symptoms were: headaches (51%), brain fog (48%), balance issues (31%), tingling (19%). Median symptom resolution time was 48 hours, while onset was 90 minutes; onset pattern was not significantly different compared to CD patients (p = 0.322). Extra-intestinal symptoms worsened by 37%(±28) during a typical reaction. Predominantly non-statistical observations from the brain imaging study are discussed.

Conclusions: Neurological symptoms in NCGS are common, and onset time is comparable to that in CD. Brain imaging may be a useful future means of investigating physiological injury and responses to gluten in further study.

Conflict of interest statement

The authors have declared that no competing interests exist.

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11. Knowledge, Attitudes, and Practices of Healthcare Workers During the Early COVID-19 Pandemic in a Main, Academic Tertiary Care Centre in Saudi Arabia

Epidemiol Infect. 2020 Aug 28;1-29. doi: 10.1017/S0950268820001958. Online ahead of print.

Authors

M H Temsah 1 2 3 , A N Alhuzaimi 1 4 , N Alamro 1 5 6 , A Alrabiaah 1 2 , F Al-Sohime 1 2 , K Alhasan 1 2 , J A Kari 7 , I Almaghlouth 1 8 , F Aljamaan 1 9 , M Al Amri 10 , M Barry 1 11 , S Al-Subaie 1 2 , A M Somily 1 12 , F Al-Zamil 1 2 Affiliations

• 1 College of Medicine, King Saud University, Riyadh, Saudi Arabia. • 2 Department of Pediatrics, King Saud University Medical City, Riyadh, Saudi Arabia. • 3 Prince Abdullah Bin Khaled Coeliac Disease Chair, Faculty of Medicine, King Saud University, Saudi Arabia. • 4 Cardiac Science Department, King Saud University Medical City, Riyadh, Saudi Arabia. • 5 Department of Family and Community Medicine, King Saud University Medical City, Riyadh, Saudi Arabia. • 6 Prince Sattam bin Abdulaziz Research Chair for Epidemiology and Public Health, King Saud University, Riyadh, Saudi Arabia. • 7 Department of Pediatrics, King Abdulaziz University, Jeddah, Saudi Arabia. • 8 College of Medicine Research Center, King Saud University, Saudi Arabia. • 9 Adult Critical Care Department, King Saud University, King Saud University Medical City / King Khalid University Hospital, Riyadh, Saudi Arabia. • 10 Department of Infectious Disease, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia. • 11 Infectious Disease Unit, Department of Internal Medicine, King Saud University, Riyadh, Saudi Arabia. • 12 Department of Pathology and Laboratory Medicine, College of Medicine, King Saud University and King Saud University Medical City, Riyadh, Saudi Arabia.

• PMID: 32854806 • DOI: 10.1017/S0950268820001958

No abstract available

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12. Ancestral Wheat Types Release Fewer Celiac Disease Related T Cell Epitopes than Common Wheat upon Ex Vivo Human Gastrointestinal Digestion

Foods. 2020 Aug 25;9(9):E1173. doi: 10.3390/foods9091173.

Authors

Tora Asledottir 1 , Rashida Rehman 1 , Gianfranco Mamone 2 , Gianluca Picariello 2 , Tove Gulbrandsen Devold 1 , Gerd Elisabeth Vegarud 1 , Arne Røseth 3 , Tor Erling Lea 1 , Trond S Halstensen 3 4 , Pasquale Ferranti 2 5 , Anne Kjersti Uhlen 6

Affiliations

• 1 Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, 1433 Ås, Norway. • 2 Institute of Food Science, National Research Council, 83100 Avellino, Italy. • 3 Department of Internal Medicine, Lovisenberg Diaconal Hospital, 0456 Oslo, Norway. • 4 Department of Oral Biology, Faculty of Dentistry, University of Oslo, 0372 Oslo, Norway. • 5 Department of Agriculture, University of Naples Federico II, 80055 Portici, Italy. • 6 Faculty of Biosciences, Norwegian University of Life Sciences, 1433 Ås, Norway.

• PMID: 32854283 • DOI: 10.3390/foods9091173

Free article Abstract

Celiac disease (CeD) is an autoimmune enteropathy triggered by immunogenic gluten peptides released during the gastrointestinal digestion of wheat. Our aim was to identify T cell epitope-containing peptides after ex vivo digestion of ancestral (einkorn, spelt and emmer) and common (hexaploid) wheat (Fram, Bastian, Børsum and Mirakel) using human gastrointestinal juices. Wheat porridge was digested using a static ex vivo model. Peptides released after 240 min of digestion were analyzed by liquid chromatography coupled to high- resolution mass spectrometry (HPLC-ESI MS/MS). Ex vivo digestion released fewer T cell epitope-containing peptides from the ancestral wheat varieties (einkorn (n = 38), spelt (n = 45) and emmer (n = 68)) compared to the common wheat varieties (Fram (n = 72), Børsum (n = 99), Bastian (n = 155) and Mirakel (n = 144)). Neither the immunodominant 33mer and 25mer α-gliadin peptides, nor the 26mer γ-gliadin peptide, were found in any of the digested wheat types. In conclusion, human digestive juice was able to digest the 33mer and 25mer α-gliadin, and the 26mer γ-gliadin derived peptides, while their fragments still contained naive T cell reactive epitopes. Although ancestral wheat released fewer immunogenic peptides after human digestion ex vivo, they are still highly toxic to celiac patients. More general use of these ancient wheat variants may, nevertheless, reduce CeD incidence.

Keywords: Celiac disease; T cell epitope; ex vivo digestion; immunogenic peptide; wheat.

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13. Diet, Perceived Intestinal Well-Being and Compositions of Fecal Microbiota and Short Chain Fatty Acids in Oat-Using Subjects with Celiac Disease or Gluten Sensitivity

Nutrients. 2020 Aug 25;12(9):E2570. doi: 10.3390/nu12092570.

Authors

Lotta Nylund 1 , Salla Hakkola 1 , Leo Lahti 2 , Seppo Salminen 3 , Marko Kalliomäki 4 5 , Baoru Yang 1 , Kaisa M Linderborg 1 Affiliations

• 1 Food Chemistry and Food Development, Department of Biochemistry, University of Turku, 20520 Turku, Finland. • 2 Department of Future Technologies, University of Turku, 20520 Turku, Finland. • 3 Functional Foods Forum, University of Turku, 20520 Turku, Finland. • 4 Department of Pediatrics, University of Turku, 20500 Turku, Finland. • 5 Department of Pediatrics and Adolescent Medicine, Turku University Hospital, 20521 Turku, Finland.

• PMID: 32854216 • DOI: 10.3390/nu12092570

Free article Abstract

A gluten-free diet may result in high fat and low fiber intake and thus lead to unbalanced microbiota. This study characterized fecal microbiota profiles by 16S MiSeq sequencing among oat-using healthy adult subjects (n = 14) or adult subjects with celiac disease (CeD) (n = 19) or non-celiac gluten sensitivity (NCGS) (n = 10). Selected microbial metabolites, self-reported 4d food diaries and perceived gut symptoms were compared. Subjects with NCGS experienced the highest amount of gut symptoms and received more energy from fat and less from carbohydrates than healthy and CeD subjects. Oat consumption resulted in reaching the lower limit of the recommended fiber intake. Frequent consumption of gluten-free pure oats did not result in microbiota dysbiosis in subjects with CeD or NCGS. Thus, the high number of gut symptoms in NCGS subjects was not linked to the microbiota. The proportion of fecal acetate was higher in healthy when compared to NCGS subjects, which may be linked to a higher abundance of Bifidobacterium in the control group compared to NCGS and CeD subjects. Propionate, butyrate and ammonia production and β-glucuronidase activity were comparable among the study groups. The results suggest that pure oats have great potential as the basis of a gluten-free diet and warrant further studies in minor microbiota disorders. Keywords: SCFAs; celiac disease; gluten-free; intestinal microbiota; non-celiac gluten sensitivity; oats.

Grant support

• 5469/31/2016/Business Finland • 1/CX/CSRD VA/United States

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14. Can a gluten-free diet be partly protective for covid-19 infection?

APMIS. 2020 Aug 27. doi: 10.1111/apm.13075. Online ahead of print.

Authors

Martin Haupt-Jorgensen 1 , Karsten Buschard 1

Affiliation

• 1 The Bartholin Institute, Department of Pathology, Rigshospitalet, Copenhagen, Denmark.

• PMID: 32854147 • DOI: 10.1111/apm.13075

Abstract

The recent French observation that daily tobacco smokers have a substantially reduced risk of developing symptomatic infection with covid-19 [1] is intriguing, since no health care professional would recommend smoking. So, what are the mechanisms and could something else be at play than tobacco smoking?

Publication types

• Letter

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15. Increasing Co-occurrence of Additional Autoimmune Disorders at Diabetes Type 1 Onset Among Children and Adolescents Diagnosed in Years 2010-2018-Single- Center Study

Front Endocrinol (Lausanne). 2020 Aug 6;11:476. doi: 10.3389/fendo.2020.00476. eCollection 2020.

Authors

Barbara Głowińska-Olszewska 1 , Maciej Szabłowski 1 , Patrycja Panas 1 , Karolina Żoła Dek 1 , Milena Jamiołkowska-Sztabkowska 1 2 , Anna Justyna Milewska 3 , Anna Kadłubiska 1 , Agnieszka Polkowska 1 , Włodzimierz Łuczyński 1 4 , Artur Bossowski 1

Affiliations

• 1 Department of Pediatrics, Endocrinology, Diabetology With Cardiology Division, Medical University of Bialystok, Białystok, Poland. • 2 Department of Pediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Bialystok, Białystok, Poland. • 3 Department of Statistics and Medical Informatics, Medical University of Bialystok, Białystok, Poland. • 4 Department of Medical Simulations, Medical University of Bialystok, Białystok, Poland.

• PMID: 32849272 • PMCID: PMC7424019 • DOI: 10.3389/fendo.2020.00476

Free PMC article Abstract

Objectives: The prevalence of type 1 diabetes mellitus (T1D) in children is growing, but its relation to other autoimmune disorders that coexist since the onset of diabetes is not recognized. The objective of this study was to assess the incidence of T1D and the prevalence of autoimmune illnesses additionally coexisting since the diabetes mellitus onset in children during a period of 9 years' observation. Methods: In this retrospective study, the incidence rate (IR) of the T1D was calculated as the total number of all cases that were newly diagnosed per 100,000 population people between 0 and 18 years of age. The selected age groups (0-4, 5-9, 10-14, and 15-18 years) were examined, respectively. The studied group included 493 children (264 [53.55%] boys) between 0 and 18 years old newly diagnosed with T1D in one of the Polish centers in the years 2010-2018. Other autoimmune illnesses diagnoses were obtained from medical records taken from the first hospital treatment, when T1D was recognized. Results: The annual standardized IR of T1D increased from 19.2/100,000 in year 2010 to 31.7/100,000 in 2018 (1.7-fold over 9 years' observation), with an increase in the incidence rate ratio (IRR) by 4% per year. The highest growth in IR was recorded in 5- to 9-year-olds (from 19.61 in 2010 to 43.45 in 2018). In 61 (12.4%) of the studied group, at least one additional autoimmune disease was diagnosed. The prevalence doubled from 10.4% in the year 2010 to 20.8% in the year 2018. Autoimmune thyroid illnesses were found in 37 children (7.5%); their incidence increased from 6.3% to almost 2- fold, 12.5%, in 2018. In 26 children (5.3%), celiac disease was recognized; the prevalence increased from 4.2 to 9.8% in the study period. The prevalence of additional autoimmune thyroid disease was higher in glutamic acid decarboxylase-positive antibodies (χ2 = 3.4, p = 0.04) patients, the oldest age group (15-18 years) (χ2 =7.1, p = 0.06), and in girls (χ2 =7.1, p = 0.007). Conclusions:The standardized IR of T1D in children increased 1.7-fold over the 9-year observation period, and IRR increased 4% per year. Additional autoimmunity represents a significant comorbidity in patients with new-onset T1D. The number of children diagnosed with additional autoimmune diseases that accompany T1D is rapidly growing in all age groups throughout recent years. Keywords: autoimmune thyroid diseases; celiac disease; children; diabetes type 1; epidemiology.

• 65 references • 5 figures

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16. Comparative Characterization of Gluten and Hydrolyzed Wheat Proteins

Biomolecules. 2020 Aug 24;10(9):E1227. doi: 10.3390/biom10091227.

Authors

Angelika Miriam Gabler 1 , Katharina Anne Scherf 1 2

Affiliations

• 1 Leibniz-Institute for Food Systems Biology at the Technical University of Munich, 85354 Freising, Germany. • 2 Department of Bioactive and Functional Food Chemistry, Institute of Applied Biosciences, Karlsruhe Institute of Technology (KIT), 76131 Karlsruhe, Germany.

• PMID: 32846879 • DOI: 10.3390/biom10091227

Free article Abstract

Hydrolyzed wheat proteins (HWPs) are widely used as functional ingredients in foods and cosmetics, because of their emulsifying and foaming properties. However, in individuals suffering from celiac disease or wheat allergy, HWPs may have a modified immunoreactivity compared to native gluten due to changes in molecular structures. Although a variety of HWPs are commercially available, there are no in-depth comparative studies that characterize the relative molecular mass (Mr) distribution, solubility, and hydrophilicity/hydrophobicity of HWPs compared to native gluten. Therefore, we aimed to fill this gap by studying the above characteristics of different commercial HWP and gluten samples. Up to 100% of the peptides/proteins in the HWP were soluble in aqueous solution, compared to about 3% in native gluten. Analysis of the Mr distribution indicated that HWPs contained high percentages of low-molecular-weight peptides/proteins and also deamidated glutamine residues. We also found considerable differences between the seven HWPs studied, so that each HWP needs to be studied in detail to help explain its potential immunoreactivity.

Keywords: celiac disease; gel electrophoresis; gliadin; gluten; high- performance liquid chromatography (HPLC); hydrolyzed wheat proteins; wheat allergy.

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17. Early-life exposure to perfluorinated alkyl substances modulates lipid metabolism in progression to celiac disease

Environ Res. 2020 Sep;188:109864. doi: 10.1016/j.envres.2020.109864. Epub 2020 Jun 30.

Authors

Lisanna Sinisalu 1 , Partho Sen 2 , Samira Salihović 3 , Suvi M Virtanen 4 , Heikki Hyöty 5 , Jorma Ilonen 6 , Jorma Toppari 7 , Riitta Veijola 8 , Matej Orešič 9 , Mikael Knip 10 , Tuulia Hyötyläinen 11

Affiliations

• 1 School of Science and Technology, Örebro University, Örebro, Sweden. • 2 Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland. • 3 School of Science and Technology, Örebro University, Örebro, Sweden; School of Medical Sciences, Örebro University, Örebro, Sweden. • 4 Finnish Institute for Health and Welfare, Public Health Promotion Unit, Helsinki, Helsinki, Finland; Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland; Tampere University Hospital, Research, Development and Innovation Center, Tampere, Finland; Tampere Center for Child Health Research, Tampere University Hospital, Tampere, Finland. • 5 Faculty of Medicine Health Technology, Tampere University, Tampere, Finland; Fimlab Laboratories, Pirkanmaa Hospital District, Tampere, Finland. • 6 Immunogenetics Laboratory, Institute of Biomedicine, University of Turku, Turku, Finland; Clinical Microbiology, Turku University Hospital, Turku, Finland. • 7 Institute of Biomedicine, Centre for Integrative Physiology and Pharmacology, And Centre for Population Health Research, University of Turku, Turku, Finland; Department of Pediatrics, Turku University Hospital, Turku, Finland. • 8 Department of Paediatrics, PEDEGO Research Unit, Medical Research Centre, University of Oulu, Oulu, Finland; Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden. • 9 Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland; School of Medical Sciences, Örebro University, Örebro, Sweden. Electronic address: [email protected]. • 10 Pediatric Research Center, Children's Hospital, University of Helsinki and Helsinki University Hospital, 00290, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Center for Child Health Research, Tampere University Hospital, Tampere, Finland. Electronic address: [email protected]. • 11 School of Science and Technology, Örebro University, Örebro, Sweden. Electronic address: [email protected].

• PMID: 32846648 • DOI: 10.1016/j.envres.2020.109864

Abstract

Celiac disease (CD) is a systemic immune-mediated disorder with increased frequency in the developed countries over the last decades implicating the potential causal role of various environmental triggers in addition to gluten. Herein, we apply determination of perfluorinated alkyl substances (PFAS) and combine the results with the determination of bile acids (BAs) and molecular lipids, with the aim to elucidate the impact of prenatal exposure on risk of progression to CD in a prospective series of children prior the first exposure to gluten (at birth and at 3 months of age). Here we analyzed PFAS, BAs and lipidomic profiles in 66 plasma samples at birth and at 3 months of age in the Type 1 Diabetes Prediction and Prevention (DIPP) study (n = 17 progressors to CD, n = 16 healthy controls, HCs). Plasma PFAS levels showed a significant inverse association with the age of CD diagnosis in infants who later progressed to the disease. Associations between BAs and triacylglycerols (TGs) showed different patterns already at birth in CD progressors, indicative of different absorption of lipids in these infants. In conclusion, PFAS exposure may modulate lipid and BA metabolism, and the impact is different in the infants who develop CD later in life, in comparison to HCs. The results indicate more efficient uptake of PFAS in such infants. Higher PFAS exposure during prenatal and early life may accelerate the progression to CD in the genetically predisposed children.

Keywords: Bile acids; Celiac disease; Exposome; Lipidomics; PFAS.

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18. Serological markers of gluten sensitivity in Border terriers with gall bladder mucocoeles J Small Anim Pract. 2020 Aug 26. doi: 10.1111/jsap.13211. Online ahead of print.

Authors

L Barker 1 , M S Tivers 2 , A Kathrani 3 , F Allerton 4 , R Powell 5 , L Stam 5 , V Black 1

Affiliations

• 1 Bristol Veterinary School, University of Bristol, Langford, Bristol, BS40 5DU, UK. • 2 Paragon Veterinary Referrals, Wakefield, WF1 2DF, UK. • 3 Royal Veterinary College, Hertfordshire, AL9 7TA, UK. • 4 Willows Veterinary Referrals, Solihull, B90 4NH, UK. • 5 SYNLAB-VPG, Manor Farm Business Park, Hertfordshire, SG5 3HR, UK.

• PMID: 32845530 • DOI: 10.1111/jsap.13211

Abstract

Objectives: To evaluate serological markers of gluten sensitivity in conjunction with cholecystokinin measurement in Border terriers with gall bladder mucocoeles.

Materials and methods: Medical records from two referral hospitals were obtained between 2011 and 2019 to identify Border terriers with gall bladder mucocoeles, non-Border terriers with gall bladder mucocoeles and control Border terriers with non-biliary diseases. Enzyme-linked immunosorbent assays were performed on stored fasted serum samples for anti-gliadin IgG, anti-canine transglutaminase-2-IgA autoantibodies and cholecystokinin. Statistical analysis was performed using the Kruskall-Wallis test to identify differences between the groups.

Results: Fifteen Border terriers with gall bladder mucocoeles, 17 non-Border terriers with gall bladder mucocoeles and 14 control Border terriers with non- biliary diseases were recruited. Median transglutaminase-2-IgA autoantibodies in Border terriers with gall bladder mucocoeles was 0.73 (range: 0.18 to 1.67), which was significantly greater than in control Border terriers at 0.41 (0.07 to 1.14). Median cholecystokinin concentration in Border terriers with gall bladder mucocoeles was 13 pg/mL (6 to 45 pg/mL), which was significantly lower than in control Border terriers at 103 pg/mL (9 to 397 pg/mL). There was no difference in the anti-gliadin IgG between these groups. There was no difference observed in the non-Border terriers with gall bladder mucocoeles with either of the other groups.

Clinical significance: Reduced cholecystokinin and increased transglutaminase-2-IgA autoantibodies was detected in Border terriers with gall bladder mucocoeles; which is in part homologous to gall bladder disease identified in human coeliac disease. The results suggest an immunological disease with impaired cholecystokinin release may be affecting gall bladder motility and possibly contributing to mucocoele formation in Border terriers.

• 35 references

Grant support

• S18-675-713/Petplan Charitable Trust

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19. Celiac Disease in Indian Children and Adolescents with Type 1 Diabetes

Indian Pediatr. 2020 Aug 15;57(8):750-752.

Authors

N Agarwal 1 , C Dave 1 , R Patel 1 , R Shukla 2 , A Bajpai 3

Affiliations

• 1 Department of Pediatric Endocrinology, Regency Center for Diabetes Endocrinology and Research, Kanpur; and GROW Society, Growth and Obesity Workforce; Uttar Pradesh, India. • 2 Department of Pediatric Endocrinology, Regency Center for Diabetes Endocrinology and Research, Kanpur, Uttar Pradesh, India. • 3 Department of Pediatric Endocrinology, Regency Center for Diabetes Endocrinology and Research, Kanpur; and GROW Society, Growth and Obesity Workforce; Uttar Pradesh, India. [email protected].

• PMID: 32844764

Abstract

To estimate the time trend and prevalence of celiac disease in 208 children with type 1 diabetes by retrospective case review. Tissue transglutaminase (TTG IgA) levels were done within the first six months of diagnosis and annually on follow-up. Celiac disease was diagnosed in 35 (16.8%; 3 before diagnosis, 18 at initial screening and 14 on follow-up). 14 subjects with negative TTG serology at presentation, developed celiac disease after 3.9 (2.9) years (range 1.4 - 12.6 years, 85.7% within 5 years). Celiac disease is common in Indian children and adolescents with type I diabetes, developing in most within five years of diagnosis.

20. Anti-transglutaminase IgA antibody measurement in coeliac disease: Method comparison IDS-iSYS vs. Thermo Fisher Phadia

Scand J Clin Lab Invest. 2020 Aug 26;1-4. doi: 10.1080/00365513.2020.1812115. Online ahead of print.

Authors

Birgitte Sandfeld-Paulsen 1 , Tina Parkner 1 , Cindy Soendersoe Knudsen 1

Affiliation

• 1 Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark.

• PMID: 32844702 • DOI: 10.1080/00365513.2020.1812115

Abstract

In coeliac disease, the diagnostic work-up is based on a combination of clinical, histopathological and serological evaluation. Among the serological tests, the presence of tissue transglutaminase (tTG) IgA antibodies is the cornerstone owed to a high sensitivity and specificity. Recently, Immunodiagnostic Systems Ltd (IDS) introduced the fully automated chemiluminescent autoimmune assays for use on the IDS-iSYS Multi-Discipline Automated System. In this study, we aimed to compare the performance of the IDS-iSYS assay to the Thermo Fisher Phadia assay and to establish the upper reference limit of tTG IgA in a healthy population from Denmark based on the IDS-iSYS assay. We discovered a total imprecision of CV = 12.2% (2.87 AU/mL) and CV = 10.6% (47.55 AU/mL). Moreover, we compared the performance of IDS-iSYS assay to Thermo Fisher Phadia assay in 236 samples from unselected patients submit for tTG IgA testing and found a concordance of 97% (p < .0001). Furthermore, in 150 healthy blood donors, we established the upper reference limit of 3.26 AU/mL (95% CI: 3.10 - 3.90) was identified. Our study validates the performance of the IDS-iSYS tTG IgA assay and demonstrates results in concordance with the established Thermo Fisher Phadia. Furthermore, it provides estimates for the upper reference interval limit of the tTG-IgA.

Keywords: Coeliac disease; Immunodiagnostic Systems Ltd; Immunoglobulin A; antibodies; tissue transglutaminase.

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21. Gluten immunogenic peptides: is knowing half the battle?

Am J Clin Nutr. 2020 Aug 25;nqaa228. doi: 10.1093/ajcn/nqaa228. Online ahead of print.

Authors

Amelie Therrien 1 , Daniel A Leffler 1 2 Affiliations

• 1 Celiac Center, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA, USA. • 2 Takeda Pharmaceutical International Co., Cambridge, MA, USA.

• PMID: 32844173 • DOI: 10.1093/ajcn/nqaa228

No abstract available

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22. Development and effectiveness assessment of a Persian-language smartphone application for celiac patients: A randomized controlled clinical trial

Patient Educ Couns. 2020 Aug 18;S0738-3991(20)30441-9. doi: 10.1016/j.pec.2020.08.014. Online ahead of print.

Authors

Zeinab Nikniaz 1 , Masood Shirmohammadi 1 , Zahra Akbari Namvar 2

Affiliations

• 1 Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. • 2 Student Research Committee, Tabriz University of Medical Sciences, Daneshgah Streat, Tabriz, Iran. Electronic address: [email protected].

• PMID: 32843265 • DOI: 10.1016/j.pec.2020.08.014

Abstract

Objectives: We aimed to design a Persian-language application for celiac patients and assess its effectiveness on patients` knowledge and adherence to a gluten-free diet (GFD).

Methods: In the present randomized controlled clinical trial, 60 patients were randomly assigned to receive education through a smartphone application (n = 30) or conventional clinical education (n = 30). The primary outcomes were assessing knowledge about celiac disease and GFD, and adherence to GFD that were assessed at baseline and three months after interventions. The knowledge and adherence were assessed by a valid author-designed knowledge questionnaire and the validated celiac disease adherence test (CDAT) respectively.

Results: The mean disease duration was 4.38 ± 3.27 years. The mean post- intervention score of knowledge about gluten-free foods was significantly higher in the intervention group compared with the placebo group after adjusting for baseline values and characteristics (p-value = 0.03). There was a significant difference in post-intervention CDAT values between the two groups (p-value = 0.01).

Conclusion: The smartphone application had a significant effect on celiac patients` knowledge about gluten-free foods and adherence to GFD.

Practice implications: The smartphone applications can be designed according to each country's particular circumstances and can be suggested by nutritionists and physicians to use by celiac patients.

Keywords: Adherence; Celiac disease; Education; Gluten-free diet; Knowledge; Smartphone application.

Conflict of interest statement

Declaration of Competing Interest The authors declare no conflict of interest Full-text links

23. [Advances in celiac disease]

Zhonghua Nei Ke Za Zhi. 2020 Sep 1;59(9):733-737. doi: 10.3760/cma.j.cn112138-20191107-00737. [Article in Chinese]

Authors

X Y Liu 1 , Y Chen 1

Affiliation

• 1 Department of Gastroenterology, Nanfang Hospital, Guangzhou 510515, China.

• PMID: 32838509 • DOI: 10.3760/cma.j.cn112138-20191107-00737

Abstract

乳糜泻是由于遗传易感基因个体摄入含麸质蛋白的谷类及其制品后而诱发的自身免疫性肠道疾病。近年来发现其全球血清患病率约为1%，且呈逐渐增长趋势。但由于临床医师对该疾病认识不足，导致很多患者未能被明确诊断而延误治疗。故本文着重介绍国内外乳糜泻的诊疗新进展，以提高公众对乳糜泻的认识，从而推动我国对乳糜泻的预防和控制。.

MeSH terms

• Celiac Disease* • Humans

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24. The role of resilience in irritable bowel syndrome, other chronic gastrointestinal conditions and the general population

Clin Gastroenterol Hepatol. 2020 Aug 21;S1542-3565(20)31152-6. doi: 10.1016/j.cgh.2020.08.043. Online ahead of print.

Authors

Colleen H Parker 1 , Bruce D Naliboff 2 , Wendy Shih 2 , Angela P Presson 3 , Lisa Kilpatrick 2 , Arpana Gupta 2 , Cathy Liu 2 , Laurie A Keefer 4 , Jenny S Sauk 5 , Robert Hirten 4 , Bruce E Sands 4 , Lin Chang 6

Affiliations

• 1 G. Oppenheimer Center for Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Disease, David Geffen School of Medicine at UCLA, Los Angeles, California;; Division of Gastroenterology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. • 2 G. Oppenheimer Center for Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Disease, David Geffen School of Medicine at UCLA, Los Angeles, California. • 3 Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City Utah. • 4 Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York. • 5 UCLA Center for Inflammatory Bowel Diseases, Vatche and Tamar Manoukian Division of Digestive Disease, David Geffen School of Medicine at UCLA, Los Angeles, California. • 6 G. Oppenheimer Center for Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Disease, David Geffen School of Medicine at UCLA, Los Angeles, California;. Electronic address: [email protected].

• PMID: 32835842 • DOI: 10.1016/j.cgh.2020.08.043

Abstract

Background: Resilience is the ability to adapt positively to stress and adversity. It is a potential therapeutic target as it is reduced in irritable bowel syndrome (IBS) compared to healthy controls and associated with worse symptom severity and poorer quality of life. The aim of this study was to examine if these findings are generalizable by comparing resilience between IBS versus the general population and other chronic gastrointestinal (GI) conditions.

Methods: Participants in the general population completed an online survey containing questionnaires measuring demographics, diagnosis of IBS and other GI conditions, symptom severity, psychological symptoms, resilience, and early adverse life events (EALs). IBS was defined as having a physician diagnosis of IBS and/or meeting Rome criteria without co-morbid GI disease. All others were included in the general population group. The chronic GI conditions group included those with inflammatory bowel disease, celiac disease and/or microscopic colitis.

Results: Resilience was lower in IBS (n=820) than the general population (n=1026; p<0.001) and associated with worse IBS symptom severity (p<0.05). Global mental health affected resilience differently in IBS compared to the general population (all p's<0.05). EALs were associated with decreased ability to bounce back from adversity in both IBS and the general population(p<0.001). Resilience scores were similar in IBS and other chronic GI conditions that present with similar symptoms.

Conclusion: Resilience is lower compared to the general U.S. population but does not appear to be specific to IBS as it is comparable to other chronic GI conditions. Low resilience negatively affects symptom severity and mental health and thus, may serve as a novel therapeutic target.

Keywords: celiac disease; inflammatory bowel disease; irritable bowel syndrome; resilience.

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25. Seronegative Villous Atrophy in Children: Clinical and Immunohistochemical Features

J Pediatr Gastroenterol Nutr. 2020 Aug 21. doi: 10.1097/MPG.0000000000002917. Online ahead of print.

Authors

Roberta Mandile 1 , Mariantonia Maglio 2 , Nicoletta Pellino 1 , Marina Russo 1 , Erasmo Miele 1 , Maria Immacolata Spagnuolo 1 , Riccardo Troncone 1 2 , Renata Auricchio 1 2

Affiliations

• 1 Department of Pediatrics, University Federico II of Naples, Italy. • 2 European Laboratory for the Investigation of Food-Induced Diseases (ELFID), Naples, Italy.

• PMID: 32833891 • DOI: 10.1097/MPG.0000000000002917

Abstract

Objectives: Villous atrophy (VA) is not pathognomonic of celiac disease (CD). We aimed at reporting distribution, clinical and immunohistochemical features of seronegative VA (SNVA) in a pediatric population.

Methods: We retrospectively collected data from patients who underwent intestinal biopsies between 2010 and 2017 and showed VA without serum CD- associated autoantibodies. Marsh-Oberhuber grading was used. Density of intraepithelial lymphocytes (IELs) expressing CD3 or TCRγδ+ receptor and of lamina propria CD25+ cells was assessed by immunohistochemistry. Intestinal deposits of anti-tissue tranglutaminase2 (anti-TG2) were also investigated by double immunofluorescence.

Results: Over a 7 year period, 64 out of 1282 patients with VA had negative serum CD serology. Diagnoses were: inflammatory bowel diseases (IBD) (21/64), Gastro-Esophageal Reflux Disease (GERD) (12/64), food allergy (8/64), infections (7/64, of which 3 HIV infections), immune deficiency (3/64), short bowel syndrome (3/64), congenital diarrhea (2/64), other/inconclusive diagnosis (8/64). 44, 15 and 5 showed Marsh 3a, 3b and 3c lesion, respectively. The latter category included 2 patients with Crohn's disease, 2 with immunodeficiencies, 1 with lymphohistiocytosis. In 41/46 (89%) patients mononuclear CD25+ cells were above the cut-off, indicating mucosal inflammation, but only 18/46 (39%) had IELs and TCRγδ+ IELs above limits of normality. In 10/46 (22%) patients a positive immunofluorescence indicated the presence of anti-TG2 mucosal antibodies.

Conclusions: SNVA is not rare representing up to 5% of the cases of VA. Most patients have a Marsh 3a lesion. Immunohistochemical analysis may be helpful in excluding CD, while the finding of mucosal anti-TG2, particularly with a weak staining, shows no absolute specificity for CD.

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26. Update on celiac disease

Curr Opin Pediatr. 2020 Aug 21. doi: 10.1097/MOP.0000000000000936. Online ahead of print.

Author

Michele J Alkalay 1

Affiliation

• 1 Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Texas Southwestern, Dallas, Texas, USA.

• PMID: 32833796 • DOI: 10.1097/MOP.0000000000000936 Abstract

Purpose of review: The purpose of this review is to describe current updates in celiac disease.

Recent findings: Recent developments in the understanding of the pathogenesis of celiac disease continue to emerge that may implicate the role of gluten exposure. Several studies have shown that the amount of gluten consumed by the infant may affect the age of onset of celiac disease in genetically predisposed individuals. New guidelines from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition allow serology- based celiac diagnosis, omitting endoscopic biopsies, in children. Recent data and updated guidelines in adults no longer support biopsies in all patients who are genetically susceptible with celiac disease who have been identified by serology with clinical signs and symptoms of celiac disease. A new assay was identified in the immune response to epitopes of the tissue transglutaminase- deamidated gliadin peptide complex. In addition, a recent study shows that serum IL-2 elevations correlate with timing and severity of symptoms after gluten ingested in celiac disease patients. Measuring gluten immunogenic peptides (GIPs) in the stool of celiac patients may help monitor adherence to a gluten-free diet (GFD). Of importance, we should be aware that the quality of life is affected in celiac disease patients. During adolescence, the education on the importance of long-term follow-up with an adult gastroenterologist is associated with more successful rates of medical care transition for young adults with celiac disease. Latiglutenase, an orally administered mixture of two gluten-specific recombinant proteases that degrades gluten proteins into small physiologically irrelevant fragments, is currently in a phase 2 trial. Latiglutenase has shown to be safe and effective in reducing symptoms of celiac disease patients upon a GFD with improvement of quality of life. Lastly, a recent study describes a mouse model that is characteristic of celiac disease.

Summary: Our knowledge of celiac disease continues to grow with increasing evidence of contributory factors to its pathogenesis. There is some evidence that the quantity ingested of gluten by the infant effects the age of onset of celiac disease in genetically susceptible patients. Changes have been made to the guidelines in the diagnosis of celiac disease proposed by new studies. Recent studies have shown the significant effects on quality of life for celiac patients. As improved laboratory methods continue to be developed, these tests can have utility in both diagnosis of celiac disease and monitoring adherence to the GFD. Current therapeutic trials offer promising nondietary treatment for celiac patients. The development of an animal model can provide a better understanding of the pathogenesis of celiac disease.

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27. Maternal Microchimerism in Cord Blood and Risk of Celiac Disease in Childhood

J Pediatr Gastroenterol Nutr. 2020 Sep;71(3):321-327. doi: 10.1097/MPG.0000000000002811.

Authors

German Tapia 1 , Georgina Mortimer, Jody Ye, Karl Mårild, Saranna Chipper-Keating, Benjamin T Gillard, Marte K Viken, Benedicte A Lie, Lars C Stene, Kathleen M Gillespie, Ketil Størdal

Affiliation

• 1 *Norwegian Institute of Public Health, Oslo, Norway †Diabetes and Metabolism, Bristol Medical School, University of Bristol, Bristol, UK ‡Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg and Queen Silvia Children's Hospital, Gothenburg, Sweden §Department of Immunology, Rikshospitalet, Oslo University Hospital ¶Department of Medical Genetics, University of Oslo, Oslo ||Pediatric Department, Østfold Hospital Trust, Grålum, Norway.

• PMID: 32833392 • DOI: 10.1097/MPG.0000000000002811

Abstract

Objectives: During pregnancy, small quantities of maternal cells are naturally transmitted to the fetus. This transmission, termed maternal microchimerism (MMc), has been implicated in autoimmune diseases but its potential role is unclear. We aimed to investigate if MMc at birth predicted childhood celiac disease (CD) risk, a common immune-mediated enteropathy often presenting in childhood.

Methods: We designed a case-control study, nested in the Norwegian Mother, Father and Child Cohort. Participants were HLA class II typed to determine noninherited, nonshared maternal alleles (NIMA). Droplet digital (dd) PCR assays specific for common HLA class II NIMAs (HLA-DQB103:01, 04:02 and 06:02/03) were used to estimate the quantity of maternal DNA, as a marker of maternal cells, in cord blood DNA from 124 children who later developed clinically diagnosed CD (median age at end of study 7.4 years, range 3.6-12.9) and 124 random controls. We tested whether presence of MMc was associated with CD using logistic regression, and compared ranks between cases and controls.

Results: MMc, for example, maternal HLA antigens not inherited by the child, was found in 42% of cases and 43% of controls, and not associated with CD (odds ratio [OR] 0.97, 95% confidence interval [CI] 0.58-1.60). The ranks of MMc quantities in cases and controls were also similar (Mann-Whitney U-test, P = 0.71). The subgroup with HLA-DQB1:03*01 as their NIMA had a potential association with MMc, where levels greater than median was associated with CD (OR 3.78, 95% CI 1.28-11.18).

Conclusion: MMc measured in cord blood was not associated with later risk of CD.

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28. Spontaneous Retroperitoneal Hemorrhage Secondary to Chronic Celiac Axis Compression Treated with Embolization Utilizing Cone Beam CT

Case Rep Radiol. 2020 Aug 1;2020:2636495. doi: 10.1155/2020/2636495. eCollection 2020. Authors

Bashar Khiatah 1 , Sam Jazayeri 1 , Charles M Hubeny 2 , Brian Nadav 2 , Amanda Frugoli 3

Affiliations

• 1 Internal Medicine Department, Community Memorial Hospital Ventura, CA, USA. • 2 Interventional Radiology, Pueblo Radiology, Santa Barbara, CA, USA. • 3 Internal Medicine Department, GME, Community Memorial Hospital Ventura, CA, USA.

• PMID: 32832185 • PMCID: PMC7422076 • DOI: 10.1155/2020/2636495

Free PMC article Abstract

Median arcuate ligament syndrome (MALS) is a rare and often misdiagnosed vascular pathology. In this paper, we discuss a 51-year-old female with MALS presenting with hypotension due to retroperitoneal hemorrhage. Currently, there is no consensus regarding the optimal treatment approach for such patients. This case report demonstrates the utility of conventional mesenteric angiography, cone beam CT with 3D reconstruction, and selective mesenteric transarterial embolization as an effective treatment approach for patients with spontaneous aneurysm rupture in MALS.

Conflict of interest statement

The authors confirm that there are no conflicts of interest regarding this publication.

• 16 references • 7 figures Publication types

• Case Reports

Full-text links

29. [Study of adherence to the gluten-free diet in coeliac patients]

An Pediatr (Barc). 2020 Aug 20;S1695-4033(20)30238-1. doi: 10.1016/j.anpedi.2020.06.017. Online ahead of print. [Article in Spanish]

Authors

María Fernández Miaja 1 , Juan José Díaz Martín 2 , Santiago Jiménez Treviño 3 , Marta Suárez González 3 , Carlos Bousoño García 3

Affiliations

• 1 Servicio de Gastroenterología-Hepatología y Nutrición, Hospital Universitario Central de Asturias, Oviedo, España; Área de Gestión Clínica de Pediatría, Hospital Universitario Central de Asturias, Oviedo, España. • 2 Servicio de Gastroenterología-Hepatología y Nutrición, Hospital Universitario Central de Asturias, Oviedo, España. Electronic address: [email protected]. • 3 Servicio de Gastroenterología-Hepatología y Nutrición, Hospital Universitario Central de Asturias, Oviedo, España.

• PMID: 32830086 • DOI: 10.1016/j.anpedi.2020.06.017

Free article Abstract

Introduction: The following of a strict gluten-free diet (GFD) is essential in the control of coeliac disease. The aim of this study was to determine the adherence to a GFD in coeliac patients and to evaluate the factors that could influence this adherence.

Material and methods: A descriptive observational study was carried out, in which gluten immunogenic peptides (GIP) were determined in faeces using a semi-quantitative method, and the Coeliac Dietary Adherence Test was completed. Sociodemographic and clinical details were collected, and an ad hoc questionnaire was prepared.

Results: Of the 80 patients included, 92.5% were adherent according to the GIP and 86.3% according to Coeliac Dietary Adherence Test (acceptable agreement; Kappa: 0.31, P=.004). The large majority (83.3%) of patients with positive GIP gave negative anti-transglutaminase antibodies in the latest determination. Current age and time of onset were significantly associated with adherence. Those with a positive GIP had a mean age of 5 years more (P=.0001) and were 52 months more on a GFD (P=.025). One quarter of those surveyed considered the diet difficult to follow. Just under two-thirds (60%) considered that the variability in the eating site was an important factor in leading to infringements, with children's parties being the main area where they occurred (66.7%). The lack of variety (61.4%) and the increased cost (98.6%) of gluten-free foods is highlighted.

Conclusions: The adherence to the GFD is generally good. The analysis of GIP helps to detect non-adherent patients that would pass unnoticed in other circumstances. Measures must be established in order to maintain good long- term adherence, taking into account the risk factors and difficulties detected.

Keywords: Adherence; Adherencia; Celiac Dietary Adherence Test; Coeliac Dietary Adherence Test; Coeliac serology; Gluten immunogenic peptides; Péptidos inmunogénicos del gluten; Serología celiaca.

Publication types • English Abstract

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30. Gluten-free Diet Reduces Symptoms, Particularly Diarrhea, in Patients With Irritable Bowel Syndrome and Anti-gliadin IgG

Clin Gastroenterol Hepatol. 2020 Aug 19;S1542-3565(20)31149-6. doi: 10.1016/j.cgh.2020.08.040. Online ahead of print.

Authors

María Inés Pinto-Sanchez 1 , Andrea Nardelli 1 , Rajka Borojevic 1 , Giada De Palma 1 , Natalia Causada Calo 1 , Justin McCarville 1 , Alberto Caminero 1 , Daniel Basra 1 , Alexa Mordhorst 1 , Ekatherina Ignatova 1 , Suzanne Hansen 1 , Melanie Uhde 2 , Gary L Norman 3 , Joseph A Murray 4 , Edgardo Smecuol 5 , David Armstrong 1 , Julio C Bai 5 , Detlef Schuppan 6 , Stephen M Collins 1 , Armin Alaedini 2 , Paul Moayyedi 1 , Elena F Verdu 1 , Premysl Bercik 1

Affiliations

• 1 Department of Medicine, Farncombe Institute, McMaster University, Hamilton, ON, Canada. • 2 Department of Medicine, Columbia University, New York, NY, USA. • 3 Inova Diagnostics, San Diego, CA, USA. • 4 Mayo Clinic, Rochester, MN, USA. • 5 Hospital de Gastroenterologia B. Udaondo, Buenos Aires, Argentina. • 6 Institute of Translational Immunology, Johannes Gutenberg University, Mainz, Germany.

• PMID: 32827724 • DOI: 10.1016/j.cgh.2020.08.040 Abstract

Background & aims: Many patients with irritable bowel syndrome (IBS) perceive that their symptoms are triggered by wheat-containing foods. We assessed symptoms and gastrointestinal transit before and after a gluten-free diet (GFD) in unselected patients with IBS and investigated biomarkers associated with symptoms.

Methods: We performed a prospective study of 50 patients with IBS (ROME III, all subtypes), with and without serologic reactivity to gluten (anti-gliadin IgG and IgA), and 25 healthy subjects (controls) at a university hospital in Hamilton, Ontario, Canada between 2012-2016. Gastrointestinal transit, gut symptoms, anxiety, depression, somatization, dietary habits, and microbiota composition were studied before and after 4 weeks of a GFD. HLA-DQ2/DQ8 status was determined. GFD compliance was assessed by a dietitian and by measuring gluten peptides in stool.

Results: There was no difference in symptoms among patients at baseline, but after the GFD, patients with anti-gliadin IgG and IgA reported less diarrhea than patients without these antibodies (P=.03). Compared with baseline, IBS symptoms improved in 18/24 patients (75%) with anti-gliadin IgG and IgA and in 8/21 patients (38%) without the antibodies. Although constipation, diarrhea, and abdominal pain were reduced in patients with anti-gliadin IgG and IgA, only pain decreased in patients without these antibodies. Gastrointestinal transit normalized in a higher proportion of patients with anti-gliadin IgG and IgA. Anxiety, depression, somatization, and well-being increased in both groups. The presence of anti-gliadin IgG was associated with overall reductions in symptoms (adjusted odds ratio compared to patients without this antibody, 128.9; 95% CI, 1.16-1427.8; P=.04). Symptoms were reduced even in patients with anti-gliadin IgG and IgA who reduced gluten intake but were not strictly compliant with the GFD. In controls, a GFD had no effect on gastrointestinal symptoms or gut function.

Conclusions: Anti-gliadin IgG can be used as a biomarker to identify patients with IBS who might have reductions in symptoms, particularly diarrhea, on a GFD. Larger studies are needed to validate these findings.

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31. Agenesis of the celiac trunk: a case report and review of the literature

Folia Morphol (Warsz). 2020 Aug 22. doi: 10.5603/FM.a2020.0093. Online ahead of print.

Authors

M Karamanidi 1 , D Chrysikos 1 , A Samolis 1 , V Protogerou 1 , N Fourla 1 , I Michalis 1 , G Papaioannou 2 , T Troupis 3

Affiliations

• 1 Faculty of Medicine Department of Anatomy National and Kapodistrian University of Athens Athens Greece. • 2 Department of Surgery. • 3 Faculty of Medicine Department of Anatomy National and Kapodistrian University of Athens Athens Greece.. [email protected].

• PMID: 32827311 • DOI: 10.5603/FM.a2020.0093

Free article Abstract

Vascular anatomical variations of the abdomen are very common. Awareness of these variations is of paramount importance in clinical practice mainly in achieving best results in minimal invasive or surgical vascular procedures. From surgical point of view, the preoperative knowledge of vascular anatomy and the relations to the surrounding structures and tissues aims to minimize inadvertent complications. Agenesis of the celiac trunk is one of the rare anatomical variations of the abdominal aorta. Limited number of cases have been reported in the medical literature, most of which are based on angiographic and cadaveric studies of adult humans. In this paper, we report a case of absence of the celiac trunk that has been detected as a incidental radiological finding in a female patient, that was admitted with abdominal pain.

Keywords: anatomical variation; celiac trunk agenesis; tripus Halleri absence.

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32. Emergent Scleroderma in a Celiac Patient After 10 Years-A Coincidence?

J Clin Rheumatol. 2020 Aug 20. doi: 10.1097/RHU.0000000000001469. Online ahead of print.

Authors

Soroush Moradi 1 , Kamyar Shokraee 2 , Alireza Sharifi 3 , Mohaddeseh Zojaji 4 , Maryam Masoumi 5

Affiliations

• 1 From the Tehran University of Medical Sciences. • 2 Minimally Invasive Surgeries Research Centers, Iran University of Medical Sciences, Tehran. • 3 Development Center, Shahid Beheshti Hospital. • 4 Gastroenterology and Hepatology Disease Research Center. • 5 Clinical Research Development Center, Qom University of Medical Sciences and Health Services, Qom, Iran.

• PMID: 32826652 • DOI: 10.1097/RHU.0000000000001469

No abstract available

Full-text links

33. Frequency of Celiac Disease and Spontaneous Normalization Rate of Celiac Serology in Children and Adolescent Patients with Type 1 Diabetes

J Clin Res Pediatr Endocrinol. 2020 Aug 21. doi: 10.4274/jcrpe.galenos.2020.2020.0108. Online ahead of print.

Authors

Edip Unal 1 , Meliha Demiral 1 , Birsen Baysal 2 , Mehmet Agın 3 , Elif Gökçe Devecioğlu 4 , Hüseyin Demirbilek 5 , Mehmet Nuri Özbek 1

Affiliations

• 1 Gazi Yaşargil Training and Research Hospital, Department of Pediatric Endocrinology, Diyarbakır, Turkey. • 2 Gazi Yasargil Training and Research Hospital, Department of Paediatrics, Diyarbakir, Turkey. • 3 Gazi Yaşargil Training and Research Hospital, Department of Pediatric Gastroenterology, Diyarbakır, Turkey. • 4 Gazi Yaşargil Training and Research Hospital, Department of Pathology, Diyarbakır, Turkey. • 5 Hacettepe University, Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey.

• PMID: 32820875 • DOI: 10.4274/jcrpe.galenos.2020.2020.0108

Free article Abstract

Purpose: The prevalence of celiac disease (CD) varies between 1% and 10% in patients with type 1 diabetes mellitus(T1DM). This study aims to determine the frequency of spontaneous recovery of celiac serology and the biopsy- proven CD frequency (BPCD) in patients with T1DM.

Methods: The data of 668 patients with celiac serology from 779 patients who were followed for the last 10 years with the diagnosis of T1DM were retrospectively evaluated.

Results: Positive serology was detected in 103 out of 668(15.4%) patients. There was spontaneous normalization in 24(23.3%), fluctuation in 11(10.7%) and permanently positive serology in 68(66%) of these patients. In 46 out of 53(86.8%) patients with positive serology diagnosis of CD was confirmed with a biopsy (BPCD). The frequency of BPCD was 6.9%, and the serology in 76.1% of them was positive at the time of the diagnosis of T1DM. The weight, height and BMI-SDS at the time of diagnosis were lower in patients with BPCD compared to the group without CD. The anti-tissue transglutaminase-IgA level of 11.8 times higher than the upper limit of normal revealed the best sensitivity (93%) and specificity (90%) for BPCD (AUC:0.95; 95% CI: 0.912-1; p<0.001).

Conclusion: In our cohort, the frequency of positive serology for CD was 15.4%, while the rate of BPCD was 6.9%. The majority (97.8%) of cases were diagnosed within the first five years of T1DM. In 23.3% of cases, positive anti- TTG-IgA spontaneously resolved without a gluten-free diet. Therefore, serological follow-up instead of immediate duodenal biopsy or gluten-free diet therapy, particularly for patients with asymptomatic and mild anti-TTG IgA level, is warranted.

Keywords: Celiac disease; children; spontaneous normalization; type 1 diabetes.

Full-text links

34. Erratum to "Re Mid to Long Term Outcomes in Management of Spontaneous Isolated Coeliac Artery Dissection" [European Journal of Vascular & Endovascular Surgery 60 (1) (2020) 151- 152]

Eur J Vasc Endovasc Surg. 2020 Aug 17;S1078-5884(20)30660-2. doi: 10.1016/j.ejvs.2020.07.049. Online ahead of print.

Authors

So Hyun Kang 1 , Hyung Sub Park 1 , Taeseung Lee 2

Affiliations

• 1 Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, South Korea. • 2 Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, South Korea. Electronic address: [email protected].

• PMID: 32819816 • DOI: 10.1016/j.ejvs.2020.07.049

No abstract available

Erratum for

• Re "Mid to Long Term Outcomes in Management of Spontaneous Isolated Coeliac Artery Dissection".

Kang SH, Park HS, Lee T.

Eur J Vasc Endovasc Surg. 2020 Jul;60(1):151-152. doi: 10.1016/j.ejvs.2020.02.010. Epub 2020 Jun 2.

PMID: 32499170No abstract available. Publication types

• Published Erratum

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35. Acute celiac artery compression syndrome with superior mesenteric artery stenosis and aortic stenosis: A rare but life- threatening complication after adult spinal deformity surgery

J Orthop Sci. 2020 Aug 17;S0949-2658(20)30202-5. doi: 10.1016/j.jos.2020.07.011. Online ahead of print.

Authors

Toshiaki Kotani 1 , Tsuyoshi Sakuma 2 , Yasushi Iijima 2 , Shinichi Sato 3 , Kazuya Nakanishi 4 , Takuya Ueda 5 , Takeshi Hara 6 , Keita Nakayama 2 , Takahiro Sunami 2 , Tomoyuki Asada 7 , Tsutomu Akazawa 8 , Shunji Kishida 2 , Yu Sasaki 2 , Kazuhide Inage 9 , Yasuhiro Shiga 9 , Shohei Minami 2 , Seiji Ohtori 9

Affiliations

• 1 Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan. Electronic address: [email protected]. • 2 Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan. • 3 Department of Gastroenterology, Seirei Sakura Citizen Hospital, Sakura, Japan. • 4 Department of Emergency and Critical Care Medicine, Japanese Red Cross Narita Hospital, Narita, Chiba, Japan. • 5 Department of Clinical Imaging, Tohoku University, Graduate School of Medicine, Sendai, Miyagi, Japan. • 6 Department of Radiology, Seirei Sakura Citizen Hospital, Sakura, Japan. • 7 Department of Orthopedic Surgery, University of Tsukuba, Tsukuba, Japan. • 8 Department of Orthopedic Surgery, St. Marianna University, School of Medicine, Kawasaki, Japan. • 9 Department of Orthopedic Surgery, Chiba University, Graduate School of Medicine, Chiba, Japan.

• PMID: 32819791 • DOI: 10.1016/j.jos.2020.07.011

No abstract available

Conflict of interest statement

Declaration of competing interest The authors have no conflicts of interest to declare.

Publication types

• Case Reports

Full-text links

36. Gluten: dietary villain or innocent bystander?

Lancet Gastroenterol Hepatol. 2020 Sep;5(9):808. doi: 10.1016/S2468- 1253(20)30248-X.

Authors

Jessica R Biesiekierski, Heidi M Staudacher

• PMID: 32818464 • DOI: 10.1016/S2468-1253(20)30248-X

No abstract available Full-text links

37. Coeliac disease and risk of birth defects in pregnancy

Gut. 2020 Aug 19;gutjnl-2020-322425. doi: 10.1136/gutjnl-2020-322425. Online ahead of print.

Authors

Nathalie Auger 1 , Amelie Therrien 2 , Marianne Bilodeau-Bertrand 3 , Chantal Nelson 4 , Laura Arbour 5

Affiliations

• 1 Department of Social and Preventive Medicine, University of Montreal Hospital Research Centre, Montreal, Quebec, Canada [email protected]. • 2 Celiac Center, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. • 3 Bureau d'information et d'études en santé des populations, Institut national de santé publique du Québec, Montreal, Quebec, Canada. • 4 Maternal and Infant Health Surveillance Section, Public Health Agency of Canada, Ottawa, Ontario, Canada. • 5 Department of Medical Genetics, The University of British Columbia, Vancouver, British Columbia, Canada.

• PMID: 32816918 • DOI: 10.1136/gutjnl-2020-322425

No abstract available

Conflict of interest statement

Competing interests: None declared. Publication types

• Letter

Full-text links

38. Quality and Content of Online Patient Resources for Celiac Disease

Dig Dis Sci. 2020 Aug 20. doi: 10.1007/s10620-020-06537-3. Online ahead of print.

Authors

Alison Buseck 1 , Benjamin Lebwohl 1 , Peter H R Green 2

Affiliations

• 1 The Celiac Disease Center at Columbia University, 180 Fort Washington Avenue, Suite 936, New York, NY, 10032, USA. • 2 The Celiac Disease Center at Columbia University, 180 Fort Washington Avenue, Suite 936, New York, NY, 10032, USA. [email protected].

• PMID: 32816213 • DOI: 10.1007/s10620-020-06537-3

Abstract

Background and aims: Patient-directed information on celiac disease has been reported to be of variable quality. We assessed the quantity and quality of information on blogs and Web sites intended to inform the layperson of celiac disease information.

Methods: We performed a cross-sectional study analyzing celiac disease blogs and Web sites intended for the layperson. We searched from 20 cities, resulting in 55 Web sites. These sites were analyzed for 38 criteria that considered relevant clinical information for people with celiac disease. Claims were classified as true, false, or not proven. The readability level of each Web site was determined.

Results: The 55 Web sites were categorized as national organizations, personal blogs, recipe-based blogs, or commercial/marketing Web sites. Only 40% of Web sites contained more than 50% of criteria. Of 212 claims assessed, 97% were found to be accurate. National organizations included the most criteria, followed by recipe-based blogs, then personal blogs, and lastly commercial/marketing Web sites. Additionally, national organizations had the highest proportion of accurate claims, followed by personal blogs, then commercial/marketing Web sites, and recipe-based blogs with the most inaccurate information. The average readability level of overall was 9.7, above the recommended readability level for patient education materials.

Conclusions: A significant number of online claims regarding celiac disease were true, but the majority of patient-facing Web sites are missing large amounts of relevant information. This warrants efforts to improve the quality of medical information published online.

Keywords: Blog; Celiac disease; Comprehension.

Full-text links

39. Cooking and sensorial quality, nutritional composition and functional properties of cold-extruded rice/white bean gluten-free fettuccine fortified with whole carob fruit flour

Food Funct. 2020 Aug 20. doi: 10.1039/d0fo01470b. Online ahead of print.

Authors

Claudia Arribas 1 , Blanca Cabellos 1 , Eva Guillamón 2 , Mercedes M Pedrosa 1 Affiliations

• 1 Food Technology Department, SGIT-INIA, Ctra de La Coruña, Km 7.5, 28040 Madrid, Spain. [email protected]. • 2 Centre for the Food Quality, SGIT-INIA, C/Universidad s/n, 42004 Soria, Spain.

• PMID: 32815934 • DOI: 10.1039/d0fo01470b

Abstract

A different rice/white bean-based gluten-free fettuccine (rice 0-100%, bean 0- 100%) fortified with 10% carob fruit has been developed. The proximate composition, total and resistant starch, and total, soluble and insoluble dietary fibre content as well as the cooking and sensorial quality of uncooked and cooked pasta were determined. All the novel gluten-free fettuccine forms showed good cooking quality (cooking loss < 10%) highlighting that those containing the carob fruit had better nutritional and healthy profiles than the commercial gluten-free rice pasta; they were low in fat (10-fold) and high in protein (on average 3.6-fold) with resistant starch (16%) and dietary fibres (2.4-fold). The cooking process increased (p < 0.05) the protein and total dietary fibre content but reduced the total and resistant starch. The addition of carob fruit increased the total dietary fibre content, thus improving the functional value of fettuccine. Considering the sensorial analysis, fettuccine produced with 40% bean and 10% carob could be well accepted by consumers and can be advised as a functional food.

Full-text links

40. En mann i 50-årene med kronisk diaré og vekttap

Tidsskr Nor Laegeforen. 2020 Aug 14;140(11). doi: 10.4045/tidsskr.19.0812. Print 2020 Aug 18. [Article in Norwegian] Authors

Vikas Kumar Sarna, Johan Lunding, Else Marit Løberg, Inger Camilla Solberg

• PMID: 32815334 • DOI: 10.4045/tidsskr.19.0812

Free article Abstract

Background: Watery diarrhoea coupled with weight loss is a serious condition with many potential causes. We present a possibly underappreciated cause which usually responds well to treatment; left untreated it may have a severe course.

Case presentation: A man in his fifties with known coronary and cerebrovascular disease was admitted for watery diarrhoea. Prerenal kidney failure occurred on the same day as the initial colonoscopy. The next day he suffered a stroke. He was anticoagulated and recovered within days. In the following months his state of malabsorption continued, with ultimately 50 % weight loss (BMI 14.7) and severe electrolyte disturbances. Intravenous electrolyte solutions and nutrition were administered. Oedema and aphthous duodenal lesions were the only endoscopic findings. Microscopic findings of total villus atrophy in all sampled sites in the small intestine, including the ileum, were striking. There were inflammatory cells in lamina propria, apoptotic cells and disappearance of goblet cells. Coeliac disease was ruled out by serology and HLA typing.

Interpretation: A final diagnosis of autoimmune enteropathy was made, based on exclusion of other intestinal and systemic diseases. Treatment with infliximab intravenously and budesonide in an open capsule regime was successful.

Publication types

• English Abstract

Full-text links

41. Gluten and skin disease beyond dermatitis herpetiformis: a review

Int J Dermatol. 2020 Aug 18. doi: 10.1111/ijd.15098. Online ahead of print.

Authors

Suraj Muddasani 1 , Amanda M Rusk 2 , Katherine L Baquerizo Nole 2

Affiliations

• 1 College of Medicine, University of Cincinnati, Cincinnati, OH, USA. • 2 Department of Dermatology, University of Cincinnati, Cincinnati, OH, USA.

• PMID: 32810304 • DOI: 10.1111/ijd.15098

Abstract

Gluten, a protein found in wheat, rye, and barley, is known to cause an immune reaction in patients with celiac disease (CD) resulting in small bowel villous atrophy and impaired nutrient absorption and cutaneous manifestations in patients with dermatitis herpetiformis (DH). It is common that patients associate skin conditions with their diet, and the advantages of a gluten-free diet (GFD) are brought up frequently. Indeed, there is evidence that certain dermatologic conditions can respond to a GFD, especially for those with concomitant CD and DH. In the last decade, new data have become available on the significance of gluten in skin disease. Herein, we review the role of gluten and a GFD on various cutaneous diseases beyond DH.

• 50 references Publication types

• Review

Full-text links

42. Systematic review and meta-analysis of the effectiveness of pre-pregnancy care for women with diabetes for improving maternal and perinatal outcomes

PLoS One. 2020 Aug 18;15(8):e0237571. doi: 10.1371/journal.pone.0237571. eCollection 2020.

Authors

Hayfaa A Wahabi 1 2 , Amel Fayed 3 4 , Samia Esmaeil 1 , Hala Elmorshedy 3 4 , Maher A Titi 1 5 , Yasser S Amer 1 6 , Rasmieh A Alzeidan 7 , Abdulaziz A Alodhayani 2 , Elshazaly Saeed 8 , Khawater H Bahkali 9 , Melissa K Kahili-Heede 10 , Amr Jamal 1 2 , Yasser Sabr 11

Affiliations

• 1 Research Chair for Evidence-Based Healthcare and Knowledge Translation, King Saud University, Riyadh, Saudi Arabia. • 2 Department of Family and Community Medicine, King Saud University Medical City and College of Medicine, Riyadh, Saudi Arabia. • 3 College of Medicine, Clinical Department, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia. • 4 High Institute of Public Health, Alexandria University, Alexandria, Egypt. • 5 Patient Safety Unit, Quality Management Department, King Saud University Medical City, Riyadh, Saudi Arabia. • 6 Clinical Practice Guidelines Unit, Quality Management Department, King Saud University Medical City, Riyadh, Saudi Arabia. • 7 Cardiac Science Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia. • 8 Prince Abdulla bin Khaled Coeliac Disease Research Chair, King Saud University, Riyadh, Saudi Arabia. • 9 Saudi Center for Disease Prevention and Control, Riyadh, Saudi Arabia. • 10 John A. Burns School of Medicine, Health Sciences Library, University of Hawaii at Manoa, Honolulu, HI, United States of America. • 11 Department of Obstetrics and Gynecology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

• PMID: 32810195 • PMCID: PMC7433888 • DOI: 10.1371/journal.pone.0237571

Free PMC article Abstract

Background: Pre-gestational diabetes mellitus is associated with increased risk of maternal and perinatal adverse outcomes. This systematic review was conducted to evaluate the effectiveness and safety of pre-conception care (PCC) in improving maternal and perinatal outcomes.

Methods: Databases from MEDLINE, EMBASE, WEB OF SCIENCE, and Cochrane Library were searched, including the CENTRAL register of controlled trials, and CINHAL up until March 2019, without any language restrictions, for any pre- pregnancy care aiming at health promotion, glycemic control, and screening and treatment of diabetes complications in women with type I or type II pre- gestational diabetes. Trials and observational studies were included in the review. Newcastle-Ottawa scale and the Cochrane collaboration methodology for data synthesis and analysis were used, along with the GRADE tool to evaluate the body of evidence.

Results: The search identified 8500 potentially relevant citations of which 40 reports of 36 studies were included. The meta-analysis results show that PCC reduced congenital malformations risk by 71%, (Risk ratio (RR) 0.29; 95% CI: 0.21-0.40, 25 studies; 5903 women; high-certainty evidence). The results also show that PCC may lower HbA1c in the first trimester of pregnancy by an average of 1.27% (Mean difference (MD) 1.27; 95% CI: 1.33-1.22; 4927 women; 24 studies, moderate-certainty evidence). Furthermore, the results suggest that PCC may lead to a slight reduction in the risk of preterm delivery of 15%, (RR 0.85; 95% CI: 0.73-0.99; nine studies, 2414 women; moderate- certainty evidence). Moreover, PCC may result in risk reduction of perinatal mortality by 54%, (RR 0.46; 95% CI: 0.30-0.73; ten studies; 3071 women; moderate-certainty evidence). There is uncertainty about the effects of PCC on the early booking for antenatal care (MD 1.31; 95% CI: 1.40-1.23; five studies, 1081 women; very low-certainty evidence) and maternal hypoglycemia in the first trimester, (RR 1.38; 95% CI: 1.07-1.79; three studies; 686 women; very low- certainty evidence). In addition, results of the meta- analysis indicate that PCC may lead to 48% reduction in the risk of small for gestational age (SGA) (RR 0.52; 95% CI: 0.37-0.75; six studies, 2261 women; moderate-certainty evidence). PCC may reduce the risk of neonatal admission to intensive care unit (NICU) by 25% (RR 0.75; 95% CI: 0.67-0.84; four studies; 1322 women; moderate-certainty evidence). However, PCC may have little or no effect in reducing the cesarean section rate (RR 1.02; 95% CI: 0.96-1.07; 14 studies; 3641 women; low-certainty evidence); miscarriage rate (RR 0.86; 95% CI: 0.70-1.06; 11 studies; 2698 women; low-certainty evidence); macrosomia rate (RR 1.06; 95% CI: 0.97-1.15; nine studies; 2787 women, low-certainty evidence); neonatal hypoglycemia (RR 0.93; 95% CI: 0.74-1.18; five studies; 880 women; low-certainty evidence); respiratory distress syndrome (RR 0.78; 95% CI: 0.47-1.29; four studies; 466 women; very low-certainty evidence); or shoulder dystocia (RR 0.28; 95% CI: 0.07-1.12; 2 studies; 530 women; very low-certainty evidence).

Conclusion: PCC for women with pre-gestational type 1 or type 2 diabetes mellitus is effective in improving rates of congenital malformations. In addition, it may improve the risk of preterm delivery and admission to NICU. PCC probably reduces maternal HbA1C in the first trimester of pregnancy, perinatal mortality and SGA. There is uncertainty regarding the effects of PCC on early booking for antenatal care or maternal hypoglycemia during the first trimester of pregnancy. PCC has little or no effect on other maternal and perinatal outcomes.

Conflict of interest statement

The authors have declared that no competing interests exist.

• 95 references • 10 figures Grant support

This study was funded by the Deanship of Scientific Research, at Princess Nourah Bint Abdulrahman University through the fast track programme. The funder had no role in study design, data collection, data analysis, decision to publish or preparation of the manuscript.

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43. The Risk of Acute and Chronic Pancreatitis in Celiac Disease

Dig Dis Sci. 2020 Aug 18. doi: 10.1007/s10620-020-06546-2. Online ahead of print.

Authors

Motasem Alkhayyat 1 2 , Mohannad Abou Saleh 1 3 , Mohammad Abureesh 4 , George Khoudari 1 , Thabet Qapaja 1 , Emad Mansoor 5 , C Roberto Simons-Linares 1 , John Vargo 1 , Tyler Stevens 1 , Alberto Rubio-Tapia 1 , Prabhleen Chahal 6 7

Affiliations

• 1 Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA. • 2 Department of Internal Medicine, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA. • 3 Gastroenterology, Hepatology and Nutrition, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue/A30, Cleveland, OH, 44195, USA. • 4 Staten Island University Hospital, 475 Seaview Ave, Staten Island, NY, 10305, USA. • 5 University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH, 44106, USA. • 6 Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA. [email protected]. • 7 Gastroenterology, Hepatology and Nutrition, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA. [email protected].

• PMID: 32809104 • DOI: 10.1007/s10620-020-06546-2

Abstract

Background and aims: Celiac disease (CD) is a chronic immune-mediated enteropathy that is precipitated by dietary gluten in genetically predisposed individuals. A few studies reported a higher incidence of pancreatitis in the CD population. Using a large US database, we sought to describe the epidemiology, risk, and outcomes of acute pancreatitis (AP) and chronic pancreatitis (CP) in CD patients.

Methods: We queried a multiple health system data analytics and research platform (Explorys Inc, Cleveland, OH, USA). A cohort of patients with a diagnosis of CD was identified. Subsequently, individuals who developed a new diagnosis of AP and CP after at least 30 days of being diagnosed with CD were identified. A multivariate regression model was performed to adjust for multiple confounding factors.

Results: Of the 72,965,940 individuals in the database, 133,400 (0.18%), 362,050 (0.50%), and 95,190 (0.13%) had CD, AP, and CP, respectively. New diagnosis of AP and CP after at least 30 days of CD diagnosis was 1.06%, 0.52%, respectively, compared to non-CD patients with 0.49% for AP and 0.13% for CP, P < .0001. In multivariate regression analysis, patients with CD were at higher risk of developing AP [OR 2.66; 95% CI 2.55-2.77] and CP [OR 2.18; 95% CI 2.04-2.34]. Idiopathic AP was the most common etiology among CD patients [OR 1.54; 95% CI 1.34-1.77].

Conclusions: In this largest US population database and after adjusting for several confounders, patients with CD were at increased risk of developing AP and CP. Celiac disease patients had worse outcomes and higher medical burden compared to non-CD patients. Recurrent abdominal pain that suggests pancreatic etiology, idiopathic pancreatitis, or elevation of pancreatic enzymes should warrant investigation for CD as a potential cause of pancreatic disease. Keywords: Celiac disease; Epidemiology; Pancreatitis; Risk factors.

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44. Assessment of disease severity on capsule endoscopy in patients with small bowel villous atrophy

J Gastroenterol Hepatol. 2020 Aug 17. doi: 10.1111/jgh.15217. Online ahead of print.

Authors

Stefania Chetcuti Zammit 1 , Mark E McAlindon 1 , David S Sanders 1 , Reena Sidhu 1

Affiliation

• 1 Gastroenterology Department, Sheffield Teaching Hospitals, United Kingdom.

• PMID: 32808308 • DOI: 10.1111/jgh.15217

Abstract

Background: There is a lack of uniformity of reporting on features of celiac disease (CD) on small bowel capsule endoscopy (SBCE). This makes determining extent of disease and comparison of severity of disease challenging.

Methodology: De-identified SBCEs of 300 patients (78 CD (26%), 18 serology negative villous atrophy (SNVA) (6%), 204 controls with normal duodenal histology (68%)) were included. Videos were reviewed by 2 experts. All patients had duodenal histology taken within 2 weeks of SBCE. The degree of agreement in CD features and extent of disease was then determined. The resulting score for each factor was used to determine overall severity of disease.

Results: There was substantial agreement in the kappa co-efficient for the detection of CD features between reviewers (0.67). Agreement for extent of affected small bowel (SB) mucosa was high (0.97). On multiple regression analysis several features of CD correlated with extent of affected SB mucosa for both reviewers. The odds ratios derived from this analysis were then used to score features of CD, enabling scores of severity to be calculated for each patient. The median overall scores for patients increased significantly according to the independent classification of severity by the capsule reviewers: mild (20, 0-79), moderate (45, 25-123), severe (89, 65-130) (p=0.0001).

Conclusion: The good correlation of CD scores between expert reviewers confirms the validity of features of CD on SBCE. An objective score of CD features in the SB is useful in the follow up of patients with CD and SNVA.

Keywords: celiac disease; serology negative villous atrophy; severity score; small bowel capsule endoscopy.

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45. Effect of common medications on the expression of SARS-CoV-2 entry receptors in liver tissue

Arch Toxicol. 2020 Aug 17;1-5. doi: 10.1007/s00204-020-02869-1. Online ahead of print.

Authors Narjes Saheb Sharif-Askari 1 , Fatemeh Saheb Sharif-Askari 1 , Bushra Mdkhana 1 , Saba Al Heialy 2 3 , Elaref Ratemi 4 , Malak Alghamdi 5 , Salah Abusnana 6 7 , Tarek Kashour 8 , Qutayba Hamid 1 6 3 , Rabih Halwani 9 10 11

Affiliations

• 1 College of Medicine, Sharjah Institute of Medical Research, University of Sharjah, P.O. Box 27272, Sharjah, United Arab Emirates. • 2 College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates. • 3 Meakins-Christie Laboratories, Research Institute of the McGill University Healthy Center, McGill University, Montreal, QC, Canada. • 4 Department of Chemical and Process Engineering Technology, Jubail Industrial College, Jubail Industrial City, Al Jubail, Saudi Arabia. • 5 Department of Pediatrics, Medical Genetic Division, College of Medicine, King Saud University, Riyadh, Saudi Arabia. • 6 Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates. • 7 Diabetes and Endocrinology Department, University Hospital Sharjah, Sharjah, United Arab Emirates. • 8 Department of Cardiology, King Fahad Cardiac Center, King Saud University Medical City, Riyadh, Saudi Arabia. • 9 College of Medicine, Sharjah Institute of Medical Research, University of Sharjah, P.O. Box 27272, Sharjah, United Arab Emirates. [email protected]. • 10 Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates. [email protected]. • 11 Prince Abdullah Ben Khaled Celiac Disease Research Chair, Department of pediatrics, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia. [email protected].

• PMID: 32808185 • PMCID: PMC7430937 • DOI: 10.1007/s00204-020-02869-1

Free PMC article Abstract

Besides lung drastic involvement, SARS-CoV-2 severely affected other systems including liver. Emerging epidemiological studies brought the attentions towards liver injury and impairment as a potential outcome of COVID19. Angiotensin-converting enzyme 2 (ACE2) and Transmembrane serine protease (TMPRSS2) are the main cell entry receptors of SARS-CoV-2. We have tested the ability of medications to regulate expression of SARS-CoV-2 receptors. Understanding that may reflect how such medications may affect the level of infectivity and permissibility of the liver following COVID-19. Using transcriptomic datasets, Toxicogenomic Project-Genomics Assisted Toxicity Evaluation System (Open TG-GATEs) and GSE30351, we have tested the ability of ninety common medications to regulate COVID-19 receptors expression in human primary hepatocytes. Most medications displayed a dose-dependent change in expression of receptors which could hint at a potentially more pronounced change with chronic use. The expression level of TMPRSS2 was increased noticeably with a number of medications such as metformin. Within the analgesics, acetaminophen revealed a dose-dependent reduction in expression of ACE2, while non-steroidal anti-inflammatory drugs had mixed effect on receptors expression. To confirm the observed effects on primary human hepatocytes, rat hepatocyte treatments data was obtained from DrugMatrix toxicogenomic database (GSE57805), which showed a similar ACE2 and TMPRSS2 expression pattern. Treatment of common co-morbidities often require chronic use of multiple medications, which may result in an additive increase in the expression of ACE2 and TMPRSS2. More research is needed to determine the effect of different medications on COVID-19 receptors.

Keywords: ACE2; Acetaminophen; COVID-19; Hepatocyte; Liver; Medications; Metformin; Nsaids; SARS-CoV-2; TMPRSS2.

Conflict of interest statement

The authors have no conflicts of interest to declare.

• 26 references • 2 figures

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46. Potential ways for gluten contamination of gluten-free grain and gluten-free foods: the buckwheat case

Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2020 Aug 17;1-10. doi: 10.1080/19440049.2020.1787529. Online ahead of print.

Authors

Guler Atasoy 1 , Bilge Ulutas 1 , Mahir Turhan 1

Affiliation

• 1 Department of Food Engineering, University of Mersin , Mersin, Turkey.

• PMID: 32805193 • DOI: 10.1080/19440049.2020.1787529

Abstract

Buckwheat has been reported to be responsible for gluten contamination in manufactured gluten-free foods (mGFFs) although it is inherently gluten-free (GF). It could happen through buckwheat grains contacting gluten-containing (GC) grains and surfaces contacted by GC grains during pre-manufacturing practices. To simulate grain contact, whole and broken GC grains (wheat, rye, barley, and oat) were mixed into buckwheat grains at the ratio of 2.5-10.0%. Grains were agitated in vessels with inner surfaces covered with buckwheat grain. Gluten was not detected in buckwheat grains contacting whole GC grains at all mixing ratios. It was not detected in the case of broken GC grains at the mixing ratio of 2.5% and oat grains at all mixing ratios. Gluten concentration increased with the increasing mixing ratio and the natural gluten concentration of broken GC grains. To simulate surface contact, GC grains were first agitated in galvanised steel vessels and then buckwheat grains were agitated together under the same conditions. Gluten was detected on galvanised steel surfaces contacted by whole and broken GC grains. It was not detected in buckwheat grains contacting the surfaces contaminated by whole GC grains. Gluten was detected in buckwheat grain in the case of the broken GC grains except for oats. Gluten concentrations increased with increasing natural gluten concentration of GC grains. Contamination of mGFFs could be linked to potential contact with buckwheat grain. This contamination issue could be resolved through regulations mandating the proof of being GF for ingredients used in the production of mGFFs.

Keywords: Gluten contamination; buckwheat; coeliac; gluten-free food; gluten-free grains.

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47. Risk of COVID-19 in celiac disease patients

Autoimmun Rev. 2020 Aug 13;102639. doi: 10.1016/j.autrev.2020.102639. Online ahead of print.

Authors

Fabiana Zingone 1 , Anna D'Odorico 2 , Greta Lorenzon 2 , Ilaria Marsilio 2 , Fabio Farinati 2 , Edoardo Vincenzo Savarino 2

Affiliations

• 1 Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy. Electronic address: [email protected]. • 2 Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.

• PMID: 32801048 • PMCID: PMC7423569 • DOI: 10.1016/j.autrev.2020.102639

Free PMC article No abstract available Conflict of interest statement

Declaration of Competing Interest None.

• 5 references

Publication types

• Letter

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48. Psychiatric disorders in patients with a diagnosis of celiac disease during childhood from 1973 to 2016

Clin Gastroenterol Hepatol. 2020 Aug 12;S1542-3565(20)31127-7. doi: 10.1016/j.cgh.2020.08.018. Online ahead of print.

Authors

Benjamin Lebwohl 1 , Linnea Haggård 2 , Louise Emilsson 3 , Jonas Söderling 2 , Bjorn Roelstraete 2 , Agnieszka Butwicka 4 , Peter Hr Green 5 , Jonas F Ludvigsson 6

Affiliations

• 1 Celiac Disease Center, Department of Medicine, Columbia University Medical Center, New York NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York NY, USA. • 2 Department Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. • 3 Department Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of general practice, Institute of Health and Society, University of Oslo, Oslo, Norway; Vårdcentralen Årjäng and Centre for Clinical Research, County Council of Värmland, Värmland, Sweden; Faculty of Medicine and Health, Örebro University, SE 701 82, Örebro, Sweden. • 4 Department Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Child and Adolescent Psychiatry Stockholm, Stockholm Health Care Services, Region Stockholm, Sweden; Department of Child Psychiatry, Medical University of Warsaw, Warsaw, Poland. • 5 Celiac Disease Center, Department of Medicine, Columbia University Medical Center, New York NY, USA. • 6 Celiac Disease Center, Department of Medicine, Columbia University Medical Center, New York NY, USA; Department Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Pediatrics, Örebro University Hospital, Örebro University, Örebro, Sweden. Electronic address: [email protected].

• PMID: 32801012 • DOI: 10.1016/j.cgh.2020.08.018

Abstract

Background & aims: Few studies have explored the link between childhood celiac disease and long-term psychiatric comorbidities. We performed a population-based cohort study of associations between childhood celiac disease and psychiatric disorders and investigated whether risk persists into adulthood.

Methods: We performed a nationwide study in Sweden using data from the ESPRESSO cohort. In this cohort, 19,186 children with a diagnosis of biopsy- verified celiac disease from 1973 through 2016 were identified from Sweden's 28 pathology departments. Each patient was matched with as many as 5 reference children (controls, n=94,249). Data on psychiatric disorders were obtained from the patient register. We used Cox proportional modeling to estimate hazard ratios (HRs).

Results: During a median follow-up time of 12.3 years, 3174 children (16.5%) with celiac disease received a new diagnosis of a psychiatric disorder, compared with 13,286 controls (14.1%). Corresponding incidence rates were 12.2 per 1000 person-years (95% Cl, 11.8-12.7) vs 10.3 per 1000 person-years (95% Cl, 10.2-10.5). Childhood celiac disease was associated with a 19% increase in risk of any psychiatric disorder (95% Cl, 1.14-1.23); the increase in risk was observed in all childhood age groups. The highest HRs were seen in the first year after celiac diagnosis (HR, 1.70; 95% Cl, 1.41-2.05). The risk increase persisted into adulthood (older than 18 years: HR, 1.11; 95% Cl, 1.04- 1.17). We found increased risks of mood disorders (HR, 1.20; 95% CI, 1.12- 1.28), anxiety disorders (HR, 1.12; 95% CI, 1.06-1.19), eating disorders (HR, 1.34; 95% CI, 1.18-1.51), attention deficit hyperactivity disorder (HR, 1.29; 95% CI, 1.20-1.39), and autism spectrum disorder (HR, 1.47; 95% CI, 1.32-1.64). We found no statistically significant risk increase for psychotic disorders, psychoactive substance misuse, behavioral disorders, personality disorders, suicide attempt, or suicide. Celiac disease was also linked to an increased use of psychiatric drugs (HR, 1.34; 95% CI, 1.24-1.43). A conditional logistic regression found that psychiatric disorders were also more common prior to diagnosis of celiac disease (odds ratio, 1.56; 95% Cl, 1.39-1.76).

Conclusions: Childhood celiac disease is associated with increased risk of subsequent psychiatric disorders, which persists into adulthood. Mental health surveillance should be integral in the care of celiac disease.

Keywords: ADHD; comorbidity; depression; epidemiology; psychiatry.

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49. Effect of Common Medications on the Expression of SARS-CoV-2 Entry Receptors in Kidney Tissue

Clin Transl Sci. 2020 Aug 16. doi: 10.1111/cts.12862. Online ahead of print.

Authors

Narjes Saheb Sharif-Askari 1 , Fatemeh Saheb Sharif-Askari 1 , Mashael Alabed 1 , Ahmad Abou Tayoun 2 3 , Tom Loney 3 , Mohammed Uddin 3 , Abiola Senok 3 , Saba Al Heialy 3 4 , Rifat Hamoudi 1 5 , Tarek Kashour 6 , Alawi Alsheikh-Ali 3 , Qutayba Hamid 1 4 5 , Rabih Halwani 1 5 7 Affiliations

• 1 Sharjah Institute of Medical Research, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates. • 2 Al Jalila Genomics Center, Al Jalila Children's Hospital, Dubai, United Arab Emirates. • 3 College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates. • 4 Meakins-Christie Laboratories, Research Institute of the McGill University Healthy Center, McGill University, Montreal, Quebec, Canada. • 5 Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates. • 6 Department of Cardiology, King Fahad Cardiac Center, King Saud University Medical City, Riyadh, Saudi Arabia. • 7 Prince Abdullah Ben Khaled Celiac Disease Research Chair, Department of Pediatrics, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia.

• PMID: 32799423 • DOI: 10.1111/cts.12862

Abstract

Besides the respiratory system, severe acute respiratory syndrome- coronavirus 2 (SARS-CoV-2) infection was shown to affect other essential organs such as the kidneys. Early kidney involvement during the course of infection was associated with worse outcomes, which could be attributed to the direct SARS-CoV-2 infection of kidney cells. In this study, the effect of commonly used medications on the expression of SARS-CoV-2 receptor, angiotensin-converting enzyme (ACE)2, and TMPRSS2 protein in kidney tissues was evaluated. This was done by in silico analyses of publicly available transcriptomic databases of kidney tissues of rats treated with multiple doses of commonly used medications. Of 59 tested medications, 56% modified ACE2 expression, whereas 24% modified TMPRSS2 expression. ACE2 was increased with only a few of the tested medication groups, namely the renin-angiotensin inhibitors, such as enalapril, antibacterial agents, such as nitrofurantoin, and the proton pump inhibitor, omeprazole. The majority of the other medications decreased ACE2 expression to variable degrees with allopurinol and cisplatin causing the most noticeable downregulation. The expression level of TMPRSS2 was increased with a number of medications, such as diclofenac, furosemide, and dexamethasone, whereas other medications, such as allopurinol, suppressed the expression of this gene. The prolonged exposure to combinations of these medications could regulate the expression of ACE2 and TMPRSS2 in a way that may affect kidney susceptibility to SARS-CoV-2 infection. Data presented here suggest that we should be vigilant about the potential effects of commonly used medications on kidney tissue expression of ACE2 and TMPRSS2.

• 26 references

Grant support

• 150317/Tissue Injury and Repair (TIR) • University of Sharjah, UAE • King Saud University

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50. Prevalence of nutritional disorders in Saudi children with inflammatory bowel disease based on the national growth reference

Arab J Gastroenterol. 2020 Aug 11;S1687-1979(20)30073-3. doi: 10.1016/j.ajg.2020.07.002. Online ahead of print.

Authors

Mohammad El Mouzan 1 , Najat Alahmadi 2 , Khalid A ALSaleeem 3 , Asaad Assiri 4 , Badr AlSaleem 5 , Ahmed Al Sarkhy 6 Affiliations

• 1 Department of Paediatrics, Gastroenterology Unit, Head Paediatric IBD Research Group, King Saud University, Riyadh, Saudi Arabia. Electronic address: [email protected]. • 2 Maternity & Children Hospital, Ministry of Health. Almadina Almonawarh, Saudi Arabia. • 3 Department of Paediatrics, Head Section of Paediatric Gastroenterology, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia. Electronic address: [email protected]. • 4 Department of Paediatrics and Prince Abdullah Bin Khalid Coeliac Disease Research Chair, King Saud University. Riyadh, Saudi Arabia. • 5 Division of Gastroenterology, The Children Hospital, King Fahad Medical City, Riyadh, Saudi Arabia. Electronic address: [email protected]. • 6 Department of Paediatrics, Gastroenterology Unit, Head Paediatric IBD Research Group, King Saud University, Riyadh, Saudi Arabia.

• PMID: 32798189 • DOI: 10.1016/j.ajg.2020.07.002

Abstract

Background and study aim: The prevalence of nutritional disorders in Saudi children with inflammatory bowel diseases (IBDs) has been reported using the World Health Organization (WHO) reference. Our aim was to provide more accurate definition of the prevalence of nutritional impairment in Saudi children with IBDs based on the national growth reference and to demonstrate the effect of using a reference from other populations on the prevalence rates.

Patients and methods: Weight, height, and body mass index data, from the multicenter study of IBDs in Saudi children and adolescents, were plotted on the new Saudi national growth reference. Statistical analyses included frequency calculations and z-test for proportions to investigate the significance of the difference in prevalence. A p-value of < 0.05 was considered significant. Results: Among a total of 374 patients, 119 (32%) had ulcerative colitis (UC) and 255 (68%) had Crohn's disease (CD). Compared with the WHO reference, the Saudi national reference produced a significantly lower prevalence of thinness in patients with UC (24% vs. 8%, p = 0.001), CD (35% vs. 20%, p = 0.002), and of short stature in patients with CD (28% vs. 11%, p < 0.001). The difference in the prevalence of overweight was not significant.

Conclusions: We provide more accurate prevalence estimate of nutritional disorders in Saudi children with IBDs based on national reference. The use of the WHO reference overestimated the prevalence of thinness and short stature in Saudi children. Prevalence estimates based on references from other populations should be interpreted with caution.

Keywords: Crohn’s disease; Nutritional disorder; Saudi children; Ulcerative colitis.

Conflict of interest statement

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51. Functional Dyspepsia and Food: Immune Overlap with Food Sensitivity Disorders

Curr Gastroenterol Rep. 2020 Aug 14;22(10):51. doi: 10.1007/s11894-020- 00789-9.

Authors

Jennifer Pryor 1 2 3 , Grace L Burns 1 2 3 , Kerith Duncanson 2 3 4 , Jay C Horvat 1 3 , Marjorie M Walker 2 3 4 , Nicholas J Talley 2 3 4 , Simon Keely 5 6 7 Affiliations

• 1 School of Biomedical Sciences & Pharmacy, Faculty of Health & Medicine, University of Newcastle, Newcastle, NSW, Australia. • 2 Priority Research Centre for Digestive Health and Neurogastroenterology, University of Newcastle, Newcastle, NSW, Australia. • 3 Hunter Medical Research Institute, New Lambton Heights, NSW, Australia. • 4 School of Medicine and Public Health, Faculty of Health & Medicine, University of Newcastle, Newcastle, NSW, Australia. • 5 School of Biomedical Sciences & Pharmacy, Faculty of Health & Medicine, University of Newcastle, Newcastle, NSW, Australia. [email protected]. • 6 Priority Research Centre for Digestive Health and Neurogastroenterology, University of Newcastle, Newcastle, NSW, Australia. [email protected]. • 7 Hunter Medical Research Institute, New Lambton Heights, NSW, Australia. [email protected].

• PMID: 32797313 • DOI: 10.1007/s11894-020-00789-9

Abstract

Purpose of review: Functional dyspepsia (FD) is a chronic functional gastrointestinal disorder characterised by upper gastrointestinal symptoms. Here, we aimed to examine the evidence for immune responses to food in FD and overlap with food hypersensitivity conditions.

Recent findings: A feature of FD in a subset of patients is an increase in mucosal eosinophils, mast cells, intraepithelial cytotoxic T cells and systemic gut-homing T cells in the duodenum, suggesting that immune dysfunction is characteristic of this disease. Rates of self-reported non-celiac wheat/gluten sensitivity (NCW/GS) are higher in FD patients. FD patients commonly report worsening symptoms following consumption of wheat, fermentable oligosaccharides, disaccharides, monosaccharides, or polyols (FODMAPs), high-fat foods and spicy foods containing capsaicin. Particularly, wheat proteins and fructan in wheat may drive symptoms. Immune mechanisms that drive responses to food in FD are still poorly characterised but share key effector cells to common food hypersensitivities including non-IgE-mediated food allergy and eosinophilic oesophagitis.

Keywords: Diet; Duodenum; FODMAPs; Food allergy; Functional dyspepsia; Non-celiac wheat sensitivity.

Publication types

• Review

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52. Endocannabinoid System and Bone Loss in Celiac Disease: Towards a Demanding Research Agenda

J Pediatr Gastroenterol Nutr. 2020 Aug 10. doi: 10.1097/MPG.0000000000002887. Online ahead of print.

Authors

Caterina Mengoli 1 , Michele Di Stefano

Affiliation

• 1 1st Internal Medicine Unit, IRCCS S.Matteo Hospital Foundation, Pavia, Italy.

• PMID: 32796436 • DOI: 10.1097/MPG.0000000000002887

No abstract available

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53. Give Gluten a Chance! Time to Schedule Gluten Re-introduction in Celiac Patients on a Long-term Gluten-Free Diet?

J Pediatr Gastroenterol Nutr. 2020 Aug 10. doi: 10.1097/MPG.0000000000002898. Online ahead of print.

Authors

Luca Elli 1 2 , Lorenzo Norsa 3 , Leda Roncoroni 1 4 , Maurizio Vecchi 1 2

Affiliations

• 1 Center for Prevention and Diagnosis of Celaic Diseaes- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. • 2 Department of pathophisiology and transplantation, University of Milano, Milano, Italy. • 3 Pediatric Hepatology Gastroenterology and Transplantation Unit, ASST "Papa Giovanni XXIII", Bergamo, Italy. • 4 Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.

• PMID: 32796435 • DOI: 10.1097/MPG.0000000000002898

No abstract available

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54. The Role of Cannabinoid Receptor Type 2 in the Bone Loss Associated with pediatric Celiac Disease J Pediatr Gastroenterol Nutr. 2020 Aug 10. doi: 10.1097/MPG.0000000000002863. Online ahead of print.

Authors

Chiara Tortora 1 , Francesca Punzo 1 , Maura Argenziano 2 , Alessandra Di Paola 2 , Carlo Tolone 1 , Caterina Strisciuglio 1 , Francesca Rossi 1

Affiliations

• 1 Department of Woman, Child and General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Via L. De Crecchio 4, 80138, Napoli. • 2 Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via S. Maria di Costantinopoli 16, 80138, Napoli.

• PMID: 32796429 • DOI: 10.1097/MPG.0000000000002863

Abstract

Objectives: In this study we investigated the role of the Cannabinoid Receptor type 2 (CB2) in the bone loss associated with Celiac Disease (CD) evaluating the effect of its pharmacological modulation on osteoclast activity. We previously demonstrated a significant association between the CB2 Q63R variant and CD, suggesting it as a possible disease biomarker. Moreover, CB2 stimulation is beneficial for reducing osteoclast activity in several bone pathologic conditions.

Methods: in vitro osteoclasts (OCs) were differentiated from peripheral blood mononuclear cells of healthy donors, CD children at diagnosis and after one year of gluten free diet (GFD) and characterized by Real Time PCR and Western Blot for the expression of CB2 and specific osteoclastic markers, TRAP and Cathepsin K. TRAP assay and Bone Resorption assay were performed to evaluate osteoclast activity before and after 48 h exposure to CB2 selective drugs (JWH-133 and AM630) and Vitamin D.

Results: We found in CD patients an osteoclast hyper-activation and low levels of CB2. CB2 stimulation with JWH-133 agonist is more effective than Vitamin D in reducing osteoclast activity while CB2 blockade with AM630 increases osteoclast activation. The anti-osteoporotic effect of JWH-133 decreases when used in co-treatment with vitamin D. GFD reduces osteoclast activity without restore CB2 expression.

Conclusions: CB2 could be a molecular marker to predict the risk of bone alterations in CD and a pharmacological target to reduce bone mass loss in patients who need a direct intervention on bone metabolism, in addition to the GFD.

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55. Pentafurcated celiac trunk

Ann Vasc Surg. 2020 Aug 11;S0890-5096(20)30656-7. doi: 10.1016/j.avsg.2020.08.007. Online ahead of print.

Authors

Mugurel Constantin Rusu 1 , Bogdan Adrian Manta 2

Affiliations

• 1 Division of Anatomy, Department 1, Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania. Electronic address: [email protected]. • 2 Division of Anatomy, Department 1, Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.

• PMID: 32795653 • DOI: 10.1016/j.avsg.2020.08.007

Abstract

Background: Commonly, but not exclusively, the celiac trunk (CT) trifurcates into the left gastric (LGA), common hepatic (CHA) and splenic (SA) arteries. Additional branches of the CT are scarcely reported in the literature. Less than ten reports were found presenting patterns of pentafurcation of the CT (pCT), all being resulted after anatomic dissections.

Method: We hereby report such a rare pCT, which was found on the computed tomography angiograms of a 71 years old female patient.

Results: From that CT were leaving three collateral branches, two ascending and one descending, and two terminal branches. The ascending ones were the left inferior phrenic artery and a secondary hepatogastric trunk, further divided into a replaced left hepatic artery and the left gastric artery. The dorsal pancreatic artery was the descending collateral branch of the pCT. The pCT ended by dividing into the CHA and SA. The CHA reached the anterior side of the portal vein to divide into the gastroduodenal and right hepatic arteries. An accessory right hepatic artery left the superior mesenteric artery (SMA) and ascended posterior to the portal vein.

Conclusions: To the authors' knowledge, the combination of a pCT and a hepatic branch from the SMA, which raises to three the main arteries of the liver, was not reported previously. Additional branches of the CT should be carefully documented by computed tomography prior to surgical or interventional approaches of the aorta in the celiac region.

Keywords: aorta; computed tomography; dorsal pancreatic artery; hepatic artery; portal vein; splenic artery; superior mesenteric artery.

Publication types

• Case Reports

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56. Immediate Hypersensitivity Reactions

Review In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan. 2020 Aug 16. Authors

Angel A. Justiz Vaillant 1 , Rishik Vashisht 2 , Patrick M. Zito 3

Affiliations

• 1 University of the West Indies • 2 Cleveland Clinic • 3 Walden University

• PMID: 30020687 • NBK513315

Free Books & Documents Excerpt

Hypersensitivity reactions (HR) are immune responses that are exaggerated or inappropriate against an antigen or allergen. Coombs and Gell classified hypersensitivity reactions into four forms. Type I, type II, and type III hypersensitivity reactions are known as immediate hypersensitivity reactions (IHR) because occur within 24 hours. Antibodies including IgE, IgM, and IgG mediate them. Type I or Anaphylactic Response Anaphylactic Responseis mediated by IgE antibodies that are produced by the immune system in response to environmental proteins (allergens) such as pollens, animal danders or dust mites. These antibodies (IgE) bind to mast cells and basophils, which contain histamine granules that are released in the reaction and cause inflammation. Type I hypersensitivity reactions can be seen in bronchial asthma, allergic rhinitis, allergic dermatitis, food allergy, allergic conjunctivitis, and anaphylactic shock. Anaphylaxis Anaphylaxis is a medical emergency because can lead to an acute, life-threatening respiratory failure. It is an IgE- mediated process. It is the most severe form of an allergic reaction, where mast cells suddenly release a large amount of histamine and later on leukotrienes. In severe cases intense bronchospasm, laryngeal edema, cyanosis, hypotension, and shock are present. Allergic bronchial asthma Allergic bronchial asthma is an atopic disease, characterized by bronchospasm. It may also be a chronic inflammatory disease. In its etiology, and environmental factors along with a genetic background play an important role. The diagnosis is dependent on history and examination. In allergic bronchial asthma, IgE is elevated, and sputum eosinophilia is common. Epidemiologically, a positive skin prick test or specific IgE are risk factors for asthma. Allergic rhinitis Allergic rhinitis is another atopic disease where histamine and leukotrienes are responsible for rhinorrhea, sneezing and nasal obstruction. Allergens are similar to those found in bronchial asthma. Nasal polyps may be seen in chronic rhinitis. Allergic conjunctivitis Allergic conjunctivitis presents with rhinitis and is IgE-mediated. Itching and eye problems including watering, redness, and swelling always occur. Food allergy One must differentiate food allergy (IgE-mediated) from food intolerance that can be cause for a variety of etiology including malabsorption and celiac disease. It is more frequent in children as seen in cow's milk allergy. Food allergy symptoms mostly affect the respiratory tract, the skin, and the gut. Skin prick tests are helpful to test for food allergens that can trigger severe reactions, e.g., peanuts, eggs, fish, and milk. Atopic eczema Atopic eczema is an IgE-mediated disease that affects the skin and has an immunopathogenesis very similar to that of allergic asthma and allergic rhinitis, which are present in more than half of the diseased. Radioallergosorbent (RAST) may reveal the specificity of the IgE antibody involved but has little help in management. Drug allergy Drugs may cause allergic reactions by any mechanism of hypersensitivity. For example, penicillin may cause anaphylaxis, which is IgE- mediated but must responses be trivial. Penicillin cross-reacts with other semisynthetic penicillins including monobactams and carbapenems and may also cross-react with other antibiotics such as cephalosporins. Type II or Cytotoxic-Mediated Response IgG and IgM mediate cytotoxic-mediated response against cell surface and extracellular matrix proteins. The immunoglobulins involved in this type of reaction damages cells by activating the complement system or by phagocytosis. Type II hypersensitivity reactions can be seen in immune thrombocytopenia, autoimmune hemolytic anemia, and autoimmune neutropenia. Immune thrombocytopenia (ITP) ITP is an autoimmune disorder that occurs at any age. Phagocytes destroy sensitized platelets in the peripheral blood. Clinically, it manifests by thrombocytopenia with shortened platelet survival and increased marrow megakaryocytes. Sudden onset of petechiae and bleeding from the gums, nose, bowel, and urinary tract occurs. Bleeding can accompany infections, drug reactions, malignancy and other autoimmune disorders such as thyroid disease and SLE. Autoimmune hemolytic anemia (AIHA) There are two types of immune hemolytic anemia: IgG-mediated (warm AIHA) and IgM-mediated (cold AIHA). The warm type may be idiopathic autoimmune or secondary to other diseases such as malignancy affecting the lymphoid tissues. The cold type may be idiopathic or secondary to infections such as Epstein-Barr virus. The primary clinical sign of the two is jaundice. The laboratory diagnosis is made by a positive Coombs test, which identifies immunoglobulins and C3 on red blood cells. Autoimmune neutropenia Autoimmune neutropenia may be present with bacterial and fungal infections, or it may occur alone or with autoimmune diseases (SLE, RA, autoimmune hepatitis), infections and lymphoma. Bone marrow examination is needed if neutropenia is severe. For associated autoimmune disorders, an autoimmune antibody panel is necessary (ANA, ENA, and dsDNA). Hemolytic disease of the fetus and the newborn (erythroblastosis fetalis) The maternal immune system suffers an initial sensitization to the fetal Rh+ red blood cells during birth, when the placenta tears away. The first child escapes disease but the mother, now sensitized, will be capable of causing a hemolytic reaction against a second Rh+ fetus, which develops anemia and jaundice once the maternal IgG crosses the placenta. Myasthenia gravis is an autoimmune disorder caused by antibodies to post- synaptic acetylcholine receptors that interfere with the neuromuscular transmission. It is characterized by extreme muscular fatigue, double vision, bilateral ptosis, deconjugate eye movements, difficulty swallowing, and weakness in upper arms. Babies born to myasthenic mothers can have transient muscle weakness due to pathogenic IgG antibodies that cross the placenta. Goodpasture syndrome Goodpasture syndrome is a type II hypersensitivity reaction characterized by the presence of nephritis in association with lung hemorrhage. In most patients, it is caused by cross- reactive autoantigens that are present in the basement membranes of the lung and kidney. A number of patients with this problem exhibit antibodies to collagen type IV, which is an important component of basement membranes. Pemphigus Pemphigus causes a severe blistering disease that affects the skin and mucous membranes. The sera of patients with pemphigus have antibodies against desmoglein-1 and desmoglein-3, which are components of desmosomes, which form junctions between epidermal cells. Pemphigus is strongly linked to HLA-DR4 (DRB1*0402), which is a molecule that presents one of the autoantigens involved in the immunopathogenesis of this disease (desmoglein-3). Type III or Immunocomplex Reactions These are also mediated by IgM and IgG antibodies that react with soluble antigens forming antigen-antibody complexes. The complement system becomes activated and releases chemotactic agents that attract neutrophils and cause inflammation and tissue damage as seen in vasculitis and glomerulonephritis. Type III hypersensitivity reactions can classically be seen in serum sickness and Arthus reaction. Serum sickness Serum sickness can be induced with massive injections of foreign antigen. Circulating immune complexes infiltrate the blood vessel walls and tissues, causing an increased vascular permeability and leading to inflammatory processes such as vasculitis and arthritis. It was a complication of anti-serum prepared in animals to which some individuals produced antibodies to the foreign protein. It was also experienced in the treatment with antibiotics such as penicillin. Arthus reaction Arthus reaction is a local reaction seen when a small quantity of antigens is injected into the skin repeatedly until detectable levels of antibodies (IgG) are present. If the same antigen is inoculated, immune complexes develop at the mentioned local site and in the endothelium of small vessels. This reaction is characterized by the presence of marked edema and hemorrhage, depending on the administered dose of the foreign antigen.

Publication types

• Review

Full-text links

StatPearls [Internet]

57. Alterations in Intestinal Microbiota of Children With Celiac Disease at Time of Diagnosis and on a Gluten-Free Diet

Gastroenterology. 2020 Aug 10;S0016-5085(20)35023-X. doi: 10.1053/j.gastro.2020.08.007. Online ahead of print.

Authors

Konstantina Zafeiropoulou 1 , Ben Nichols 1 , Mary Mackinder 1 , Olga Biskou 1 , Eleni Rizou 1 , Antonia Karanikolou 1 , Clare Clark 1 , Elaine Buchanan 2 , Tracey Cardigan 2 , Hazel Duncan 2 , David Wands 2 , Julie Russell 3 , Richard Hansen 2 , Richard K Russell 2 , Paraic McGrogan 2 , Christine A Edwards 1 , Umer Z Ijaz 3 , Konstantinos Gerasimidis 4 Affiliations

• 1 Human Nutrition, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, New Lister Building, Glasgow Royal Infirmary, G31 2ER, Glasgow. • 2 Department of Paediatric Gastroenterology, Royal Hospital for Children, Glasgow. • 3 Civil Engineering, School of Engineering, Oakfield Avenue, University of Glasgow, Glasgow. • 4 Human Nutrition, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, New Lister Building, Glasgow Royal Infirmary, G31 2ER, Glasgow. Electronic address: [email protected].

• PMID: 32791131 • DOI: 10.1053/j.gastro.2020.08.007

Abstract

Background & aims: It is not clear whether alterations in the intestinal microbiota of children with celiac disease cause the disease or are a result of disease and/or its treatment with gluten-free diet (GFD).

Methods: We obtained 167 fecal samples from 141 children (20 with new- onset celiac disease, 45 treated with a GFD, 57 healthy children, and 19 unaffected siblings of children with celiac disease) in Glasgow, Scotland. Samples were analyzed by 16S rRNA sequencing and diet-related metabolites were measured by gas chromatography. We obtained fecal samples from 13 of the children with new-onset CD after 6 and 12 months on GFD. Relationships between microbiota with diet composition, gastrointestinal function, and biomarkers of GFD compliance were explored.

Results: Microbiota α diversity did not differ among groups. Microbial dysbiosis was not observed in children with new-onset celiac disease. In contrast, 2.8% (Bray-Curtis dissimilarity index, P=.025) and 2.5% (UniFrac distances, P=.027) of the variation in microbiota composition could be accounted for by the GFD. Between 3% to 5% of all taxa differed among all group comparisons. Eleven distinctive operational taxonomic units composed a microbe signature specific to celiac disease with high diagnostic probability. Most of the operational taxonomic units that differed between patients on GFD with new-onset celiac disease vs healthy children were associated with nutrient and food group intake (from 75% to 94%), and with biomarkers of gluten ingestion. Fecal levels of butyrate and ammonia decreased during the GFD.

Conclusions: Although several alterations in the intestinal microbiota of children with established celiac disease appear to be effects of a GFD, there are specific bacteria that are distinct biomarkers of celiac disease. Studies are needed to determine whether these bacteria contribute to pathogenesis of celiac disease.

Keywords: OTU; microbiome; pediatric; short chain fatty acids.

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58. Extrahepatic autoimmune diseases in primary biliary cholangitis: Prevalence and significance for clinical presentation and disease outcome

J Gastroenterol Hepatol. 2020 Aug 13. doi: 10.1111/jgh.15214. Online ahead of print.

Authors

Cumali Efe 1 , Murat Torgutalp 2 , Ida Henriksson 3 , Fatema Alalkim 4 , Ellina Lytvyak 5 , Hirsh Trivedi 6 , Fatih Eren 7 , Janett Fischer 8 , Maneerat Chayanupatkul 9 10 , Claudia Coppo 11 , Tugrul Purnak 12 , Luigi Muratori 11 , Mårten Werner 13 , Paolo Muratori 11 , Fredrik Rorsman 14 , Kristina Onnerhag 15 , Emma Nilsson 16 , Alexandra Heurgué-Berlot 17 , Nurhan Demir 1 , David Semela 18 , Murat Kıyıcı 7 , Thomas D Schiano 9 , Aldo J Montano-Loza 5 , Thomas Berg 8 , Ersan Ozaslan 19 , Eric M Yoshida 4 , Alan Bonder 6 , Hanns-Ulrich Marschall 20 , Benedetta Terziroli Beretta-Piccoli 21 , Staffan Wahlin 22 Affiliations

• 1 Department of Gastroenterology, Gazi Yaşargil Education and Research Hospital, Diyarbakir, Turkey. • 2 Department of Rheumatology, Ankara University Hospital, Ankara, Turkey. • 3 Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden. • 4 Division of Gastroenterology, University of British Columbia and Vancouver General Hospital, Vancouver, British Columbia, Canada. • 5 University of Alberta Division of Gastroenterology and Liver Unit, Edmonton, Alberta, Canada. • 6 Division of GI and Hepatology, Beth Israel Medical Center, Harvard Medical School, Boston, Massachusetts, USA. • 7 Department of Gastroenterology, Medical Faculty, Uludag University, Bursa, Turkey. • 8 Division of Gastroenterology, Clinic and Polyclinic for Oncology, Hepatology, Infectious Diseases and Pneumology, University Clinic Leipzig, Leipzig, Germany. • 9 Division of Liver Diseases, The Mount Sinai Medical Center, New York, New York, USA. • 10 Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. • 11 Center for the Study and Treatment of Autoimmune Diseases of the Liver and Biliary System, University of Bologna, Bologna, Italy. • 12 Department of Gastroenterology, Hacettepe University, Ankara, Turkey. • 13 Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. • 14 Department of Gastroenterology and Hepatology, Uppsala University Hospital, Uppsala, Sweden. • 15 Department of Gastroenterology and Hepatology, Skåne University Hospital, Malmö, Sweden. • 16 Department of Clinical Sciences, Gastroenterology Division, Skåne University Hospital, Lund, Sweden. • 17 Department of Hepato-Gastroenterology, CHU Reims, Reims, France. • 18 Division of Gastroenterology and Hepatology, Kantonsspital St. Gallen, St. Gallen, Switzerland. • 19 Department of Gastroenterology, Ankara City Hospital, Ankara, Turkey. • 20 Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. • 21 Epatocentro Ticino, Lugano, Switzerland. • 22 Hepatology Division, Centre for Digestive Diseases, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.

• PMID: 32790935 • DOI: 10.1111/jgh.15214

Abstract

Background and aim: The prevalence and clinical significance of extrahepatic autoimmune diseases (EHAIDs) have not been evaluated in a large cohort of primary biliary cholangitis (PBC).

Methods: The medical records of 1554 patients with PBC from 20 international centers were retrospectively reviewed. Development of decompensated cirrhosis (ascites, variceal bleeding, and/or hepatic encephalopathy) and hepatocellular carcinoma were considered clinical endpoints.

Results: A total of 35 different EHAIDs were diagnosed in 440 (28.3%) patients with PBC. Patients with EHAIDs were more often female (92.5% vs 86.1%, P < 0.001) and seropositive for anti-mitochondrial antibodies (88% vs 84%, P = 0.05) and antinuclear antibodies and/or smooth muscle antibodies (53.8% vs 43.6%, P = 0.005). At presentation, patients with EHAIDs had significantly lower levels of alkaline phosphatase (1.76 vs 1.98 × upper limit of normal [ULN], P = 0.006), aspartate aminotransferase (1.29 vs 1.50 × ULN, P < 0.001), and total bilirubin (0.53 vs 0.58 × ULN, P = 0.002). Patients with EHAIDs and without EHAIDs had similar rates of GLOBE high-risk status (12.3% vs 16.1%, P = 0.07) and Paris II response (71.4% vs 69.4%, P = 0.59). Overall, event-free survival was not different in patients with and without EHAIDs (90.8% vs 90.7%, P = 0.53, log rank). Coexistence of each autoimmune thyroid diseases (10.6%), Sjögren disease (8.3%), systemic sclerosis (2.9%), rheumatoid arthritis (2.7%), systemic lupus erythematosus (1.7%), celiac disease (1.7%), psoriasis (1.5%), and inflammatory bowel diseases (1.3%) did not influence the outcome. Conclusions: Our study confirms that EHAIDs are frequently diagnosed in patients with PBC. The presence of EHAIDs may influence the clinical phenotype of PBC at presentation but has no impact on PBC outcome.

Keywords: Ankylosing spondylitis; Anti-phospholipid syndrome; Autoimmune hemolytic anemia; Idiopathic thrombocytopenic purpura; IgA nephropathy; Multiple sclerosis; Polyarteritis nodosa; Polymyositis; Sarcoidosis; Temporal arteritis.

• 39 references

Full-text links

59. A single nucleotide polymorphism genetic risk score to aid diagnosis of coeliac disease: a pilot study in clinical care

Aliment Pharmacol Ther. 2020 Aug 13. doi: 10.1111/apt.15826. Online ahead of print.

Authors

Seth A Sharp 1 , Samuel E Jones 1 , Robert A Kimmitt 2 , Michael N Weedon 1 , Anne M Halpin 3 , Andrew R Wood 1 , Robin N Beaumont 1 , Seema King 4 , David A van Heel 5 , Patricia M Campbell 3 , William A Hagopian 6 , Justine M Turner 4 , Richard A Oram 1 2

Affiliations

• 1 Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK. • 2 Royal Devon & Exeter, NHS Foundation Trust, Exeter, UK. • 3 Division of Nephrology and Transplant Immunology, University of Alberta, Edmonton, AB, Canada. • 4 Faculty of Medicine and Dentistry, Pediatrics, University of Alberta, Edmonton, AB, Canada. • 5 Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK. • 6 Pacific Northwest Research Institute, Seattle, WA, USA.

• PMID: 32790217 • DOI: 10.1111/apt.15826

Abstract

Background: Single nucleotide polymorphism-based genetic risk scores (GRS) model genetic risk as a continuum and can discriminate coeliac disease but have not been validated in clinic. Human leukocyte antigen (HLA) DQ gene testing is available in clinic but does not include non-HLA attributed risk and is limited by discrete risk stratification.

Aim: To accurately characterise both HLA and non-HLA coeliac disease genetic risk as a single nucleotide polymorphism-based GRS and evaluate diagnostic utility.

Methods: We developed a 42 single nucleotide polymorphism coeliac disease GRS from a European case-control study (12 041 cases vs 12 228 controls) using HLA-DQ imputation and published genome-wide association studies. We validated the GRS in UK Biobank (1237 cases) and developed direct genotyping assays. We tested the coeliac disease GRS in a pilot clinical cohort of 128 children presenting with suspected coeliac disease.

Results: The GRS was more discriminative of coeliac disease than HLA-DQ stratification in UK Biobank (receiver operating characteristic area under the curve [ROC-AUC] = 0.88 [95% CIs: 0.87-0.89] vs 0.82 [95% CIs: 0.80-0.83]). We demonstrated similar discrimination in the pilot clinical cohort (114 cases vs 40 controls, ROC-AUC = 0.84 [95% CIs: 0.76-0.91]). As a rule-out test no children with coeliac disease in the clinical cohort had a GRS below 38th population centile.

Conclusion: A single nucleotide polymorphism-based GRS may offer more effective and cost-efficient testing of coeliac disease genetic risk in comparison to HLA-DQ stratification. As a comparatively inexpensive test it could facilitate non-invasive coeliac disease diagnosis but needs detailed assessment in the context of other diagnostic tests and against current diagnostic algorithms.

• 37 references

Grant support

• 17/0005757/DUK_/Diabetes UK/United Kingdom • 16/0005529/DUK_/Diabetes UK/United Kingdom • University of Alberta • 084743/WT_/Wellcome Trust/United Kingdom • WT097835MF/WT_/Wellcome Trust/United Kingdom • DK/NIDDK NIH HHS/United States • National Institute of Allergy and Infectious Diseases • HG/NHGRI NIH HHS/United States • National Institute of Child Health and Human Development • Juvenile Diabetes Research Foundation International • U01-DK062418/NH/NIH HHS/United States

Full-text links

60. Influence of nutrition education in paediatric coeliac disease: impact of the role of the registered dietitian: a prospective, single-arm intervention study

J Hum Nutr Diet. 2020 Aug 12. doi: 10.1111/jhn.12800. Online ahead of print.

Authors

M Suárez-González 1 , C Bousoño García 1 , S Jiménez Treviño 1 , T Iglesias Cabo 2 , J J Díaz Martín 1

Affiliations • 1 Pediatric Gastroenterology and Nutrition Unit, Central University Hospital of Asturias, Oviedo, Spain. • 2 Statistical Consulting Unit, Scientific and Technological Resources, University of Oviedo, Oviedo, Spain.

• PMID: 32790023 • DOI: 10.1111/jhn.12800

Abstract

Background: The diagnosis of coeliac disease (CD) involves a change in the diet of the individual, which may influence their quality of life and nutritional status. The present study aimed to determine whether nutrition education by a registered dietitian is able to improve eating habits and body composition in children with CD.

Methods: Dietary, physical activity and body composition changes were analysed, comparing baseline assessments with those 1 year after receiving education on healthy eating. At both time points, a 3-day dietary survey, a food frequency consumption questionnaire, an adherence to the Mediterranean diet test (Kidmed), duration of activity and an electrical bioimpedance study were conducted. Student's paired t-test and the McNemar test were also employed.

Results: Seventy-two subjects (42 girls) with an mean (range) age of 10 (2-16) years were included. Before the intervention, an unbalanced diet was observed, rich in protein and fat, and deficient in complex carbohydrates. Only 14% consumed an adequate Mediterranean diet. After nutrition intervention, a significant increase in the consumption of plant-based foods and a concomitant decrease in meat, dairy and processed food intake (P < 0.001) were observed. Moreover, 92% of the patients (P < 0.001) managed to consume an adequate Mediterranean diet. Similarly, an increase was observed in the duration of physical activity undertaken [mean (SD) 1.02 (1.79) h, P < 0.001] and improvements in body composition were recorded, with a 17% decrease in fat mass percentage (P < 0.001).

Conclusions: Nutrition intervention focused on healthy eating is effective with respect to improving the nutritional status and diet quality in CD patients. Keywords: coeliac disease; gluten-free diet; healthy eating; nutrition education; nutritional status.

• 60 references

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61. Enteric parasitic infection disturbs bacterial structure in Mexican children with autoantibodies for type 1 diabetes and/or celiac disease

Gut Pathog. 2020 Aug 11;12:37. doi: 10.1186/s13099-020-00376-3. eCollection 2020.

Authors

Ana M Calderón de la Barca 1 , Reyna S Castillo-Fimbres 1 , María Esther Mejía-León 2 , Luis Quihui-Cota 1 , Adrián Ochoa-Leyva 3 , Sandra V Aguayo-Patrón 1 4

Affiliations

• 1 Dept. Nutrición, Centro de Investigación en Alimentación y Desarrollo, A.C., Astiazarán Rojas No. 46, Hermosillo, 83304 Sonora Mexico. • 2 Facultad de Medicina Mexicali, Universidad Autónoma de Baja California, Dr. Humberto Torres Sanginés S/N Centro Cívico, Mexicali, 21000 B.C. Mexico. • 3 Dept. Microbiología Molecular, Instituto de Biotecnología, Universidad Nacional Autónoma de México, Cuernavaca. Av. Universidad 2001, Col. Chamilpa, Cuernavaca, 62210 Morelos Mexico. • 4 Universidad del Valle de México, Hermosillo, Son. Mexico.

• PMID: 32788927 • PMCID: PMC7418185 • DOI: 10.1186/s13099-020-00376-3

Free PMC article Abstract

Background: Intestinal bacterial dysbiosis and increased gut permeability are associated with higher risk of developing type 1 diabetes (T1D) or celiac disease (CD). There is a lack of information on parasitism involved in gut disturbance of predisposed children. We evaluated the effect of enteropathogenic parasites (Cryptosporidium spp., Cyclospora spp. G. lamblia, and Blastocystis spp.) on the bacterial structure of feces from children with autoantibodies for T1D or CD. Participants included 37 children under 18 years of age, from whom stools were analyzed for enteric parasites by qPCR and 22/37 for bacterial profile by sequencing the V3-V4 region of the 16s rRNA gene. Dietary, clinical, and socioeconomic data was recorded.

Results: Pathogens parasitized 28/37 participants, Cryptosporidium spp. was the most prevalent (62.2%), followed by both Cyclospora cayetanensis and Blastocystis spp (37.8%). There were no dietary differences (p > 0.05) attributable to parasitism. Co-infected participants with Cryptosporidium and Cyclospora did not differ (p = 0.064) from non-infected participants in bacterial alpha phylogenetic diversity. The same parasites' co-infection was associated with a decreased abundance of the Ruminococaceae (p = 0.04) and Verrucomicrobioceae families, of the Akkermansia genus (p = 0.009). There was a lower Firmicutes/Bacteroidetes ratio (p = 0.02) in infected than in uninfected participants.

Conclusions: Cryptosporidium and Cyclospora affected the bacterial structure at family and genus levels, decreasing the ratio between Firmicutes and Bacteroidetes in children with auto-antibodies for T1D or CD, which could increase the risk of illness onset.

Keywords: Akkermansia; Celiac disease; Cryptosporidium; Cyclospora; Enteric pathogens; Type 1 diabetes.

Conflict of interest statement Competing interestsAuthors declare no conflict of interests.

• 40 references • 2 figures

Full-text links

62. [IL-15, gluten and HLA-DQ8 drive tissue destruction in coeliac disease]

Z Gastroenterol. 2020 Aug;58(8):786. doi: 10.1055/a-1186-3792. Epub 2020 Aug 12. [Article in German]

Author

Max Reinshagen 1

Affiliation

• 1 Medizinische Klinik I, Klinikum Braunschweig.

• PMID: 32785916 • DOI: 10.1055/a-1186-3792

No abstract available

Conflict of interest statement

Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.

Full-text links

63. Updated Food Composition Database for Cereal-Based Gluten Free Products in Spain: Is Reformulation Moving on?

Nutrients. 2020 Aug 7;12(8):E2369. doi: 10.3390/nu12082369.

Authors

Violeta Fajardo 1 , María Purificación González 1 , María Martínez 1 , María de Lourdes Samaniego-Vaesken 1 , María Achón 1 , Natalia Úbeda 1 , Elena Alonso-Aperte 1

Affiliation

• 1 Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Alcorcón, 28925 Madrid, Spain.

• PMID: 32784763 • DOI: 10.3390/nu12082369

Free article Abstract

We developed a comprehensive composition database of 629 cereal-based gluten free (GF) products available in Spain. Information on ingredients and nutritional composition was retrieved from food package labels. GF products were primarily composed of rice and/or corn flour, and 90% of them included added rice starch. The most common added fat was sunflower oil (present in one third of the products), followed by palm fat, olive oil, and cocoa. Only 24.5% of the products had the nutrition claim "no added sugar". Fifty-six percent of the GF products had sucrose in their formulation. Xanthan gum was the most frequently employed fiber, appearing in 34.2% of the GF products, followed by other commonly used such as hydroxypropyl methylcellulose (23.1%), guar gum (19.7%), and vegetable gums (19.6%). Macronutrient analysis revealed that 25.4% of the products could be labeled as a source of fiber. Many of the considered GF food products showed very high contents of energy (33.5%), fats (28.5%), saturated fatty acids (30.0%), sugars (21.6%), and salt (28.3%). There is a timid reformulation in fat composition and salt reduction, but a lesser usage of alternative flours and pseudocereals.

Keywords: celiac disease; food composition database; gluten containing products; gluten-free diet; gluten-free products.

Grant support

• FUSP-BS-PPC-USP02/2015/Universidad San Pablo - CEU

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64. Extremely low prevalence of Celiac disease in Japan: Eternal silence or just the calm before the storm?

JGH Open. 2020 Aug 7;4(4):554-555. doi: 10.1002/jgh3.12352. eCollection 2020 Aug.

Authors

Ryota Hokari 1 , Masaaki Higashiyama 1

Affiliation

• 1 Department of Internal Medicine National Defense Medical College Tokorozawa Japan.

• PMID: 32782935 • PMCID: PMC7411549 • DOI: 10.1002/jgh3.12352

Free PMC article No abstract available

• 10 references Publication types

• Editorial

Full-text links

65. Utilization of quinoa flour ( Chenopodium quinoa Willd.) in gluten-free pasta formulation: Effects on nutritional and sensory properties

Food Sci Technol Int. 2020 Aug 11;1082013220940092. doi: 10.1177/1082013220940092. Online ahead of print.

Authors

Berat Demir 1 , Nermin Bilgiçli 2

Affiliations

• 1 Bahri Dağdaş International Agricultural Research Institute, Konya, Turkey. • 2 Department of Food Engineering, Engineering and Architecture Faculty, Necmettin Erbakan University, Konya, Turkey.

• PMID: 32781850 • DOI: 10.1177/1082013220940092

Abstract

In this study, raw and germinated quinoa seed flour was utilized in gluten-free pasta formulation. Rice:corn semolina (50:50) blend was used in gluten-free pasta as a control group. Quinoa flours were replaced with rice:corn semolina blend at different (0-30%) ratios in gluten-free pasta formulation. Guar gum (3%) was also used to tolerate structural defects caused by gluten deficiency. Trials were conducted according to (2 × 4) × 2 factorial design. Color values, cooking properties, and chemical and sensory attributes of gluten-free pasta samples were determined. Quinoa flour type and quinoa flour addition ratio factors significantly (p < 0.05) affected the L*, a* color values and all of the cooking properties of the gluten-free pasta samples. Utilization of germinated quinoa flour in gluten-free pasta revealed lower water uptake, volume increase, firmness, and higher cooking loss values than that of raw quinoa flour. Quinoa flour especially improved the mean values of protein, total phenolic content, antioxidant activity from 8.1%, 0.7 mg GAE/g, and 13.4%, up to 12.7%, 1.5 mg GAE/g, and 28.8%, respectively. A significant (p < 0.05) increment was observed in Ca, Fe, K, Mg, P, and Z content of the gluten-free pasta and all addition ratios of quinoa flour. As a result, increasing amount of quinoa flour enriched the nutritional composition of gluten-free pasta but high utilization ratio resulted in slight sensory losses.

Keywords: Germination; gluten free; pasta; phenolic compounds; quinoa.

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66. Acorn Flour as a Source of Bioactive Compounds in Gluten-Free Bread

Molecules. 2020 Aug 6;25(16):E3568. doi: 10.3390/molecules25163568.

Authors

Rita Beltrão Martins 1 2 , Irene Gouvinhas 1 , Maria Cristiana Nunes 3 , José Alcides Peres 2 , Anabela Raymundo 3 , Ana I R N A Barros 1

Affiliations

• 1 CITAB-Centre for the Research and Technology of Agro-Environmental and Biological Sciences, Universidade de Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal. • 2 Centro de Química-Vila Real-Universidade de Trás-os-Montes e Alto Douro Universidade de Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal. • 3 LEAF-Linking Landscape, Environment, Agriculture and Food, Instituto Superior de Agronomia, Universidade de Lisboa, Tapada da Ajuda, 1349-017 Lisbon, Portugal.

• PMID: 32781519 • DOI: 10.3390/molecules25163568

Free article Abstract

Polyphenols are important bioactive compounds whose regular ingestion has shown different positive impacts in health. Celiac patients have nutritional deficiencies, bringing many problems to their health. Thus, it is important to develop gluten-free (GF) products, such as bread, with nutritional benefits. The acorn is the fruit of holm oak and cork oak, being an underexploited resource nowadays. Its nutritional and functional characteristics are remarkable: rich in unsaturated fatty acids and fiber, vitamin E, chlorophylls, carotenoids, phenolic compounds, and antioxidant properties. The purpose of this study was to assess the use of acorn flour as a bioactive compounds source and natural GF ingredient for baking GF bread. Bread loaves were prepared with buckwheat, rice, acorn flour, and potato starch. Two levels of acorn flour (23% and 35% of the flour mixture) were tested. The physical, nutritional, and sensory characteristics of the bread were analysed, as well as the composition of phenolic compounds: total phenols, ortho-diphenols, and flavonoids. The phenolic profile was assessed by Reverse Phase-High- Performance Liquid Chromatography-Diode Array Detector (RP-HPLC-DAD). The antioxidant activity of the bread extracts was determined by 2,2-azino-bis (3-ethylbenzothiazoline-6-sulphonic acid) diammonium salt (ABTS), diphenyl- 1-picrylhidrazyl radical (DPPH), and ferric reducing antioxidant power (FRAP) methodologies. Acorn flour can be considered a good source of bioactive compounds and antioxidants in GF bread. Acorn flour showed good technological properties in GF baking, improving bread nutritional and sensory characteristics.

Keywords: acorn flour; antioxidants; bioactive compounds; circular economy; gluten-free bread; gluten-free flours; phenolic compounds; underexploited raw materials.

Grant support • UIDB/04033/2020/Fundação para a Ciência e a Tecnologia • UIDB/00616/2020/Fundação para a Ciência e a Tecnologia • PD/BD/135332/2017/Fundação para a Ciência e a Tecnologia • UID/AGR/04129/2020/Fundação para a Ciência e a Tecnologia

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67. Celiac Artery Compression Syndrome

Review In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan. 2020 Aug 13.

Authors

Taimur Saleem 1 , Shravan Katta 2 , Donald T. Baril 3

Affiliations

• 1 St. Dominic Hospital • 2 Texas Health • 3 David Geffen School of Medicine UCLA

• PMID: 29262206 • NBK470601

Free Books & Documents Excerpt

Celiac artery compression syndrome is also known as Dunbar syndrome or median arcuate ligament syndrome. It is a rare medical condition characterized by recurrent abdominal pain. The condition results from the compression of the celiac artery by a fibrous band of the diaphragm known as the median arcuate ligament. Lipshutz first reported the anatomical compression of the celiac artery in 1917. As a clinical entity, median arcuate ligament syndrome was first described by Harolja in 1963. Dunbar described the first clinical study on this entity in 1965. Copyright © 2020, StatPearls Publishing LLC.

Publication types

• Review

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StatPearls [Internet]

68. A familial case of Kikuchi-Fujimoto disease in dizygotic twins

Pediatr Rheumatol Online J. 2020 Aug 10;18(1):62. doi: 10.1186/s12969-020- 00457-2.

Authors

Ashfaque Quadir 1 , Ken Peacock 2 , Peter Hsu 3 , Davinder Singh-Grewal 4 , Stephen Alexander 5

Affiliations

• 1 Department of General Medicine, The Children's Hospital at Westmead, Westmead, Sydney, NSW, 2145, Australia. [email protected]. • 2 Department of General Medicine, The Children's Hospital at Westmead, Westmead, Sydney, NSW, 2145, Australia. • 3 Department of Immunology, The Children's Hospital at Westmead, Westmead, Sydney, NSW, 2145, Australia. • 4 Department of Rheumatology, The Sydney Children's Hospitals Network, Westmead and Randwick, Sydney, NSW, 2145, Australia. • 5 Department of Nephrology, The Children's Hospital at Westmead, Westmead, Sydney, NSW, 2145, Australia.

• PMID: 32778173 • PMCID: PMC7418326 • DOI: 10.1186/s12969-020-00457-2

Free PMC article Abstract

Background: Kikuchi-Fujimoto disease (KFD) or necrotizing histiocytic lymphadenitis, was described separately by both Kikuchi and Fujimoto in Japan in the early 1970's. Despite its rarity in the pediatric population, it is an important differential in persistent lymphadenopathy. Familial cases of KFD in the literature are rare. Here we describe the first reported case of KFD in non- identical twin sisters.

Case presentation: Twin 1 presented with a 3-week history of worsening right- sided cervical lymphadenopathy, daily fevers, significant lethargy, weight loss and arthralgia of her knees and ankles at the age of 12 years in 2015. She had had an unremarkable medical history. A biopsy of her lymph nodes showed histiocytic necrosis consistent with KFD. Twin 2 presented with a three-week history of lethargy, fatigue, weight loss and left-sided posterior cervical chain lymphadenopathy at 16 years of age in 2018. She had a history of frequently relapsing nephrotic syndrome and celiac disease. A biopsy of her lymph nodes was undertaken and showed histiocytic necrosis consistent with KFD.

Conclusions: KFD is a rare but self-limiting pathological process of necrotizing histiocytic lymphadenitis. Although further research is needed, there is an increasing amount of evidence which suggests a multifactorial pathological basis of disease. The two cases we document here are the first reported cases of familial KFD in dizygotic HLA-identical twins which reinforces the likely HLA- linkage in the etiology of KFD.

Keywords: Familial; Histiocytic; Kikuchi-Fujimoto; Lymphadenitis; Lymphadenopathy; Necrotizing; Twins.

Conflict of interest statement

The authors declare that they have no competing interests.

• 15 references • 2 figures Full-text links

69. Quantitative approach to study secondary structure of proteins by FT-IR spectroscopy, using a model wheat gluten system

Int J Biol Macromol. 2020 Aug 7;S0141-8130(20)34058-7. doi: 10.1016/j.ijbiomac.2020.07.299. Online ahead of print.

Authors

Mehtap Fevzioglu 1 , Oguz Kaan Ozturk 2 , Bruce R Hamaker 3 , Osvaldo H Campanella 4

Affiliations

• 1 Agricultural and Biological Engineering, Purdue University, 225 South University Street, West Lafayette, IN 47907, USA; Whistler Carbohydrate Research Center, Purdue University, 745 Agricultural Mall Drive, West Lafayette, IN 47907, USA. Electronic address: [email protected]. • 2 Whistler Carbohydrate Research Center, Purdue University, 745 Agricultural Mall Drive, West Lafayette, IN 47907, USA; Department of Food Science, Philip E. Nelson Hall of Food Science, Purdue University, 745 Agricultural Mall Drive, West Lafayette, IN 47907, USA. Electronic address: [email protected]. • 3 Whistler Carbohydrate Research Center, Purdue University, 745 Agricultural Mall Drive, West Lafayette, IN 47907, USA; Department of Food Science, Philip E. Nelson Hall of Food Science, Purdue University, 745 Agricultural Mall Drive, West Lafayette, IN 47907, USA. Electronic address: [email protected]. • 4 Whistler Carbohydrate Research Center, Purdue University, 745 Agricultural Mall Drive, West Lafayette, IN 47907, USA; Department of Food Science and Technology, The Ohio State University, 2015 Fyffe Road, Columbus, OH 43210-1007, USA. Electronic address: [email protected]. • PMID: 32777421 • DOI: 10.1016/j.ijbiomac.2020.07.299

Abstract

Amide I and Amide III vibrational modes are frequently used to study protein secondary structure with Fourier transform infrared (FT-IR) spectroscopy. However, for protein mixtures, neither the sole Amide I nor Amide III region provides sufficient information for structural quantitation because of overlapping peaks, especially in the Amide I region. Here, an improved quantitative approach is proposed to estimate secondary structure of protein systems using resolution enhancement and curve-fitting data processing techniques on a gluten model system to investigate structure-function relationships. Twelve different scenarios were prepared to assign bands in the Amide I region. Frequency ranges of 1660-1640 cm-1 and 1665-1660 cm-1 were found to highly contribute to variability in secondary structure contents of samples. Utilization of the Amide III region as a conducive tool to assign bands in the Amide I region led to a better differentiation of some secondary structural motifs and a more accurate quantitation of protein secondary structure. The study presents an understanding of FT-IR data analysis for a quick technique to assess secondary structures of protein mixtures.

Keywords: FT-IR; Gluten; Protein secondary structure.

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70. Life-threatening diarrhea in an elderly patient

Gastroenterology. 2020 Aug 7;S0016-5085(20)35026-5. doi: 10.1053/j.gastro.2020.07.054. Online ahead of print.

Authors

Jonathan Soldera 1 , Guilherme Portela Coelho 2 , Carlos Frederico Heinrich 3 Affiliations

• 1 Associate Professor, Department of Clinical Gastroenterology, School of Medicine, Universidade de Caxias do Sul (UCS), Caxias do Sul (RS), Brazil. Doctoral Student: Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre (RS), Brazil. Associate Member, Grupo de Estudos da Doença Inflamatória Intestinal do Brasil (GEDIIB), São Paulo (SP), Brazil. Electronic address: [email protected]. • 2 Diagnose Group - Pathology, Genetics and Molecular Biology, Caxias do Sul (RS), Brazil. Master`s in Medicine: Surgery, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre (RS), Brazil. Master in Business Administration, Fundação Getúlio Vargas (FGV), São Paulo (SP), Brazil. • 3 Radiologist, Vero/Dellaudo Radiology Clinic, Caxias do Sul (RS), Brazil. Residency, Department of Radiology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre (RS), Brazil.

• PMID: 32777280 • DOI: 10.1053/j.gastro.2020.07.054

No abstract available

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71. Another Chicken and Egg Story: Systematic Review on Lichen Planus as a Precursor for Celiac Disease in Adult Population

Cureus. 2020 Aug 2;12(8):e9526. doi: 10.7759/cureus.9526.

Authors

Sahar Khan 1 , Shweta Patel 2 , Saipavankumar M 3 , Pousettef Hamid 4 Affiliations

• 1 Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA. • 2 Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA. • 3 Pediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA. • 4 Neurology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.

• PMID: 32775115 • PMCID: PMC7402537 • DOI: 10.7759/cureus.9526

Free PMC article Abstract

Celiac disease is receiving much attention due to the gluten-free diet trend. Many health-conscious individuals practice a gluten-free diet, even if they do not have celiac disease. As it is an autoimmune disorder, it is associated with many other autoimmune diseases. We were interested in one skin condition, another autoimmune disorder lichen planus as a correlative factor for celiac disease. The following systematic review may give some clues. We searched online resources including PubMed, PubMed Central, Cochrane library, and Google scholar for systematic reviews, traditional reviews, randomized controlled trials, and meta-analysis on celiac disease and lichen planus. We included human studies published in peer-reviewed journals in the English language. After reviewing 2389 initial results of our search, we excluded 1250 duplicates, 1108 abstracts, 42 irrelevant articles. We assessed the remaining 26 articles for their quality using various quality assessment tools. After the quality assessment, we included nine final articles in our systematic review. Out of these nine studies, there were four systematic reviews, one traditional review, two case reports, and two observational studies. Only two articles had exclusively studied the specific association between celiac and lichen planus. The remaining studies included data that gave an overall association between other skin manifestations of celiac disease. From our study, we could not establish the relationship between celiac disease and lichen planus. We need more case-control studies and clinical trials with a larger population to get conclusive data. From current data, we can conclude that both immunological processes correlate but there is no causation. There is also a need for clinical trials to explore the exacerbation of lichen planus due to celiac disease.

Keywords: autoimmune; celiac disease/complication; etiology; gluten sensitivity; humans; immunology; lichen planus; missed diagnosis; prevalence; skin disease/ dermatology.

Conflict of interest statement

The authors have declared that no competing interests exist.

• 24 references • 1 figure

Publication types

• Review

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72. Deciphering the immunogenic potential of wheat flour: a reference map of the salt- soluble proteome from the U.S. wheat Butte 86

Proteome Sci. 2020 Aug 1;18:8. doi: 10.1186/s12953-020-00164-6. eCollection 2020.

Authors

Susan B Altenbach 1 , Han-Chang Chang 1 , Annamaria Simon-Buss 1 2 Affiliations

• 1 Western Regional Research Center, United States Department of Agriculture-Agricultural Research Service, Albany, CA USA. • 2 Hamburg School of Food Science, Institute of Food Chemistry, University of Hamburg, Hamburg, Germany.

• PMID: 32774173 • PMCID: PMC7395986 • DOI: 10.1186/s12953-020-00164-6

Free PMC article Abstract

Background: Within the complex wheat flour proteome, the gluten proteins have attracted most of the attention because of their importance in determining the functional properties of wheat flour doughs and their roles in human health conditions such as celiac disease and food allergies. However, certain non-gluten proteins also trigger immunological responses but may be present in flour in low amounts or obscured by the more abundant gluten proteins in two-dimensional gels of total protein preparations.

Methods: Non-gluten proteins were preferentially extracted from the flour with a dilute salt solution and separated by two-dimensional gel electrophoresis. Proteins in 173 gel spots were identified by tandem mass spectrometry after cleavage with trypsin or chymotrypsin. Transgenic wheat lines in which specific groups of gluten proteins were suppressed by RNA interference were used to estimate the amount of carry-over of gluten proteins in the salt-soluble protein fraction.

Results: Fifty-seven different types of non-gluten proteins were identified, including 14 types that are known or suspected immunogenic proteins. The predominant proteins in 18 gel spots were gluten proteins. Some of these also contained non-gluten proteins. Analysis of the salt-soluble proteins from a transgenic line in which omega-1,2 gliadins were eliminated by RNA interference indicated that certain omega-1,2 gliadins were present in large amounts in the salt-soluble fraction and obscured relatively small amounts of beta-amylase and protein disulfide isomerase. In comparison, analysis of a transgenic line in which alpha gliadins were absent revealed that glyceraldehyde-3 phosphate dehydrogenase was a moderately abundant protein that co-migrated with several alpha gliadins.

Conclusions: In this study, we constructed a proteomic map of the non-gluten protein fraction of wheat flour from the US wheat Butte 86 that complements a proteomic map of the total flour proteins developed previously for the same cultivar. Knowing the identities of low abundance proteins in the flour as well as proteins that are hidden by some of the major gluten proteins on two- dimensional gels is critical for studies aimed at assessing the immunogenic potential of wheat flour and determining which wheat proteins that should be targeted in future gene editing experiments to reduce the immunogenic potential of wheat flour.

Keywords: Albumins/globulins; Allergens; Celiac disease; Mass spectrometry; Non-celiac wheat sensitivity; Wheat flour proteome.

Conflict of interest statement

Competing interestsThe authors declare that they have no competing interests.

• 25 references • 3 figures

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73. Daily Dilemmas in Pediatric Gastrointestinal Pathology

Surg Pathol Clin. 2020 Sep;13(3):399-411. doi: 10.1016/j.path.2020.05.002. Epub 2020 Jul 11.

Authors

Juan Putra 1 , Jeffrey D Goldsmith 2 Affiliations

• 1 Department of Laboratory Medicine and Pathobiology, University of Toronto, 555 University Avenue, Toronto, Ontario M5G1X8, Canada; Division of Pathology, Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G1X8, Canada. • 2 Department of Pathology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA. Electronic address: [email protected].

• PMID: 32773191 • DOI: 10.1016/j.path.2020.05.002

Abstract

The evaluation of gastrointestinal pathology in children often requires a different approach from that in adults. In this concise review, the authors outline 3 diagnostic challenges that are often encountered in daily practice; these include eosinophilic diseases, duodenal intraepithelial lymphocytosis with preserved villous architecture, and terminal ileal inflammation in the setting of idiopathic inflammatory bowel disease.

Keywords: Backwash ileitis; Celiac disease; Crohn disease; Duodenal intraepithelial lymphocytosis; Eosinophilic esophagitis; Mucosal eosinophilia; Terminal ileitis; Ulcerative colitis.

Conflict of interest statement

Disclosure The authors have nothing to disclose.

Publication types

• Review

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74. Anti-tissue transglutaminase titers are associated with endoscopic findings and severity of mucosal damage in children with celiac disease

Eur J Pediatr. 2020 Aug 8. doi: 10.1007/s00431-020-03770-w. Online ahead of print.

Authors

Tomer Ziv-Baran 1 , Yulia Dubov 2 3 , Ronit Weinberger 2 , Anat Guz-Mark 3 4 , Raanan Shamir 3 4 , Amit Assa 5 6

Affiliations

• 1 Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. • 2 Immunology Laboratory, Clalit Health Services, Tel Aviv, Israel. • 3 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. • 4 Institute of Gastroenterology, Nutrition and Liver Disease, Schneider Children's Medical Center, 14 Kaplan St., 4920235, Petah Tikva, Israel. • 5 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. [email protected]. • 6 Institute of Gastroenterology, Nutrition and Liver Disease, Schneider Children's Medical Center, 14 Kaplan St., 4920235, Petah Tikva, Israel. [email protected].

• PMID: 32772154 • DOI: 10.1007/s00431-020-03770-w

Abstract

We aimed to assess the correlation between clinical findings, serology, endoscopic findings, and histology in children diagnosed with celiac disease. Medical records of children diagnosed with celiac disease (2010-2017) at the Schneider Children's Hospital were reviewed retrospectively. Correlation between serologic measures anti-tissue transglutaminase (anti-tTG)/anti- endomysial antibodies (EMA) and other variables including mucosal damage, endoscopic findings (scalloping of duodenal folds), and clinical findings (abdominal pain, diarrhea, and anemia) was assessed. Out of 686 patients, 432 patients fulfilled the inclusion criteria (females 262, 61%; median age 6.0; interquartile range 4.0-9.0 years). Distribution of histopathology findings was Marsh IIIa 4%, Marsh IIIb 25%, and Marsh IIIc 71% with 313 (73%) patients having anti-tTG titer of ≥ 10 times the upper normal limit. Anti-tTG titer (but not EMA) positively correlated with Marsh grades, scalloping of duodenal folds and anemia. Anti-tTG ≥ 10 times the upper normal limit was associated with Marsh IIIc changes with an adjusted odds ratio of 4.5 (95% confidence interval, 1.7-12.1). Diarrhea and abdominal pain were not associated with serologic, endoscopic, or histologic markers of disease severity.Conclusion: Anti-tTG titers correlated with macroscopic and microscopic mucosal damage, with anemia but not with diarrhea or abdominal pain in children with celiac disease. What is Known: • Tissue transglutaminase antibody titers were shown to correlate with the degree of mucosal damage in patients with celiac disease. • There is a limited evidence regarding the association of celiac serologies with endoscopic and clinical measures. What is New: • Higher titers of tissue transglutaminase but not anti-endomysial antibodies are associated with more severe histologic and endoscopic damage and with the presence of anemia. • Symptoms do not correlate with the severity of mucosal damage such as scalloping of duodenal folds and histopathology changes according to Marsh classification or with serologic markers.

Keywords: Celiac disease; Children; Clinical characteristics; Histopathology; Serology.

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75. Healthcare Resource Utilization and Costs in Celiac Disease: A US Claims Analysis

Am J Gastroenterol. 2020 Aug 5. doi: 10.14309/ajg.0000000000000759. Online ahead of print. Authors

Katherine Cappell 1 , Aliki Taylor 2 , Barbara H Johnson 1 , Steve Gelwicks 1 , Song Wang 3 , Michele Gerber 3 , Daniel A Leffler 3 4

Affiliations

• 1 IBM Watson Health, Cambridge, Massachusetts, USA. • 2 Takeda Pharmaceuticals International, London, United Kingdom. • 3 Takeda Pharmaceuticals International Co, Cambridge, Massachusetts, USA. • 4 Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.

• PMID: 32769422 • DOI: 10.14309/ajg.0000000000000759

Abstract

Introduction: Celiac disease (CeD) is a lifelong immune-mediated enteropathy in which dietary gluten triggers an inflammatory reaction in the small intestine. This retrospective cohort study examines healthcare resource utilization (HRU) and costs between patients with CeD and matched controls.

Methods: Patients with CeD (cases) with an endoscopic biopsy and ≥2 medical encounters with a CeD diagnosis between January 1, 2010, and October 1, 2015, were identified in the MarketScan databases. The date of the first claim with a CeD diagnosis on or after the endoscopic biopsy was the index date. Cases were matched 1:1 to patients without CeD (controls) on demographic characteristics and Deyo-Charlson Comorbidity Index score. Clinical characteristics, all-cause, and CeD-related HRU and costs (adjusted to 2017 US dollars) were compared between cases and controls during the 12 months before (baseline) and 24 months after (follow-up) the index date.

Results: A total of 11,008 cases (mean age 40.6 years, 71.3% women) were matched to 11,008 controls. During the follow-up, a higher proportion of cases had all-cause and CeD-related HRU including inpatient admissions, emergency department visits, gastroenterologist visits, dietician visits, endoscopic biopsies, and gastroenterology imaging (all P ≤ 0.002). Incremental all-cause and CeD-related costs were in the first ($7,921 and $2,894) and second ($3,777 and $935) year of follow-up, driven by outpatient services costs.

Discussion: In this US national claims database analysis, there was evidence of an increase in both all-cause and CeD-related HRU and related costs in patients with CeD compared with matched patients without CeD, suggesting a significant economic burden associated with CeD.

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76. Endovascular management of isolated superior mesenteric artery dissecting aneurysm by retrograde catheterization via collaterals from the celiac artery

Ann Vasc Surg. 2020 Aug 5;S0890-5096(20)30631-2. doi: 10.1016/j.avsg.2020.07.039. Online ahead of print.

Authors

Hui Zhao 1 , Jia-le Ou 1 , Zhen-Zhong Wu 1 , Yong Wang 2 , Joyman Makamure 3 , Min Rao 4 , Hong-Yao Hu 5

Affiliations

• 1 Department of Interventional Radiology, Renmin Hospital of Wuhan University, Wuhan, China. • 2 Department of Interventional Radiology, Second Affiliated Hospital, Hainan Medical University, Haikou, China. • 3 Department of Radiology, Hubei Key Laboratory of Molecular Imaging, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. • 4 Department of Interventional Radiology, Renmin Hospital of Wuhan University, Wuhan, China. Electronic address: [email protected]. • 5 Department of Interventional Radiology, Renmin Hospital of Wuhan University, Wuhan, China. Electronic address: [email protected].

• PMID: 32768549 • DOI: 10.1016/j.avsg.2020.07.039

Abstract

Isolated superior mesenteric artery (SMA) dissecting aneurysm is frequently symptomatic and potentially catastrophic, thus it usually requires endovascular treatment. The endovascular management can be challenging in certain cases as catheterization of the collapsed true lumen is often very difficult. This case report is to describe a new approach for catheterization of the true lumen of SMA in a case of isolated SMA dissecting aneurysm. A 63- year-old male with a SMA dissecting aneurysm underwent stent-graft placement for treatment. Catheterization of the true lumen via the anterograde approach was unsuccessful due to angulation and collapse of SMA true lumen as a result of the dissecting aneurysm. A guidewire was passed through the collaterals from the celiac artery and retrogradely passed across the collapsed SMA true lumen into the aorta. We then used a snare that had been delivered through the contralateral femoral access to capture and retrieve the guidewire. A delivery system was advanced into the SMA and a stent-graft was successfully deployed to occlude the dissecting aneurysm. This report introduces a new feasible retrograde approach which provides access to the SMA true lumen via celiac collaterals in cases of difficult antegrade catheterization of a SMA dissecting aneurysm.

Keywords: collaterals; dissecting aneurysm; endovascular stent; technique.

Publication types

• Case Reports

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77. Anatomy, Abdomen and Pelvis, Celiac Ganglia

Review In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan. 2020 Aug 10.

Authors

Raquel Candal 1 , Vamsi Reddy 2 , Navdeep S. Samra 1

Affiliations

• 1 LSU Health Shreveport • 2 Medical College of Georgia

• PMID: 30844156 • NBK538129

Free Books & Documents Excerpt

Both the digestive system and accessory structures have a complex nerve infrastructure that often goes unnoticed. Celiac ganglia are nerve bundles located in the upper abdomen as part of the autonomic nervous system that is functionally responsible for innervating the digestive tract and abdominal visceral tissue. The ganglia serve as integrative centers for coordinating intestinal motility as well as secretion and absorption throughout the digestive tract. The ganglia's close tie with the gastrointestinal tract makes them essential in a variety of clinical scenarios, including pancreatic cancer and gastroparesis.

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• Review Full-text links

StatPearls [Internet]

78. Arthritis

Review In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan. 2020 Aug 10.

Authors

Shayan Senthelal 1 , Jinpu Li 1 , Amandeep Goyal 2 , Pankaj Bansal 3 , Mark A. Thomas 4

Affiliations

• 1 Albert Einstein College of Medicine • 2 Marietta Memorial Hospital • 3 Mayo Clinic Health System • 4 Montefiore Medical Center

• PMID: 30085534 • NBK518992

Free Books & Documents Excerpt

Arthritis is derived from the Greek term “disease of the joints.” It is defined as an acute or chronic joint inflammation that often co-exists with pain and structural damage. Arthritis is not synonymous with arthralgia, which refers to pain localized to a joint, regardless of the origin of the pain (which may or may not be due to joint inflammation). Arthritis affected both the Neanderthals and ancient Egyptians, but It was not until 1886 that Dr. John K. Spencer coined the term “osteoarthritis.” More than 100 different types of arthritis have been described, the most common being osteoarthritis or degenerative arthritis which is non-inflammatory arthritis. Inflammatory arthritis can occur in several settings, and inflammation can be caused by autoimmune processes (rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, etc.), crystal deposition induced inflammation (gout, pseudogout, basic calcium phosphate disease) or infections (septic arthritis, Lyme's arthritis). Inflammatory arthritis can also accompany other autoimmune connective tissue diseases such as systemic lupus erythematosus, Sjogren syndrome, scleroderma, myositis, inflammatory bowel disease, celiac disease, etc. The goal of this activity is to provide a general overview of the most common arthritides and briefly touch on key aspects of the different major disease types.

Publication types

• Review

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StatPearls [Internet]

79. Celiac Disease

Review In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan. 2020 Aug 10.

Authors

Ewa B. Posner 1 , Muhammad Haseeb 2

Affiliations

• 1 University Hospital of North Durham • 2 University of Pittsburgh

• PMID: 28722929 • NBK441900 Free Books & Documents Excerpt

Celiac disease is an enteropathy of the small intestine. It is triggered by exposure to gluten in the diet of susceptible people. The susceptibility is genetically determined. The condition is chronic, and currently, the only treatment consists of permanent exclusion of gluten from the food intake. Patients with celiac disease can present with diarrhea and failure to thrive; some may be asymptomatic.

Publication types

• Review

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StatPearls [Internet]

80. Correction to: Hispanic Spinocerebellar Ataxia Type 35 (SCA35) with a Novel Frameshift Mutation

Cerebellum. 2020 Aug 7. doi: 10.1007/s12311-020-01169-9. Online ahead of print.

Authors

Chih-Chun Lin 1 , Shi-Rui Gan 2 , Deepak Gupta 3 , Armin Alaedini 4 5 , Peter H Green 4 5 , Sheng-Han Kuo 6

Affiliations

• 1 Methodist Neurological Institute, Houston, TX, USA. • 2 Department of Neurology and Institute of Neurology, The First Affiliated Hospital of Fujian Medical University, Fujian, China. • 3 Department of Neurology, Columbia UniversityMedical Center, 650 West 168th Street, Room 305, New York, NY, 10032, USA. • 4 Department of Medicine, Columbia University Medical Center, New York, NY, USA. • 5 Celiac Disease Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA. • 6 Department of Neurology, Columbia UniversityMedical Center, 650 West 168th Street, Room 305, New York, NY, 10032, USA. [email protected].

• PMID: 32767197 • DOI: 10.1007/s12311-020-01169-9

Abstract

The authors found out that there was a mistake in the Table 2 of the published paper.

Erratum for

• Hispanic Spinocerebellar Ataxia Type 35 (SCA35) with a Novel Frameshift Mutation.

Lin CC, Gan SR, Gupta D, Alaedini A, Green PH, Kuo SH.

Cerebellum. 2019 Apr;18(2):291-294. doi: 10.1007/s12311-018-0978-6.

PMID: 30229425Free PMC article.

Publication types

• Published Erratum

Full-text links

81. Fecal microRNAs as Innovative Biomarkers of Intestinal Diseases and Effective Players in Host-Microbiome Interactions

Cancers (Basel). 2020 Aug 5;12(8):E2174. doi: 10.3390/cancers12082174.

Authors

Meysam Sarshar 1 2 3 , Daniela Scribano 4 5 , Cecilia Ambrosi 6 , Anna Teresa Palamara 1 6 , Andrea Masotti 2

Affiliations

• 1 Department of Public Health and Infectious Diseases, Sapienza University of Rome, Laboratory Affiliated to Institute Pasteur Italia- Cenci Bolognetti Foundation, 00185 Rome, Italy. • 2 Research Laboratories, Bambino Gesù Children's Hospital, IRCCS, 00146 Rome, Italy. • 3 Microbiology Research Center (MRC), Pasteur Institute of Iran, 1316943551 Tehran, Iran. • 4 Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy. • 5 Dani Di Giò Foundation-Onlus, 00193 Rome, Italy. • 6 IRCCS San Raffaele Pisana, Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy.

• PMID: 32764361 • DOI: 10.3390/cancers12082174

Free article Abstract

Over the past decade, short non-coding microRNAs (miRNAs), including circulating and fecal miRNAs have emerged as important modulators of various cellular processes by regulating the expression of target genes. Recent studies revealed the role of miRNAs as powerful biomarkers in disease diagnosis and for the development of innovative therapeutic applications in several human conditions, including intestinal diseases. In this review, we explored the literature and summarized the role of identified dysregulated fecal miRNAs in intestinal diseases, with particular focus on colorectal cancer (CRC) and celiac disease (CD). The aim of this review is to highlight one fascinating aspect of fecal miRNA function related to gut microbiota shaping and bacterial metabolism influencing. The role of miRNAs as "messenger" molecules for inter kingdom communications will be analyzed to highlight their role in the complex host-bacteria interactions. Moreover, whether fecal miRNAs could open up new perspectives to develop novel suitable biomarkers for disease detection and innovative therapeutic approaches to restore microbiota balance will be discussed.

Keywords: bacterial small RNAs; biomarkers; celiac disease; colorectal cancer; extracellular vesicles; fecal microRNAs; host-microbiome interplay; small non- coding RNAs.

Publication types

• Review

Grant support

• Project SG-2018-12365432/Ministero della Salute • none/Dani Di Giò Foundation-Onlus

Full-text links

82. An updated overview of spectrum of gluten-related disorders: clinical and diagnostic aspects

BMC Gastroenterol. 2020 Aug 6;20(1):258. doi: 10.1186/s12876-020-01390-0.

Authors Nazanin Taraghikhah 1 , Sara Ashtari 2 , Nastaran Asri 1 , Bijan Shahbazkhani 3 , David Al- Dulaimi 4 , Mohammad Rostami-Nejad 5 , Mostafa Rezaei-Tavirani 6 , Mohammad Reza Razzaghi 7 , Mohammad Reza Zali 2

Affiliations

• 1 Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran. • 2 Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran. • 3 Division of Gastroenterology and Liver Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. • 4 Department of Gastroenterology, South Warwickshire Foundation Trust, Warwickshire, UK. • 5 Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran. [email protected]. • 6 Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. • 7 Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

• PMID: 32762724 • PMCID: PMC7409416 • DOI: 10.1186/s12876-020-01390-0

Free PMC article Abstract

The incidence of gluten-related disorders (GRDs) continues to increase and its global prevalence is estimated at approximately 5% of the population. Celiac disease (CD), dermatitis herpetiformis (DH), gluten ataxia (GA), wheat allergy (WA), and non-celiac gluten sensitivity (NCGS) are the five major GRDs that present with a wide range of clinical manifestations. The diagnosis of GRDs can be challenging because the typical and atypical clinical manifestations of the GRDs overlap. In this review, the current definitions of gluten-related disorders, focusing on their clinical features, diagnostic and therapeutic approaches are presented. We concluded that GRDs are usually diagnosed using a combination of clinical features, serological tests, and histopathological findings. Treatment usually involves dietary modification.

Keywords: Ataxia; Celiac disease; Diagnosis; Diet, gluten-free; Gluten; Hypersensitivity.

Conflict of interest statement

The authors declare that they have no competing interests.

• 163 references • 2 figures

Publication types

• Review

Full-text links

83. Gluten intake and metabolic health: conflicting findings from the UK Biobank

Eur J Nutr. 2020 Aug 6. doi: 10.1007/s00394-020-02351-9. Online ahead of print.

Authors

Inken Behrendt 1 , Mathias Fasshauer 2 3 4 , Gerrit Eichner 5

Affiliations

• 1 Institute of Nutritional Science, Justus-Liebig-University of Giessen, Goethestr. 55, 35390, Giessen, Germany. [email protected] giessen.de. • 2 Institute of Nutritional Science, Justus-Liebig-University of Giessen, Goethestr. 55, 35390, Giessen, Germany. • 3 Department of Internal Medicine (Endocrinology, Nephrology, and Rheumatology), University of Leipzig, Leipzig, Germany. • 4 Leipzig University Medical Center, IFB AdiposityDiseases, Leipzig, Germany. • 5 Mathematical Institute, Justus-Liebig-University of Giessen, Giessen, Germany.

• PMID: 32761538 • DOI: 10.1007/s00394-020-02351-9

Abstract

Purpose: The impact of gluten intake on metabolic health in subjects without celiac disease is unclear. The present study aimed to assess the association between gluten intake and body fat percentage (primary objective), as well as a broad set of metabolic health markers.

Methods: Gluten intake was estimated in 39,927 participants of the UK Biobank who completed a dietary questionnaire for assessment of previous 24-h dietary intakes. Multiple linear regression analyses were performed between gluten intake and markers of metabolic health with Holm adjustment for multiple comparisons.

Results: Median gluten intake was 9.7 g/day (male: 11.7 g/day; female: 8.2 g/day; p < 0.0001). In multiple linear regression analysis, association between gluten intake and percentage body fat was negative in males (β = - 0.028, p = 0.0020) and positive in females (β = 0.025, p = 0.0028). Furthermore, gluten intake was a negative predictor of total cholesterol (male: β = - 0.031, p = 0.0154; female: β = - 0.050, p < 0.0001), high-density lipoprotein cholesterol (male: β = - 0.052, p < 0.0001; female: β = - 0.068, p < 0.0001), and glomerular filtration rate (sexes combined: β = - 0.031, p < 0.0001) in both sexes. In females only, gluten intake was positively associated with waist circumference (β = 0.041, p < 0.0001), waist-to-height ratio (β = 0.040, p < 0.0001), as well as body mass index (β = 0.043, p < 0.0001), and negatively related to low-density lipoprotein cholesterol (β = - 0.035, p = 0.0011). A positive association between gluten intake and triglycerides was observed in males only (β = 0.043, p = 0.0001).

Conclusion: This study indicates that gluten intake is associated with markers of metabolic health. However, all associations are weak and not clinically meaningful. Limiting gluten intake is unlikely to provide metabolic health benefits for a population in total.

Keywords: Body composition; Dyslipidemia; Gluten; Hypertension; Metabolic health; Obesity.

Grant support

• SFB 1052/2 C6/Deutsche Forschungsgemeinschaft (DE) • FKZ: 01EO1501, K6a-87 and K7-107/Bundesministerium für Bildung und Forschung

Full-text links

84. Prognostic Role of Mismatch Repair Status, Histotype and High-Risk Pathologic Features in Stage II Small Bowel Adenocarcinomas

Ann Surg Oncol. 2020 Aug 5. doi: 10.1245/s10434-020-08926-4. Online ahead of print.

Authors

Alessandro Vanoli 1 , Federica Grillo 2 , Camilla Guerini 3 , Giuseppe Neri 3 , Giovanni Arpa 3 , Catherine Klersy 4 , Gabriella Nesi 5 , Paolo Giuffrida 6 , Gianluca Sampietro 7 , Sandro Ardizzone 8 , Paolo Fociani 9 , Roberto Fiocca 2 , Giovanni Latella 10 , Fausto Sessa 11 , Antonietta D'Errico 12 , Deborah Malvi 12 , Claudia Mescoli 13 , Massimo Rugge 13 , Stefano Ferrero 14 , Gilberto Poggioli 15 , Fernando Rizzello 16 , Maria C Macciomei 17 , Donatella Santini 12 , Umberto Volta 18 , Roberto De Giorgio 19 , Giacomo Caio 19 , Antonio Calabrò 20 , Carolina Ciacci 21 , Maria D'Armiento 22 , Aroldo Rizzo 23 , Gaspare Solina 24 , Michele Martino 6 , Francesco Tonelli 25 , Vincenzo Villanacci 26 , Renato Cannizzaro 27 , Vincenzo Canzonieri 28 29 , Ada Maria Florena 30 , Livia Biancone 31 , Giovanni Monteleone 31 , Roberto Caronna 32 , Antonio Ciardi 33 , Luca Elli 34 , Flavio Caprioli 34 , Maurizio Vecchi 34 , Renata D'Incà 35 , Fabiana Zingone 35 , Anna D'Odorico 35 , Marco Vincenzo Lenti 6 , Barbara Oreggia 36 , Luca Reggiani Bonetti 37 , Antonino Giulio Giannone 30 , Augusto Orlandi 38 , Valeria Barresi 39 , Rachele Ciccocioppo 40 , Giuseppe Amodeo 40 , Elena Biletta 41 , Ombretta Luinetti 3 , Paolo Pedrazzoli 6 42 , Andrea Pietrabissa 43 , Gino Roberto Corazza 6 , Enrico Solcia 3 , Marco Paulli 3 , Antonio Di Sabatino 6

Affiliations

• 1 Anatomic Pathology Unit, Department of Molecular Medicine, University of Pavia and Fondazione IRCCS San Matteo Hospital, Pavia, Italy. [email protected]. • 2 Pathology Unit, Department of Surgical and Diagnostic Sciences, University of Genoa and Ospedale Policlinico San Martino University Hospital, Genoa, Italy. • 3 Anatomic Pathology Unit, Department of Molecular Medicine, University of Pavia and Fondazione IRCCS San Matteo Hospital, Pavia, Italy. • 4 Clinical Epidemiology and Biometry Unit, Fondazione IRCCS San Matteo Hospital, Pavia, Italy. • 5 Division of Pathological Anatomy, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy. • 6 Department of Internal Medicine, University of Pavia and Fondazione IRCCS San Matteo Hospital, Pavia, Italy. • 7 Unit of General Surgery, ASST Rhodense, Rho Hospital, University of Milan, Milan, Italy. • 8 Gastroenterology Unit, Luigi Sacco University Hospital, Milan, Italy. • 9 Anatomic Pathology Unit, ASST Ovest Milanese, Milan, Italy. • 10 Gastroenterology Unit, Department of Life and Environmental Sciences, University of L'Aquila, L'Aquila, Italy. • 11 Pathology Unit, Department of Medicine and Surgery, University of Insubria, Varese, Italy. • 12 Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Institute of Oncology and Transplant Pathology, St. Orsola- Malpighi Hospital, University of Bologna, Bologna, Italy. • 13 Pathology Unit, Department of Medicine, University of Padua, Padua, Italy. • 14 Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy. • 15 Surgery of the Alimentary Tract, Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. • 16 Intestinal Chronic Bowel Disease Unit, Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Hospital, Alma Mater Studiorum University of Bologna, Bologna, Italy. • 17 Pathology Unit, San Camillo-Forlanini Hospital, Rome, Italy. • 18 Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy. • 19 Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy. • 20 Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy. • 21 Department of Medicine and Surgery, University of Salerno, Salerno, Italy. • 22 Public Health Department, Federico II University of Naples, Naples, Italy. • 23 Unit of Pathology, Cervello Hospital, Palermo, Italy. • 24 Units of General Surgery, Cervello Hospital, Palermo, Italy. • 25 Surgery and Translational Medicine, University of Florence, Florence, Italy. • 26 Institute of Pathology, Spedali Civili Hospital, Brescia, Italy. • 27 Department of Gastroenterology, Centro di Riferimento Oncologico (CRO) di Aviano IRCCS, Aviano, Italy. • 28 Pathology Unit, Centro di Riferimento Oncologico (CRO) di Aviano IRCCS, Aviano, Italy. • 29 Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy. • 30 Pathologic Anatomy Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy. • 31 Department of Systems Medicine, University of Tor Vergata, Rome, Italy. • 32 Department of Surgical Sciences, La Sapienza University, Rome, Italy. • 33 Department of Radiological, Oncological, Pathological Sciences, Umberto I Hospital, La Sapienza University, Rome, Italy. • 34 Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. • 35 Gastroenterology Section, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy. • 36 General Surgery Unit, Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy. • 37 Section of Pathology, Department of Diagnostic Medicine and Public Health, University of Modena and Reggio Emilia, Modena, Italy. • 38 Department of Biopathology and Image Diagnostics, University of Tor Vergata, Rome, Italy. • 39 Section of Anatomical Pathology, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy. • 40 Gastroenterology Unit, Department of Medicine, AOUI Policlinico G.B. Rossi, University of Verona, Verona, Italy. • 41 Anatomic Pathology ASL Biella, Biella, Italy. • 42 Oncology Unit, IRCCS San Matteo Hospital, Pavia, Italy. • 43 Department of Surgery, General Surgery II, University of Pavia and Fondazione IRCCS San Matteo Hospital, Pavia, Italy.

• PMID: 32761330 • DOI: 10.1245/s10434-020-08926-4

Abstract

Background: Small bowel adenocarcinoma is a relatively rare cancer, often diagnosed in an advanced stage. In localized and resectable disease, surgery alone or in combination with adjuvant chemotherapy is the mainstay of treatment. In the recently published National Comprehensive Cancer Network Clinical Practice guidelines, criteria for selecting patients with stage II small bowel adenocarcinoma to receive adjuvant chemotherapy are provided, and they are mainly extrapolated from studies on colorectal cancer.

Patients and methods: In the present study, we aimed to verify whether mismatch repair deficiency phenotype, high-risk pathologic features (including T4, positive resection margins and a low number of lymph nodes harvested), as well as tumor histologic subtype, were associated with cancer-specific survival in 66 stage II non-ampullary small bowel adenocarcinoma patients, collected through the Small Bowel Cancer Italian Consortium. A central histopathology review was performed. Mismatch repair deficiency was tested by immunohistochemistry for MLH1, MSH2, MSH6 and PMS2, and confirmed by polymerase chain reaction for microsatellite instability.

Results: We identified mismatch repair deficiency, glandular/medullary histologic subtype, and celiac disease as significant predictors of favorable cancer-specific survival using univariable analysis with retained significance in bivariable models adjusted for pT stage. Among the high-risk features, only T4 showed a significant association with an increased risk of death; however, its prognostic value was not independent of mismatch repair status.

Conclusions: Mismatch repair protein expression, histologic subtype, association with celiac disease, and, in the mismatch repair proficient subset only, T stage, may help identify patients who may benefit from adjuvant chemotherapy.

Grant support

• Ministero Italiano della Salute/Fondazione IRCCS Policlinico San Matteo

Full-text links

85. Ultrasonography is insensitive but specific for detecting aortic wall abnormalities in dogs infected with Spirocerca lupi

Vet Rec. 2020 Aug 5;vetrec-2019-105836. doi: 10.1136/vr.105836. Online ahead of print.

Authors

Nadav Merhavi 1 , Gilad Segev 2 , Eran Dvir 3 , Dana Peery 4

Affiliations

• 1 Veterinary Diagnostic Imaging, The Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel [email protected]. • 2 Internal Medicine, The Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel. • 3 Tel Hai College, Tel Hai, Upper Galilee, Israel. • 4 Veterinart Diagnostic Imaging, The Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel.

• PMID: 32759378 • DOI: 10.1136/vr.105836

Abstract

Background: Spirocercosis is caused by the nematode Spirocerca lupi (S lupi). The disease mainly affects dogs and is typically diagnosed by oesophagoscopy or faecal examination; however, these diagnostic tests may deliver false negative results during the migration phase of the nematode. The aim of the present prospective study was to evaluate whether ultrasonography could detect abnormalities in the abdominal aorta, celiac artery, and gastric wall structure as a diagnostic aid to detect S lupi infection in dogs.

Methods: Oesophagoscopy and a focused abdominal ultrasound scan were performed in 40 dogs that presented to the Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, with gastrointestinal complaints. Ultrasonography scan findings of 20 dogs with oesophageal nodules, indicating S lupi infection (study group), were compared with those of 20 control dogs.

Results: Vascular wall irregularity was significantly more common in the study group than in the control group (9/20 v 1/20, respectively; P=0.008).

Conclusion: Ultrasonographic evaluation of the abdominal aorta, celiac artery, and gastric wall structure is not a sensitive diagnostic marker for spirocercosis in dogs. However, the presence of vascular wall irregularity of the abdominal aorta or celiac artery might indicate S lupi migration.

Keywords: aneurysm; aorta; spirocerca; ultrasound.

Conflict of interest statement

Competing interests: None declared.

Full-text links

86. Avoiding duodenal biopsy in investigating coeliac disease during covid-19

BMJ. 2020 Aug 5;370:m3082. doi: 10.1136/bmj.m3082.

Author

Ian L P Beales 1

Affiliation

• 1 Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK.

• PMID: 32759290 • DOI: 10.1136/bmj.m3082

No abstract available

Conflict of interest statement

Competing interests: None declared.

Comment on

• Investigating coeliac disease in adults.

Ashton JJ, Smith R, Smith T, Beattie RM.

BMJ. 2020 Jun 17;369:m2176. doi: 10.1136/bmj.m2176.

PMID: 32554547No abstract available.

Publication types

• Letter • Comment

MeSH terms

• Betacoronavirus • Biopsy • Celiac Disease* • Coronavirus Infections* • Humans • Intestines • Pandemics* • Pneumonia, Viral*

Supplementary concepts

• COVID-19 • severe acute respiratory syndrome coronavirus 2

Full-text links

87. Are patients with chronic rhinosinusitis with nasal polyps at a decreased risk of COVID-19 infection?

Int Forum Allergy Rhinol. 2020 Aug 5;10.1002/alr.22672. doi: 10.1002/alr.22672. Online ahead of print.

Authors

Fatemeh Saheb Sharif-Askari 1 , Narjes Saheb Sharif-Askari 1 , Swati Goel 1 , Samer Fakhri 2 , Saleh Al-Muhsen 3 , Qutayba Hamid 1 4 5 , Rabih Halwani 1 4 6

Affiliations

• 1 Sharjah Institute of Medical Research, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates. • 2 Department of Otorhinolaryngology-Head & Neck Surgery, Faculty of Medicine and AUBMC, American University of Beirut, Beirut, Lebanon. • 3 Immunology Research Lab, department of pediatrics, College of Medicine, King Saud University, Saudi Arabia. • 4 Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates. • 5 Meakins-Christie Laboratories, Research Institute of the McGill University Health Center, Montreal, Quebec, Canada. • 6 Prince Abdullah Ben Khaled Celiac Disease Chair, department of pediatrics, Faculty of Medicine, King Saud University, Saudi Arabia.

• PMID: 32757347 • PMCID: PMC7436719 • DOI: 10.1002/alr.22672

Free PMC article No abstract available

• 13 references

Publication types

• Letter

Grant support

• 150317/Tissue Injury and Repair (TIR) Group operational grant • COVID-19 research grant • 2001090275/University of Sharjah, Seed grant • 2001090278/University of Sharjah, Collaborative research grant • Sandooq Al Watan Applied Research & Development grant • Prince Abdullah Ben Khalid Celiac Disease Research Chair, under the Vice Deanship of Research Chairs, King Saud University, Riyadh, Kingdom of Saudi Arabia • DRI-KSU-928/Deputyship for Research & Innovation, Ministry of Education in Saudi Arabia

Full-text links

88. Co-occurrence of compression syndromes: celiac axis stenosis, superior mesenteric artery and nutcracker syndrome Rev Esp Enferm Dig. 2020 Aug 5. doi: 10.17235/reed.2020.6945/2020. Online ahead of print.

Authors

Javier A Cienfuegos 1 , Isabel Vivas Pérez 2 , Fernando Rotellar 3

Affiliations

• 1 Cirugía/ Apoyo Investigación, Clinica Universidad de Navarra, España. • 2 Radiología, Clínica Universidad de Navarra, España. • 3 Cirugía General, Clínica Universidad de Navarra, España.

• PMID: 32755144 • DOI: 10.17235/reed.2020.6945/2020

Free article Abstract

Moreno Márquez et al. report an association between arcuate ligament syndrome (ALS) and the "nutcracker" phenomenon (compression of the left renal vein). The case illustrates the association between several syndromes, which all involve compression of vascular or gastrointestinal structures: arcuate ligament syndrome, superior mesenteric artery syndrome (SMAS) or Wilkie's syndrome, the "nutcracker" syndrome and May-Thurner syndrome (compression of the left iliac vein).

Full-text links

89. Gluten neuropathy: electrophysiological progression and HLA associations

J Neurol. 2020 Aug 4. doi: 10.1007/s00415-020-10137-6. Online ahead of print.

Authors Panagiotis Zis 1 2 3 , Ptolemaios Sarrigiannis 4 , Artemios Artemiadis 5 , David S Sanders 6 , Marios Hadjivassiliou 4

Affiliations

• 1 Academic Directorate of Neurosciences, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK. [email protected]. • 2 Medical School, University of Cyprus, Nicosia, Cyprus. [email protected]. • 3 Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK. [email protected]. • 4 Academic Directorate of Neurosciences, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK. • 5 Medical School, University of Cyprus, Nicosia, Cyprus. • 6 Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.

• PMID: 32754830 • DOI: 10.1007/s00415-020-10137-6

Abstract

Objective: Gluten neuropathy (GN) is the term used to describe peripheral neuropathy that occurs in patients with gluten sensitivity (GS) or coeliac disease (CD) in the absence of other risk factors. We aimed to describe the neurophysiological progression rate of GN across time and look into the potential role of genetic susceptibility in its development.

Methods: This is a cohort study of 45 patients with GN with a mean follow-up period of 8 ± 5 years. The assessments included clinical and neurophysiological data and HLA-DQ genotyping.

Results: The mean age at diagnosis was 60 ± 12 years. The majority of patients had a length-dependent neuropathy (75.6%), whereas the rest were diagnosed with sensory ganglionopathy (SG). DQA1*02-positive patients were more likely to suffer with SG compared to the DQA1*02 negative patients (60% versus 13.8%, p = 0.009). There was also a trend for statistical significance regarding the DQB1*06 allele and the DQA1*01/DQB1*06 haplotype were found more frequently in patients with GN than in healthy controls (p = 0.026 and p = 0.047, respectively). A linear effect of time on the neurophysiological findings was found in radial sensory nerve action potential (1.9% mean annual decrement, p = 0.036), sural sensory nerve action potential (3.3% mean annual decrement, p = 0.013) and tibial nerve motor compound action potential (6.5% mean annual decrement, p < 0.001) amplitudes, independently from age or gender.

Conclusions: GN is a late manifestation of GS and CD. The majority of patients have the length-dependent neuropathy with a linear deterioration over time. HLA genotyping of GS and CD patients who suffer from neuropathic symptoms is recommended as it can help identifying patients at risk for developing SG.

Keywords: Coeliac disease; Gluten sensitivity; HLA genotyping; Peripheral neuropathy; Progression.

Full-text links

90. X-ray microtomography is a novel method for accurate evaluation of small-bowel mucosal morphology and surface area

Sci Rep. 2020 Aug 4;10(1):13164. doi: 10.1038/s41598-020-69487-w.

Authors

Johannes Virta 1 2 , Markus Hannula 3 , Ilmari Tamminen 3 , Katri Lindfors 4 , Katri Kaukinen 4 5 , Alina Popp 6 , Juha Taavela 7 , Päivi Saavalainen 8 , Pauliina Hiltunen 1 2 , Jari Hyttinen 3 , Kalle Kurppa 9 10 11

Affiliations

• 1 Center for Child Health Research, Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, 33520, Tampere, Finland. • 2 Department of Pediatrics, Tampere University Hospital, Tampere, Finland. • 3 Computational Biophysics and Imaging Group, The Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. • 4 Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. • 5 Department of Internal Medicine, Tampere University Hospital, Tampere, Finland. • 6 Carol Davila University of Medicine and Pharmacy, and Alessandrescu- Rusescu National Institute for Mother and Child Health, Bucharest, Romania. • 7 Central Finland Central Hospital, Jyväskylä, Finland. • 8 Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland. • 9 Center for Child Health Research, Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, 33520, Tampere, Finland. [email protected]. • 10 Department of Pediatrics, Tampere University Hospital, Tampere, Finland. [email protected]. • 11 The University Consortium of Seinäjoki, Seinäjoki, Finland. [email protected].

• PMID: 32753621 • PMCID: PMC7403326 • DOI: 10.1038/s41598-020-69487-w

Free PMC article Abstract

The often poorly orientated small-bowel mucosal biopsies taken for the diagnostics of celiac disease and other intestinal disorders are prone to misinterpretation. Furthermore, conventional histopathology has suboptimal sensitivity for early histopathological changes observed in short-term challenge studies. X-ray microtomography (micro-CT) is a promising new method for accurate imaging of human-derived biological samples. Here, we report that micro-CT could be utilized to create virtual reconstructions of endoscopically obtained intestinal biopsies. The formed digital 3D images enabled selection of always optimal cutting angles for accurate measurement of the mucosal damage and revealed diagnostic lesions in cases interpreted as normal with conventional histomorphometry. We also demonstrate that computer-assisted point cloud analysis can be used to calculate biologically meaningful surface areas of the biopsies in different stages of mucosal damage with excellent replicability and correlation with other disease parameters. We expect the improved diagnostic accuracy and capability to measure the surface areas to provide a powerful tool for the diagnostics of intestinal diseases and for future clinical and pharmaceutical trials.

Conflict of interest statement

The authors declare no competing interests.

• 42 references • 4 figures

Full-text links

91. Current Evidence on the Efficacy of Gluten- Free Diets in Multiple Sclerosis, Psoriasis, Type 1 Diabetes and Autoimmune Thyroid Diseases

Nutrients. 2020 Aug 1;12(8):E2316. doi: 10.3390/nu12082316.

Authors

Moschoula Passali 1 2 , Knud Josefsen 3 , Jette Lautrup Frederiksen 1 2 , Julie Christine Antvorskov 3

Affiliations

• 1 Multiple Sclerosis Clinic, Department of Neurology, Rigshospitalet- Glostrup, Valdemar Hansens Vej 13, 2600 Glostrup, Denmark. • 2 Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark. • 3 The Bartholin Institute, Rigshospitalet, Ole Maaløes Vej 5, 2200 Copenhagen, Denmark.

• PMID: 32752175 • DOI: 10.3390/nu12082316

Free article Abstract

In this review, we summarize the clinical data addressing a potential role for gluten in multiple sclerosis (MS), psoriasis, type 1 diabetes (T1D) and autoimmune thyroid diseases (ATDs). Furthermore, data on the prevalence of celiac disease (CD) and gluten-related antibodies in the above patient groups are presented. Adequately powered and properly controlled intervention trials investigating the effects of a gluten-free diet (GFD) in non-celiac patients with MS, psoriasis, T1D or ATDs are lacking. Only one clinical trial has studied the effects of a GFD among patients with MS. The trial found significant results, but it is subject to major methodological limitations. A few publications have found beneficial effects of a GFD in a subgroup of patients with psoriasis that were seropositive for anti-gliadin or deamidated gliadin antibodies, but no effects were seen among seronegative patients. Studies on the role of gluten in T1D are contradictive, however, it seems likely that a GFD may contribute to normalizing metabolic control without affecting levels of islet autoantibodies. Lastly, the effects of a GFD in non-celiac patients with ATDs have not been studied yet, but some publications report that thyroid- related antibodies respond to a GFD in patients with concomitant CD and ATDs. Overall, there is currently not enough evidence to recommend a GFD to non-celiac patients with MS, psoriasis, ATDs or T1D.

Keywords: autoimmune thyroid disease; autoimmunity; celiac disease; gliadin; gluten; gluten-free diet; multiple sclerosis; neurology; psoriasis; type 1 diabetes.

Publication types

• Review

Grant support

• A38270/Scleroseforeningen • NA/Kirsten og Freddy Johansens Fond

Full-text links

92. Green tea polyphenols mitigate the plant lectins-induced liver inflammation and immunological reaction in C57BL/6 mice via NLRP3 and Nrf2 signaling pathways

Food Chem Toxicol. 2020 Aug 1;144:111576. doi: 10.1016/j.fct.2020.111576. Online ahead of print.

Authors

Dongxu Wang 1 , Man Zhang 2 , Taotao Wang 3 , Tiantian Liu 2 , Yuanxin Guo 4 , Daniel Granato 5

Affiliations

• 1 School of Grain Science and Technology, Jiangsu University of Science and Technology, Zhenjiang, Jiangsu, 212003, PR China; School of Tea and Food Science & Technology, Anhui Agricultural University, Hefei, Anhui, 230036, PR China. Electronic address: [email protected]. • 2 School of Tea and Food Science & Technology, Anhui Agricultural University, Hefei, Anhui, 230036, PR China. • 3 Department of Clinical Nutrition, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212000, PR China. • 4 School of Grain Science and Technology, Jiangsu University of Science and Technology, Zhenjiang, Jiangsu, 212003, PR China. • 5 Innovative Food System, Production Systems Unit - Natural Resources Institute Finland (LUKE), FI-02150, Espoo, Finland. Electronic address: [email protected].

• PMID: 32750449 • DOI: 10.1016/j.fct.2020.111576 Abstract

Plant-derived dietary lectins have been reported to be involved in the pathogenesis of several inflammatory diseases, including hepatitis, inflammatory bowel disease, diabetes, and celiac disease. In this present study, we aimed to assess whether green tea polyphenols (GTPs) exerts protective effects against plant lectins-induced liver inflammation and immunological reaction in mice. The C57BL/6 mice received intragastric GTPs (200 mg/kg b.w.) once per day for 7 consecutive days prior to plant lectins stimulation (50 mg/kg b.w., intraperitoneally). GTPs supplementation alleviated the histopathological changes of liver and the disorder of serum biochemical parameters in plant lectins-challenged mice. GTPs supplementation also alleviated plant lectins-induced oxidative stress and liver inflammation, decreasing protein contents and gene expression levels of pro- inflammatory cytokines in the plasma and hepatic tissue and increasing antioxidant capacity in the liver. GTPs decreased the protein expression levels of myeloperoxidase, F4/80 and neutrophil, as determined by immunohistochemical analysis, and T lymphocytes (CD4 and CD8) contents as determined by immunofluorescence analysis, in the liver. Moreover, we found that GTPs inhibited Nod-like receptor family, pyrin domain containing 3 (NLRP3) inflammasome expression and increased nuclear factor erythroid 2- related factor 2 (Nrf2) pathways in the liver tissues of plant lectins-challenged mice. Taken together, these results show that GTPs alleviates hepatic inflammatory damage and immunological reaction after plant lectins challenge, and GTPs (or green tea intake) supplements can be beneficial for people exposed to plant lectins.

Keywords: Catechins; Flavonoids; Immunological reaction; Liver injury; NLRP3 inflamassome; Oxidative stress; Plant lectins.

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93. Concise Commentary: Budesonide-When Going Gluten-Free Is Not Good Enough Dig Dis Sci. 2020 Aug 4. doi: 10.1007/s10620-020-06514-w. Online ahead of print.

Author

Prashant Singh 1

Affiliation

• 1 Division of Gastroenterology, University of Michigan, Medical Science Research Building I, Room 6520B, 1150 Medical Center Drive, Ann Arbor, 48109, USA. [email protected].

• PMID: 32749637 • DOI: 10.1007/s10620-020-06514-w

No abstract available Publication types

• Editorial

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94. A new comprehensive ultrasonic diagnostic method for celiac artery compression syndrome that hybridizes "arterial compression hook sign" and peak systolic velocity

J Ultrasound. 2020 Aug 4. doi: 10.1007/s40477-020-00519-x. Online ahead of print.

Authors

Daisuke Miura 1 , Rino Hiwatashi 2 , Mitsuto Sakita 2 , Tomoko Sakata 3 Affiliations

• 1 Department of Clinical Laboratory, Fukuoka Tokushukai Hospital, 4-5 Sugu Kita, Kasuga-shi, Fukuoka, 816-0864, Japan. [email protected]. • 2 Department of Clinical Laboratory, Fukuoka Tokushukai Hospital, 4-5 Sugu Kita, Kasuga-shi, Fukuoka, 816-0864, Japan. • 3 Department of Laboratory Medicine, Fukuoka Tokushukai Hospital, 4- 5 Sugu Kita, Kasuga-shi, Fukuoka, 816-0864, Japan.

• PMID: 32749575 • DOI: 10.1007/s40477-020-00519-x

Abstract

Purpose: Diagnosing celiac artery compression syndrome (CACS) is based on an imaging finding of celiac artery compression (CAC), but the diagnostic criteria are inconsistent. The study aim was to devise an ultrasonographic screening method to effectively diagnose CAC in occult CACS.

Methods: The subjects were 61 patients with suspected CACS who underwent ultrasonography at our hospital from May 2017 to December 2019 and were divided into the following two groups: the "arterial compression hook sign"- positive group (n = 15, mean age: 26.6 ± 16.4 years, six males, nine females) and -negative group (n = 41, mean age: 32.5 ± 18.6 years, 12 males, 34 females). We used B-mode and advanced dynamic flow to detect arterial compression hook sign and pulse Doppler to measure expiration peak systolic velocity (EPSV) and inspiration PSV (IPSV).

Results: The EPSV was significantly higher in the arterial compression hook sign-positive group (304.7 ± 47.4 cm/s) than in the -negative groups (158.2 ± 38.7 cm/s), (p < 0.001). Receiver operating characteristic curve analysis was performed to calculate the EPSV cutoff value for presence of CAC, which was 226 cm/s (sensitivity: 0.957, specificity: 1.000, AUC: 0.997, 95% confidence interval: 0.99-1). The IPSV was lower in the positive group than in the negative group in all cases (EPSV - IPSV range: 68-199 cm/s). Conclusion: Our results showed that if arterial compression hook sign determined by B-mode ultrasound, EPSV > 226 cm/s, and IPSV decreases by ≥ 68 cm/s, then CAC can be detected with high specificity.

Keywords: Arterial compression hook sign; Celiac artery compression syndrome; Median arcuate ligament syndrome; Ultrasound.

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95. Fracture risk assessment in celiac disease: a registry-based cohort study

Osteoporos Int. 2020 Aug 3. doi: 10.1007/s00198-020-05579-7. Online ahead of print.

Authors

D R Duerksen 1 , L M Lix 2 , H Johansson 3 4 , E V McCloskey 3 5 , N C Harvey 6 7 , J A Kanis 3 4 , W D Leslie 2

Affiliations

• 1 University of Manitoba, Winnipeg, Canada. [email protected]. • 2 University of Manitoba, Winnipeg, Canada. • 3 Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK. • 4 Mary McKillop Health Institute, Australian Catholic University, Melbourne, Australia. • 5 Centre for Integrated Research in Musculoskeletal Ageing (CIMA), Mellanby Centre for Bone Research, University of Sheffield, Sheffield, UK. • 6 MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. • 7 NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK. • PMID: 32748311 • DOI: 10.1007/s00198-020-05579-7

Abstract

Celiac disease is associated with an increased fracture risk but is not a direct input to the FRAX® calculation. When celiac disease is considered as a secondary osteoporosis risk factor or BMD is included in the FRAX assessment, FRAX accurately predicts fracture risk.

Introduction: The fracture risk assessment tool (FRAX®) uses clinical factors and bone mineral density (BMD) measurement to predict 10-year major osteoporotic (MOF) fracture probability. The study aim was to determine whether celiac disease affects MOF risk independent of FRAX score.

Methods: The Manitoba BMD Registry includes clinical data, BMD measurements, 10-year probability of MOF calculated for each individual using the Canadian FRAX tool and diagnosed celiac disease. Using linkage to population-based healthcare databases, we identified incident MOF diagnoses over the next 10 years for celiac disease and general population cohorts.

Results: Celiac disease (N = 693) was associated with increased fracture risk adjusted for FRAX score computed without secondary osteoporosis or BMD (adjusted hazard ratio [HR] 1.43, 95% confidence interval [CI] 1.11-1.86). Celiac disease was no longer a significant risk factor for fracture when secondary osteoporosis or BMD were included in the FRAX calculation (p > 0.1). In subjects with celiac disease, each SD increase in FRAX score (calculated with and without secondary osteoporosis or BMD) was associated with higher risk of incident MOF (adjusted HR 1.66 to 1.80), similar to the general population (p-interaction > 0.2). Including celiac disease as secondary osteoporosis or including BMD in FRAX 10-year MOF probability calculations (10.1% and 8.6% respectively) approximated the observed cumulative 10-year MOF probability (10.8%, 95% CI 7.8-13.9%).

Conclusions: Celiac disease is associated with an increased risk of major osteoporotic fractures. When celiac disease is considered as a secondary osteoporosis risk factor or BMD is included in FRAX assessment, FRAX accurately predicts fracture risk. Keywords: Celiac disease; Epidemiology; FRAX score; Major osteoporotic fracture risk; Osteoporosis.

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96. On the diagnosis of childhood coeliac disease: Past and present

Acta Paediatr. 2020 Aug 2. doi: 10.1111/apa.15512. Online ahead of print.

Authors

Lars Stenhammar 1 , Anna Myléus 2 , Olof Sandström 3 , Lotta Högberg 1

Affiliations

• 1 Department of Paediatrics, Linköping University, Norrköping Hospital, Norrköping, Sweden. • 2 Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden. • 3 Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.

• PMID: 32740975 • DOI: 10.1111/apa.15512

No abstract available

• 5 references

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97. Point-of-Care-test screening versus Case Finding for pediatric celiac disease: a pragmatic study in primary care

Acta Paediatr. 2020 Aug 2. doi: 10.1111/apa.15514. Online ahead of print.

Authors

Giuseppe Primavera 1 , Andrea Aiello 2 , Caterina Grosso 3 , Gianluca Trifirò 4 , Stefano Costa 5 , Anne-Marie Grima 6 , Socrate Pallio 7 , Mondher Toumi 8 , Giuseppe Magazzu 9 , Salvatore Pellegrino 5 , Sicilian Celiac Disease Study Group

Affiliations

• 1 National Health System, ASL Palermo, Italy. • 2 Creativ-Ceutical, Milan, Italy. • 3 Ragusa Hospital Pediatric Unit, ASL Ragusa, Italy. • 4 Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy. • 5 Regional Celiac Center, AOU Messina, Italy. • 6 Mater Dei Hospital, Department of Child and Adolescent Health, Malta. • 7 Digestive Endoscopy Unit, University of Messina, Italy. • 8 Faculty of Medicine, Public Health Department, Aix-Marseille University, Marseille, France. • 9 University of Messina, Patologiaumanadetev Department, Italy.

• PMID: 32740955 • DOI: 10.1111/apa.15514

Abstract

In pediatric Celiac Disease (CD), symptoms may not be a reliable factor in the diagnosis of celiac disease as described by Rosen et al (1) and thus recommendations for reviewing CD screening criteria were suggested (2). Apart from the costs, an important limiting factor in pediatric population mass screening using conventional immunoglobulin (Ig) A tissue transglutaminase (tTGIgA) may be the low compliance of asymptomatic children to be referred for testing. On the other hand, the alternative approach, the CF strategy, relies on selecting the individuals to be tested for CD, in the presence of conditions known to be associated with CD, by the family pediatrician.

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98. Study of serology and genetics of celiac disease in patients with juvenile systemic lupus erythematosus 'celiac in juvenile systemic lupus'

Eur J Gastroenterol Hepatol. 2020 Oct;32(10):1322-1327. doi: 10.1097/MEG.0000000000001865.

Authors

Ayman M Shamseya 1 , Eman H Elsayed 1 , Hanaa M Donia 2

Affiliations

• 1 Departments of Internal Medicine. • 2 Clinical Pathology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt.

• PMID: 32732814 • DOI: 10.1097/MEG.0000000000001865

Abstract

Introduction: Several case reports and case series have suggested a possible association between celiac disease (CD) and systemic lupus erythematosus (SLE). Patients with CD developing SLE and vice versa have been reported, highlighting a possible association. Up to 23% of patients with CD have raised anti-double-stranded DNA and likewise 5-22% of SLE patients are seropositive for CD.

Objective: Aim was to screen for CD in the serum of patients suffering from juvenile SLE (JSLE).

Methods: One hundred JSLE patients and 40 (age- and sex-matched) healthy subjects were subjected to laboratory screening for CD, endoscopic examination and histopathological examination of the duodenal biopsies to confirm CD diagnosis (in seropositive cases only).

Results: tTG Ab tested positive in 10% and negative in 90% of patients. tTG Ab correlated significantly with Systemic Lupus Erythematosus Disease Activity Index score (P < 0.001) and insignificantly with hemoglobin and C-reactive protein. Esophago-gastro-duodenoscopy was done to all 10 patients with positive serology for CD revealing six patients with manifest celiac (positive serology and positive endoscopy/biopsy) and four cases of latent celiac (positive serology and negative endoscopy/biopsy).

Conclusion: Most CD patients with articular symptoms remain undiagnosed, which makes screening justified in high-risk patients with autoimmune diseases. This study highlights the strong relationship between JSLE and CD and the need to screen JSLE patients and also other auto-immune rheumatic diseases for the concomitant existence of CD.

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99. Truncated aptamers as selective receptors in a gluten sensor supporting direct measurement in a deep eutectic solvent

Biosens Bioelectron. 2020 Oct 1;165:112339. doi: 10.1016/j.bios.2020.112339. Epub 2020 Jun 4.

Authors Rossella Svigelj 1 , Nicolo Dossi 1 , Stefania Pizzolato 1 , Rosanna Toniolo 2 , Rebeca Miranda- Castro 3 , Noemí de-Los-Santos-Álvarez 3 , María Jesús Lobo-Castañón 4

Affiliations

• 1 Department of Agrifood, Environmental and Animal Science, University of Udine, Italy. • 2 Department of Agrifood, Environmental and Animal Science, University of Udine, Italy. Electronic address: [email protected]. • 3 Departamento de Química Física y Analítica, Universidad de Oviedo, Av. Julián Clavería 8, 33006, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias, Av. de Roma, 33011, Oviedo, Spain. • 4 Departamento de Química Física y Analítica, Universidad de Oviedo, Av. Julián Clavería 8, 33006, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias, Av. de Roma, 33011, Oviedo, Spain. Electronic address: [email protected].

• PMID: 32729482 • DOI: 10.1016/j.bios.2020.112339

Abstract

Enzyme-linked immunosorbent assays are currently the most popular methods to quantify gluten in foods. Unfortunately, the antibodies used as specific receptors in such methods are not compatible with the usual solvents for the extraction of gluten proteins. In consequence, commercial tests require a high dilution of the sample after the extraction, increasing the limit of quantification and decreasing convenience. In this work, we have rationally truncated an aptamer capable of recognizing gliadin in a deep eutectic solvent (DES). The truncated aptamer is a 19-nucleotides-long DNA that minimizes self-hybridization, allowing the development of an electrochemical sandwich- based sensor for the quantification of gluten in the DES ethaline. The sensor incorporates two identical biotin-labeled truncated aptamers, one of which is immobilized on a carbon screen-printed electrode and the other reports the binding of gliadin after incubation in streptavidin-peroxidase. This sensor can detect gliadin in DES, with a dynamic range between 1 and 100 μg/L and an intra-assay coefficient of variation of 11%. This analytical performance allows the quantification of 20 μg of gluten/kg of food when 1 g of food is extracted with 10 mL of ethaline. We demonstrate the ability of this method to achieve the measurement of gluten in food samples, after the extraction with pure ethaline. The assay is useful for the analysis of residual gluten levels in foods, thus facilitating the evaluation of any potential health risk associated with the consumption of such food by people with celiac disease or other gluten- related disorders.

Keywords: Aptamer; Deep eutectic solvent; Gluten; Sandwich assay.

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100. Effect of phytase treatment of sorghum flour, an alternative for gluten free foods and bioaccessibility of essential minerals

J Food Sci Technol. 2020 Sep;57(9):3474-3481. doi: 10.1007/s13197-020- 04382-w. Epub 2020 Apr 11.

Authors

Ana Paula Rebellato 1 , Eduardo A Orlando 1 , Viviane C Toretti Thedoropoulos 1 , Ralf Greiner 2 , Juliana A Lima Pallone 1

Affiliations

• 1 Department of Food Science, School of Food Engineering, University of Campinas, Monteiro Lobato Street, 80, Campinas, São Paulo 13083-862 Brazil. • 2 Food Technology and Bioprocess Engineering, Max Rubner-Institut, Federal Research Institute of Nutrition and Food, Haid-und-Neu-Straße 9, 76131 Karlsruhe, Germany.

• PMID: 32728294 • PMCID: PMC7374524 (available on 2021-09-01) • DOI: 10.1007/s13197-020-04382-w Abstract

This study evaluated the effect of phytase treatment on the bioavailability of iron (Fe), calcium (Ca), zinc (Zn), and myo-inositol phosphate fractions in sorghum flour; and characterized its macronutrients and minerals. The proximate composition and mineral content indicated that, sorghum flour has a nutritional potential superior to wheat and maize. The results obtained in the solubility and dialysis assays indicated that, naturally occurring minerals (without phytase treatment) in sorghum flour, presented considerable bioaccessibility; reaching 32, 47 and 67% of dialyzable Fe, Zn, and Ca respectively. The use of phytase had a positive influence on the reduction of myo-inositol phosphates, mainly the IP6 fraction, present in sorghum flour samples, and an increase in the soluble percentage (Fe 52% for one sample, for Zn higher than 266%) and dialyzed minerals (Fe 7.8-150%; Zn 19.7 for one sample; and Ca 5-205%) for most samples. Therefore, the essential minerals naturally occurring in sorghum have an absorption potential; and the use of phytase reduced the IP6 fraction and improved the availability of the minerals evaluated.

Keywords: Calcium; In vitro tests; Iron; Myo-inositol phosphate fractions; Sorghum flour; Zinc.

101. Coeliac-Like Disease Is a Rare Immune- Related Complication Induced by Nivolumab in NSCLC

J Thorac Oncol. 2020 Aug;15(8):e147-e148. doi: 10.1016/j.jtho.2019.12.119.

Authors

Romain Kokorian 1 , Thomas Grainville 2 , Lucie Robert 1 , Romain Corre 3 , Hervé Lena 3 , Astrid Lievre 4 , Charles Ricordel 5

Affiliations

• 1 CLCC Eugène Marquis, Service d'oncologie médicale, CLCC Eugène Marquis, Rennes, France. • 2 CHU Rennes, Service des maladies de l'appareil digestif, CHU Rennes, Rennes, France; Université de Rennes 1, Rennes, France. • 3 CHU Rennes, Service de Pneumologie, CHU Rennes, Rennes, France; INSERM U1242, Chemestry Oncogenesis Stress and Signaling, CLCC Eugène Marquis, Rennes, France. • 4 CLCC Eugène Marquis, Service d'oncologie médicale, CLCC Eugène Marquis, Rennes, France; INSERM U1242, Chemestry Oncogenesis Stress and Signaling, CLCC Eugène Marquis, Rennes, France. • 5 CHU Rennes, Service de Pneumologie, CHU Rennes, Rennes, France; INSERM U1242, Chemestry Oncogenesis Stress and Signaling, CLCC Eugène Marquis, Rennes, France. Electronic address: charles.ricordel@chu- rennes.fr.

• PMID: 32718543 • DOI: 10.1016/j.jtho.2019.12.119

No abstract available Publication types

• Letter

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102. Multislice Computed Tomographic Manifestation of Transient Hepatic Attenuation Difference in the Left Lobe of the Liver: A Retrospective Study

Adv Ther. 2020 Sep;37(9):3954-3966. doi: 10.1007/s12325-020-01428-5. Epub 2020 Jul 26.

Authors

Bin Yang 1 , Guangyan Si 2 , Qizhou He 1 , Shulan Liu 1 , Sikai Wang 1 , Rong Xian 1 , Jie Zhang 1 , Fei Yu 1 , Jian Guan 3 Affiliations

• 1 Department of Radiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Lu Zhou, 646000, Sichuan, People's Republic of China. • 2 Department of Radiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Lu Zhou, 646000, Sichuan, People's Republic of China. [email protected]. • 3 Department of Radiology, The First Affiliated Hospital of Zhongshan University, Guang Zhou, 510080, Guangdong, People's Republic of China.

• PMID: 32715380 • DOI: 10.1007/s12325-020-01428-5

Abstract

Introduction: Transient hepatic attenuation differences (THAD) are areas of high parenchymal enhancement observed during the hepatic arterial phase on computed tomography (CT). THAD in the left lobe of the liver can lead to surgical complications.

Methods: A retrospective study was conducted on patients who underwent multislice computed tomography (MSCT) examination of the upper abdomen to understand the morphology, distribution, and causes of THAD and their correlation with hepatic artery variation.

Results: Among 179 cases, 65 and 114 belonged to diseased and normal groups, respectively. THAD as observed in MSCT demonstrated various shapes: lobe/segment (127 cases; 70.9%), irregular sheet (31; 17.3%), strip shape (9; 5.02%), arc/semicircle (7; 3.9%), and segment + flaky (5; 2.79%). THAD were found to be caused by liver tumor (32.3%), hepatic inflammatory lesions (6.15%), biliary tract diseases (13.8%), perihepatic disease compression (9.23%), portal vein obstructive disease (1.53%), and lesion in left hepatic lobe with hepatic artery variation (29.2%). THAD exhibited variation in distribution in the left lobe of the liver. Among 114 cases, THAD in 18 (15.7%) cases were observed in the S2 segment, six (5.26%) in the S3 segment, and 90 (78.9%) in multiple segments of the liver, that is, 50 cases in S2 and S3 segments and 40 cases in S2, S3, and S4 segments. The hepatic artery of 179 cases was of various types based on Hiatt classification: 57 cases of Hiatt I (31%), 65 cases of Hiatt II (37%), 11 cases of Hiatt III (6%), 17 cases of Hiatt IV (10%), 7 cases of Hiatt V (4%), 12 cases of large left hepatic artery (7%), 6 cases of right hepatic artery originating from the celiac trunk (3%), and 4 cases (2%) of superior mesenteric artery originating from the celiac trunk.

Conclusion: THAD can occur as a result of specific pathological causes and hence should be considered as a diagnostic sign in liver pathologies.

Keywords: Hepatic artery variation; Left hepatic lobe; MSCT; Transient hepatic attenuation difference.

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103. Correlation between salivary and serum CA15-3 concentrations in patients with breast cancer

Mol Clin Oncol. 2020 Aug;13(2):155-161. doi: 10.3892/mco.2020.2062. Epub 2020 Jun 4.

Authors

Daniele Xavier Assad 1 2 , Elisa Cançado Porto Mascarenhas 1 3 , Ana Gabriela Costa Normando 1 , Hélène Chardin 4 5 , Gustavo Barcelos Barra 6 , Riccardo Pratesi 7 , Yanna Karla de Medeiros Nóbrega 8 , Ana Carolina Acevedo 1 , Eliete Neves Silva Guerra 1

Affiliations

• 1 Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasília Campus Universitário Darcy Ribeiro, Brasília, DF 70910-900, Brazil. • 2 Medical Oncology Department, Hospital Sírio-Libanês, Brasília, DF 70200-730, Brazil. • 3 Department Medical Oncology, Cettro-Centro de Câncer de Brasília, Brasilia, DF 70710-904, Brazil. • 4 Department of Analytical, Bioanalytical Sciences and Miniaturization (LSABM), ESPCI Paris, PSL Research University, Paris 75005, France. • 5 Faculty of Dental Surgery, Paris Descartes Sorbonne Paris Cité University, Paris 92120, France. • 6 Sabin Medicina Diagnóstica, Brasília, DF 70632-340, Brazil. • 7 Interdisciplinary Laboratory of Biosciences and Celiac Disease Research Center, School of Medicine, University of Brasilia, Brasília, DF 70910-900, Brazil. • 8 Applied Analysis Laboratory, Department of Pharmaceutical Sciences, Health Sciences Faculty, University of Brasília, Brasília, DF 70910-900, Brazil.

• PMID: 32714539 • PMCID: PMC7366245 • DOI: 10.3892/mco.2020.2062

Free PMC article Abstract

The early detection of breast cancer enables the use of less aggressive treatment and increases patient survival. The transmembrane glycoprotein mucin 1, which is also known as cancer antigen 15-3 (CA15-3), is aberrantly glycosylated and overexpressed in a variety of epithelial cancers, and serves a crucial role in the progression of the disease. CA15-3 is currently used as a marker of breast cancer. In the present study, CA15-3 concentrations in saliva and blood of patients with breast cancer were evaluated to test new assays to detect salivary CA15-3 in addition to ELISA and its diagnostic value. To the best of our knowledge, there are no previous reports of the use of chemiluminescence assay (CLIA) and electrochemiluminescence assay (ECLIA) in saliva. Saliva and blood were collected on the same day from patients with breast cancer (n=26) and healthy controls (n=28). For each subject, the level of serum CA15-3 was measured using ECLIA, and the level of salivary CA15-3 was measured using ECLIA, CLIA and enzyme-linked immunosorbent assay (ELISA). ELISA and CLIA were able to detect CA15-3 in saliva; however, ECLIA could not detect salivary CA15-3. There was no significant difference between the mean serum and salivary CA15-3 levels in patients with breast cancer or healthy controls. The levels of CA15-3 were highest for luminal breast cancer subtypes and stage IV cases. A moderate correlation was observed between salivary and serum CA15-3 levels as measured by ELISA in breast cancer patients (r=0.56; P=0.0047). The results demonstrated that ECLIA was not a good method to detect salivary CA15-3, although it is the gold standard for detecting serum CA15-3. The presence of CA15-3 in saliva was confirmed, and this will be useful in future research. Further investigations are necessary to confirm the ability to detect salivary CA15-3 and its correlation with serum CA15-3.

Keywords: breast cancer; cancer antigen 15-3; chemiluminescence assay; electrochemiluminescence assay; saliva.

• 28 references • 1 figure

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104. The Value of Screening for Celiac Disease in Systemic Lupus Erythematosus: A Single Experience of a Tertiary Medical Center

Rheumatol Ther. 2020 Sep;7(3):649-656. doi: 10.1007/s40744-020-00223-6. Epub 2020 Jul 23.

Authors

Fahidah AlEnzi 1 , Mada Yateem 2 , Manal Shaikh 2 , Fahad AlSohaibani 3 , Badryah Alhaymouni 4 , AlShaikh Ahmed 4 , Sulaiman M Al-Mayouf 2

Affiliations

• 1 Clinical Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia. [email protected]. • 2 Pediatric Rheumatology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. • 3 Adult Gastroenterology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. • 4 Adult Rheumatology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.

• PMID: 32705576 • PMCID: PMC7410907 • DOI: 10.1007/s40744-020-00223-6

Free PMC article Abstract

Introduction: Systemic lupus erythematosus (SLE) is a multi-organ inflammatory disease associated with autoimmune diseases. The aim of the study is to assessed the frequency of celiac disease (CD) in adults and children with SLE (aSLE and cSLE, respectively) and compare them with rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA) patients; the study also explored the clinical impact of CD serologic markers on SLE disease activity and severity.

Methods: This was a cross-sectional study. Patients with SLE who had regular follow-up in rheumatology clinics were evaluated for laboratory and clinical variables using serology and the SLE Disease Activity Index (SLEDAI). To assess the occurrence of CD serology in cSLE and aSLE and the clinical impact of CD serologic markers on SLE, patients were tested for antigliadin (AGA), anti- endomysium (EmA) and anti-tissue transglutaminase (tTG) antibodies. RA and JIA patients were included for comparison. Duodenal biopsy was conducted in patients who exhibited CD markers.

Results: The CD marker was found in 29 (11.6%) of the 250 patients. AGA was present in seven aSLE patients and tTG in two (11.1%). Among cSLE patients, the autoantibody was present in 17.6% (AGA in four, tTG in two, and EmA in three). For RA patients, five had AGA and tTG and one had EmA, with an overall positivity of 9.7%. Five JIA patients had AGA (four with EmA and five with tTG) with overall positivity of 10.9%; the serum IgA level was normal in all patients except one. Duodenal endoscopic biopsy was performed in patients with positive CD markers (two declined). Histologic confirmation of CD was reported in one RA and one JIA patient but in none of the SLE patients. There was no correlation between the presence of CD markers and autoantibodies in SLE. Conclusion: CD antibodies did not influence SLE activity. Thus, SLE patients may not need to be screened for CD antibodies.

Keywords: Celiac disease; Juvenile idiopathic arthritis; Rheumatoid arthritis; Systemic lupus erythematosus.

• 36 references

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105. Serum Level and Gene Expression of Interleukin-15 Do Not Correlate with Villous Atrophy in Celiac Disease Patients

Genet Test Mol Biomarkers. 2020 Aug;24(8):502-507. doi: 10.1089/gtmb.2019.0265. Epub 2020 Jul 17.

Authors

Elham Aghamohamadi 1 , Parviz Kokhaei 2 , Mohammad Rostami-Nejad 3 , Fatemeh Pak 1 , Kamran Rostami 4 , Afshin Moradi 3 , Mohamad Amin Pourhoseingholi 3 , Vahid Chaleshi 5 , Andrea Masotti 6 , Mohammad Reza Zali 3

Affiliations

• 1 Department of Immunology, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran. • 2 Cancer Research Center, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran. • 3 Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran. • 4 Department of Gastroenterology, Mid Central DHB, Palmerston Hospital, Palmerston North, New Zealand. • 5 Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran. • 6 Research Laboratories, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy.

• PMID: 32700980 • DOI: 10.1089/gtmb.2019.0265

Abstract

Background and Aims: Interleukin-15 (IL-15) is a key player in the pathogenesis of celiac disease (CD). We investigated the functional role of IL- 15 in the process of epithelial cell phenotypic modification at different stages of CD. Materials and Methods: In this study, we looked for correlations between the IL-15 mRNA levels in duodenal tissue and serum protein levels in a cohort of Iranian patients affected by CD based on the degree of histopathology. Ninety-five formalin-fixed, paraffin-embedded duodenal tissue specimens were collected: 23 with a Marsh I value; 30 with a Marsh II value; 32 with a Marsh III value; and 10 normal controls. The expression levels of the IL-15 gene in these biopsy specimens were determined by real-time quantitative polymerase chain reaction (qPCR), and IL-15 serum protein concentrations were determined by enzyme-linked immunosorbent assay and compared to tissue expression. Results: The IL-15 mRNA levels were higher in patients with Marsh II compared with the control group, and the Marsh I, and Marsh III groups. The differences between the Marsh II and Marsh I patients were statistically significant (p = 0.03). Similarly, the serum concentration of IL-15 was higher in Marsh II patients compared to those with Marsh I and Marsh III lesions, although the differences were not statistically significant (p = 0.221). Conclusions: Our results demonstrate that IL-15 gene expression might be elevated only in the early stages of CD onset (and histological damage) and that IL-15 serum levels do not significantly correlate with its tissue expression whatever the degree of histopathology.

Keywords: celiac disease; histopathology; interleukin-15; marsh classification; paraffin-embedded tissues.

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106. [Gluten-free diet: lights and shadows]

Nutr Hosp. 2020 Aug 27;37(4):643-644. doi: 10.20960/nh.03250. [Article in Spanish]

Authors

Rafael Martín-Masot 1 , Víctor Manuel Navas-López 1

Affiliation

• 1 Sección de Gastroenterología y Nutrición Infantil. Hospital Materno Infantil. Hospital Regional Universitario de Málaga.

• PMID: 32698594 • DOI: 10.20960/nh.03250

No abstract available Publication types

• English Abstract

107. Candida albicans in celiac disease: A wolf in sheep's clothing

Autoimmun Rev. 2020 Sep;19(9):102621. doi: 10.1016/j.autrev.2020.102621. Epub 2020 Jul 18.

Authors

Lerner Aaron 1 , Matthias Torsten 2

Affiliations

• 1 AESKU, KIPP Institute, Wendelsheim, Germany. Electronic address: [email protected]. • 2 AESKU, KIPP Institute, Wendelsheim, Germany.

• PMID: 32693029 • DOI: 10.1016/j.autrev.2020.102621

Abstract

Candida albicans is a commensal fungus with a potential pathogenicity and celiac disease is an autoimmune condition. Both share multiple pathophysiological junctions, including serological markers against cell-wall proteins of Candida, anti-gliadin antibodies are positive in both entities, gluten and a candidal virulence factor share sequence similarity and the autoantigen of celiac disease, the tissue transglutaminase, is pivotal in Candida albicans commensalism and hostile behavior and its covalently cross linked products are stable and resistant to breakdown in the two entities. Those autoimmune/infectious cross roads are the basis for the hypothesis that Candida albicans is an additional environmental factor for celiac disease autoimmunogenesis.

Keywords: Candida albicans; Celiac disease; Cross reactivity; Gluten; Hwp1; Sequence homology; Shared antibodies; Transglutaminase.

Conflict of interest statement

Declaration of Competing Interest The authors declare no conflict of interest.

Publication types

• Review

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108. Lane-Hamilton Syndrome: An Illustration of Extraintestinal Manifestations of Celiac Disease

Clin Pediatr (Phila). 2020 Nov;59(13):1195-1198. doi: 10.1177/0009922820941210. Epub 2020 Jul 19.

Authors

Anna W Reed 1 , Ania Dabrowski 1 , Shelly Joseph 1 , Shruti M Paranjape 1 , Christine Karwowski 1

Affiliation

• 1 Johns Hopkins Children's Center, Baltimore, MD, USA.

• PMID: 32686478 • DOI: 10.1177/0009922820941210

No abstract available

Full-text links

109. A comparison of the nutritional profile and price of gluten-free products and their gluten-containing counterparts available in the Spanish market

Nutr Hosp. 2020 Aug 27;37(4):814-822. doi: 10.20960/nh.03016.

Authors Nancy Babio 1 , Núria Lladó Bellette 1 , María Besora-Moreno 1 , Gemma Castillejo 2 , Núria Guillén 1 , Francesc Martínez-Cerezo 2 , Elisenda Vilchez 3 , Esther Roger 4 , Pablo Hernández- Alonso 1 , Jordi Salas Salvadó 1

Affiliations

• 1 Universitat Rovira i Virgili. Departament de Bioquimica i Biotecnologia. Unitat Nutrició Humana. • 2 Institut d'Investigació Sanitària Pere Virgili. Hospital Universitari Sant Joan de Reus. • 3 Departamento de Nutrición. Associació Celíacs de Catalunya. • 4 Asociación de Celíacos de Cataluña.

• PMID: 32686439 • DOI: 10.20960/nh.03016

Abstract in En , Spanish

Background: to date, gluten-free (GF) diet is the only treatment available for individuals with celiac disease. Both individual and collective food intake assessments are a challenge because a food composition database of GF products (GFPs) is lacking. Objectives: to describe the process of developing a food composition database of GFPs, and to compare the nutritional profile and price of some GFPs and non-GFPs. Methods: initially, a total of 216 brands of GFPs marketed in Spain were recorded. Nutritional information was collected from nutritional labels and product fact sheets that had been provided by food companies or collected first-hand by researchers. Then, the nutritional profile and price of the cereal and cereal byproducts foodstuff groups, including 19 types of products, were compared. Statistical analyses were performed using the SPSS statistical program (22.0 edition; SPSS, Chicago, IL, USA). Results: a total of 2,247 GFPs from 126 different foodstuff brands were included in the food composition database of GFPs (CELIAC- BASE). We classified these products into 14 foodstuff groups. The protein content of the GFPs studied was significantly lower, and the price was higher, than that of their non-GFP counterparts. Some, but not all, GFPs had a higher content of fat and sugar, and a lower content of dietary fiber as compared to their non-GFP counterparts. Some GFPs were up to 6 times more expensive than the corresponding non-GFPs. Conclusions: CELIAC-BASE is a pioneering tool for dietitians. Many GFPs have poor nutritional profiles and should be consumed only occasionally in a balanced GF diet.

Introducción: hasta la fecha, una dieta sin gluten (SG) es el único tratamiento para las personas con enfermedad celíaca. Tanto las evaluaciones de ingesta de alimentos individuales como las colectivas son un desafío debido a la falta de una base de datos de composición de productos SG (PSG). Objetivos: describir el proceso de desarrollo de una base de datos de composición de PSG y comparar el perfil nutricional y el precio de algunos PSG y productos con gluten. Métodos: inicialmente, se registraron un total de 216 marcas de PSG comercializadas en España. La información nutricional se recopiló de las etiquetas nutricionales y hojas informativas de los productos, que habían sido proporcionadas por las compañías de alimentos o recopiladas de primera mano por los investigadores. Luego, se compararon el perfil nutricional y el precio de los grupos de cereales y subproductos alimenticios, incluidos 19 tipos de productos. Los análisis estadísticos se realizaron utilizando el programa estadístico SPSS (edición 22.0; SPSS, Chicago, IL, EUA). Resultados: se incluyeron un total de 2247 PSG de 126 marcas de alimentos diferentes en la base de datos de composición de PSG (CELIAC-BASE). Clasificamos estos productos en 14 grupos de alimentos. El contenido de proteínas de los PSG estudiados fue significativamente menor, y el precio de los mismos fue más alto, que el de sus homólogos con gluten. Algunos PSG, pero no todos, presentaron un mayor contenido de grasa y azúcar, y un menor contenido de fibra dietética, que sus contrapartes con gluten. Algunos PSG eran hasta 6 veces más caros que sus homólogos con gluten. Conclusiones: CELIAC-BASE es una herramienta pionera para dietistas-nutricionistas. Muchos PSG tienen perfiles nutricionales no saludables y deben consumirse solo ocasionalmente en una dieta equilibrada libre de gluten.

Keywords: Enfermedad celíaca. Evaluación nutricional. Dieta libre de gluten..

110. The growing global interest in the gluten free diet as reflected by Google searches

Dig Liver Dis. 2020 Sep;52(9):1061-1062. doi: 10.1016/j.dld.2020.06.036. Epub 2020 Jul 16.

Authors A Rej 1 , F W D Tai 2 , P H R Green 3 , B Lebwohl 4 , D S Sanders 5

Affiliations

• 1 Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, S10 2JF, United Kingdom. Electronic address: [email protected]. • 2 Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, S10 2JF, United Kingdom. • 3 Celiac Disease Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, United States. • 4 Celiac Disease Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, United States; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, United States. • 5 Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, S10 2JF, United Kingdom; Academic Unit of Gastroenterology, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom.

• PMID: 32684509 • DOI: 10.1016/j.dld.2020.06.036

No abstract available

Conflict of interest statement

Declaration of Competing Interest David Surendran Sanders receives an educational grant from Schaer (a gluten‐free food manufacturer). Dr Schaer did not have any input in drafting of this manuscript. The remaining authors disclose no conflicts of interest.

Publication types

• Letter

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111. Distal pancreas-coeliac axis resection with preoperative selective embolization of the coeliac axis: a single high-volume centre experience

Langenbecks Arch Surg. 2020 Aug;405(5):635-645. doi: 10.1007/s00423-020- 01919-7. Epub 2020 Jul 18.

Authors

J H Storkholm 1 , S K Burgdorf 2 , C P Hansen 1

Affiliations

• 1 Department of Surgery CTx, Rigshospitalet, Copenhagen, Denmark. • 2 Department of Surgery CTx, Rigshospitalet, Copenhagen, Denmark. [email protected].

• PMID: 32683485 • DOI: 10.1007/s00423-020-01919-7

Abstract

Background: Patients with ductal adenocarcinoma in the body and/or tail of the pancreas with involvement of the common hepatic artery and/or celiac axis have until recently been considered unresectable. In selected cases, distal pancreatectomy (DP) with en bloc celiac axis resection (DP-CAR) may be an option to achieve R0 resection.

Methods: Patients with tumours in the body and/or tail of the pancreas locally advanced with involvement of the common hepatic artery and/or celiac axis, with no distant metastases, were evaluated for DP-CAR procedures. Preoperative embolization was performed 10-14 days prior to surgery to enhance collateral arterial supply for the liver and stomach. Results: A total of 21 patients went through DP-CAR of whom 15 were preoperatively embolized. R0 resection vas achieved in 76% of the patients comparable to our standard distal pancreatectomies. The DP-CAR patients had a significant longer postoperative hospital stay, but no difference in major complications, including pancreatic fistulas compared with our standard distal pancreatectomies. No 30 nor 90 days postoperative mortality were recorded. Median survival in patients who underwent DP and DP-CAR procedures was 24.0 and 23.5 months, respectively (P > 0.5).

Conclusion: Outcomes after DP-CAR are comparable to standard distal pancreatectomies. DP-CAR after preoperative embolization is feasible and may in selected patients be a good option for treating patients with tumours in the body and/or tail of the pancreas with central arterial involvement.

Keywords: Cancer; DP-CAR; Pancreas; Surgery.

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112. Gluten free sourdough bread enriched with cricket flour for protein fortification: Antioxidant improvement and Volatilome characterization

Food Chem. 2020 Dec 15;333:127410. doi: 10.1016/j.foodchem.2020.127410. Epub 2020 Jun 27.

Authors

Lorenzo Nissen 1 , Seyedeh Parya Samaei 2 , Elena Babini 3 , Andrea Gianotti 4

Affiliations

• 1 Interdepartmental Centre of Agri-Food Industrial Research (CIRI), Alma Mater Studiorum - University of Bologna, P.za G. Goidanich 60, 47521 Cesena (FC), Italy. Electronic address: [email protected]. • 2 Department of Agricultural and Food Sciences (DISTAL), Alma Mater Studiorum - University of Bologna, Piazza Goidanich 60, 47521 Cesena (FC), Italy. Electronic address: [email protected]. • 3 Department of Agricultural and Food Sciences (DISTAL), Alma Mater Studiorum - University of Bologna, Piazza Goidanich 60, 47521 Cesena (FC), Italy. Electronic address: [email protected]. • 4 Interdepartmental Centre of Agri-Food Industrial Research (CIRI), Alma Mater Studiorum - University of Bologna, P.za G. Goidanich 60, 47521 Cesena (FC), Italy; Department of Agricultural and Food Sciences (DISTAL), Alma Mater Studiorum - University of Bologna, Piazza Goidanich 60, 47521 Cesena (FC), Italy. Electronic address: [email protected].

• PMID: 32682227 • DOI: 10.1016/j.foodchem.2020.127410

Abstract

Insects represent a novel source of edible high nutritional value proteins which are gaining increasing interest as an alternative to traditional animal foods. In this work, cricket flour was used to produce gluten-free sourdough breads, suitable for celiac people and "source of proteins". The doughs were fermented by different methods and pH and microbial growth, volatile compounds, protein profile, and antioxidant activity, before and after baking, were analyzed and compared to standard gluten-free doughs. The results showed that cricket-enriched doughs and the standard had similar fermentation processes. Cricket enrichment conferred to the breads a typical flavoring profile, characterized by a unique bouquet of volatile compounds, made by nonanoic acid, 2,4-nonadienal (E,E), 1-hexanol, 1-heptanol, and 3- octen-2-one, expressed in different amounts depending on the type of inoculum. Finally, antioxidant activities were significantly enhanced in cricket breads, indicating that cricket powder provides to bakery gluten-free goods high nutritional value proteins and antioxidant properties.

Keywords: 1,4-Butanediol (PubChem CID: 8064); 1-heptanol (PubChem CID: 8129); 1-hexanol (PubChem CID: 8103); 1-octen-3-ol (PubChem CID: 18827); 2,4-butanedione (PubChem CID: 650); 2,4-nonadienal, (E,E) (PubChem CID: 5283339); 2-heptanone (PubChem CID: 8051); 3-octen-2-one (PubChem CID: 15475); Antioxidant activity; Cricket; Hexanoic acid (PubChem CID: 8892); Lactobacillus spp.; Multivariate analysis; Nonanoic acid (PubChem CID: 8158); Novel food; SPME-GC–MS; Saccharomyces cerevisiae.

Conflict of interest statement

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113. Discordance Between Serology and Histology for Celiac Disease in a Cohort with Coexisting Liver Disorders

J Can Assoc Gastroenterol. 2020 Aug;3(4):185-193. doi: 10.1093/jcag/gwz010. Epub 2019 Apr 22.

Authors

Lena Cvetkovic 1 , Gabriel Bernard 1 , Nathanaelle Galette 1 , Pierre-Olivier Hétu 2 , Catherine Vincent 3 , Mickael Bouin 1 , Amelie Therrien 1

Affiliations

• 1 Department of Medicine - Division of Gastroenterology, Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada. • 2 Department of Biochemistry, Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada. • 3 Department of Medicine, Division of Hepatology, Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada.

• PMID: 32671328 • PMCID: PMC7338843 • DOI: 10.1093/jcag/gwz010

Free PMC article Abstract

Background: The liver and celiac disease (CeD) share a complex relationship. While in some patients, isolated hypertransaminasemia is the only manifestation of CeD, liver diseases (LD) may also be associated with the presence of isolated tissue transglutaminase antibodies IgA (tTG IgA) without histologic evidence of CeD.

Aims: To examine the yield of tTG IgA testing (a) in the workup for chronic liver disease (CLD) or cytolysis and (b) to identify biopsy-confirmed CeD (BxCeD) among patients with concomitant LD.

Methods: Retrospective study including two cohorts. Cohort 1 represented 444 consecutive individuals without known CeD for which liver specialists requested tTG IgA. Incidence of positive tTG and BxCeD was evaluated. Cohort 2 included 212 consecutive individuals with positive tTG IgA and subsequent duodenal biopsies. The frequency and clinical characteristics of individuals without BxCeD were examined, with and without concurrent LD.

Results: The rate of first time positive tTG IgA among the tests requested by a liver specialist (cohort 1) was 2.0% (n = 9). However, 33.0% (n = 3) of these patients did not have BxCeD. Cohort 2 included 33 individuals with coexisting LD, of which 42.4% did not have BxCeD, compared with 16.2% of the patients without LD (P < 0.001). The majority of the patients without BxCeD (65.1%) showed an increase < 3 times upper limit of normal of tTG IgA.

Conclusions: Although there is clinical value in testing for CeD in the context of LD, there could be a high rate of positive CeD serology unaccompanied by histologic signs in patients with coexisting LD.

Keywords: Celiac disease; Liver disease; Potential celiac disease; Tissue transglutaminase antibodies.

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114. Rationally engineered prolyl endopeptidases from Sphingomonas capsulata with improved hydrolytic activity towards pathogenic peptides of celiac diseases

Eur J Med Chem. 2020 Sep 15;202:112499. doi: 10.1016/j.ejmech.2020.112499. Epub 2020 Jul 6.

Authors

Bin Xiao 1 , Chun Zhang 1 , Xiaotong Song 1 , Miao Wu 1 , Jianping Mao 1 , Rong Yu 1 , Yongxiang Zheng 2

Affiliations

• 1 Department of Biopharmaceutics, West China School of Pharmacy, Sichuan University, Chengdu, 610041, PR China; Key Laboratory of Drug- Targeting and Drug Delivery System of the Education Ministry, Sichuan Engineering Laboratory for Plant-Sourced Drug and Sichuan Research Center for Drug Precision Industrial Technology, West China School of Pharmacy, Sichuan University, Chengdu, 610041, PR China. • 2 Department of Biopharmaceutics, West China School of Pharmacy, Sichuan University, Chengdu, 610041, PR China; Key Laboratory of Drug- Targeting and Drug Delivery System of the Education Ministry, Sichuan Engineering Laboratory for Plant-Sourced Drug and Sichuan Research Center for Drug Precision Industrial Technology, West China School of Pharmacy, Sichuan University, Chengdu, 610041, PR China. Electronic address: [email protected]. • PMID: 32668378 • DOI: 10.1016/j.ejmech.2020.112499

Abstract

Celiac disease affects approximately 1% of the population and is a major public health problem worldwide. It is trigged by gluten-derived peptides, which have unusually high proline-glutamine motif content and are highly resistant to proteolysis by digestive enzymes of the gastrointestinal tract. The only treatment for celiac disease is strict, lifelong adherence to a gluten-free diet, which is effective but costly and difficult to maintain. Therefore, novel non-dietary therapies for celiac disease are urgently needed. Gluten- degrading enzymes are promising non-dietary treatments, and some enzymes have been investigated in preclinical or clinical studies. A combination of prolyl endopeptidase from Sphingomonas capsulata (SC PEP) and a glutamine- specific endoprotease (EP-B2 from barley) known as latiglutenase showed insufficient benefits in phase II clinical trials, likely because of its low enzyme activity in the gastric environment. Therefore, improving enzyme activity is essential for the clinical application of SC PEP. Enzyme activity can be enhanced using computer-aided rational protein design tools. In this study, we combined molecular docking and molecular dynamics simulation to rationally design SC PEP mutants and experimentally evaluated their activities. We identified mutants with up to 90-103% increases in specific activity and up to 80-202% increases in the catalytic rate. We have investigated the mechanism underlying the enhanced activity of these mutants, and found that a conformational transition of the β-propeller domain and catalytic domain of SC PEP was important for enzyme activity, and this transition was affected by residues in the catalytic domain and at the domain interface; a shorter distance between the substrate Pro and the oxyanion holes was also crucial for improving SC PEP catalytic activity. Our results provide useful information for the rational design of highly active SC PEPs to accelerate the development of enzyme therapeutics candidates for Celiac disease.

Keywords: Celiac disease; Molecular docking; Molecular dynamics; Prolyl endopeptidase; Rational design.

Conflict of interest statement Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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115. Incidence of Celiac Disease in Down Syndrome: A Longitudinal, Population- Based Birth Cohort Study

Clin Pediatr (Phila). 2020 Oct;59(12):1086-1091. doi: 10.1177/0009922820941247. Epub 2020 Jul 15.

Authors

Kathryn K Ostermaier 1 , Amy L Weaver 2 , Scott M Myers 3 , Ruth E Stoeckel 2 , Slavica K Katusic 2 , Robert G Voigt 1

Affiliations

• 1 Baylor College of Medicine, Houston TX, USA. • 2 Mayo Clinic, Rochester, MN, USA. • 3 Geisinger Autism & Developmental Medicine Institute, Lewisburg, PA, USA.

• PMID: 32664755 • DOI: 10.1177/0009922820941247

Abstract

American Academy of Pediatrics (AAP) guidelines for children with Down syndrome (DS) include assessment for celiac disease (CD), although data to support this recommendation have been inconsistent. We determined the incidence of CD among children with DS in a population-based birth cohort of children born from 1976 to 2000 in Olmsted County, Minnesota. Individuals with karyotype-confirmed DS and CD (using diagnosis codes, positive serology, and duodenal biopsies) were identified. The incidence of CD in DS was compared with the published incidence of CD for Olmsted County residents (17.4 [95% confidence interval = 15.2-19.6] per 100 000 person-years). Among 45 individuals with DS from the birth cohort, 3 (6.7%) were identified with positive celiac serology and confirmatory biopsies at ages 9, 12, and 23 years, for an incidence of 325 per 100 000 person-years. Thus, individuals with DS have more than 18 times the incidence rate of CD compared with the general population, supporting the AAP guidelines.

Keywords: Down syndrome; celiac disease; trisomy 21.

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116. Proteomic modelling of gluten digestion from a physiologically relevant food system: A focus on the digestion of immunogenic peptides from wheat implicated in celiac disease

Food Chem. 2020 Dec 15;333:127466. doi: 10.1016/j.foodchem.2020.127466. Epub 2020 Jul 5.

Authors

Olivia Ogilvie 1 , Sarah Roberts 2 , Kevin Sutton 3 , Laura Domigan 4 , Nigel Larsen 5 , Juliet Gerrard 6 , Nicholas Demarais 7

Affiliations

• 1 School of Biological Sciences, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; Riddet Institute, Massey University, Private Bag 11 222, Palmerston North 4442, New Zealand; The New Zealand Institute for Plant and Food Research Limited, Private Bag 4704, Christchurch Mail Centre, Christchurch 8140, New Zealand. Electronic address: [email protected]. • 2 Riddet Institute, Massey University, Private Bag 11 222, Palmerston North 4442, New Zealand; The New Zealand Institute for Plant and Food Research Limited, Private Bag 4704, Christchurch Mail Centre, Christchurch 8140, New Zealand. Electronic address: [email protected]. • 3 Riddet Institute, Massey University, Private Bag 11 222, Palmerston North 4442, New Zealand; The New Zealand Institute for Plant and Food Research Limited, Private Bag 4704, Christchurch Mail Centre, Christchurch 8140, New Zealand. Electronic address: [email protected]. • 4 School of Biological Sciences, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; Riddet Institute, Massey University, Private Bag 11 222, Palmerston North 4442, New Zealand; Department of Chemical and Materials Engineering The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. Electronic address: [email protected]. • 5 Riddet Institute, Massey University, Private Bag 11 222, Palmerston North 4442, New Zealand; The New Zealand Institute for Plant and Food Research Limited, Private Bag 4704, Christchurch Mail Centre, Christchurch 8140, New Zealand. • 6 School of Biological Sciences, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; Riddet Institute, Massey University, Private Bag 11 222, Palmerston North 4442, New Zealand; School of Chemical Sciences, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. Electronic address: [email protected]. • 7 School of Biological Sciences, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; Department of Chemical and Materials Engineering The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. Electronic address: [email protected].

• PMID: 32659668 • DOI: 10.1016/j.foodchem.2020.127466

Abstract

Celiac disease is an autoimmune illness activated by gluten peptides produced during gastrointestinal digestion. A simulated in vitro digestion of gluten was conducted to define the profile and kinetic release pattern of immunogenic gluten peptides in a physiologically relevant food matrix. White bread was digested using the INFOGEST in vitro standardised digestion protocol from 0 to 240 min and subsequently analysed by SDS-PAGE, quantitative LC-MS/MS, untargeted LC-MS/MS and ELISA. The release profile of six gluten peptides was defined by quantitative LC-MS/MS; none were detected in the gastric phase, but rapidly peaked in the intestinal phase. These results were corroborated by the ELISA analysis. Untargeted proteomics identified 83 immunogenic peptides. Their qualitative concentrations were defined throughout digestion, demonstrating complex relationships through proteolysis. This analysis suggests immunogenic gluten may peak within the intestinal duodenum and gives new insights into the complexity of gluten digestion from a physiologically relevant food matrix.

Keywords: Bread; Celiac disease; Digestion; Gluten; Mass spectrometry; Peptidomics; Proteomics.

Conflict of interest statement

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117. TNF-α, IL-17, and IL-22 production in the rectal mucosa of nonceliac wheat sensitivity patients: role of adaptive immunity

Am J Physiol Gastrointest Liver Physiol. 2020 Sep 1;319(3):G281-G288. doi: 10.1152/ajpgi.00104.2020. Epub 2020 Jul 13. Authors

Pasquale Mansueto 1 , Diana Di Liberto 2 , Francesca Fayer 1 , Maurizio Soresi 1 , Girolamo Geraci 3 , Antonio Giulio Giannone 4 , Aurelio Seidita 5 , Alberto D'Alcamo 1 , Francesco La Blasca 1 , Marianna Lo Pizzo 2 , Ada Maria Florena 4 , Francesco Dieli 2 , Antonio Carroccio 1

Affiliations

• 1 Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy. • 2 Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), University of Palermo, Palermo, Italy. • 3 Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy. • 4 Pathology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy. • 5 Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (IRCCS-ISMETT), University of Pittsburgh Medical Center Italy, Palermo, Italy.

• PMID: 32658621 • DOI: 10.1152/ajpgi.00104.2020

Abstract

In recent years, a new gluten- or wheat-related disease has emerged, a condition labeled "nonceliac gluten sensitivity" (NCGS) or "nonceliac wheat sensitivity" (NCWS). NCWS pathogenesis is still uncertain and attributed to very different mechanisms. We aimed to study the different T-lymphocyte subsets in the rectal mucosa of NCWS patients to demonstrate the possible contribution of adaptative immune response. Twelve patients (11 women, 1 man, age range 23-61 yr, median 32 yr) with a definitive diagnosis of NCWS were recruited at random for the present study. They underwent rectal endoscopy with multiple mucosal biopsies at the end of a double-blind placebo-controlled (DBPC) wheat challenge when they reported the reappearance of the symptoms. As controls we included 11 "healthy patients", sex- and age-matched with the patients who underwent colonoscopy evaluation for rectal bleeding due to hemorrhoids. Cells freshly obtained from rectal tissue were stained to detect anti-CD45, anti-CD3, anti-CD4, and anti- CD8. Furthermore, intracellular staining was performed with anti-tumor necrosis factor (TNF)-α, anti-interleukin (IL)-17, and anti-IL-22. Production of TNF-α by CD45+, CD3+, CD4+, and CD8+ cells, as well as of IL-17 by CD4+ cells, was higher in the rectal tissue of NCWS patients than in controls. On the contrary, IL-22 production by CD8+ cells was lower in NCWS patients than in the controls. In NCWS patients diagnosed by DBPC wheat challenge, there is a complex immunological activation, with a significant role for the adaptive response.NEW & NOTEWORTHY Nonceliac wheat sensitivity (NCWS) is a syndrome characterized by symptoms triggered by gluten intake. The pathogenesis is still uncertain. Studies have shown a role for innate immunity. We demonstrated that production of TNF-α by CD45+, CD3+, CD4+, and CD8+ cells and of IL-17 by CD4+ cells is higher in the rectal tissue of NCWS patients than in controls. We clearly demonstrated that in patients with NCWS there is a significant role for the adaptive response.

Keywords: IL-17; IL-22; TNF-α; adaptive immunity; nonceliac wheat sensitivity.

Grant support

• PE-2016-02363692/Ministero della Salute (Ministry of Health, Italy) • Project 013-2014/Italian Foundation for Celiac Disease

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118. Compositional and immunogenic evaluation of fractionated wheat beers using mass spectrometry

Food Chem. 2020 Dec 15;333:127379. doi: 10.1016/j.foodchem.2020.127379. Epub 2020 Jul 5.

Authors

Wanying Cao 1 , Joseph L Baumert 1 , Melanie L Downs 2 Affiliations

• 1 Food Allergy Research and Resource Program, Department of Food Science and Technology, Food Innovation Center, 1901 North 21st Street, University of Nebraska-Lincoln, Lincoln, NE 68588, United States. • 2 Food Allergy Research and Resource Program, Department of Food Science and Technology, Food Innovation Center, 1901 North 21st Street, University of Nebraska-Lincoln, Lincoln, NE 68588, United States. Electronic address: [email protected].

• PMID: 32653678 • DOI: 10.1016/j.foodchem.2020.127379

Abstract

The safety and regulatory status of fermented products derived from gluten- containing grains for patients with celiac disease remains controversial. Bottom-up mass spectrometry (MS) has complemented immunoassays for the compositional and immunogenic analyses of wheat beers. However, uncharacterized proteolysis during brewing followed by the secondary digestion for MS has made the analysis and data interpretation complicated. In this study, the composition and immunogenic potential of seven commercially available wheat beers were evaluated using bottom-up MS with the aid of fractionation and a multi-step peptide search strategy to identify peptides generated by various types of proteolysis. Gluten-derived peptides accounted for approximately 50% and 20% of the total number of wheat- derived and barley-derived peptides, respectively, in the investigated beers. Although relatively large polypeptides cannot be thoroughly characterized using traditional bottom-up proteomics, up to 50% of peptides identified contained celiac-immunogenic motifs, and consumption of wheat beers would pose risks for celiac patients.

Keywords: Celiac disease; Fermentation; Gluten; Mass spectrometry; Proteomics; Wheat beers.

Conflict of interest statement Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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119. Gastrointestinal diseases and their impact on drug solubility: Celiac disease

Eur J Pharm Sci. 2020 Sep 1;152:105460. doi: 10.1016/j.ejps.2020.105460. Epub 2020 Jul 6.

Authors

Angela Effinger 1 , Caitriona M O'Driscoll 2 , Mark McAllister 3 , Nikoletta Fotaki 4

Affiliations

• 1 Department of Pharmacy and Pharmacology, University of Bath, Bath, UK. • 2 School of Pharmacy, University College Cork, Cork, Ireland. • 3 Pfizer Drug Product Design, Sandwich, UK. • 4 Department of Pharmacy and Pharmacology, University of Bath, Bath, UK. Electronic address: [email protected].

• PMID: 32645425 • DOI: 10.1016/j.ejps.2020.105460

Abstract

The aim of this study was to develop an in vitro tool for predicting drug solubility and dissolution in intestinal fluids of patients with Celiac disease (CED). Biorelevant media for patients with CED were developed based on published information and a Design of Experiment (DoE) approach. The CED biorelevant media were characterised according to their surface tension, osmolality, dynamic viscosity and buffer capacity. By performing solubility studies of six drugs with different physicochemical properties in CED media, we aimed to identify drugs at high risk of altered luminal solubility in CED patients. Identified differences in CED patients compared to healthy subjects were related to a higher concentration of bile salts, lecithin and cholesterol and included as factors in the DoE resulting in 8 CED biorelevant media. Differences in media properties were observed for the surface tension between biorelevant media based on CED patients and healthy subjects. In terms of solubility, only a minimal effect of CED on the solubility of the hydrophilic neutral compound azathioprine was observed. For neutral moderately lipophilic compounds (budesonide, celecoxib), a higher surfactant concentration resulted in most cases in a higher drug solubility, while it was specific to each drug whether this was mainly driven by bile salts or lecithin. In comparison, drug solubilisation of ionisable compounds with moderate to high lipophilicity was less impacted by CED differences. The developed biorelevant CED media serve as in vitro tool to identify the main media factors impacting on drug solubility.

Keywords: Biorelevant media; Celiac disease; Gastrointestinal diseases; Physicochemical properties; Solubility.

Conflict of interest statement

Declaration of Competing Interests None.

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120. Folate Content and Chemical Composition of Commercially Available Gluten-Free Flour Alternatives

Plant Foods Hum Nutr. 2020 Sep;75(3):337-343. doi: 10.1007/s11130-020- 00833-z.

Authors Jennifer A Jamieson 1 , Lauren Viana 2 , Marcia M English 2

Affiliations

• 1 Department of Human Nutrition, Saint Francis Xavier University, PO Box 5000 StFX, 2320 Notre Dame Ave., Antigonish, Nova Scotia, B2G 2W5, Canada. [email protected]. • 2 Department of Human Nutrition, Saint Francis Xavier University, PO Box 5000 StFX, 2320 Notre Dame Ave., Antigonish, Nova Scotia, B2G 2W5, Canada.

• PMID: 32638209 • DOI: 10.1007/s11130-020-00833-z

Abstract

Concerns about the nutritional and sensory qualities of gluten-free (GF) products has generated interest in the evaluation of novel gluten-free ingredients. Folate content is of particular interest due to limited sources of enriched folic acid in a GF diet as well as lack of nutrient composition data in novel flours. The aim of this study was to determine the total folate content and chemical composition of GF flours commercially available in Canada. A tri- enzyme method was used to extract folate from the flour samples, and a microbiological assay was used to measure the total folate contents. The chemical compositions of the GF flours were determined according to standard Association of Official Agricultural Chemists (AOAC) International methods. Compared to all-purpose flour, 265 ± 6.9 μg/100 (dry-weight basis), chickpea flour registered the highest folate content 451 ± 10.8 μg/100 (dry- weight basis) followed by quinoa flour, 174 ± 12.4 μg/ 100 g folate (dry-weight basis). Fonio, had a total starch content of ~77% but was not a source of folate. Flaxseed, chickpea, chia and coconut flours had the highest reported protein contents (mean value: 21.3 ± 1.3%) whereas flaxseed (~42%), and chia (~35%), had the highest lipid content. These findings may inform the selection of gluten-replacement flours with acceptable nutritional properties.

Keywords: Flour; Gluten-free; Lactobacillus rhamnosus; Proximate composition; Total folate. MeSH terms

• Diet, Gluten-Free • Flour* • Folic Acid* • Glutens • Nutritive Value

Substances

• Glutens • Folic Acid

Grant support

• UCR 2018-15B/St. Francis Xavier University

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121. Pasting, viscoelastic and rheological characterization of gluten free (cereals, legume and underutilized) flours with reference to wheat flour

J Food Sci Technol. 2020 Aug;57(8):2960-2966. doi: 10.1007/s13197-020- 04328-2. Epub 2020 Mar 30.

Authors

Sonal Patil 1 2 , Sachin K Sonawane 2 , Manoj Mali 3 , S T Mhaske 3 , Shalini S Arya 1

Affiliations

• 1 Food Engineering and Technology Department, Institute of Chemical Technology, Matunga, Mumbai, 400019 India. • 2 Food Science and Technology, School of Biotechnology and Bioinformatics, D. Y. Patil University, Level 5, Plot No. 50, CBD Belapur, Navi Mumbai, 400614 India. • 3 Department of Polymer and Surface Engineering, Institute of Chemical Technology, Matunga, Mumbai, 400019 India.

• PMID: 32624601 • PMCID: PMC7316925 (available on 2021-08-01) • DOI: 10.1007/s13197-020-04328-2

Abstract

In this study, the rheological properties of dough prepared from gluten free flours (rice, sorghum, moong, water chestnut and unripe banana) and wheat dough were determined. Pasting properties and viscoelastic properties were analyzed using rheometer and dough rheology experiment was performed on texture analyzer. Water chestnut flour exhibited highest peak viscocity (22.6 Pa s), trough viscosity (12.1), breakdown viscosity (10.5 Pa s) and final viscosity (14.92 Pa s) than others while unripe banana flour showed highest setback viscosity (4.54 Pa s). Pasting temperature was found to be highest for sorghum followed by wheat and others. The highest elastic (G') and loss (G″) module were obtained for moong flour. Wheat and gluten free flours were found to exhibit thixotropic effect. Moong flour dough was found to be the stickiest (dough stickiness 57.83 g) followed by WCF, UBF, wheat, rice and sorghum. Similar trend was observed for dough strength. These flours can be proved as key materials for the gluten-free products market and can provide additional inexpensive advantage to the food processing industry.

Keywords: Gluten free; Pasting properties; Rheology; Thixotropic effect; Viscoelastic properties.

Conflict of interest statement

Conflict of interestAuthors do not have any conflict. 122. Effect of wheat grain protein composition on end-use quality

J Food Sci Technol. 2020 Aug;57(8):2771-2785. doi: 10.1007/s13197-019- 04222-6. Epub 2020 Jan 4.

Authors

Ambika Sharma # 1 , Sheenu Garg # 1 , Imran Sheikh 1 , Pritesh Vyas 1 , H S Dhaliwal 1

Affiliation

• 1 Department of Biotechnology, Akal College of Agriculture, Eternal University, Baru Sahib, 173101 Himachal Pradesh India.

# Contributed equally.

• PMID: 32624587 • PMCID: PMC7316921 (available on 2021-08-01) • DOI: 10.1007/s13197-019-04222-6

Abstract

The quality of wheat products has been a new challenge next to wheat production which was achieved substantially during green revolution. The end-use quality of wheat is an essential factor for its commercial demand. The quality of wheat is largely based on the wheat storage proteins which extensively influences the dough properties. High molecular weight glutenin subunits (HMWGS), low molecular weight glutenin subunits (LMWGS) and gliadins significantly influence the end-use quality. Genomics and proteomics study of these gluten proteins of bread and durum wheat have explored new avenues for precise identification of the alleles and their role in end-use quality improvement. Secalin protein of Secale cereale encoded by Sec-1 loci and is associated with 1RS.1BL translocation has been known for deterioration of end-use quality. Chromosomal manipulations using various approaches have led to the development of new recombinant lines of wheat without secalin. Advanced techniques associated with assessment of end-use quality have integrated the knowledge of useful or deteriorating HMWGS/LMWGS alleles and their potential role in end-use quality. This review gives a comprehensive insight of different aspects of the end-use quality perspective for bread making in wheat along with some information on the immunological interference of gluten in celiac disease.

Keywords: 1RS.1BL translocation; Celiac disease; End-use quality; Gluten; Secalin.

Publication types

• Review

123. Correction to: Celiac Disease Screening for High-Risk Groups: Are We Doing It Right?

Dig Dis Sci. 2020 Sep;65(9):2743. doi: 10.1007/s10620-020-06453-6.

Authors

Dennis Kumral 1 , Sana Syed 2

Affiliations

• 1 Department of Medicine, Division of Gastroenterology and Hepatology, University of Virginia, 1215 Lee Street, PO Box 800708, Charlottesville, VA, 22908, USA. [email protected]. • 2 Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, School of Medicine, University of Virginia, MR-4 Bldg, 409 Lane Rd., Charlottesville, VA, 22908, USA.

• PMID: 32623549 • DOI: 10.1007/s10620-020-06453-6

Abstract

The original version of the article is unfortunately missing the funding information. Funding note is given below. Erratum for

• Celiac Disease Screening for High-Risk Groups: Are We Doing It Right?

Kumral D, Syed S.

Dig Dis Sci. 2020 Aug;65(8):2187-2195. doi: 10.1007/s10620-020-06352- w.

PMID: 32504350Review.

Publication types

• Published Erratum

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124. Williams-Beuren Syndrome and celiac disease: A real association?

Eur J Med Genet. 2020 Sep;63(9):103999. doi: 10.1016/j.ejmg.2020.103999. Epub 2020 Jul 2.

Authors

Elisabetta Pangallo 1 , Barbara Parma 2 , Milena Mariani 3 , Paola Cianci 3 , Anita De Paoli 3 , Silvia Maitz 4 , Chiara Fossati 4 , Roberto Panceri 4 , Massimo Agosti 1 , Angelo Selicorni 3

Affiliations

• 1 Department of Pediatric, 'F. Del Ponte' Hospital, University of Insubria, Varese, Italy. • 2 Department of Pediatric, ASST-Lariana, Sant'Anna Hospital, San Fermo Della Battaglia (Como), Italy. Electronic address: barbara.parma@asst- lariana.it. • 3 Department of Pediatric, ASST-Lariana, Sant'Anna Hospital, San Fermo Della Battaglia (Como), Italy. • 4 Department of Pediatric, Fondazione MBMM San Gerardo Hospital, Monza, Italy.

• PMID: 32622956 • DOI: 10.1016/j.ejmg.2020.103999

Abstract

Celiac disease (CD) screening in patients with Williams-Beuren Syndrome (WBS) is suggested, although data described in literature are discordant regarding CD prevalence in WBS. We retrospectively collected data from 101 WBS Italian patients [mean age: 13.5 years], to clarify the CD prevalence in a large cohort. All patients underwent a CD biochemical screening: IgA and anti- transglutaminase reflex antibodies (tTGA). CD-specific HLA typing was available for 42 patients. Small intestinal biopsy was performed in patients according to ESPGHAN guidelines. In 7 WBS patients an overt celiac disease was diagnosed. In 3 patients CD was confirmed by symptoms, HLA-DQ heterodimers and CD specific antibodies title, whereas in 4 patients, it was confirmed by a small intestinal biopsy. CD prevalence in our cohort is 6.9% (7/101). In 42/101 patients the CD-specific HLA typing was available, detecting 29/42 (69%) patients genetically predisposed to CD. The CD prevalence and CD-specific HLA prevalence are both higher than in the general population (p < 0.001; p < 0.001). Our cohort is the most numerous described confirming that the CD risk in WBS patients is significantly greater than in general population. Moreover, our HLA typing results, as well as scientific literature, suggest that the higher CD prevalence in WBS patients might not be intrinsically related to the genetic disease itself but with the higher HLA prevalence. However, HLA typing should be performed in bigger WBS cohorts to confirm this hypothesis. Our data confirms that HLA typing is mandatory in WBS patients and that CD screening should be performed only if genetically predisposed.

Keywords: Celiac disease; HLA typing; Williams-Beuren Syndrome.

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125. Delays in colonoscopy start time are associated with reductions in adenoma detection rates

Dig Liver Dis. 2020 Aug;52(8):905-908. doi: 10.1016/j.dld.2020.06.011. Epub 2020 Jul 2.

Authors

Monika Laszkowska 1 , Srihari Mahadev 1 , Chin Hur 2 , Peter H R Green 1 , Benjamin Lebwohl 3

Affiliations

• 1 Celiac Disease Center, Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA. • 2 Division of Digestive and Liver Diseases, Department of Medicine, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY, USA; Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY, USA. • 3 Celiac Disease Center, Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA. Electronic address: [email protected].

• PMID: 32622611 • DOI: 10.1016/j.dld.2020.06.011

Abstract

Background: Prior investigations of the impact of case delays on adenoma detection rates have not found a significant association, though these studies included modest delays, with few cases delayed by more than one hour.

Aims: The aim of this study was to measure the impact of prolonged case delays on the colonoscopy outcome measures of adenoma detection rate and withdrawal time. Methods: We performed a single center cohort study including patients aged ≥50 years undergoing screening colonoscopy during a 4.5 year period. Using multivariate regression, we measured the impact of delays on adenoma detection rate and withdrawal time, adjusting for age, gender, endoscopist, time of day of the procedure, and bowel preparation quality.

Results: Of 7905 screening colonoscopies, 2503 (32%) were delayed by >1 h. On multivariable analysis, cases delayed 1-2 h were associated with a significant decrease in adenoma detection rate relative to cases delayed ≤1 h (OR 0.88, 95% CI 0.78-1.00, p = 0.049). Withdrawal time was not significantly associated with case delays.

Conclusions: Prolonged case delays over 1 h are associated with reduced adenoma detection rates. Future research on factors underlying prolonged delays may help mitigate these barriers to care and improve quality outcomes.

Keywords: Adenoma detection rate; Procedure delay; Screening colonoscopy; Withdrawal time.

Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no conflict of interest.

Full-text links

126. Ultrasound-assisted fabrication of gluten- free dough for automatic producing dumplings

Ultrason Sonochem. 2020 Nov;68:105198. doi: 10.1016/j.ultsonch.2020.105198. Epub 2020 May 30. Authors

Sviatlana A Ulasevich 1 , Tatiana A Gusinskaia 2 , Alina D Semina 2 , Anton A Gerasimov 2 , Evgeny A Kovtunov 2 , Natalia V Iakovchenko 2 , Olga Yu Orlova 2 , Ekaterina V Skorb 2

Affiliations

• 1 ITMO University, St. Petersburg, Lomonosova St. 9, 192007, Russia. Electronic address: [email protected]. • 2 ITMO University, St. Petersburg, Lomonosova St. 9, 192007, Russia.

• PMID: 32593966 • DOI: 10.1016/j.ultsonch.2020.105198

Abstract

Nowadays celiac disease is becoming more common. It is the autonomic genetic disease that is accompanied by damage to the intestines due to a reaction to eating some proteins. People who are suffering from celiac disease cannot eat food containing gluten, including dough made from gluten- containing seeds. But the gluten-free dough has commonly bad rheological properties and cannot be used for automatic molding the dumplings. In this article, we propose the ultrasonic-assisted technology to fabricate the gluten- free dough with improved rheological properties acceptable for automatic molding of the dumplings. Application of ultrasonic treatment at a frequency of 35 kHz during the dough preparation leads to the homogenization of the dough structure and changing the rheological properties of the dough. The ultrasound induces mechanical, physical and chemical/biochemical changes of the dough components through cavitation. The sonication causes a doubled dough volume increase followed by an additional mass yield of the dumplings equal 2-10% per kilogram of dough. Besides extra beneficial economic effect, our technology provides an additional sterilization effect of the fabricated dough.

Keywords: Gelatinization; Gluten-free dough; Sonication; Ultrasonic treatment; Viscosity.

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127. The Utility of IgA-Based Serologic Markers in Diagnosing Celiac Disease in Children 24 Months of Age or Younger

J Pediatr. 2020 Sep;224:158-161.e2. doi: 10.1016/j.jpeds.2020.04.009. Epub 2020 Jun 24.

Authors

Muhammad Rehan Khan 1 , Jocelyn A Silvester 2 , Brandon Sparks 3 , Zackary Hintze 2 , Tracy Ediger 3 , Joseph J Larson 4 , Ivor Hill 3 , Imad Absah 5

Affiliations

• 1 Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Division of Pediatric Gastroenterology & Hepatology, Rochester, MN. Electronic address: [email protected]. • 2 Department of Pediatrics, Harvard Celiac Research Program, Boston Children's Hospital, Boston, MA. • 3 Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH. • 4 Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN. • 5 Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Division of Pediatric Gastroenterology & Hepatology, Rochester, MN.

• PMID: 32593411 • DOI: 10.1016/j.jpeds.2020.04.009 Abstract

Current screening guidelines in North America for celiac disease recommend additional IgG based testing for younger children. Our multicenter retrospective study showed that the anti-tissue transglutaminase IgA antibody test should be the recommended initial test in all children, including those ≤24 months of age.

Publication types

• Case Reports

Full-text links

128. Assessment of European Society of Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) guidelines in an Australian paediatric population

Pathology. 2020 Aug;52(5):568-575. doi: 10.1016/j.pathol.2020.05.002. Epub 2020 Jun 22.

Authors

Grace Thompson 1 , Zubin Grover 2 , Richard Loh 3 , Catherine Mews 2 , Madhur Ravikumara 2 , Gareth Jevon 4 , Lloyd D'Orsogna 5 , Andrew McLean-Tooke 6

Affiliations

• 1 Department of Clinical Immunology, PathWest Laboratory Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia. Electronic address: [email protected]. • 2 Department of Gastroenterology, Perth Children's Hospital, Perth, WA, Australia. • 3 Department of Clinical Immunology, PathWest Laboratory Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia. • 4 Department of Anatomical Pathology, PathWest Laboratory Medicine, Perth Children's Hospital, Perth, WA, Australia. • 5 Department of Clinical Immunology, PathWest Laboratory Medicine, Fiona Stanley Hospital, Perth, WA, Australia. • 6 Department of Clinical Immunology, PathWest Laboratory Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia; Department of Immunology, Perth Children's Hospital, Perth, WA, Australia.

• PMID: 32586687 • DOI: 10.1016/j.pathol.2020.05.002

Abstract

Coeliac disease (CD) diagnosis is based on clinical assessment, detection of specific autoantibodies and histological examination of small intestinal biopsies. The European Society of Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) guidelines have recently been updated and recommend CD may be diagnosed without a biopsy or HLA typing in symptomatic patients with high titre IgA tissue transglutaminase antibodies (aTTG) and positive endomysial antibodies (EMA). However, the need for EMA in patients with high level aTTG has been questioned. We aimed to determine the diagnostic benefit of HLA typing, EMA and IgG antibodies to deamidated gliadin (DGP) in children with high level aTTG. We prospectively evaluated children presenting for assessment of possible CD. All patients underwent small bowel biopsy, serological testing and HLA typing. Results were analysed and correlated with histopathological diagnosis. A total of 209 children were assessed; 61.5% were found to have CD and 29% could have avoided biopsy as per 2020 ESPGHAN guidelines. Titres of aTTG ≥60 U/mL or DGP ≥28 U/mL gave 100% specificity and 100% positive predictive value (PPV) for CD. HLA typing and EMA did not improve the PPV of patients with aTTG ≥60 U/mL, but addition of DGP ≥28 U/mL improved diagnostic sensitivity whilst retaining 100% specificity. Addition of HLA and EMA testing in patients with high titre aTTG antibodies does not improve diagnostic performance and may possibly be omitted from the serological workup in these patients. Our data support combining aTTG and DGP testing and optimising cut-offs to maximise specificity as an alternative biopsy-free diagnostic approach. Keywords: Coeliac disease; HLA typing; endomysial antibody.

Full-text links

129. FLT3 stop mutation increases FLT3 ligand level and risk of autoimmune thyroid disease

Nature. 2020 Aug;584(7822):619-623. doi: 10.1038/s41586-020-2436-0. Epub 2020 Jun 24.

Authors

Saedis Saevarsdottir 1 2 3 4 , Thorunn A Olafsdottir 5 6 , Erna V Ivarsdottir 5 7 , Gisli H Halldorsson 5 , Kristbjorg Gunnarsdottir 5 , Asgeir Sigurdsson 5 , Ari Johannesson 8 , Jon K Sigurdsson 5 , Thorhildur Juliusdottir 5 , Sigrun H Lund 5 , Asgeir O Arnthorsson 5 , Edda L Styrmisdottir 5 , Julius Gudmundsson 5 , Gerdur M Grondal 6 8 9 , Kristjan Steinsson 6 8 9 10 , Lars Alfredsson 11 , Johan Askling 12 , Rafn Benediktsson 6 8 , Ragnar Bjarnason 6 13 , Arni J Geirsson 6 8 , Bjorn Gudbjornsson 6 9 , Hallgrimur Gudjonsson 6 8 , Haukur Hjaltason 6 14 , Astradur B Hreidarsson 6 8 , Lars Klareskog 12 , Ingrid Kockum 15 , Helga Kristjansdottir 9 , Thorvardur J Love 6 10 16 , Bjorn R Ludviksson 6 17 , Tomas Olsson 15 , Pall T Onundarson 6 18 , Kjartan B Orvar 6 8 , Leonid Padyukov 12 , Bardur Sigurgeirsson 6 , Vinicius Tragante 5 , Kristbjorg Bjarnadottir 5 , Thorunn Rafnar 5 , Gisli Masson 5 , Patrick Sulem 5 , Daniel F Gudbjartsson 5 7 , Pall Melsted 5 7 , Gudmar Thorleifsson 5 , Gudmundur L Norddahl 5 , Unnur Thorsteinsdottir 5 6 , Ingileif Jonsdottir 5 6 17 , Kari Stefansson 19 20

Affiliations

• 1 deCODE genetics/Amgen, Reykjavik, Iceland. [email protected]. • 2 Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden. [email protected]. • 3 Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland. [email protected]. • 4 Department of Medicine, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland. [email protected]. • 5 deCODE genetics/Amgen, Reykjavik, Iceland. • 6 Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland. • 7 School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland. • 8 Department of Medicine, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland. • 9 Center for Rheumatology Research, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland. • 10 The Icelandic Medical Center, Mjodd, Reykjavik, Iceland. • 11 Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. • 12 Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden. • 13 Children's Medical Center, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland. • 14 Department of Neurology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland. • 15 Department of Clinical Neuroscience, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden. • 16 Department of Science, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland. • 17 Department of Immunology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland. • 18 Department of Hematology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland. • 19 deCODE genetics/Amgen, Reykjavik, Iceland. [email protected]. • 20 Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland. [email protected].

• PMID: 32581359 • DOI: 10.1038/s41586-020-2436-0 Abstract

Autoimmune thyroid disease is the most common autoimmune disease and is highly heritable1. Here, by using a genome-wide association study of 30,234 cases and 725,172 controls from Iceland and the UK Biobank, we find 99 sequence variants at 93 loci, of which 84 variants are previously unreported2-7. A low-frequency (1.36%) intronic variant in FLT3 (rs76428106-C) has the largest effect on risk of autoimmune thyroid disease (odds ratio (OR) = 1.46, P = 2.37 × 10-24). rs76428106-C is also associated with systemic lupus erythematosus (OR = 1.90, P = 6.46 × 10-4), rheumatoid factor and/or anti- CCP-positive rheumatoid arthritis (OR = 1.41, P = 4.31 × 10-4) and coeliac disease (OR = 1.62, P = 1.20 × 10-4). FLT3 encodes fms-related tyrosine kinase 3, a receptor that regulates haematopoietic progenitor and dendritic cells. RNA sequencing revealed that rs76428106-C generates a cryptic splice site, which introduces a stop codon in 30% of transcripts that are predicted to encode a truncated protein, which lacks its tyrosine kinase domains. Each copy of rs76428106-C doubles the plasma levels of the FTL3 ligand. Activating somatic mutations in FLT3 are associated with acute myeloid leukaemia8 with a poor prognosis and rs76428106-C also predisposes individuals to acute myeloid leukaemia (OR = 1.90, P = 5.40 × 10-3). Thus, a predicted loss-of- function germline mutation in FLT3 causes a reduction in full-length FLT3, with a compensatory increase in the levels of its ligand and an increased disease risk, similar to that of a gain-of-function mutation.

Full-text links

130. Aqueous RAFT Synthesis of Low Molecular Weight Anionic Polymers for Determination of Structure/Binding Interactions with Gliadin

Macromol Biosci. 2020 Aug;20(8):e2000125. doi: 10.1002/mabi.202000125. Epub 2020 Jun 22. Authors

Ashleigh N Bristol 1 , Brooke P Carpenter 1 , Ashley N Davis 1 , Lisa K Kemp 1 , Vijayaraghavan Rangachari 2 , Shahid Karim 3 , Sarah E Morgan 1

Affiliations

• 1 School of Polymer Science and Engineering, 118 College Dr., #5050, The University of Southern Mississippi, Hattiesburg, MS, 39406-5050, USA. • 2 Department of Chemistry and Biochemistry, The University of Southern Mississippi, Hattiesburg, MS, 39406-5050, USA. • 3 School of Biological, Environmental, and Earth Sciences, 118 College Dr., #5018, The University of Southern Mississippi, Hattiesburg, MS, 39406-5050, USA.

• PMID: 32567240 • DOI: 10.1002/mabi.202000125

Abstract

Gliadin, a component of gluten and a known epitope, is implicated in celiac disease (CeD) and results in an inflammatory response in CeD patients when consumed. Acrylamide-based polyelectrolytes are employed as models to determine the effect of molecular weight and pendent group on non-covalent interaction modes with gliadin in vitro. Poly(sodium 2-acrylamido-2- methylpropane sulfonate) and poly(sodium 3-methylpropyl-3-butanoate) are synthesized via aqueous reversible addition fragmentation chain transfer (aRAFT) polymerization and characterized by gel permeation chromatography- multiangle laser light scattering. The polymer/gliadin blends are examined via circular dichroism, zeta potential measurements, 8-anilinonaphthalene-1- sulfonic acid fluorescence spectroscopy, and dynamic light scattering. Acrylamide polymers containing strong anionic pendent groups have a profound effect on gliadin secondary structure and solution behavior below the isoelectric point, while polymers containing hydrophobic character only have a minor impact. The polymers have little effect on gliadin secondary structure and solution behavior at the isoelectric point. Keywords: anionic polymers; aqueous reversible addition fragmentation chain transfer; eliac disease; gliadin; non-covalent binding.

• 49 references

Grant support

• R15 GM123431/GM/NIGMS NIH HHS/United States • 1449999/National Science Foundation • R15GM 123431/NH/NIH HHS/United States • R15GM 123431/NH/NIH HHS/United States

Full-text links

131. Microdochium majus and other fungal pathogens associated with reduced gluten quality in wheat grain

Int J Food Microbiol. 2020 Oct 16;331:108712. doi: 10.1016/j.ijfoodmicro.2020.108712. Epub 2020 Jun 2.

Authors

Heidi Udnes Aamot 1 , Erik Lysøe 2 , Shiori Koga 3 , Katherine Ann Gredvig Nielsen 4 , Ulrike Böcker 3 , Guro Brodal 2 , Ruth Dill-Macky 5 , Anne Kjersti Uhlen 6 , Ingerd Skow Hofgaard 2

Affiliations

• 1 Division of Biotechnology and Plant Health, Norwegian Institute of Bioeconomy Research (NIBIO), P.O. Box 115, NO-1431 Ås, Norway. Electronic address: [email protected]. • 2 Division of Biotechnology and Plant Health, Norwegian Institute of Bioeconomy Research (NIBIO), P.O. Box 115, NO-1431 Ås, Norway. • 3 Nofima AS, P.O. Box 201, NO-1431 Ås, Norway. • 4 Division of Biotechnology and Plant Health, Norwegian Institute of Bioeconomy Research (NIBIO), P.O. Box 115, NO-1431 Ås, Norway; Department of Plant Sciences, Norwegian University of Lifesciences, P.O. Box 5003, NO-1432 Ås, Norway. • 5 Division of Biotechnology and Plant Health, Norwegian Institute of Bioeconomy Research (NIBIO), P.O. Box 115, NO-1431 Ås, Norway; Department of Plant Pathology, University of Minnesota, 495 Borlaug Hall, 1991 Upper Buford Circle, St Paul, MN 55108, USA. • 6 Nofima AS, P.O. Box 201, NO-1431 Ås, Norway; Department of Plant Sciences, Norwegian University of Lifesciences, P.O. Box 5003, NO-1432 Ås, Norway.

• PMID: 32563775 • DOI: 10.1016/j.ijfoodmicro.2020.108712

Abstract

The bread-making quality of wheat depends on the viscoelastic properties of the dough in which gluten proteins play an important role. The quality of gluten proteins is influenced by the genetics of the different wheat varieties and environmental factors. Occasionally, a near complete loss of gluten strength, measured as the maximum resistance towards stretching (Rmax), is observed in grain lots of Norwegian wheat. It is hypothesized that the loss of gluten quality is caused by degradation of gluten proteins by fungal proteases. To identify fungi associated with loss of gluten strength, samples from a selection of wheat grain lots with weak gluten (n = 10, Rmax < 0.3 N) and strong gluten (n = 10, Rmax ≥ 0.6 N) was analyzed for the abundance of fungal operational taxonomic units (OTUs) using DNA metabarcoding of the nuclear ribosomal Internal Transcribed Spacer (ITS) region ITS1. The DNA quantities for a selection of fungal pathogens of wheat, and the total amount of fungal DNA, were analyzed by quantitative PCR (qPCR). The mean level of total fungal DNA was higher in grain samples with weak gluten compared to grain samples with strong gluten. Heightened quantities of DNA from fungi within the Fusarium Head Blight (FHB) complex, i.e. Fusarium avenaceum, Fusarium graminearum, Microdochium majus, and Microdochium nivale, were observed in grain samples with weak gluten compared to those with strong gluten. Microdochium majus was the dominant fungus in the samples with weak gluten. Stepwise regression modeling based on different wheat quality parameters, qPCR data, and the 35 most common OTUs revealed a significant negative association between gluten strength and three OTUs, of which the OTU identified as M. majus was the most abundant. The same analysis also revealed a significant negative relationship between gluten strength and F. avenaceum detected by qPCR, although the DNA levels of this fungus were low compared to those of M. majus. In vitro growth rate studies of a selection of FHB species showed that all the tested isolates were able to grow with gluten as a sole nitrogen source. In addition, proteins secreted by these fungi in liquid cultures were able to hydrolyze gluten substrate proteins in zymograms, confirming their capacity to secrete gluten-degrading proteases. The identification of fungi with potential to influence gluten quality can enable the development of strategies to minimize future problems with gluten strength in food-grade wheat.

Keywords: DNA metabarcoding; Fusarium; Mycobiota; Parastagonospora nodorum; Protease.

Conflict of interest statement

Declaration of competing interest The authors declare that they have no conflicts of interest.

Full-text links

132. Hyposplenism, Hashimoto's Autoimmune Thyroiditis and Overlap Syndrome (Celiac Disease and Autoimmune Hepatitis Type 1)

Am J Med Sci. 2020 Sep;360(3):293-299. doi: 10.1016/j.amjms.2020.04.022. Epub 2020 Apr 25.

Authors

Alice Balaceanu 1 , Secil Omer 2 , Raluca Stirban 3 , Octavian Zara 4 , Ion Dina 2

Affiliations • 1 "Carol Davila" University of Medicine and Pharmacy, "Sf. Ioan" Clinical Emergency Hospital, Internal Medicine Department, Bucharest, Romania. Electronic address: [email protected]. • 2 "Carol Davila" University of Medicine and Pharmacy, "Sf. Ioan" Clinical Emergency Hospital, Gastroenterology Department, Bucharest, Romania. • 3 "Sf. Ioan" Clinical Emergency Hospital, Internal Medicine Department, Bucharest, Romania. • 4 "Sf. Ioan" Clinical Emergency Hospital, Interventional Cardiology Department, Bucharest, Romania.

• PMID: 32563569 • DOI: 10.1016/j.amjms.2020.04.022

Abstract

Hyposplenism is associated with autoimmune diseases, inflammatory bowel disease, severe celiac disease, autoimmune thyroiditis, untreated HIV infection and chronic graft-versus-host disease. The aim of this study was to review the existing data on hyposplenism associated with celiac disease and Hashimoto's autoimmune thyroiditis. Our research was based on a clinical case concerning a 41-year-old female who presented with asthenia, fatigue, dyspepsia and chronic diarrhea. The medical history revealed autoimmune Hashimoto's thyroiditis, type 2 diabetes, fatty liver disease, chronic gastritis and thrombocytosis. Multiple investigations showed hyposplenism and complex autoimmune dysfunction with positive serum markers for celiac disease and type 1 autoimmune hepatitis along with minor symptomatology. The intestinal symptomatology of celiac disease is often hid by hypothyroidism-associated autoimmune thyroiditis. Asymptomatic or minimally symptomatic celiac disease associated with Hashimoto's autoimmune thyroiditis is diagnosed by biomarkers. Hyposplenism in celiac disease can occur regardless of the disease stage, latent or symptomatic.

Keywords: Autoimmune hepatitis; Celiac disease; Hashimoto's thyroiditis; Hyposplenism; Thrombocytosis.

• Review

Full-text links

133. Structural, thermal and rheological properties of gluten dough: Comparative changes by dextran, weak acidification and their combination

Food Chem. 2020 Nov 15;330:127154. doi: 10.1016/j.foodchem.2020.127154. Epub 2020 May 28.

Authors

Yao Zhang 1 , Tingting Hong 1 , Wenjie Yu 1 , Na Yang 2 , Zhengyu Jin 3 , Xueming Xu 4

Affiliations

• 1 School of Food Science and Technology, Jiangnan University, 1800 Lihu Road, Wuxi 214122, PR China. • 2 School of Food Science and Technology, Jiangnan University, 1800 Lihu Road, Wuxi 214122, PR China; National Engineering Laboratory for Cereal Fermentation Technology, Jiangnan University, 1800 Lihu Road, Wuxi 214122, PR China. • 3 State Key Laboratory of Food Science and Technology, Jiangnan University, 1800 Lihu Road, Wuxi 214122, PR China; School of Food Science and Technology, Jiangnan University, 1800 Lihu Road, Wuxi 214122, PR China. • 4 State Key Laboratory of Food Science and Technology, Jiangnan University, 1800 Lihu Road, Wuxi 214122, PR China; School of Food Science and Technology, Jiangnan University, 1800 Lihu Road, Wuxi 214122, PR China; National Engineering Laboratory for Cereal Fermentation Technology, Jiangnan University, 1800 Lihu Road, Wuxi 214122, PR China. Electronic address: [email protected].

• PMID: 32531630 • DOI: 10.1016/j.foodchem.2020.127154

Abstract

Dextran-containing sourdough has been exploited in breadmaking, obtaining additive-free bread of high quality. Effect of dextran, weak acidification and their association on gluten dough structure, thermal properties and rheology was investigated. Electrophoresis (SDS-PAGE) showed that dextran and acids both lowered the band intensity in the high molecular weight area (Mw > 175 kDa) and size exclusion (SE-HPLC) revealed that weak acidification induced a decrease of 4.73% of the glutenin macropolymer (GMP) content. The higher free thiol (SH) was observed after dextran addition, further suggesting the hindered glutenin polymerization. Fourier transform infrared spectroscopy (FTIR) found that dextran and weak acidity caused increased β-turn and decreased β-sheet structures, suggesting a gluten of lower coherence and resistance to extension. Weakened thermal stability and viscoelasticity were subsequently detected by differential scanning calorimetry (DSC), thermogravimetric analysis (TGA) and dynamic rheology. However, structural, thermal and rheological properties of the weakly acidified group were improved by the associated dextran.

Keywords: Acidification; Dextran; Dextran (PubChem CID: 4125253); Gluten proteins; Structure; Wheat gluten (PubChem SID: 135322122).

Conflict of interest statement

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134. Oral processing and dynamics of texture perception in commercial gluten-free breads

Food Res Int. 2020 Aug;134:109233. doi: 10.1016/j.foodres.2020.109233. Epub 2020 Apr 15.

Authors

P Puerta 1 , L Laguna 2 , B Villegas 1 , A Rizo 1 , S Fiszman 1 , A Tarrega 1

Affiliations

• 1 Instituto de Agroquímica y Tecnología de Alimentos (IATA-CSIC), Agustín Escardino, 7, Paterna, Valencia, Spain. • 2 Instituto de Agroquímica y Tecnología de Alimentos (IATA-CSIC), Agustín Escardino, 7, Paterna, Valencia, Spain. Electronic address: [email protected].

• PMID: 32517905 • DOI: 10.1016/j.foodres.2020.109233

Abstract

There is an increasing demand for gluten-free products, with the texture being a critical aspect. The aim of this work was to study the food bolus properties of gluten-free breads in relation to the dynamics of sensations perceived during its consumption. In this study, five-commercial gluten-free breads and two regular breads were analysed for their texture, crumb structure, and moisture content. Bread bolus particle size after three chews, bolus characteristics at the swallowing point, and oral activity were determined. The dynamics of textural sensations during bread consumption was evaluated using the temporal dominance of sensations (TDS) technique. Texture and structure properties vary among gluten-free breads being some of them close to regular breads (crumb with more and smaller cells that shows low hardness and high springiness) that lead to different in-mouth breakdown and TDS patterns. At the beginning, harder breads with low springiness values resulted in hard dominant sensations, in contrast, breads with low hardness and high springiness values were perceived soft and spongy. Breads that fragmented into a greater number of small size particles created crumbly and sandy sensations, characteristic of gluten-free breads with large air cell sizes. Compact sensation appeared in breads with low saliva uptake during bolus formation, while pasty and sticky sensations were related to a cohesive and adhesive bolus, respectively. Not only structure and mechanical properties, but also its oral behaviour in terms of fragmentation and bolus formation can fully explain the dynamics of texture perception of gluten-free breads.

Keywords: Bolus properties; Dynamic sensations; Gluten-free bread; Texture.

Conflict of interest statement

Declaration of Competing Interest The authors declared that there is no conflict of interest.

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135. Celiac Disease Screening for High-Risk Groups: Are We Doing It Right?

Dig Dis Sci. 2020 Aug;65(8):2187-2195. doi: 10.1007/s10620-020-06352-w.

Authors

Dennis Kumral 1 , Sana Syed 2

Affiliations

Erratum in

• Correction to: Celiac Disease Screening for High-Risk Groups: Are We Doing It Right?

Kumral D, Syed S.

Dig Dis Sci. 2020 Sep;65(9):2743. doi: 10.1007/s10620-020-06453-6.

PMID: 32623549

Abstract

Celiac disease (CD) is an immune-mediated enteropathy triggered by dietary ingestion of gluten in genetically susceptible patients. CD is often diagnosed by a "case-finding" approach of symptomatic patients. In recent times, the diagnostic paradigm has shifted to investigate patients who may be asymptomatic, but are at high risk of developing CD due to shared genetic susceptibilities. These high-risk groups include first-degree relatives of CD patients and patients with Type 1 diabetes mellitus, autoimmune thyroid disease, Down's syndrome, and Turner syndrome. Moreover, CD is often diagnosed as the cause of iron deficiency anemia or unexplained chronic diarrhea. Although screening for CD with serological tests is not recommended for the general population, it should be considered in these special populations. In this review, we explore screening for CD among high-risk groups in light of recent research and development in the CD arena.

Keywords: Anti-tissue transglutaminase; Autoimmune thyroid disease; Celiac disease; First-degree relatives; High-risk populations; Iron deficiency anemia; Screening; Serology; Type 1 diabetes mellitus.

Publication types

• Review

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136. The expression levels of CHI3L1 and IL15Rα correlate with TGM2 in duodenum biopsies of patients with celiac disease

Inflamm Res. 2020 Sep;69(9):925-935. doi: 10.1007/s00011-020-01371-9. Epub 2020 Jun 4.

Authors

Paola Catrogiovanni 1 , Giuseppe Musumeci 1 , Salvatore Giunta 1 , Rosa Imbesi 1 , Michelino Di Rosa 2

Affiliations

• 1 Anatomy, Histology and Movement Sciences, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Via S. Sofia 87, 95125, Catania, Italy. • 2 Anatomy, Histology and Movement Sciences, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Via S. Sofia 87, 95125, Catania, Italy. [email protected].

• PMID: 32500186 • DOI: 10.1007/s00011-020-01371-9

Abstract

Objective and design: Celiac disease (CD) is an intestinal inflammatory disorder of the small intestine. Gliadins are a component of gluten and there are three main types (α, γ, and ω). Recent studies indicate that gliadin peptides are able to activate an innate immune response. IL15 is a major mediator of the innate immune response and is involved in the early alteration of CD mucosa. The chitinase molecules are highly expressed by the innate immune cells during the inflammatory processes.

Material or subjects: We analyzed several microarray datasets of PBMCs and duodenum biopsies of CD patients and healthy control subjects (HCs). We verified the modulation CHI3L1 in CD patients and correlated the expression levels to the IL15, IL15Rα, TGM2, IFNγ, and IFNGR1/2. Duodenal biopsy samples belonged to nine active and nine treated children patients (long-term effects of gliadin), and 17 adult CD patients and 10 adults HCs. We also selected 169 samples of PBMCs from 127 CD patients on adherence to a gluten-free diet (GFD) for at least 2 years and 44 HCs.

Results: Our analysis showed that CHI3L1 and IL15Rα were significantly upregulated in adult and children's celiac duodenum biopsies. In addition, the two genes were correlated significantly both in children than in adults CD duodenum biopsies. No significant modulation was observed in PBMCs of adult CD patients compared to the HCs. The correlation analysis of the expression levels of CHI3L1 and IL15Rα compared to TGM showed significant values both in adults and in children duodenal biopsies. Furthermore, the IFNγ expression levels were positively correlated with CHI3L1 and IL15Rα. Receiver operating characteristic (ROC) analysis confirmed the diagnostic ability of CHI3L1 and IL15Rα to discriminate CD from HCs.

Conclusion: Our data suggest a role for CHI3L1 underlying the pathophysiology of CD and represent a starting point aiming to inspire new investigation that proves the possible use of CHI3L1 as a diagnostic factor and therapeutic target.

Keywords: Bioinformatics; CHI3L1; Celiac disease; Chitinases; IL15; IL15Rα.

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137. Determination and Comparison of the Lipid Profile and Sodium Content of Gluten-Free and Gluten-Containing Breads from the Spanish Market

Plant Foods Hum Nutr. 2020 Sep;75(3):344-354. doi: 10.1007/s11130-020- 00828-w. Authors

Alba Tres 1 2 , Natalia Tarnovska 1 , Elisa Varona 1 2 , Beatriz Quintanilla-Casas 1 2 , Stefania Vichi 1 2 , Anna Gibert 3 , Elisenda Vilchez 3 , Francesc Guardiola 4 5

Affiliations

• 1 Nutrition, Food Science and Gastronomy Department-XaRTA, Torribera Food Science Campus, Faculty of Pharmacy and Food Science, Universitat de Barcelona, Av. Prat de la Riba, 171, 08921, Santa Coloma de Gramenet, Spain. • 2 Institut de Recerca en Nutrició i Seguretat Alimentària, Universitat de Barcelona, Av. Prat de la Riba, 171, 08921, Santa Coloma de Gramenet, Spain. • 3 Associació de Celíacs de Catalunya, Carrer de la Independència, 257, 08026, Barcelona, Spain. • 4 Nutrition, Food Science and Gastronomy Department-XaRTA, Torribera Food Science Campus, Faculty of Pharmacy and Food Science, Universitat de Barcelona, Av. Prat de la Riba, 171, 08921, Santa Coloma de Gramenet, Spain. [email protected]. • 5 Institut de Recerca en Nutrició i Seguretat Alimentària, Universitat de Barcelona, Av. Prat de la Riba, 171, 08921, Santa Coloma de Gramenet, Spain. [email protected].

• PMID: 32488604 • PMCID: PMC7378101 • DOI: 10.1007/s11130-020-00828-w

Free PMC article Abstract

The objective is to verify if gluten-free (GF) and gluten-containing (G) breads differ in their sodium content and lipid profile. Samples of GF (n = 20) and G (n = 14) sliced white sandwich bread of commercial brands most frequently consumed in Spain were collected. The fatty acid (FA) composition and the contents of sodium, fat, cholesterol and phytosterols were determined. Sodium, fat and cholesterol contents were significantly higher in GF bread. The FA composition also differed, while G breads declared in most instances the use of sunflower oil as fat ingredient and presented a higher polyunsaturated FA percentage; GF breads declared a wide variety of fats and oils as ingredients (coconut, palm, olive, sunflower, etc.) which was reflected in their FA profile. Cholesterol content was higher in GF bread because five samples declared the use of whole egg, while G samples did not include any egg product in their formulas. Phytosterol content was higher in G bread but its variability was greater in GF bread. In conclusion, nutritional quality of GF bread varied depending on the ingredients used and might be lower than that of G bread. However, these differences in composition could be reduced or eliminated through changes in the formulation of GF bread. Moreover, the comparison of the results obtained in our laboratory for fat and salt content with the declared contents on the labels showed a much higher deviation for GF samples and it can be concluded that the quality of the nutritional information declared was lower in GF samples.

Keywords: Fat, cholesterol, phytosterol and sodium content; Fatty acid composition; Gluten-free bread; Nutritional value.

Conflict of interest statement

The authors declare that they have no conflict of interest.

• 35 references • 2 figures

MeSH terms

• Bread* • Diet, Gluten-Free • Glutens* • Lipids • Sodium • Spain

Substances

• Lipids • Glutens • Sodium

Grant support • FBG-309407/Associació de Celíacs de Catalunya

Full-text links

138. The need for fully bio-based facemasks to counter coronavirus outbreaks: A perspective

Sci Total Environ. 2020 Sep 20;736:139611. doi: 10.1016/j.scitotenv.2020.139611. Epub 2020 May 22.

Authors

Oisik Das 1 , Rasoul Esmaeely Neisiany 2 , Antonio Jose Capezza 3 , Mikael S Hedenqvist 4 , Michael Försth 5 , Qiang Xu 6 , Lin Jiang 6 , Dongxiao Ji 7 , Seeram Ramakrishna 7

Affiliations

• 1 Material Science Division, Department of Engineering Sciences and Mathematics, Luleå University of Technology, Luleå 97187, Sweden; School of Mechanical Engineering, Nanjing University of Science and Technology, 210094 Nanjing, China. Electronic address: [email protected]. • 2 Department of Materials and Polymer Engineering, Faculty of Engineering, Hakim Sabzevari University, Sabzevar 9617976487, Iran. • 3 Department of Fibre and Polymer Technology, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Stockholm 100 44, Sweden; Department of Plant Breeding, SLU Swedish University of Agricultural Sciences, BOX 101, SE-230 53 Alnarp, Sweden. • 4 Department of Fibre and Polymer Technology, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Stockholm 100 44, Sweden. Electronic address: [email protected]. • 5 Structural and Fire Engineering Division, Department of Civil, Environmental and Natural Resources Engineering, Luleå University of Technology, Luleå 97187, Sweden. • 6 School of Mechanical Engineering, Nanjing University of Science and Technology, 210094 Nanjing, China. • 7 Department of Mechanical Engineering, National University of Singapore, Singapore 117575, Singapore.

• PMID: 32473458 • PMCID: PMC7243761 • DOI: 10.1016/j.scitotenv.2020.139611

Free PMC article Abstract

The onset of coronavirus pandemic has sparked a shortage of facemasks in almost all nations. Without this personal protective equipment, healthcare providers, essential workers, and the general public are exposed to the risk of infection. In light of the aforementioned, it is critical to balance the supply and demand for masks. COVID-19 will also ensure that masks are always considered as an essential commodity in future pandemic preparedness. Moreover, billions of facemasks are produced from petrochemicals derived raw materials, which are non-degradable upon disposal after their single use, thus causing environmental pollution and damage. The sustainable way forward is to utilise raw materials that are side-stream products of local industries to develop facemasks having equal or better efficiency than the conventional ones. In this regard, wheat gluten biopolymer, which is a by- product or co-product of cereal industries, can be electrospun into nanofibre membranes and subsequently carbonised at over 700 °C to form a network structure, which can simultaneously act as the filter media and reinforcement for gluten-based masks. In parallel, the same gluten material can be processed into cohesive thin films using plasticiser and hot press. Additionally, lanosol, a naturally-occurring substance, imparts fire (V-0 rating in vertical burn test), and microbe resistance in gluten plastics. Thus, thin films of flexible gluten with very low amounts of lanosol (<10 wt%) can be bonded together with the carbonised mat and shaped by thermoforming to create the facemasks. The carbon mat acting as the filter can be attached to the masks through adapters that can also be made from injection moulded gluten. The creation of these masks could simultaneously be effective in reducing the transmittance of infectious diseases and pave the way for environmentally benign sustainable products. Keywords: Bio-based membranes; Coronavirus; Electrospinning; Facemasks; Gluten.

• Cited by 3 articles • 44 references • 6 figures

MeSH terms

• Betacoronavirus • Biomedical Technology • Catechols / chemistry • Communicable Disease Control / instrumentation* • Coronavirus Infections / prevention & control* • Filtration / instrumentation • Glutens / chemistry • Humans • Masks* • Pandemics / prevention & control* • Pneumonia, Viral / prevention & control*

Substances

• Catechols • lanosol • Glutens

Supplementary concepts

• COVID-19 • severe acute respiratory syndrome coronavirus 2

Full-text links

139. Low-molecular-weight glutenin subunit LMW-N13 improves dough quality of transgenic wheat

Food Chem. 2020 Oct 15;327:127048. doi: 10.1016/j.foodchem.2020.127048. Epub 2020 May 12.

Authors

Xuye Du 1 , Jialian Wei 1 , Xi Luo 1 , Zhiguo Liu 2 , Yuqing Qian 2 , Bin Zhu 1 , Qingbei Weng 3 , Heng Tang 4

Affiliations

• 1 School of Life Sciences, Guizhou Normal University, No. 116, Baoshan North Street, Guiyang, Guizhou Province, China. • 2 College of Plant Protection, Shandong Agricultural University, No. 61, Daizong Street, Taian, Shandong Province, China. • 3 School of Life Sciences, Guizhou Normal University, No. 116, Baoshan North Street, Guiyang, Guizhou Province, China. Electronic address: [email protected]. • 4 College of Plant Protection, Shandong Agricultural University, No. 61, Daizong Street, Taian, Shandong Province, China. Electronic address: [email protected].

• PMID: 32454285 • DOI: 10.1016/j.foodchem.2020.127048

Abstract

In our previous study, a novel LMW-GS designated as LMW-N13 with a unique molecular structure was identified from Aegilops uniaristata. LMW-N13 has been characterized as the largest LMW-GS, so far, and possesses an extra cysteine residue compared with typical LMW-GS. In order to analyze the contribution of LMW-N13 to dough quality, in this work, three transgenic wheat lines overexpressing LMW-N13 were generated. Compared with non- transformation (NT) lines, transgenic (TG) lines demonstrated superior dough properties. These superior dough properties were accompanied by the higher contents of glutenin macropolymer (GMP) and total protein. The microstructure of the dough was further investigated by scanning electron microscopy; starch granules in NT lines were smaller than those in transgenic lines. The protein matrix in NT lines was relatively loose and discontinuous. Conversely, the protein matrix in transgenic lines was more continuous and tight. The application of LMW-N13 in wheat breeding is also discussed.

Keywords: Low-molecular-weight glutenin subunit; Microstructure; Mixing properties; Processing quality; Transgenic wheat lines.

Conflict of interest statement

MeSH terms

• Aegilops / genetics • Disulfides / chemistry • Flour / analysis* • Glutens / chemistry* • Glutens / genetics • Glutens / metabolism • Microscopy, Electron, Scanning • Molecular Weight • Plants, Genetically Modified / chemistry* • Plants, Genetically Modified / metabolism • Starch / chemistry • Triticum / chemistry* • Triticum / metabolism • Water / chemistry

Substances

• Disulfides • Water • Glutens • Starch • glutenin

Full-text links

140. Osteoporosis in Premenopausal Women: A Clinical Narrative Review by the ECTS and the IOF

J Clin Endocrinol Metab. 2020 Aug 1;105(8):dgaa306. doi: 10.1210/clinem/dgaa306.

Authors

Jessica Pepe 1 , Jean-Jacques Body 2 , Peyman Hadji 3 , Eugene McCloskey 4 , Christian Meier 5 , Barbara Obermayer-Pietsch 6 , Andrea Palermo 7 , Elena Tsourdi 8 9 , M Carola Zillikens 10 , Bente Langdahl 11 , Serge Ferrari 12

Affiliations

• 1 Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, "Sapienza" University of Rome, Italy. • 2 Department of Medicine, CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium. • 3 Frankfurt Center of Bone Health, Frankfurt, Germany and Philipps- University of Marburg, Marburg, Germany. • 4 Centre for Integrated Research in Musculoskleetal Ageing, Mellanby Centre for Bone Research, Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK. • 5 Division of Endocrinology, Diabetology and Metabolism, University Hospital and University of Basel, Basel, Switzerland. • 6 Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria. • 7 Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Rome, Italy. • 8 Department of Medicine III, Technische Universität Dresden Medical Center, Dresden, Germany. • 9 Center for Healthy Aging, Technische Universität Dresden Medical Center, Dresden, Germany. • 10 Bone Center, Department of Internal Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands. • 11 Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark. • 12 Service of Bone Diseases, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland.

• PMID: 32453819 • DOI: 10.1210/clinem/dgaa306

Abstract

Context: Consensus regarding diagnosis and management of osteoporosis in premenopausal women (PW) is still lacking due to few studies carried out in this population.

Design: The European Calcified Tissue Society and the International Osteoporosis Foundation convened a working group to produce an updated review of literature published after 2017 on this topic.

Results: Fragility fractures in PW are rare and mostly due to secondary osteoporosis (ie, in presence of an underlying disease such as hormonal, inflammatory, or digestive disorders). In absence of another disorder, low bone mineral density (BMD) together with fragility fractures qualifies as idiopathic osteoporosis. In contrast, low BMD alone does not necessarily represent osteoporosis in absence of bone microarchitectural abnormalities. BMD increases in PW with osteoporosis when the underlying disease is treated. For example, in celiac disease, an increase of 9% in radius trabecular volumetric density was achieved after 1 year of gluten-free diet, while anti- tumor necrosis factor alpha improved BMD in PW with inflammatory bowel diseases. In amenorrhea, including anorexia nervosa, appropriately delivered estrogen replacement therapy can also improve BMD. Alternatively, antiresorptive or anabolic therapy has been shown to improve BMD in a variety of conditions, the range of improvement (3%-16%) depending on skeletal site and the nature of the secondary cause. No studies were powered to demonstrate fracture reduction. The effects of bisphosphonates in childbearing women have been scantly studied and caution is needed.

Conclusion: The majority of PW with osteoporosis have an underlying disease. Specific therapy of these diseases, as well as antiresorptive and anabolic drugs, improve BMD, but without evidence of fracture reduction.

Keywords: antiresorptive therapy; fracture; osteoporosis; pregnancy; premenopausal women; secondary osteoporosis.

Full-text links

141. Noncoeliac wheat sensitivity and diet

Curr Opin Clin Nutr Metab Care. 2020 Sep;23(5):322-327. doi: 10.1097/MCO.0000000000000671.

Authors

Dorota Mańkowska-Wierzbicka 1 , Marta Stelmach-Mardas 2

Affiliations

• 1 Department of Gastroenterology, Metabolic Diseases, Internal Medicine and Dietetics, Poznan, Poland. • 2 Department of Biophysics, Poznan University of Medical Sciences, Poznań, Poland.

• PMID: 32452869 • DOI: 10.1097/MCO.0000000000000671

Abstract

Purpose of review: Noncoeliac gluten sensitivity (NCGS) can be suspected after exclusion of coeliac disease and wheat allergy. However, poorly understood pathogenesis of the NCGS, lack of gold standard for diagnosis and agreement in the definition for the NCGS condition, open the space for future investigation. This review aims to give an overview on the diagnosis and effective diet composition in the treatment of NCGS symptoms.

Recent findings: It appears that a diet low in fermentable oligo, di, and monosaccharides and polyols (FODMAPs) and gluten-free diet play a prominent role in the strategy of NCGS management. Considering available evidence with respect to diagnostic tools, it is challenging to prepare a standard guideline for NCGS diagnosis and treatment with clear cut-offs for symptom reduction/improvement that could directly be translated into test results. Nutritional support, including the use of pre/probiotics, has to be tailored to the individual situation of NCGS patients.

Summary: The exclusion of such components of wheat as amylase/trypsin inhibitors, wheat-germ agglutinins, or free of FODMAPs diet can reduce clinical symptoms of NCGS. The further investigation on microbiota changes may strengthen the knowledge in this area, where the major challenge is to develop biomarkers for NCGS investigation.

Full-text links

142. Changes in protein structural characteristics upon processing of gluten- free millet pasta

Food Chem. 2020 Oct 15;327:127052. doi: 10.1016/j.foodchem.2020.127052. Epub 2020 May 19.

Authors

Catrin Tyl 1 , Alessandra Marti 2 , Baraem P Ismail 3

Affiliations • 1 Department of Food Science and Nutrition, University of Minnesota, Saint Paul, MN 55108, USA. Electronic address: [email protected]. • 2 Department of Food Science and Nutrition, University of Minnesota, Saint Paul, MN 55108, USA; Department of Food, Environmental and Nutritional Sciences, Università degli Studi di Milano, 20133 Milan, Italy. Electronic address: [email protected]. • 3 Department of Food Science and Nutrition, University of Minnesota, Saint Paul, MN 55108, USA. Electronic address: [email protected].

• PMID: 32446025 • DOI: 10.1016/j.foodchem.2020.127052

Abstract

Proso millet exhibits favorable agronomic and nutritional properties but is currently under-utilized in the northern hemisphere. This study compared processing-induced changes in protein characteristics of commercial pasta to fresh gluten-free pasta from proso millet varieties differing in prolamin profile. Protein solubility, accessible thiols and secondary structures were measured in dough, sheeted and cooked pasta. Relationships between protein conformation and characteristics related to pasta quality were determined. Cooking significantly lowered protein solubility and induced exposure of thiol groups as well as a shift in secondary structure distribution, while sheeting only had a minor effect. Random structures positively and significantly (P < 0.05) correlated with solubility, cooking loss and protein digestibility. In contrast, β-sheets, the main secondary structure in cooked pasta, negatively correlated with these properties. The utilization of proso millet in gluten-free pasta is promising, however, processing optimization to elicit targeted protein modifications to balance quality and nutritional attributes requires further investigation.

Keywords: Gluten-free pasta; Pasta processing; Proso millet; Protein secondary structure; Protein solubility.

MeSH terms

• Cooking • Digestion • Edible Grain / chemistry • Flour / analysis* • Glutens / chemistry* • Millets / chemistry* • Millets / metabolism • Principal Component Analysis • Protein Structure, Secondary • Solubility • Spectroscopy, Fourier Transform Infrared

Substances

• Glutens

Full-text links

143. Serologic Evaluation of Celiac Disease for Patients Younger Than 2 Years of Age

J Pediatr. 2020 Sep;224:16-17. doi: 10.1016/j.jpeds.2020.05.023. Epub 2020 May 21.

Authors

Daniel Mallon 1 , Temara M Hajjat 2

Affiliations • 1 Cincinnati Children's Hospital Medical Center/University of Cincinnati College of Medicine, Cincinnati, Ohio. Electronic address: [email protected]. • 2 Cincinnati Children's Hospital Medical Center/University of Cincinnati College of Medicine, Cincinnati, Ohio.

• PMID: 32445650 • DOI: 10.1016/j.jpeds.2020.05.023

No abstract available Publication types

• Editorial

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144. Natural variants of α-gliadin peptides with wheat proteins with reduced toxicity in coeliac disease - CORRIGENDUM

Br J Nutr. 2020 Aug 28;124(4):480. doi: 10.1017/S000711452000149X. Epub 2020 May 22.

Authors

Nika Japelj, Tanja Suligoj, Wei Zhang, Beatriz Côrte-Real, Joachim Messing, Paul J Ciclitira

• PMID: 32441231 • DOI: 10.1017/S000711452000149X

No abstract available

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145. Chromogranin Serves as Novel Biomarker of Endocrine and Gastric Autoimmunity

J Clin Endocrinol Metab. 2020 Aug 1;105(8):dgaa288. doi: 10.1210/clinem/dgaa288.

Authors

Antonia Ebert 1 , Jochem König 2 , Lara Frommer 1 , Detlef Schuppan 3 4 , George J Kahaly 1

Affiliations

• 1 Department of Medicine I, Johannes Gutenberg University (JGU) Medical Center, Mainz, Germany. • 2 Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), Johannes Gutenberg University Medical Center, Mainz, Germany. • 3 Institute for Translational Immunology and Research Center for Immunotherapy (FZI), Johannes Gutenberg University Medical Center, Mainz, Germany. • 4 Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.

• PMID: 32436949 • DOI: 10.1210/clinem/dgaa288

Abstract

Context: The glycoprotein chromogranin A (CgA) is expressed by endocrine and neuroendocrine cells. High levels of serum CgA serve as markers of neuroendocrine tumors (NET), but its role in autoimmunity has not been assessed.

Objective: To investigate CgA utility as a marker of endocrine autoimmunity.

Methods: CgA serum levels were evaluated in 807 consecutive unselected participants (cross-sectional study) with the time-resolved amplified cryptate emission technology. Results: Serum CgA concentrations were increased in 66%, 39%, 38%, and 24% of patients with NET, type 1 diabetes (T1D), autoimmune gastritis (AG) and autoimmune polyendocrinopathy (AP), respectively. Compared with healthy participant controls (C), the odds of positive CgA measurement were up to 28 times higher in the disease groups. In detail, the odds ratios (ORs) for positive CgA levels were 27.98, 15.22, 7.32 (all P < 0.0001) and 3.89 (P = 0.0073) in patients with NET, T1D, AG, and AP, respectively. In AG, CgA and serum gastrin correlated positively (r = 0.55; P < 0.0001). The area under the receiver operating characteristic curve to predict AG was higher for parietal cell antibody (PCA) positivity than for CgA (0.84 vs 0.67; P < 0.0001). However, in combination with PCA and intrinsic factor autoantibodies, CgA independently improved prediction of AG (OR 6.5; P = 0.031). An impact of age on CgA positivity and on CgA value was detected (P < 0.0001) while current smoking significantly increased CgA serum levels by 25% (P = 0.0080).

Conclusion: CgA qualifies as a novel biomarker for T1D, AP, and AG.

Keywords: autoimmune gastritis; autoimmune polyendocrinopathy; celiac disease; chromogranin; thyroid autoimmunity; type 1 diabetes.

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146. Median Arcuate Ligament Syndrome With Celiac Artery Aneurysm and Dissection

Vasc Endovascular Surg. 2020 Aug;54(6):525-527. doi: 10.1177/1538574420927866. Epub 2020 May 21.

Authors

Hans Michell 1 , Nariman Nezami 2 , Aaron Dewald 1 , Anant Bhave 1 , Christopher Morris 1 , Dmitriy Akselrod 1 Affiliations

• 1 Department of Radiology, University of Vermont Medical Center, Burlington, VT, USA. • 2 Division of Vascular and Interventional Radiology, Department of Radiology and Radiological Sciences, Johns Hopkins Hospital, Baltimore, MD, USA.

• PMID: 32436479 • DOI: 10.1177/1538574420927866

Abstract

Median arcuate ligament syndrome (MALS) is the chronic symptomatic compression of the celiac artery by the median arcuate ligament. A known potential sequela of MALS is celiac artery aneurysm, which could predispose the diseased artery to dissection. However, the presence of celiac artery dissection and MALS is yet to be reported. Here, we present a case of MALS with a coincident celiac artery aneurysm and dissection.

Keywords: aneurysm; dissection; median arcuate ligament syndrome.

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147. Oral vitamin E supplementation in reducing nitrosative stress in adults treated for celiac disease

Pol Arch Intern Med. 2020 Aug 27;130(7-8):711-713. doi: 10.20452/pamw.15369. Epub 2020 May 19.

Authors

Agnieszka Piątek-Guziewicz, Agnieszka Dąbek, Magdalena Przybylska-Feluś, Paweł Zagrodzki, Tomasz Mach, Małgorzata Zwolińska-Wcisło • PMID: 32426954 • DOI: 10.20452/pamw.15369

Free article No abstract available

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148. Evaluation of wheat flour substitution type (corn, green banana and rice flour) and concentration on local dough properties during bread baking

Food Chem. 2020 Oct 1;326:126972. doi: 10.1016/j.foodchem.2020.126972. Epub 2020 May 11.

Authors

Rafael Grassi de Alcântara 1 , Rosemary Aparecida de Carvalho 1 , Fernanda Maria Vanin 2

Affiliations

• 1 Food Engineering Department, University of São Paulo, Faculty of Animal Science and Food Engineering (USP/FZEA), Laboratory of Bread and Dough Process (LAPROPAMA), Av. Duque de Caxias Norte 225, 13635-900 Pirassununga, SP, Brazil. • 2 Food Engineering Department, University of São Paulo, Faculty of Animal Science and Food Engineering (USP/FZEA), Laboratory of Bread and Dough Process (LAPROPAMA), Av. Duque de Caxias Norte 225, 13635-900 Pirassununga, SP, Brazil. Electronic address: [email protected].

• PMID: 32422510 • DOI: 10.1016/j.foodchem.2020.126972 Abstract

Different bread formulations, which provide different dough structures, were studied in order to better understand the effect of wheat flour substitution, flour type and concentration on dough development during baking, and their relationship with physical properties of the final product. Breads were produced with partial substitution of wheat flour by corn (CF), green banana (GF) and rice flour (RF), at different concentrations, and then baked at different times. Wheat flour substitution by CF, GF and RF in bread reduces heat transfer to the dough center by about 21%, 35% and 20%, respectively; and the water loss by about 5%, 15% and 0%, respectively. Those reductions were more influenced by flour type, than flour concentration. When wheat flour is substituted, the mechanisms of water migration are modified, once the pore system of bread dough is more discrete and stiffens later. Calculated thermal conductivity and diffusivity of the different flours used, and its correlations with average composite-bread heating rates (0.93) and water loss (0.85), respectively, indicates that thermal properties of composite bread dough could represent an important issue to be explored in dough systems with reduced gluten concentration.

Keywords: Corn flour; Dough formulation; Green banana flour; Heat transfer; Moisture content; Rice flour; Starch gelatinization; Stiffness.

Conflict of interest statement

MeSH terms

• Bread* • Flour* • Glutens / analysis • Musa* / chemistry • Oryza* / chemistry • Temperature • Triticum / chemistry • Water • Zea mays* / chemistry

Substances

• Water • Glutens

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149. Retrograde Recanalization of the Celiac Artery via the Pancreaticoduodenal Arcade as a Safe and Valid Alternative to Antegrade Access

Vasc Endovascular Surg. 2020 Aug;54(6):477-481. doi: 10.1177/1538574420927132. Epub 2020 May 18.

Authors

Federico Pedersoli 1 , Markus Zimmermann 1 , Maximilian Schulze-Hagen 1 , Paul Sieben 1 , Emona Barzakova 1 , Fabian Goerg 1 , Sebastian Keil 1 , Alexander Gombert 2 , Christiane K Kuhl 1 , Peter Isfort 1 , Philipp Bruners 1

Affiliations

• 1 Department of Diagnostic and Interventional Radiology, RWTH University Hospital Aachen, Aachen, Germany. • 2 Clinic for Vascular Surgery, RWTH University Hospital Aachen, Aachen, Germany.

• PMID: 32419653 • DOI: 10.1177/1538574420927132 Abstract

Purpose: The antegrade recanalization of an occlusion or high-grade stenosis of the celiac artery via the aorta often represents a technical challenge. A retrograde approach via the superior mesenteric artery and the pancreaticoduodenal arcade may be an alternative approach. Based on our experience, we assess the technical success and the short- and mid-term outcomes of this bailout procedure.

Methods: We performed a retrospective analysis of all consecutive patients who underwent recanalization and stent implantation in the celiac artery between January 2010 and December 2018. Data on vascular access, the materials used including stents, as well as the length of the intervention, radiation exposure, and follow-up were assessed.

Results: Recanalization in combination with stent implantation into the celiac artery was performed in 43 patients. In 39 (91%) of 43 patients, the recanalization was successful with an antegrade approach via the aorta, whereas in 4 (9%) of 43 patients the passage of the stenosis was possible only through a retrograde approach through the superior mesenteric artery and the pancreaticoduodenal arcade followed be advancement of the microwire through the celiac artery into the aorta. The tip of the microwire was captured in the aorta with a snare and pulled out in the femoral introducer sheath and used as a guide for the antegrade implantation of a balloon-expandable stent.

Conclusions: The retrograde recanalization of the celiac artery via the pancreaticoduodenal arcade may be technically challenging yet represents a feasible alternative in case of a failed antegrade approach.

Keywords: acute mesenteric ischemia; celiac artery; chronic mesenteric ischemia; interventional therapy; recanalization; superior mesenteric artery.

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150. Gluten-free diet impact on dynamics of pancreatic islet-specific autoimmunity detected at celiac disease diagnosis

Pediatr Diabetes. 2020 Aug;21(5):774-780. doi: 10.1111/pedi.13054. Epub 2020 Jun 8.

Authors

Claudio Tiberti 1 , Monica Montuori 2 , Chiara Maria Trovato 1 2 , Francesca Panimolle 1 , Tiziana Filardi 1 , Francesco Valitutti 2 , Andrea Lenzi 1 , Salvatore Cucchiara 2 , Susanna Morano 1

Affiliations

• 1 Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy. • 2 Department of Pediatrics, Pediatric Gastroenterology, and Liver Unit, Sapienza University of Rome, Rome, Italy.

• PMID: 32418261 • DOI: 10.1111/pedi.13054

Abstract

Objective: Almost 6% of celiac disease (CD) patients at diagnosis are positive for at least one of the main pancreatic islet autoantibodies that characterize type 1 diabetes (T1D). Few information, dated back to almost two decades ago, exist as to whether a gluten-free diet (GFD) could reduce the islet-specific autoimmunity detected in patients at CD diagnosis. Aim of the study was to evaluate the impact of GFD on 31 patients who presented islet-specific autoimmunity at CD diagnosis.

Methods: CD patient sera collected at diagnosis and throughout the GFD were analyzed for the main humoral autoantibodies so far identified in T1D, directed against one or more among insulin, glutamic-acid decarboxylase, tyrosine-phosphatase 2, and zinc cation-efflux transporter autoantigens. Results: GFD (median duration 39 months) was associated to a decrease or disappearance of the islet-specific autoantibodies in 71% of CD patients. Almost 80% of the patients who became autoantibody-negative during the GFD were positive for only one of the islet-specific autoimmune markers at CD diagnosis, with none of them developing diabetes. Conversely, 80% of the CD patients positive at diagnosis for ≥2 islet-specific autoantibodies were still positive after more than two years of GFD, with 25% of them developing T1D.

Conclusions: Various factors appear to influence, individually or in combination, the effects of the GFD on pancreatic islet-specific autoimmune response detected at CD diagnosis. These factors include the number of diabetes autoantibodies found at CD diagnosis, the adherence to the GFD, its duration and an asymptomatic clinical presentation of CD.

Keywords: celiac disease; gluten-free diet; islet-specific autoimmunity; type 1 diabetes.

• 34 references

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151. Type 1 Diabetes and Celiac Disease: Can (and Should) We Raise the Cut-off of Tissue Transglutaminase Immunoglobulin A to Decide Whether to Biopsy?

J Pediatr. 2020 Aug;223:8-10. doi: 10.1016/j.jpeds.2020.03.063. Epub 2020 May 13.

Author

Stefano Guandalini 1 Affiliation

• 1 Section of Pediatric Gastroenterology, Hepatology and Nutrition, University of Chicago Medicine, Chicago, Illinois. Electronic address: [email protected].

• PMID: 32417081 • DOI: 10.1016/j.jpeds.2020.03.063

No abstract available Publication types

• Editorial

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152. Associations between migraine, celiac disease, non-celiac gluten sensitivity and activity of diamine oxidase

Med Hypotheses. 2020 Sep;142:109738. doi: 10.1016/j.mehy.2020.109738. Epub 2020 Apr 11.

Authors

K Griauzdaitė 1 , K Maselis 2 , A Žvirblienė 1 , A Vaitkus 1 , D Jančiauskas 1 , I Banaitytė- Baleišienė 1 , L Kupčinskas 1 , D Rastenytė 1

Affiliations

• 1 Hospital of Lithuanian University of Health Sciences Kauno Klinikos, Eivenių g. 2, Kaunas, Lithuania. • 2 Hospital of Lithuanian University of Health Sciences Kauno Klinikos, Eivenių g. 2, Kaunas, Lithuania. Electronic address: [email protected]. • PMID: 32416409 • DOI: 10.1016/j.mehy.2020.109738

Abstract

Background and pilot study: Recent reports reveal a close relationship between migraine and gastrointestinal disorders (GI), such as celiac disease (CD) and non-celiac gluten sensitivity (NCGS). CD is a genetic autoimmune disorder, which affects the mucosa of the small intestine. Gluten, found in various grains, not only plays a major role in the pathophysiology of CD and NCGS, but also aggravates migraine attacks. Another common food component, which can induce migraine headaches, is histamine. Diamine oxidase (DAO) is an enzyme, which degrades histamine. Reduced activity of DAO means reduced histamine degradation, which can cause histamine build- up and lead to various symptoms, including headaches and migraine. In this paper we propose a hypothesis, that in pathogenesis of migraine, low serum DAO activity is related to CD and NCGS. We also conducted our own pilot study of 44 patients with severe migraine in efforts to evaluate the co- presence of decreased serum DAO activity and celiac disease/NCGS in patients. 44 consecutive migraine patients were divided into 2 groups: decreased DAO activity (group 1; n = 26) and normal DAO activity (group 2; n = 18). All patients were screened for celiac disease. The diagnosis of NCGS was made after exclusion of CD, food allergies and other GI disorders in the presence of gluten sensitivity symptoms. Furthermore, dietary recommendations were given to all participants and their effects were assessed 3 months after the initial evaluation via the MIDAS (Migraine Disability Assessment) questionnaire.

Results and conclusions: Only 1 patient fit the criteria for celiac disease, rendering this result inconclusive. Pathological findings of the remainder of patients were attributed to NCGS (n = 10). 9 of 10 patients with NCGS belonged to the decreased serum DAO activity group (group 1; n = 26), suggesting a strong relationship between reduced serum DAO activity and NCGS. MIDAS questionnaire revealed, that patients with decreased serum DAO activity were more severely impacted by migraine than those with normal DAO activity, and this remained so after our interventions. Dietary adjustments significantly reduced the impact of migraine on patients' daily activities after 3 months in both groups. We argue, that migraine, celiac disease and NCGS may benefit from treatment with a multidisciplinary approach, involving neurologists, gastroenterologists and dietitians.

Keywords: Celiac disease; Diamine oxidase activity; Gluten; Migraine; Non- celiac.

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153. Suppressed immune profile in children with combined type 1 diabetes and celiac disease

Clin Exp Immunol. 2020 Sep;201(3):244-257. doi: 10.1111/cei.13454. Epub 2020 Jun 14.

Authors

A Tompa 1 2 , K Åkesson 3 , S Karlsson 1 , M Faresjö 1

Affiliations

• 1 The Biomedical platform, Department of Natural Science and Biomedicine, School of Health and Welfare, Jönköping University, Jönköping, Sweden. • 2 Division of Diagnostics, Region Jönköping County, Jönköping, Sweden. • 3 Department of Pediatrics, Ryhov County Hospital, Jönköping, Sweden.

• PMID: 32415995 • PMCID: PMC7419926 • DOI: 10.1111/cei.13454

Free PMC article Abstract

Children diagnosed with a combination of type 1 diabetes (T1D) and celiac disease (CD) show a dysregulated T helper type 1 (Th1)/Th17 response. Besides the cellular involvement, several soluble immune markers are involved in the autoimmune process of both T1D and CD. Only few studies have examined the peripheral pattern of different cytokines, chemokines and acute-phase proteins (APP) in children with combined T1D and CD. To our knowledge, no studies have evaluated the serum levels of adipocytokines and matrix metalloproteinases (MMPs) in this context. The purpose of the present study was to acquire more knowledge and to gain deeper understanding regarding the peripheral immunoregulatory milieu in children with both T1D and CD. The study included children diagnosed with both T1D and CD (n = 18), children with T1D (n = 27) or CD (n = 16) and reference children (n = 42). Sera were collected and analysis of 28 immune markers (cytokines, chemokines, APPs, adipocytokines and MMPs) was performed using the Luminex technique. The major findings showed that children with a double diagnosis had lower serum levels of interleukin (IL)-22, monocyte chemoattractant protein (MIP)-1α, monocyte chemoattractant protein (MCP)-1, procalcitonin, fibrinogen, visfatin and matrix metalloproteinase (MMP)-2. These results indicate a suppressed immune profile in children with combined T1D and CD, including Th17 cytokines, chemokines, APPs, adipocytokines and MMPs. We conclude that, besides cytokines and chemokines, other immune markers, e.g. APPs, adipocytokines and MMPs, are of importance for further investigations to elucidate the heterogeneous immune processes present in patients diagnosed with T1D in combination with CD.

Keywords: celiac disease; children; immune markers; type 1 diabetes.

Conflict of interest statement

This work was funded with grants from FUTURUM Academy for Healthcare, Region Jönköping County, Sweden and Division of Diagnostics, Region Jönköping County, Sweden. There were no conflicts of interest in the presented study, either regarding the collection, analysis and interpretation of data or the writing of the report, the decision to submit for publication or any financial and commercial conflicts.

• 72 references • 5 figures

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154. Accelerated shelf-life model of gluten-free rusks by using oxidation indices

Food Chem. 2020 Oct 1;326:126971. doi: 10.1016/j.foodchem.2020.126971. Epub 2020 May 5.

Authors

Elisabetta Bravi 1 , Valeria Sileoni 2 , Giuseppe Perretti 3 , Ombretta Marconi 3

Affiliations

• 1 Italian Brewing Research Center CERB, University of Perugia, Via S. Costanzo n.c.n., 06126 Perugia, Italy. • 2 Italian Brewing Research Center CERB, University of Perugia, Via S. Costanzo n.c.n., 06126 Perugia, Italy. Electronic address: [email protected]. • 3 Department of Agricultural, Food and Environmental Sciences, University of Perugia, Via S. Costanzo, n.c.n., 06126 Perugia, Italy.

• PMID: 32408001 • DOI: 10.1016/j.foodchem.2020.126971

Abstract

The demand for gluten-free products has been growing over the last few years as is the need to improve their quality. The objective of this research was to develop a shelf life prediction model of gluten-free rusks. To this aim, a kinetic study of the primary and secondary oxidative process was run and the kinetic parameters (rate constant, activation energy, and temperature quotient) were calculated. The protective effect of the antioxidant included in the recipe was also evaluated, and the prediction model was applied to predict the shelf life of an experimental batch of gluten-free rusks with a lower content of antioxidant. The results highlighted (i) the reliability of the prediction model and (ii) the effectiveness of the antioxidant in reducing the rate of primary oxidation. Moreover, (iii) a possible hexanal threshold (lower than 121 µg/kg), correlated with rancid perception in gluten-free rusks, was also speculated.

Keywords: Activation energy; Gluten-free rusks; Hexanal; Kinetic model; Peroxide value; Rate constant; Shelf life; Temperature quotient; Water activity.

Conflict of interest statement

MeSH terms

• Antioxidants / chemistry • Diet, Gluten-Free • Flour • Food Storage / methods* • Foods, Specialized* • Kinetics • Models, Theoretical • Oxidation-Reduction • Reproducibility of Results • Sunflower Oil • Temperature

Substances

• Antioxidants • Sunflower Oil Full-text links

155. Human and Doll's Hair in a Gastric Trichobezoar, Endoscopic Retrieval Hazards

J Pediatr Gastroenterol Nutr. 2020 Aug;71(2):163-170. doi: 10.1097/MPG.0000000000002779.

Authors

Andreia F Niţă 1 , Chris J Hill 2 , Richard M Lindley 3 , Sean S Marven 3 , Mike A Thomson 1

Affiliations

• 1 Centre for Paediatric Gastroenterology, International Academy for Paediatric Endoscopy Sheffield Children's NHS Trust, Western Bank. • 2 Electron Microscopy Service, Department of Biomedical Science, Sheffield University. • 3 Department of Paediatric Surgery, Sheffield Children's NHS Trust, Western Bank, Sheffield, UK.

• PMID: 32404761 • DOI: 10.1097/MPG.0000000000002779

Abstract

Trichobezoars are masses of ingested hair, usually the individual's own hair, that accumulate in the gastrointestinal tract, most commonly in the stomach. When extending into the small intestine, this is termed "Rapunzel syndrome." Removal has traditionally been by laparotomy; however, successful endoscopic removal has also been described. We report the case of a 9-year- old-girl with undiagnosed coeliac disease and Rapunzel syndrome who underwent endoscopic removal of a large trichobezoar, which was followed by unexpected multiple perforations of the small bowel and stomach. Argon plasma coagulation (APC) and snare electrocautery were employed during endoscopy to remove the trichobezoar piecemeal, and approximately 70% was removed without any clear signs of damage to the mucosa. It was discovered subsequently that about 20 of her dolls were found without hair. On investigating the composition of a specific doll hair from the manufacturer, it was discovered that it could be hazardous if burned. It was, therefore, hypothesized that a constellation of factors had conspired to lead to perforation, that is, the potentially hazardous gas produced from the electrical energy applied to the synthetic hair and possible mucosal damage by the physical abrasion of this hair. A review of the literature on endoscopic attempts to remove trichobezoars irrespective of the result reveals a success rate of 30.7%.

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156. Child and Parent Mental Health Problems in Pediatric Celiac Disease: A Prospective Study

J Pediatr Gastroenterol Nutr. 2020 Sep;71(3):315-320. doi: 10.1097/MPG.0000000000002769.

Authors

Georgios Giannakopoulos 1 , Daphne Margoni 2 , Giorgos Chouliaras 2 , Joanna Panayiotou 2 , Aglaia Zellos 2 , Alexandra Papadopoulou 2 , Magda Liakopoulou 1 , Giorgos Chrousos 2 , Christina Kanaka-Gantenbein 2 , Gerasimos Kolaitis 1 , Eleftheria Roma 2

Affiliations

• 1 Department of Child Psychiatry. • 2 First Department of Paediatrics, School of Medicine, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece.

• PMID: 32404753 • DOI: 10.1097/MPG.0000000000002769 Abstract

Objectives: The aim of our study was to estimate the levels of mental health problems in children with celiac disease (CD) along with their parents' mental health status, to compare these levels with those of healthy controls and to investigate how these problems are affected by a gluten-free diet (GFD).

Methods: Our study constituted 50 patients with CD at diagnosis before the initiation of a GFD (age 8.6 ± 3.7 years, group A), 39 patients with CD on a GFD for at least 12 months (age 10.4 ± 3.4 years, group B) and 38 healthy controls (age 7.7 ± 3.8 years, group C), as well as their parents. One of the parents of each child completed the Child Behaviour Checklist (CBCL) and the Symptom Checklist 90 (SCL-90-R) to evaluate the children's and parents' mental health problems, respectively. Twenty patients in group A were reevaluated at least 12 months after initiation of a GFD (group D).

Results: At diagnosis, CD patients had higher scores in the CBCL for internalizing problems than healthy controls (55.7 ± 10.3 vs 47.9 ± 15.4, P = 0.007) and their parents demonstrated increased severity of mental health problems, including anxiety and depression, than the parents of healthy controls (0.72 ± 0.49 vs 0.54 ± 0.58, P = 0.013).

Conclusions: CD patients at diagnosis and their parents, had more mental health problems, including anxiety and depression, than healthy controls.

Full-text links

157. Evaluating the Dietary Intakes of Energy, Macronutrients, Sugar, Fiber, and Micronutrients in Children With Celiac Disease

J Pediatr Gastroenterol Nutr. 2020 Aug;71(2):246-251. doi: 10.1097/MPG.0000000000002743. Authors

Alison Ting 1 , Tamarah Katz 2 , Rosie Sutherland 1 , Victoria Liu 1 , Chai Wei Tong 1 , Yajuan Gao 2 , Daniel A Lemberg 1 3 , Usha Krishnan 1 3 , Nitin Gupta 1 3 , Michael J Coffey 1 , Chee Yee Ooi 1 3

Affiliations

• 1 School of Women and Children's Health, Faculty of Medicine, University of New South Wales, Sydney. • 2 Department of Nutrition and Dietetics, Sydney Children's Hospital, Randwick. • 3 Department of Gastroenterology, Sydney Children's Hospital, Randwick, New South Wales, Australia.

• PMID: 32404743 • DOI: 10.1097/MPG.0000000000002743

Abstract

Objectives: Children with celiac disease (CD) follow a lifelong gluten-free diet. This restrictive diet may be associated with nutritional compromise. Our objectives were, therefore, to evaluate the dietary composition (energy, macronutrients and micronutrients, and fiber) in children with CD compared with healthy controls (HC) and relationship between dietary composition and socioeconomic status.

Methods: This cross-sectional, case-control study recruited children with CD ages 2 to 18 years and HC matched for age, sex, and socioeconomic status. Clinical, sociodemographic, and dietary information were collected. A false discovery rate correction was applied to the P-value for multiple comparisons (q-value).

Results: Sixty-five CD children were matched with 65 HC (mean [SD] age: 10.2 [3.6] vs 10.1 [3.7] years, P = 0.96). Compared with HC, CD children had higher intakes of energy (2413.2 [489.9] vs 2190.8 (593.5) kcal/day, P = 0.02), total fat (818.1 ± 180.9 vs 714.3 ± 212.2 kcal/day, q = 0.018), and subtypes of fat (saturated, polyunsaturated, and monounsaturated). There were no differences in other macronutrients, sugar, micronutrients, or fiber between CD and HC, and no difference in dietary intake among CD between socioeconomic disadvantage versus advantage. Children with CD had lower weight z-scores (-0.06 [1.05] vs 0.47 [0.96], P = 0.003) and body mass index (BMI) z-scores (-0.02 [0.88] vs 0.41 [1.09], P = 0.02) than HC.

Conclusions: Children with CD had higher calorie and fat intake compared with HC. Despite this, CD children had lower weight and BMI z-scores compared with HC.

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158. Pilot study on non-celiac gluten sensitivity: effects of Bifidobacterium longum ES1 co- administered with a gluten-free diet

Minerva Gastroenterol Dietol. 2020 Sep;66(3):187-193. doi: 10.23736/S1121- 421X.20.02673-2. Epub 2020 May 12.

Authors

Francesco Di Pierro 1 , Francesca Bergomas 2 , Paolo Marraccini 2 , Maria R Ingenito 2 , Lorena Ferrari 2 , Luisella Vigna 2

Affiliations

• 1 Scientific Department, Velleja Research, Milan, Italy - [email protected]. • 2 Obesity and Work Center, Occupational Medicine Unit, Department of Preventive Medicine, Maggiore Polyclinic Hospital, IRCCS Ca' Granda Foundation, Milan, Italy.

• PMID: 32397695 • DOI: 10.23736/S1121-421X.20.02673-2

Free article Abstract

Background: Bifidobacterium longum ES1 is a strain probiotic, colonizing the human gut and capable of a degradative action on gliadin. In an attempt to find new nutritional solutions aimed at improving the quality of life of patients with non-celiac gluten sensitivity (NCGS) we evaluated the effectiveness of this strain, in association with a gluten-free diet, comparing its efficacy versus diet therapy alone.

Methods: The experimental design included a non-randomized, open-label, 1:1 intervention study in parallel groups. Enrolled patients with symptoms attributable to NCGS, and with negative diagnoses of both wheat allergy and celiac disease, were included in this three-month trial divided into four outpatient visits (baseline, T1, T2 and T3). Fifteen patients for each group completed the experimental protocol.

Results: Our results showed that a combination of diet and probiotic determined a more significant reduction in the frequency and intensity of intestinal and extra-intestinal symptoms, and a clear improvement in stool consistency.

Conclusions: Although the study was carried out on a small number of patients, the results of our pilot trial suggest that a combined strategy of naturally gluten-free diet therapy with administration of the probiotic strain ES1 appears to offer a greater advantage than the dietary regime alone in improving the clinical symptomatic picture and in stabilizing the intestinal microbiota.

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159. Abnormalities in metabolic pathways in celiac disease investigated by the metabolic profiling of small intestinal mucosa, blood plasma and urine by NMR spectroscopy

NMR Biomed. 2020 Aug;33(8):e4305. doi: 10.1002/nbm.4305. Epub 2020 May 11.

Authors

Deepti Upadhyay 1 , Alka Singh 2 , Prasenjit Das 3 , Jiya Mehtab 2 , Siddhartha Dattagupta 3 , Vineet Ahuja 2 , Govind K Makharia 2 , Naranamangalam R Jagannathan 1 4 , Uma Sharma 1

Affiliations

• 1 Department of NMR and MRI Facility, All India Institute of Medical Sciences, New Delhi, India. • 2 Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India. • 3 Department of Pathology, All India Institute of Medical Sciences, New Delhi, India. • 4 Department of Radiology, Chettinad Academy of Research & Education, Kelambakkam, Tamil Nadu, India.

• PMID: 32394522 • DOI: 10.1002/nbm.4305

Abstract

Celiac disease (CeD) is an autoimmune enteropathy caused by gluten intake in genetically predisposed individuals. We investigated the metabolism of CeD by metabolic profiling of intestinal mucosa, blood plasma and urine using NMR spectroscopy and multivariate analysis. The metabolic profile of the small intestinal mucosa was compared between patients with CeD (n = 64) and disease controls (DCs, n = 30). The blood plasma and urinary metabolomes of CeD patients were compared with healthy controls (HCs, n = 39). Twelve metabolites (proline (Pro), arginine (Arg), glycine (Gly), histidine (His), glutamate (Glu), aspartate, tryptophan (Trp), fumarate, formate, succinate (Succ), glycerophosphocholine (GPC) and allantoin (Alln)) of intestinal mucosa differentiated CeD from controls. The metabolome of blood plasma with 18 metabolites (Pro, Arg, Gly, alanine, Glu, glutamine, glucose (Glc), lactate (Lac), acetate (Ace), acetoacetate (AcAc), β-hydroxybutyrate (β-OHB), pyruvate (Pyr), Succ, citrate (Cit), choline (Cho), creatine (Cr), phosphocreatine (PCr) and creatinine) and 9 metabolites of urine (Pro, Trp, β-OHB, Pyr, Succ, N- methylnicotinamide (NMN), aminohippurate (AHA), indoxyl sulfate (IS) and Alln) distinguished CeD from HCs. Our data demonstrated changes in nine metabolic pathways. The altered metabolites were associated with increased oxidative stress (Alln), impaired healing and repair mechanisms (Pro, Arg), compromised anti-inflammatory and cytoprotective processes (Gly, His, NMN), altered energy metabolism (Glc, Lac, β-OHB, Ace, AcAc, Pyr, Succ, Cit, Cho, Cr and PCr), impaired membrane metabolism (GPC and Cho) and intestinal dysbiosis (AHA and IS). An orthogonal partial least square discriminant analysis model provided clear differentiation between patients with CeD and controls in all three specimens. A classification model built by combining the distinguishing metabolites of blood plasma and urine samples gave an AUC of 0.99 with 97.7% sensitivity, 93.3% specificity and a predictive accuracy of 95.1%, which was higher than for the models built separately using small intestinal mucosa, blood plasma and urine. In conclusion, a panel of metabolic biomarkers in intestinal biopsies, plasma and urine samples has potential to differentiate CeD from controls and may complement traditional tests to improve the diagnosis of CeD.

Keywords: NMR spectroscopy; biomarker; blood plasma; celiac disease; metabolomics; proline; small intestinal mucosa; urine.

• 69 references

Grant support

• BT/Bio-CARe/01/233/2010-11/Department of Biotechnology , Ministry of Science and Technology • IR/SO/LU-05/2007/AIIMS/Department of Science and Technology, Govt. of India

Full-text links

160. Raising the Cut-Off Level of Anti-Tissue Transglutaminase Antibodies to Detect Celiac Disease Reduces the Number of Small Bowel Biopsies in Children with Type 1 Diabetes: A Retrospective Study

J Pediatr. 2020 Aug;223:87-92.e1. doi: 10.1016/j.jpeds.2020.02.086. Epub 2020 May 4.

Authors

Margreet Wessels 1 , Anouk Velthuis 2 , Ellen van Lochem 3 , Eline Duijndam 2 , Gera Hoorweg- Nijman 4 , Ineke de Kruijff 4 , Victorien Wolters 5 , Eveline Berghout 6 , Jos Meijer 7 , Jan Alle Bokma 8 , Dick Mul 9 , Janielle van der Velden 10 , Lian Roovers 11 , M Luisa Mearin 12 , Petra van Setten 2

Affiliations

• 1 Department of Pediatrics, Rijnstate Hospital, Arnhem, The Netherlands; Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands. • 2 Department of Pediatrics, Rijnstate Hospital, Arnhem, The Netherlands. • 3 Department of Medical Microbiology and Immunology, Rijnstate Hospital, Arnhem, The Netherlands. • 4 Department of Pediatrics, St Antonius Hospital, Utrecht, The Netherlands. • 5 Department of Pediatric Gastroenterology, University Medical Center Utrecht-Wilhelmina Children's Hospital, Utrecht, The Netherlands. • 6 Department of Pediatrics, Deventer Hospital, Deventer, The Netherlands. • 7 Department of Pathology, Rijnstate Hospital, Arnhem, The Netherlands. • 8 Department of Pediatrics, Spaarne Hospital, Hoofddorp, The Netherlands. • 9 Department of Pediatrics, Haga Hospital (Juliana Children's Hospital), The Hague, The Netherlands. • 10 Department of Pediatrics, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. • 11 Clinical Research Department, Rijnstate Hospital, Arnhem, The Netherlands. • 12 Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands.

• PMID: 32381465 • DOI: 10.1016/j.jpeds.2020.02.086

Abstract

Objective: To study the optimal cut-off value for anti-tissue transglutaminase type 2 IgA antibodies (TG2A) in serum to select for diagnostic small bowel biopsies for celiac disease in children with type 1 diabetes mellitus.

Study design: Children with type 1 diabetes mellitus with elevated TG2A titers and duodenal biopsies performed during the course of their diabetes treatment were included. Anti-endomysial antibodies were recorded if present. The optimal TG2A cut-off value, expressed as the ratio between obtained value and upper limit of normal (ULN), was determined using receiver operating characteristic curve analysis and compared with the cut-off value used in the European Society for Pediatric Gastroenterology, Hepatology and Nutrition guidelines in terms of sensitivity, specificity, positive and negative predictive value.

Results: We included 63 children. The optimal cut-off value for performing biopsies is demonstrated to be 11 times the ULN. Raising the cut-off value from 3 times the ULN to 11 times the ULN changed sensitivity from 96% to 87% and increased specificity from 36% to 73%, increased the positive predictive value from 88% to 94% and lowered negative predictive value from 67% to 53%. The percentage of normal histology was decreased from 12% to 6%.

Conclusions: Increasing the TG2A cut-off value for performing duodenal biopsies in children with type 1 diabetes mellitus and suspected celiac disease leads to a substantial reduction of unnecessary biopsies. We advocate to adapt the European Society for Pediatric Gastroenterology, Hepatology and Nutrition 2012 guidelines for this group of children, including monitoring patients with TG2A levels of less than 11 times the ULN over time.

Keywords: ESPGHAN guidelines; diagnostics.

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161. Assessment of Autonomic Nervous System in Children with Celiac Disease: A Heart Rate Variability Study

Indian Pediatr. 2020 Aug 15;57(8):719-722. Epub 2020 May 6.

Authors

Seyma Kayali 1 , Suna Selbuz 2

Affiliations

• 1 Department of Pediatric Cardiology, Health Sciences University, Kecioren Training and Research Hospital, Ankara, Turkey. Correspondence to: Dr Seyma Kayali, Department of Pediatric Cardiology, Kecioren Training and Research Hospital, Pýnarbasi Mah, Sanatoryum Cad, Ardahan Sok No.25, 06380 Kecioren, Ankara. ak- [email protected]. • 2 Department of Pediatric Gastroenterology, Health Sciences University, Kecioren Training and Research Hospital, Ankara, Turkey.

• PMID: 32376794

Free article Abstract

Objective: We evaluated the activity of autonomic nervous system in children with celiac disease by using heart rate variability (HRV) analysis.

Methods: HRV parameters of 37 children with celiac disease were compared to 36 age- and sex-matched healthy controls. None of the participants had a systemic, central or peripheral neurological disease.

Results: Statistically significant differences were present in two parameters; standard deviation of all RR intervals (SDNN) and standard deviation of 5- minute RR interval means (SDANN). Age was negatively correlated with mean, minimum and maximum heart rate. Duration of disease was positively correlated with low frequency power-high frequency power ratio. No correlation was found between anti-tissue transglutaminase IgA level and HRV parameters.

Conclusions: Celiac disease may affect autonomic nervous function in children even if there are no symptoms of dysautonomia.

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162. Collagenous Colitis Is Associated With HLA Signature and Shares Genetic Risks With Other Immune-Mediated Diseases

Gastroenterology. 2020 Aug;159(2):549-561.e8. doi: 10.1053/j.gastro.2020.04.063. Epub 2020 May 1.

Authors

Eli Stahl 1 , Giulia Roda 2 , Amanda Dobbyn 1 , Jianzhong Hu 1 , Zhongyang Zhang 1 , Helga Westerlind 3 , Ferdinando Bonfiglio 3 , Towfique Raj 4 , Joana Torres 5 , Anli Chen 6 , Robert Petras 7 , Darrell S Pardi 8 , Alina C Iuga 9 , Gabriel S Levi 6 , Wenqing Cao 10 , Prantesh Jain 11 , Florian Rieder 12 , Ilyssa O Gordon 12 , Judy H Cho 1 , Mauro D'Amato 13 , Noam Harpaz 6 , Ke Hao 1 , Jean Frederic Colombel 14 , Inga Peter 1 Affiliations

• 1 Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York. • 2 Inflammatory Bowel Diseases Center, Humanitas Research Hospital, Milan, Italy. • 3 Department of Medicine, Karolinska Institutet, Stockholm, Sweden. • 4 Ronald M. Loeb Center for Alzheimer's Disease, Departments of Neuroscience, and Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York. • 5 Department of Gastroenterology, Hospital Beatriz Angelo, Loures, Portugal. • 6 Department of Pathology, Icahn School of Medicine, New York, New York. • 7 AmeriPath Institute of Gastrointestinal Pathology and Digestive Disease, Cleveland, Ohio. • 8 Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota. • 9 Department of Biology and Cell Pathology, Columbia University, New York, New York. • 10 Division of Anatomic Pathology, New York University Langone Medical Center, New York, New York. • 11 Department of Hematology and Oncology, University Hospitals, Case Comprehensive Cancer Center, Cleveland, Ohio. • 12 Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio. • 13 Department of Medicine, Karolinska Institutet, Stockholm, Sweden; School of Biological Sciences, Monash University, Clayton, Victoria, Australia. • 14 The Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: jean- [email protected].

• PMID: 32371109 • DOI: 10.1053/j.gastro.2020.04.063 Abstract

Background & aims: Collagenous colitis (CC) is an inflammatory bowel disorder with unknown etiopathogenesis involving HLA-related immune- mediated responses and environmental and genetic risk factors. We carried out an array-based genetic association study in a cohort of patients with CC and investigated the common genetic basis between CC and Crohn's disease (CD), ulcerative colitis (UC), and celiac disease.

Methods: DNA from 804 CC formalin-fixed, paraffin-embedded tissue samples was genotyped with Illumina Immunochip. Matching genotype data on control samples and CD, UC, and celiac disease cases were provided by the respective consortia. A discovery association study followed by meta-analysis with an independent cohort, polygenic risk score calculation, and cross-phenotype analyses were performed. Enrichment of regulatory expression quantitative trait loci among the CC variants was assessed in hemopoietic and intestinal cells.

Results: Three HLA alleles (HLA-B∗08:01, HLA-DRB1∗03:01, and HLA- DQB1∗02:01), related to the ancestral haplotype 8.1, were significantly associated with increased CC risk. We also identified an independent protective effect of HLA-DRB1∗04:01 on CC risk. Polygenic risk score quantifying the risk across multiple susceptibility loci was strongly associated with CC risk. An enrichment of expression quantitative trait loci was detected among the CC-susceptibility variants in various cell types. The cross-phenotype analysis identified a complex pattern of polygenic pleiotropy between CC and other immune-mediated diseases.

Conclusions: In this largest genetic study of CC to date with histologically confirmed diagnosis, we strongly implicated the HLA locus and proposed potential non-HLA mechanisms in disease pathogenesis. We also detected a shared genetic risk between CC, celiac disease, CD, and UC, which supports clinical observations of comorbidity.

Keywords: Collagenous Colitis; Crohn’s Disease; HLA; Immunochip.

Grant support • K08 DK110415/DK/NIDDK NIH HHS/United States

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163. Rotavirus and autoimmunity

J Infect. 2020 Aug;81(2):183-189. doi: 10.1016/j.jinf.2020.04.041. Epub 2020 Apr 30.

Authors

J Gómez-Rial 1 , I Rivero-Calle 2 , A Salas 3 , F Martinón-Torres 2

Affiliations

• 1 Grupo de Investigación en Genética, Vacunas, Infecciones y Pediatría (GENVIP), Instituto de Investigación Sanitaria de Santiago (IDIS) and Hospital Clínico Universitario and Universidade de Santiago de Compostela (SERGAS), Travesa da Choupana s/n 15706 Galicia, Spain; Laboratorio de Inmunología, Servicio de Análisis Clínicos, Hospital Clínico Universitario Santiago de Compostela (SERGAS), Travesa da Choupana s/n 15706 Galicia, Spain. Electronic address: [email protected]. • 2 Grupo de Investigación en Genética, Vacunas, Infecciones y Pediatría (GENVIP), Instituto de Investigación Sanitaria de Santiago (IDIS) and Hospital Clínico Universitario and Universidade de Santiago de Compostela (SERGAS), Travesa da Choupana s/n 15706 Galicia, Spain; Translational Pediatrics and Infectious Diseases, Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela, Travesa da Choupana s/n 15706 Galicia, Spain. • 3 Grupo de Investigación en Genética, Vacunas, Infecciones y Pediatría (GENVIP), Instituto de Investigación Sanitaria de Santiago (IDIS) and Hospital Clínico Universitario and Universidade de Santiago de Compostela (SERGAS), Travesa da Choupana s/n 15706 Galicia, Spain; Unidade de Xenética, Instituto de Ciencias Forenses, Facultade de Medicina, Universidade de Santiago de Compostela, and GenPoB Research Group, Instituto de Investigaciones Sanitarias (IDIS), Hospital Clínico Universitario de Santiago (SERGAS), Travesa da Choupana s/n 15706 Galicia, Spain.

• PMID: 32360880 • DOI: 10.1016/j.jinf.2020.04.041

Abstract

Rotavirus, a major etiological agent of acute diarrhea in children worldwide, has historically been linked to autoimmunity. In the last few years, several physiopathological approaches have been proposed to explain the leading mechanism triggering autoimmunity, from the old concept of molecular mimicry to the emerging theory of bystander activation and break of tolerance. Epidemiological and immunological data indicate a strong link between rotavirus infection and two of the autoimmune pathologies with the highest incidence: celiac disease and diabetes. The role for current oral rotavirus vaccines is now being elucidated, with a so far positive protective association demonstrated.

Keywords: Autoimmunity; Celiac Disease; Rotavirus; Type 1 Diabetes; Vaccines.

Publication types

• Review

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164. Costs and Use of Health Care in Patients With Celiac Disease: A Population-Based Longitudinal Study

Am J Gastroenterol. 2020 Aug;115(8):1253-1263. doi: 10.14309/ajg.0000000000000652. Authors

Karl Mårild 1 2 , Jonas Söderling 3 , Soran R Bozorg 4 , Åsa H Everhov 3 5 , Benjamin Lebwohl 6 , Peter H R Green 6 , Martin Neovius 3 , Jonas F Ludvigsson 4 6 7

Affiliations

• 1 Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden. • 2 Department of Pediatric Gastroenterology, Queen Silvia Children's Hospital, Gothenburg, Sweden. • 3 Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Stockholm, Sweden. • 4 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. • 5 Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden. • 6 Department of Medicine, Celiac Disease Center, Columbia University Medical Centre, Columbia University, New York, USA. • 7 Department of Pediatrics, Örebro University Hospital, Örebro, Sweden.

• PMID: 32349030 • DOI: 10.14309/ajg.0000000000000652

Abstract

Introduction: Celiac disease (CD) affects 1% of the population. Its effect on healthcare cost, however, is barely understood. We estimated healthcare use and cost in CD, including their temporal relationship to diagnosis.

Methods: Through biopsy reports from Sweden's 28 pathology departments, we identified 40,951 prevalent patients with CD (villous atrophy) as of January 1, 2015, and 15,086 incident patients with CD diagnosed in 2008-2015, including 2,663 who underwent a follow-up biopsy to document mucosal healing. Each patient was compared with age- and sex-matched general population comparators (n = 187,542). Using nationwide health registers, we retrieved data on all inpatient and nonprimary outpatient care, prescribed diets, and drugs.

Results: Compared with comparators, healthcare costs in 2015 were, on average, $1,075 (95% confidence interval, $864-1,278) higher in prevalent patients with CD aged <18 years, $715 ($632-803) in ages 18-64 years, and $1,010 ($799-1,230) in ages ≥65 years. Half of all costs were attributed to 5% of the prevalent patients. Annual healthcare costs were $391 higher 5 years before diagnosis and increased until 1 year after diagnosis; costs then declined but remained 75% higher than those of comparators 5 years postdiagnosis (annual difference = $1,044). Although hospitalizations, nonprimary outpatient visits, and medication use were all more common with CD, excess costs were largely unrelated to the prescription of gluten-free staples and follow-up visits for CD. Mucosal healing in CD did not reduce the healthcare costs.

Discussion: The use and costs of health care are increased in CD, not only before, but for years after diagnosis. Mucosal healing does not seem to lower the healthcare costs.

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165. Effect of Na 2 CO 3 on quality and volatile compounds of steamed bread fermented with yeast or sourdough

Food Chem. 2020 Sep 15;324:126786. doi: 10.1016/j.foodchem.2020.126786. Epub 2020 Apr 11.

Authors

Jinzhong Xi 1 , Dan Xu 2 , Fengfeng Wu 1 , Zhengyu Jin 1 , Xueming Xu 3

Affiliations • 1 State Key Laboratory of Food Science and Technology, Jiangnan University, 214122 Wuxi, China; School of Food Science and Technology, Jiangnan University, 214122 Wuxi, China. • 2 State Key Laboratory of Food Science and Technology, Jiangnan University, 214122 Wuxi, China; School of Food Science and Technology, Jiangnan University, 214122 Wuxi, China; Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta T6G2P5, Canada. • 3 State Key Laboratory of Food Science and Technology, Jiangnan University, 214122 Wuxi, China; School of Food Science and Technology, Jiangnan University, 214122 Wuxi, China. Electronic address: [email protected].

• PMID: 32344353 • DOI: 10.1016/j.foodchem.2020.126786

Abstract

The effects of Na2CO3 on the quality, change of protein subunits and volatile compounds of sourdough leavened Chinese steamed bread (sourdough-CSB) and yeast leavened CSB (yeast-CSB) were investigated. Results suggested that, low Na2CO3 level endowed both CSB with softer crumb and little change of surface color. Besides, Na2CO3 addition improved the overall aroma profile by inhibiting the production of aroma-negative compounds (butanoic acid, 1- octen-3-ol, hexanal and heptanal). Sodium dodecyl sulfate polyacrylamide gel electrophoresis analysis showed an obvious increase in intensity of protein bands with low molecular weight, consistent with the result of size-exclusion high-performance liquid chromatography analysis and free sulfhydryl group (SH) content, indicating the hydrolysis of glutenin macropolymer (GMP) under alkaline condition in yeast-CSB. While in sourdough-CSB, GMP and SH content firstly decreased at low Na2CO3 level (0-0.2%) and then increased at high Na2CO3 level (0.3%-0.5%).

Keywords: Alkali; Chinese steamed bread; Na(2)CO(3); Protein; Quality; Sourdough; Volatile compounds.

MeSH terms

• Aldehydes / analysis • Bread* / analysis • Carbonates* • Cooking • Electrophoresis, Polyacrylamide Gel • Fermentation • Fermented Foods and Beverages • Food Quality • Glutens / analysis • Hydrolysis • Molecular Weight • Odorants / analysis* • Proteins / analysis • Proteins / metabolism • Saccharomyces cerevisiae • Steam • Volatile Organic Compounds / analysis*

Substances

• Aldehydes • Carbonates • Proteins • Steam • Volatile Organic Compounds • sodium carbonate • Glutens • heptanal • n-hexanal • glutenin

Full-text links

166. Reinventing the nutraceutical value of gluten: The case of l-theanine-gluten as a potential alternative to the gluten exclusion diet in celiac disease

Food Chem. 2020 Sep 15;324:126840. doi: 10.1016/j.foodchem.2020.126840. Epub 2020 Apr 18.

Authors

Miguel Ribeiro 1 , Sandra Lopes 2 , Stefania Picascia 3 , Carmen Gianfrani 3 , Fernando M Nunes 4

Affiliations

• 1 CQ-VR, Chemistry Research Centre, Chemistry Department, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal. Electronic address: [email protected]. • 2 CQ-VR, Chemistry Research Centre, Chemistry Department, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal. • 3 Institute of Biochemistry and Cell Biology-CNR, Via Pietro Castellino, 111, 80131 Naples, Italy. • 4 CQ-VR, Chemistry Research Centre, Chemistry Department, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal. Electronic address: [email protected].

• PMID: 32344339 • DOI: 10.1016/j.foodchem.2020.126840

Abstract

Functional foods have created an open environment for the development of new solutions to health-related issues. In celiac disease, there is still no therapeutic alternative other than the observance of a gluten-free diet. In this context, we developed a wheat flour enriched in l-theanine aimed to be a potential alternative to the gluten-free diet. Through microbial transglutaminase-catalysed transamidation of gluten proteins using ethylamine as amine nucleophile, substantial amounts of glutamine residues were converted in theanine residues. Furthermore, using T-cell lines generated from intestinal biopsy specimens of celiac disease patients, this treatment showed the potential to strongly reduce the ability of gluten proteins to stimulate a T-cell-mediated immune response. From a rheological point of view, the functionality of gluten was retained. Considering L- theanine's evidence-based health benefits, a novel functional food is presented here and for celiac disease can be a path towards the development of an alternative to the gluten-free diet.

Keywords: Alternative therapy; Celiac disease; Functional food; Gluten-free diet; Nutrition; l-theanine-gluten.

Conflict of interest statement

MeSH terms

• Celiac Disease / diet therapy • Celiac Disease / immunology* • Diet, Gluten-Free • Dietary Supplements • Elasticity • Ethylamines / metabolism • Flour* • Functional Food • Glutamates / chemistry* • Glutens / chemistry* • Glutens / metabolism • Humans • Intestines / cytology • Intestines / immunology • T-Lymphocytes / immunology* • Transglutaminases / metabolism • Triticum

Substances

• Ethylamines • Glutamates • Glutens • theanine • Transglutaminases • ethylamine

Full-text links

167. Type 1 diabetes and epilepsy in childhood and adolescence: Do glutamic acid decarboxylase autoantibodies play a role? Data from the German/Austrian/Swiss/Luxembourgian DPV Registry

Pediatr Diabetes. 2020 Aug;21(5):766-773. doi: 10.1111/pedi.13034. Epub 2020 May 7.

Authors

Gideon John de Sousa 1 2 , Sascha René Tittel 3 4 , Martin Häusler 5 , Paul Martin Holterhus 6 , Gabriele Berger 7 , Martin Holder 8 , Clemens Kamrath 9 , Sven Golembowski 10 , Silke Herrlinger 11 , Reinhard Walter Holl 3 4

Affiliations

• 1 Children's Hospital Dortmund, Dortmund, Germany. • 2 Department of Pediatrics, University of Witten/Herdecke, Witten, Germany. • 3 Institute of Epidemiology and Medical Biometry, Central Institute for Biomedical Technology, University of Ulm, Ulm, Germany. • 4 German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany. • 5 Division of Neuropediatrics and Social Pediatrics, Department of Pediatrics, University Hospital RWTH Aachen, Aachen, Germany. • 6 Children's Hospital, University of Kiel, Kiel, Germany. • 7 Medical University of Vienna, Wien, Austria. • 8 Children's Hospital, Olgahospital Stuttgart, Stuttgart, Germany. • 9 Children's Hospital, University of Giessen, Giessen, Germany. • 10 Children's Hospital, Sana Klinikum Lichtenberg Berlin, Berlin, Germany. • 11 Children's Hospital, Klinikum Bremen Mitte, Bremen, Germany.

• PMID: 32333480 • DOI: 10.1111/pedi.13034

Abstract

Aims: We aimed to analyze the relationship between epilepsy and glutamic acid decarboxylase autoantibodies (GADA) in patients with type 1 diabetes mellitus (T1DM) and the impact of GADA on demographic, clinical, and metabolic data in T1DM patients with epilepsy.

Methods: We searched for patients with T1DM ≤20 years and GADA measurements, and within this group for patients with epilepsy. We formed groups: T1DM + Epilepsy + GADA positive; T1DM + Epilepsy + GADA negative; T1DM + GADA positive; T1DM + GADA negative. We used logistic regression to analyze the relationship between epilepsy and GADA with odds ratio adjusted for sex, duration of diabetes (DOD), and age at diabetes onset (ADO). We used logistic regression with odds ratio adjusted for DOD and ADO onset using epilepsy as a dependent variable and GADA, HbA1c, ketoacidosis, severe hypoglycemia (SH), sex, celiac disease, and autoimmune thyroiditis as independent variables. We conducted regression analyses adjusted for sex, DOD, and ADO to analyze differences in clinical/metabolic parameters between the groups.

Results: Epilepsy was not more frequent in GADA-positive patients (GPP). Logistic regression including all patients with GADA measurements showed that hypoglycemia with coma (HC) correlated with epilepsy when compared to no SH. We found no differences in clinical and metabolic data between GPP and GADA-negative patients (GNP) with epilepsy. SH occurred more often in GPP with epilepsy in comparison to GPP without epilepsy. GNP with epilepsy had a higher rate of HC than GPP without epilepsy.

Conclusion: We found no relationship between epilepsy and GADA. A relationship between T1DM and epilepsy might be explainable by SH.

Keywords: children and adolescents; diabetes mellitus type 1; epilepsy; glutamic acid decarboxylase autoantibodies; severe hypoglycemia.

• 40 references

Publication types

• Research Support, Non-U.S. Gov't

Full-text links

168. Characteristics of patients with celiac disease and connective tissue disease overlap

Int J Dermatol. 2020 Aug;59(8):e309-e312. doi: 10.1111/ijd.14892. Epub 2020 Apr 25.

Authors

Bridget E Shields 1 , Emile Latour 2 , Nicole M Fett 3

Affiliations

• 1 Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USA. • 2 Biostatistics Shared Research, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA. • 3 Department of Dermatology, Oregon Health and Science University, Portland, OR, USA.

• PMID: 32333402 • DOI: 10.1111/ijd.14892

No abstract available

• 7 references

Publication types

• Letter

Full-text links

169. A compact SPR biosensor device for the rapid and efficient monitoring of gluten- free diet directly in human urine

Anal Bioanal Chem. 2020 Sep;412(24):6407-6417. doi: 10.1007/s00216-020- 02616-6. Epub 2020 Apr 24.

Authors

E Cristina Peláez 1 , M-Carmen Estevez 2 , Remedios Domínguez 3 , Carolina Sousa 4 , Angel Cebolla 3 , Laura M Lechuga 1

Affiliations

• 1 Nanobiosensors and Bioanalytical Applications Group, Catalan Institute of Nanoscience and Nanotechnology (ICN2), CSIC, CIBER-BBN and BIST, Campus UAB Bellaterra, 08193, Barcelona, Spain. • 2 Nanobiosensors and Bioanalytical Applications Group, Catalan Institute of Nanoscience and Nanotechnology (ICN2), CSIC, CIBER-BBN and BIST, Campus UAB Bellaterra, 08193, Barcelona, Spain. [email protected]. • 3 Biomedal S.L, Polígono Industrial Parque Plata, c/ Calzada Romana 40, 41900, Camas, Seville, Spain. • 4 Department of Microbiology and Parasitology, Faculty of Pharmacy, University of Seville, c/Profesor García González, S/N, 41012, Seville, Spain.

• PMID: 32333077 • DOI: 10.1007/s00216-020-02616-6

Abstract

Celiac disease (CD) is a chronic autoimmune disorder induced in genetically susceptible individuals by the ingestion of gluten from wheat, rye, barley, or certain varieties of oats. A careful diet follow-up is necessary to avoid health complications associated with long-term gluten intake by the celiac patients. Small peptides (GIP, gluten immunogenic peptides) derived from gluten digestion, which are excreted in the urine and feces, have emerged as promising biomarkers to monitor gluten intake. We have implemented a simple and sensitive label-free point-of-care (POC) device based on surface plasmon resonance for the direct detection of these biomarkers in urine. The assay employs specific monoclonal antibodies and has been optimized for the detection of the 33-mer α2-gliadin, known as the main immunogenic peptide of wheat gluten, and for the detection of GIP. Direct detection in undiluted urine has been accomplished by using biosensing chips containing a robust and stable biorecognition layer, obtained after carefully optimizing the biofunctionalization protocol. Excellent limits of detection have been reached (1.6-4.0 ng mL-1 using mAb G12 and A1, respectively), which ensures the detection of gluten peptides even when the gluten intake is around the maximum tolerable amount in the digestive tract (< 50 mg) for celiac individuals. No sample pretreatment, extraction, or dilution is required, and the analysis takes less than 15 min. The assays have excellent reproducibility' as demonstrated by measuring spiked urine samples containing the same target concentration using different biofunctionalized chips prepared and stored at different periods of time (i.e., CV% of 3.58% and 11.30%, for G12- and A1-based assays, respectively). The assay has been validated with real samples. These features pave the way towards an end-user easy-to-handle biosensor device for the rapid monitoring of gluten-free diet (GFD) and follow- up of the health status in celiac patients.

Keywords: 33-mer gliadin peptide; Celiac disease; Gluten immunogenic peptides; Gluten-free diet; POC device; Urine.

• Cited by 1 article

Grant support

• SEV-2017-0706/Ministerio de Economía y Competitividad

Full-text links

170. Effects of multi-frequency ultrasound on physicochemical properties, structural characteristics of gluten protein and the quality of noodle

Ultrason Sonochem. 2020 Oct;67:105135. doi: 10.1016/j.ultsonch.2020.105135. Epub 2020 Apr 18.

Authors

Hongxin Zhang 1 , Guangjing Chen 2 , Min Liu 1 , Xiaofei Mei 1 , Qingqing Yu 1 , Jianquan Kan 3

Affiliations

• 1 College of Food Science, Southwest University, 2 Tiansheng Road, Beibei, Chongqing 400715, PR China. • 2 Food and Pharmaceutical Engineering Institute, Guiyang University, Guiyang, Guizhou 550005, PR China. Electronic address: [email protected]. • 3 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 and Rural Affairs of the People's Republic of China, Chongqing 400715, PR China; Chinese-Hungarian Cooperative Research Centre for Food Science, Chongqing 400715, PR China. Electronic address: [email protected].

• PMID: 32330688 • DOI: 10.1016/j.ultsonch.2020.105135

Abstract

In this study, the influence of multi-frequency ultrasound irradiation on the functional properties and structural characteristics of gluten, as well as the textural and cooking characteristics of the noodles were investigated. Results showed that the textural and cooking characteristics of noodles that contain less gluten pretreated by multi-frequency ultrasonic were ultrasonic frequency dependent. Moreover, the noodles that contain a smaller amount of sonicated gluten could achieve the textural and cooking quality of commercial noodles. There was no significant difference in the cooking and texture characteristics between commercial noodles and noodles with 12%, 11%, and 10% gluten pretreated by single-frequency (40 kHz), dual-frequency (28/40 kHz), and triple-frequency sonication (28/40/80 kHz), respectively. Furthermore, the cavitation efficiency of triple-frequency ultrasound was greater than that of dual-frequency and single-frequency. As the number of ultrasonic frequencies increased, the solubility, water holding capacity and oil holding capacity of gluten increased significantly (p < 0.05), and the particle size was reduced from 197.93 ± 5.28 nm to 110.15 ± 2.61 nm. Furthermore, compared to the control group (untreated), the UV absorption and fluorescence intensity of the gluten treated by multi-frequency ultrasonication increased. The surface hydrophobicity of gluten increased from 8159.1 ± 195.87 (untreated) to 11621.5 ± 379.72 (28/40/80 kHz). Raman spectroscopy showed that the α- helix content of all sonicated gluten protein samples decreased after sonication, while the β-sheet and β-turn content increased, and tryptophan and tyrosine residues were exposed. Through scanning electron microscope (SEM) analysis, the gluten protein network structure after ultrasonic treatment was loose, and the pore size of the gluten protein network increased from about 10 μm (untreated) to about 26 μm (28/40/80 kHz). This work elucidated the effect of ultrasonic frequency on the performance of gluten, indicating that with increasing frequency combination increases, the ultrasound effect became more pronounced and protein unfolding increased, thereby impacting the functional properties and the quality of the final product. This study provided a theoretical basis for the application of multi- frequency ultrasound technology in the modification of gluten protein and noodle processing.

Keywords: Cooking characteristics and texture characteristic; Multi-frequency ultrasound; Noodles; Structural properties and physicochemical characterization; Wheat gluten protein.

Full-text links

171. Routine Screening for Celiac Disease in Children With Down Syndrome Improves Case Finding

J Pediatr Gastroenterol Nutr. 2020 Aug;71(2):252-256. doi: 10.1097/MPG.0000000000002742.

Authors

Edwin Liu 1 , Kristine Wolter-Warmerdam 2 , Juana Marmolejo 2 , Dee Daniels 1 , Garrett Prince 3 , Fran Hickey 1

Affiliations

• 1 Department of Pediatrics. • 2 Children's Hospital Colorado, Aurora, CO. • 3 University of Colorado School of Medicine.

• PMID: 32304557 • DOI: 10.1097/MPG.0000000000002742 Abstract

Objectives: Children with Down syndrome have an estimated 6-fold increased risk of developing celiac disease in the United States compared with the general population, yet the determination to screen for celiac disease in this population is not agreed upon. The objectives of this study are to assess the prevalence of celiac disease in children with Down syndrome in our center and compare features from this population identified clinically and through screening.

Methods: This is a retrospective chart review of 1317 children with Down syndrome who received treatment at a single institution from 2011 to 2017. All participants (n = 90; 53.3% boys) met inclusion criteria of celiac disease diagnosis between 1 month and 22 years of age and Down syndrome. Clinical details were collected, which included the results from celiac disease screening tests, reason for diagnosis and/or testing, symptoms, nutrition notes, demographics, comorbidities, and outcomes.

Results: Prevalence of celiac disease in our population of children with Down syndrome ages 3 years or older was 9.8%. Mean age at diagnosis was 9.24 years (SD = 4.98) with an average of 2.85 years (SD ± 3.52) lag from the onset of symptoms to diagnosis for children clinically identified in comparison with 1.69 years (SD ± 2.09) for children identified through routine screening. Eighty- two percentage of clinic patients received a diagnosis of celiac disease because of routine screening compared with clinical testing based on identified symptoms alone.

Conclusion: Our results suggest the need for routine celiac disease screening in children with Down syndrome to improve case-finding and avoid diagnostic delay.

Full-text links

172. Celiac Disease in Patients With Cystic Fibrosis on Ivacaftor: A Case Series J Pediatr Gastroenterol Nutr. 2020 Aug;71(2):257-260. doi: 10.1097/MPG.0000000000002736.

Authors

Michelle Hjelm 1 , Ala K Shaikhkhalil 2

Affiliations

• 1 Division of Pulmonary Medicine. • 2 Division of Gastroenterology, Hepatology, and Nutrition, Nationwide Children's Hospital, Columbus, OH.

• PMID: 32304549 • DOI: 10.1097/MPG.0000000000002736

Abstract

Cystic fibrosis transmembrane conductance regulator (CFTR) protein modulators have revolutionized care for individuals with cystic fibrosis (CF) with positive effects on the gastrointestinal (GI) tract. There is emerging evidence linking CFTR dysfunction to celiac disease (CD). We present 3 cases of patients with CF, genotype F508del/G551D, treated with CFTR modulator, ivacaftor, and diagnosed with CD. These patients tested for CD because they had persistent GI symptoms that had partially improved with ivacaftor. This case series highlights the importance of a better understanding of how CFTR modulators impact the GI tract, their possible link to CD, and the importance of considering CD when evaluating GI symptoms in individuals with CF.

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173. Evidence That Pathogenic Transglutaminase 2 in Celiac Disease Derives From Enterocytes Gastroenterology. 2020 Aug;159(2):788-790. doi: 10.1053/j.gastro.2020.04.018. Epub 2020 Apr 14.

Authors

Rasmus Iversen 1 , Sunniva F Amundsen 1 , Liv Kleppa 1 , M Fleur du Pré 1 , Jorunn Stamnaes 1 , Ludvig M Sollid 2

Affiliations

• 1 K.G. Jebsen Coeliac Disease Research Centre, University of Oslo, Oslo, Norway; Department of Immunology, University of Oslo and Oslo University Hospital, Oslo, Norway. • 2 K.G. Jebsen Coeliac Disease Research Centre, University of Oslo, Oslo, Norway; Department of Immunology, University of Oslo and Oslo University Hospital, Oslo, Norway. Electronic address: [email protected].

• PMID: 32302613 • DOI: 10.1053/j.gastro.2020.04.018

No abstract available

Full-text links

174. A novel approach to produce phage single domain antibody fragments for the detection of gluten in foods

Food Chem. 2020 Aug 15;321:126685. doi: 10.1016/j.foodchem.2020.126685. Epub 2020 Mar 23.

Authors

Aina García-García 1 , Raquel Madrid 2 , Isabel González 2 , Teresa García 2 , Rosario Martín 2 Affiliations

• 1 Departamento de Nutrición y Ciencia de los Alimentos, Facultad de Veterinaria, Universidad Complutense de Madrid, 28040 Madrid, Spain. Electronic address: [email protected]. • 2 Departamento de Nutrición y Ciencia de los Alimentos, Facultad de Veterinaria, Universidad Complutense de Madrid, 28040 Madrid, Spain.

• PMID: 32240918 • DOI: 10.1016/j.foodchem.2020.126685

Abstract

In this study, we demonstrated the feasibility of isolating recombinant phage- antibodies against gluten from a non-immunized library of human single- domain antibodies (dAbs). Phage display technology enabled the selection of affinity probes by successive rounds of biopanning against a biotinylated synthetic peptide comprising repetitive immunogenic gluten motifs. The analysis of a wide representation of heterologous plant species corroborated that two of the isolated clones were specific to wheat, barley and rye proteins. The phage antibody selected as the most appropriate clone for the detection of gluten in foods (dAb8E-phage) was further applied in an indirect ELISA to the analysis of 50 commercial food samples. Although the limit of detection achieved did not improve those of current immunoassays, the proposed methodology could provide promising new pathways for the generation of recombinant antibodies that allow a comprehensive determination of gluten in foods, whilst replacing the need for animal immunization.

Keywords: Allergen labelling; Antibody discovery; Celiac disease; ELISA; Gluten; Phage display; Single-domain antibody.

Conflict of interest statement

• Allergens / immunology* • Enzyme-Linked Immunosorbent Assay • Food • Food Analysis* • Glutens / analysis • Glutens / immunology* • Hordeum / chemistry • Hordeum / immunology* • Humans • Immunoglobulin Fragments / immunology • Peptide Library • Plant Proteins / chemistry • Plant Proteins / immunology* • Secale / chemistry • Secale / immunology* • Triticum / chemistry • Triticum / immunology*

Substances

• Allergens • Immunoglobulin Fragments • Peptide Library • Plant Proteins • Glutens

Full-text links

175. Thiol-disulfide homeostasis in children with celiac disease

Pediatr Int. 2020 Aug;62(8):950-956. doi: 10.1111/ped.14243.

Authors Atakan Comba 1 , Ayşe Semra Güreser 2 , Djursun Karasartova 2 , Almila Şenat 3 , Özcan Erel 3 , Ayşegül Taylan Özkan 2

Affiliations

• 1 Department of Pediatrics, Faculty of Medicine, Training and Research Hospital, Hitit University, Çorum, Turkey. • 2 Department of Medical Microbiology, Faculty of Medicine, Hitit University, Çorum, Turkey. • 3 Department of Biochemistry, Ankara Yıldırım Beyazit University, Ankara, Turkey.

• PMID: 32239752 • DOI: 10.1111/ped.14243

Abstract

Background: Toxic gliadin peptide damages enterocytes in celiac disease by causing oxidative stress. Thiols are organic compounds that defend against oxidative stress. This study aimed to investigate the changes in thiol-disulfide homeostasis in children with celiac disease.

Methods: The study included patients with celiac disease, children diagnosed with functional gastrointestinal disorders, and healthy children. Patients' serum native and total thiol-disulfide amounts, disulfide/total thiol percentage ratios, disulfide / native thiol percentage ratios, and native thiol/total thiol percentage ratios were measured.

Results: The study involved 172 children, of whom 90 (52.3%) were girls. The mean participant age was 8.6 ± 4.2 years. A total of 59 (34.3%) children had celiac disease, 56 (32.6%) had functional gastrointestinal disorders, and 57 (33.1%) were healthy. The total thiol and disulfide levels of patients with celiac disease (305 ± 87 μmol/L and 25 ± 15 μmol/L, respectively) were significantly lower than those of healthy children (349 ± 82 μmol/L and 40 ± 15 μmol/L, respectively) (P = 0.006 and P < 0.001, respectively). Native and total thiol levels (226 ± 85 μmol/L and 279 ± 99 μmol/L, respectively) in patients with celiac disease who consumed a gluten-containing diet were significantly lower than those of patients who consumed a gluten-free diet (278 ± 64 μmol/L and 327 ± 69 μmol/L, respectively) (P = 0.017 and P = 0.041, respectively). Conclusions: Thiol-disulfide homeostasis, an important antioxidant defense component of the gastrointestinal system, is disrupted in children with celiac disease. A gluten-free diet helped partially ameliorate this decline.

Keywords: celiac disease; child; disulfide; oxidative stress; thiol.

• 25 references

Full-text links

176. Amylose and amylopectin functionality during storage of bread prepared from flour of wheat containing unique starches

Food Chem. 2020 Aug 1;320:126609. doi: 10.1016/j.foodchem.2020.126609. Epub 2020 Mar 13.

Authors

Mieke A Nivelle 1 , Alice S Beghin 2 , Patricia Vrinten 3 , Toshiki Nakamura 4 , Jan A Delcour 2

Affiliations

• 1 Laboratory of Food Chemistry and Biochemistry and Leuven Food Science and Nutrition Research Centre (LFoRCe), KU Leuven, Kasteelpark Arenberg 20, B-3001 Leuven, Belgium. Electronic address: [email protected]. • 2 Laboratory of Food Chemistry and Biochemistry and Leuven Food Science and Nutrition Research Centre (LFoRCe), KU Leuven, Kasteelpark Arenberg 20, B-3001 Leuven, Belgium. • 3 Bioriginal Food & Science Corporation, Saskatoon, Saskatchewan S7J 0R1, Canada. • 4 Tohoku Agricultural Research Centre NARO, Morioka, Iwate 020-0198, Japan. Electronic address: [email protected]. • PMID: 32222658 • DOI: 10.1016/j.foodchem.2020.126609

Abstract

Bread crumb firming is largely determined by the properties of gluten and starch, and the transformations they undergo during bread making and storage. Amylose (AM) and amylopectin (AP) functionality in fresh and stored bread was investigated with NMR relaxometry. Bread was prepared from flours containing normal and atypical starches, e.g., flour from wheat line 5-5, with or without the inclusion of Bacillus stearothermophilus α-amylase. Initial crumb firmness increased with higher levels of AM or shorter AM chains. Both less extended AM and gluten networks and too rigid AM networks led to low crumb resilience. AP retrogradation during storage increased when crumb contained more AP or longer AP branch chains. Shorter AP branch chains, which were present at higher levels in 5-5 than in regular bread, were less prone to retrogradation, thereby limiting gluten network dehydration due to gluten to starch moisture migration. Correspondingly, crumb firming in 5-5 bread was restricted.

Keywords: Amylopectin; Amylopectin retrogradation; Amylose; Crumb resilience and firmness; Gluten; Network hydration; Time domain proton nuclear magnetic resonance; Water.

Conflict of interest statement

MeSH terms

• Amylopectin / chemistry* • Amylopectin / metabolism • Amylose / chemistry* • Amylose / metabolism • Bacterial Proteins • Bread / analysis* • Flour / analysis • Food Storage* • Geobacillus stearothermophilus / enzymology • Glutens / chemistry • Magnetic Resonance Spectroscopy • Starch / chemistry • Triticum / chemistry • Water • alpha-Amylases / metabolism

Substances

• Bacterial Proteins • Water • Glutens • Starch • Amylose • Amylopectin • alpha-Amylases

Full-text links

177. Fecal gluten immunogenic peptides as indicators of dietary compliance in celiac patients

Minerva Gastroenterol Dietol. 2020 Sep;66(3):201-207. doi: 10.23736/S1121- 421X.20.02662-8. Epub 2020 Mar 24.

Authors

Brunetta Porcelli 1 , Fabio Ferretti 2 , Francesca Cinci 3 , Ivano Biviano 4 , Alessia Santini 4 , Elisabetta Grande 5 , Francesco Quagliarella 5 , Lucia Terzuoli 3 , Maria R Bacarelli 2 , Nicola Bizzaro 6 , Marina Vascotto 5 , Mario Marini 4

Affiliations • 1 Section of Biochemistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy - [email protected]. • 2 Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy. • 3 Section of Biochemistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy. • 4 Unit of Gastroenterology and Operative Endoscopy, Siena University Hospital, Siena, Italy. • 5 Unit of Pediatrics, Siena University Hospital, Siena, Italy. • 6 Laboratory of Clinical Pathology, San Antonio Hospital Tolmezzo, Udine Integrated University Healthcare Company, Udine, Italy.

• PMID: 32218420 • DOI: 10.23736/S1121-421X.20.02662-8

Abstract

Background: It is important to have methods for evaluating dietary compliance in patients with celiac disease (CD). Determination of fecal gluten immunogenic peptides (GIPs) was recently proposed as a method of detecting gluten intake. The aim of this study was to evaluate whether determination of GIPs can be used as an indicator of compliance with a gluten-free diet (GFD).

Methods: Twenty-five persons with CD on a gluten-free diet for at least one year were enrolled in the study. Compliance with the diet was assessed by the Biagi questionnaire, evaluation of symptoms and assay of IgA anti-tissue transglutaminase antibodies (IgA anti-tTG). GIPs were determined by iVYLISA GIP-S test (Biomedal S.L., Seville, Spain) on an automated Chorus analyzer (DIESSE Diagnostica Senese, Siena, Italy), after extraction of fecal samples by the method developed by DIESSE.

Results: Four patients tested positive for GIPs (GIP+), two of whom complied strictly with the gluten-free diet according to the Biagi questionnaire. None of the four GIP-positive patients manifested symptoms. IgA anti-tTG was significantly higher in GIP+ than in GIP- subjects.

Conclusions: Assay of fecal GIPs identified more patients who were not complying with the diet than the Biagi questionnaire or evaluation of symptoms. The anti-tTG and GIP results agreed perfectly; however, since anti- tTG antibodies remain high for longer and are not a completely reliable marker of GFD intake, detection of fecal GIPs offers a direct, objective, quantitative assessment of exposure, even occasional, to gluten and could be used to check dietary compliance.

Full-text links

178. Controversies over human health and ecological impacts of glyphosate: Is it to be banned in modern agriculture?

Environ Pollut. 2020 Aug;263(Pt A):114372. doi: 10.1016/j.envpol.2020.114372. Epub 2020 Mar 14.

Authors

Islam Md Meftaul 1 , Kadiyala Venkateswarlu 2 , Rajarathnam Dharmarajan 3 , Prasath Annamalai 3 , Md Asaduzzaman 4 , Aney Parven 1 , Mallavarapu Megharaj 5

Affiliations

• 1 Global Centre for Environmental Remediation (GCER), Faculty of Science, The University of Newcastle, Callaghan, NSW 2308, Australia; Department of Agricultural Chemistry, Sher-e-Bangla Agricultural University, Dhaka 1207, Bangladesh. • 2 Formerly Department of Microbiology, Sri Krishnadevaraya University, Anantapuramu 515003, India. • 3 Global Centre for Environmental Remediation (GCER), Faculty of Science, The University of Newcastle, Callaghan, NSW 2308, Australia. • 4 NSW Department of Primary Industries, Pine Gully Road, Wagga Wagga, NSW 2650, Australia. • 5 Global Centre for Environmental Remediation (GCER), Faculty of Science, The University of Newcastle, Callaghan, NSW 2308, Australia; Cooperative Research Centre for Contamination Assessment and Remediation of the Environment (CRC CARE), The University of Newcastle, Callaghan, NSW 2308, Australia. Electronic address: [email protected].

• PMID: 32203845 • DOI: 10.1016/j.envpol.2020.114372

Abstract

Glyphosate, introduced by Monsanto Company under the commercial name Roundup in 1974, became the extensively used herbicide worldwide in the last few decades. Glyphosate has excellent properties of fast sorption in soil, biodegradation and less toxicity to nontarget organisms. However, glyphosate has been reported to increase the risk of cancer, endocrine-disruption, celiac disease, autism, effect on erythrocytes, leaky-gut syndrome, etc. The reclassification of glyphosate in 2015 as 'probably carcinogenic' under Group 2A by the International Agency for Research on Cancer has been broadly circulated by anti-chemical and environmental advocacy groups claiming for restricted use or ban of glyphosate. In contrast, some comprehensive epidemiological studies involving farmers with long-time exposure to glyphosate in USA and elsewhere coupled with available toxicological data showed no correlation with any kind of carcinogenic or genotoxic threat to humans. Moreover, several investigations confirmed that the surfactant, polyethoxylated tallow amine (POEA), contained in the formulations of glyphosate like Roundup, is responsible for the established adverse impacts on human and ecological health. Subsequent to the evolution of genetically modified glyphosate-resistant crops and the extensive use of glyphosate over the last 45 years, about 38 weed species developed resistance to this herbicide. Consequently, its use in the recent years has been either restricted or banned in 20 countries. This critical review on glyphosate provides an overview of its behaviour, fate, detrimental impacts on ecological and human health, and the development of resistance in weeds and pathogens. Thus, the ultimate objective is to help the authorities and agencies concerned in resolving the existing controversies and in providing the necessary regulations for safer use of the herbicide. In our opinion, glyphosate can be judiciously used in agriculture with the inclusion of safer surfactants in commercial formulations sine POEA, which is toxic by itself is likely to increase the toxicity of glyphosate. Keywords: Aminomethylphosphonic acid (AMPA); Glyphosate; Herbicide resistance; Human and ecological health; Polyethoxylated tallow amine (POEA).

Conflict of interest statement

Declaration of competing interest None.

Publication types

• Review

MeSH terms

• Agriculture • Crops, Agricultural • Glycine* / analogs & derivatives • Herbicides* • Humans

Substances

• Herbicides • glyphosate • Glycine

Full-text links

179. Effect of salts from the lyotropic series on the handling properties of dough prepared from two hard red spring wheat cultivars of differing quality Food Chem. 2020 Aug 1;320:126615. doi: 10.1016/j.foodchem.2020.126615. Epub 2020 Mar 14.

Authors

Nicole A Avramenko 1 , Erin J Hopkins 1 , Pierre Hucl 2 , Martin G Scanlon 3 , Michael T Nickerson 4

Affiliations

• 1 Department of Food and Bioproduct Sciences, University of Saskatchewan, 51 Campus Drive, Saskatoon, SK S7N 5A8, Canada. • 2 Crop Development Centre, University of Saskatchewan, 51 Campus Drive, Saskatoon, SK S7N 5A8, Canada. • 3 Department of Food and Human Nutritional Sciences, 209 Human Ecology Building, University of Manitoba, Winnipeg, MB R3T 2N2, Canada. • 4 Department of Food and Bioproduct Sciences, University of Saskatchewan, 51 Campus Drive, Saskatoon, SK S7N 5A8, Canada. Electronic address: [email protected].

• PMID: 32203834 • DOI: 10.1016/j.foodchem.2020.126615

Abstract

The influence of select salts from the lyotropic series (NH4Cl, KCl, NaCl, MgCl2, CaCl2, and MgSO4) on the rheology and stickiness of dough prepared from a strong (Pembina) and a weak (Harvest) hard red spring wheat flour were examined at a 1 and 2% salt levels, with water mobility and water association with different dough components also being assessed at the 1% salt level. Overall, Pembina was found to develop stronger gluten networks that were more resilient than those of Harvest as evident from a lower tan δ and less compliance during shear creep recovery rheology. However, the effect of salt- type differed based on cultivar. Pembina showed lower dough stickiness than Harvest in all cases. NH4Cl decreased dough stickiness the most for both cultivars. The use of alternative salts affected the association of water with the starch-fraction and gluten-fraction in doughs, and this effect was cultivar- dependent. Keywords: Alternative salts; Bread; Dough; Lyotropic series; Rheology; Salt reduction; Stickiness; Water association.

Conflict of interest statement

MeSH terms

• Bread / analysis* • Flour / analysis • Food Handling • Glutens / chemistry • Hardness • Sodium Chloride / chemistry* • Triticum / chemistry* • Water / chemistry

Substances

• Water • Sodium Chloride • Glutens

Full-text links

180. Revealing the effect mechanism of NaCl on the rheological properties of dough of Chinese traditional hand-stretched dried noodles Food Chem. 2020 Aug 1;320:126606. doi: 10.1016/j.foodchem.2020.126606. Epub 2020 Mar 15.

Authors

Jin-Rong Wang 1 , Xiao-Na Guo 1 , Jun-Jie Xing 1 , Ke-Xue Zhu 2

Affiliations

• 1 State Key Laboratory of Food Science and Technology, Jiangnan University, 1800 Lihu Avenue, Wuxi 214122, Jiangsu Province, PR China; School of Food Science and Technology, Jiangnan University, 1800 Lihu Avenue, Wuxi 214122, Jiangsu Province, PR China. • 2 State Key Laboratory of Food Science and Technology, Jiangnan University, 1800 Lihu Avenue, Wuxi 214122, Jiangsu Province, PR China; School of Food Science and Technology, Jiangnan University, 1800 Lihu Avenue, Wuxi 214122, Jiangsu Province, PR China. Electronic address: [email protected].

• PMID: 32203831 • DOI: 10.1016/j.foodchem.2020.126606

Abstract

Chinese traditional hand-stretched dried noodle is very popular in China for its unique taste and flavor quality, and NaCl plays a vital role in its processing. The effects of NaCl (1%-6%, w/w) on rheological and gluten properties of dough of Chinese traditional hand-stretched dried noodle were studied. The addition of NaCl (1%-4% w/w) enhanced storage modulus, loss modulus and extensibility of dough, while these rheological parameters started to decreased when NaCl amount reached 5% (w/w). With salt addition increased from 0% to 6% (w/w), the solubility of gluten in SDS medium showed a significant (p < 0.05) decreasing trend, while opposite result was found on the yield and G' of gluten macro polymer. These changes on gluten indicated that the interaction among gluten molecules increased with the increase of salt amount. Excessive salt (5%-6%, w/w) disrupted the gluten network, which was responsible for the reduction of dynamic and extensional properties. Keywords: Dough; Gluten macro polymer; Gluten matrix; Rheological properties; SDS extractable protein.

Conflict of interest statement

MeSH terms

• China • Flour / analysis* • Food Analysis • Glutens / chemistry* • Rheology* • Sodium Chloride / chemistry • Sodium Chloride, Dietary*

Substances

• Sodium Chloride, Dietary • Sodium Chloride • Glutens

Full-text links

181. Role of Celiac Trunk and Patient Body Mass Index on Omental Flap for Management of Thoracic Aortic Graft Infection: Reply

Ann Thorac Surg. 2020 Sep;110(3):1092-1093. doi: 10.1016/j.athoracsur.2020.02.021. Epub 2020 Mar 19. Authors

J Andres Hernandez 1 , John T Stranix 2 , Stephen J Kovach 1

Affiliations

• 1 Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania. • 2 Department of Plastic Surgery, University of Virginia Health System, 1300 Jefferson Park Ave, 4th Flr, Charlottesville, VA 22908. Electronic address: [email protected].

• PMID: 32199822 • DOI: 10.1016/j.athoracsur.2020.02.021

No abstract available Publication types

• Letter

Full-text links

182. Association between celiac disease and systemic lupus erythematosus: a Mendelian randomization study

Rheumatology (Oxford). 2020 Sep 1;59(9):2642-2644. doi: 10.1093/rheumatology/keaa071.

Author

Jun Inamo 1

Affiliation • 1 Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.

• PMID: 32176771 • DOI: 10.1093/rheumatology/keaa071

No abstract available

Full-text links

183. Effects of inclusion of corn gluten feed in dairy rations on dry matter intake, milk yield, milk components, and ruminal fermentation parameters: a meta-analysis

Trop Anim Health Prod. 2020 Sep;52(5):2359-2369. doi: 10.1007/s11250-020- 02261-2. Epub 2020 Mar 13.

Authors

Babak Darabighane 1 , Farzad Mirzaei Aghjehgheshlagh 2 , Ali Mahdavi 3 , Bahman Navidshad 1 , John K Bernard 4

Affiliations

• 1 Department of Animal Science, University of Mohaghegh Ardabili, Ardabil, Iran. • 2 Department of Animal Science, University of Mohaghegh Ardabili, Ardabil, Iran. [email protected]. • 3 Faculty of Veterinary Medicine, Semnan University, Semnan, Iran. • 4 Department of Animal and Dairy Science, University of Georgia, Tifton, GA, 31793, USA.

• PMID: 32170651 • DOI: 10.1007/s11250-020-02261-2 Abstract

Corn gluten feed (CGF) is a co-product of wet milling that can replace energy or fiber ingredients in dairy cow rations. The present meta-analysis examines how inclusion of CGF can affect dry matter intake (DMI), milk yield (MY), milk components, and ruminal fermentation parameters. A literature search was conducted to identify papers published from 1990 to 2018. Effect size for all parameters was calculated as standardized mean difference with a 95% confidence interval. Heterogeneity was determined using Q test and I2 statistic, while meta-regression was used to examine factors influencing heterogeneity. Results indicate that feeding CGF increased the effect size for DMI and MY. No differences were observed for effect size for percentage milk fat or protein; however, increases were observed in the effect size for milk fat yield, milk protein yield, milk lactose percentage, and milk lactose yield. Ruminal fermentation parameters revealed a decrease in the effect size for pH and acetate and an increase for propionate. No differences were observed in the effect size for total VFA or butyrate. The Q test demonstrated heterogeneity (P < 0.1) for MY, MFP, and pH. The results indicate differences in forage intake between groups receiving CGF and control as an important factor contributing to heterogeneity for DMI, MFP, and pH. It can be concluded from this meta-analysis that in addition to increased DMI, inclusion of CGF in cow diets increases MY and improves milk components. Furthermore, inclusion of CGF in the diet lowers ruminal pH while decreasing acetate and increasing propionate contents.

Keywords: Corn gluten feed; Dairy cow; Meta-analysis; Milk.

Full-text links

184. Effect of Celiac Artery and Body Mass Index on Omental Flap for Infected Thoracic Aortic Graft?

Ann Thorac Surg. 2020 Sep;110(3):1092. doi: 10.1016/j.athoracsur.2020.01.069. Epub 2020 Mar 5. Authors

Mehmet Alagoz 1 , Ahmet Dolapoglu 2

Affiliations

• 1 Department of Cardiothoracic and Vascular Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, 6400 Fannin St, Ste 2850, Houston, TX 77030. Electronic address: [email protected]. • 2 Cardiovascular Surgery Department, Balıkesir University Medical School, Balıkesir, Turkey.

• PMID: 32147415 • DOI: 10.1016/j.athoracsur.2020.01.069

No abstract available Publication types

• Letter

Full-text links

185. Ulcerative jejunitis in refractory celiac disease diagnosed on capsule endoscopy

Gastrointest Endosc. 2020 Aug;92(2):430-432. doi: 10.1016/j.gie.2020.02.032. Epub 2020 Feb 28.

Authors

Jasleen Grewal 1 , Ashwinee Condon 1 , Neil B Marya 1 , Stephen Kim 1

Affiliation • 1 Department of Medicine, Vatche and Tamar Manoukian Division of Digestive Diseases, University of California at Los Angeles, Los Angeles, California, USA.

• PMID: 32113889 • DOI: 10.1016/j.gie.2020.02.032

No abstract available

Full-text links

186. Optimization of encapsulation of maltogenic amylase into a mixture of maltodextrin and beeswax and its application in gluten-free bread

J Texture Stud. 2020 Aug;51(4):631-641. doi: 10.1111/jtxs.12516. Epub 2020 Feb 25.

Authors

Sepideh Haghighat-Kharazi 1 , Mohammad Reza Kasaai 1 , Jafar Mohammadzadeh Milani 1 , Khosro Khajeh 2

Affiliations

• 1 Department of Food Science and Technology, Sari Agricultural Sciences and Natural Resources University, Mazandaran, Iran. • 2 Department of Biochemistry, Tarbiat Modares University, Tehran, Iran.

• PMID: 32065662 • DOI: 10.1111/jtxs.12516 Abstract

In this work maltogenic amylase (MAase) was encapsulated into the mixture of maltodexrin and beeswax (BW) for retarding staling of gluten-free bread. The effects of maltogenic amylase (MAase) concentration (8.2, 45, and 82 mg/ml), maltodextrin with dextrose equivalent (DE) 4-7 (MD) (1, 2.5, and 4%) and, BW (1, 2.5, and 4%) on the encapsulation efficiency (EE) of encapsulated enzyme were optimized using RSM. The optimized formulation was MAase with 8.2 mg/ml, MD 4% and BW 1%, leading to the highest EE (79.35%), thus chosen for subsequent experiments. The prepared particles were 1,190.50 nm with PDI of 0.336 and zeta potential of -8.30 mV. Surface morphologies of produced particles were almost spherical with layered appearance. Batter with this formulation led to higher cross over point in frequency sweep than free enzyme-loaded batter. Lower weight loss, higher volume index, darker crust color, whiter crumb color, more aerated microstructure, less hardness in crumb, and higher sensorial acceptability on the first day and during storage period in the breads containing encapsulated MAase was observed.

Keywords: beeswax; encapsulation; gluten-free bread; maltodextrin; maltogenic amylase.

• 37 references

187. Gliadin-Induced Ex Vivo T-Cell Response in Dermatitis Herpetiformis: A Predictor of Clinical Relapse on Gluten Challenge?

J Invest Dermatol. 2020 Sep;140(9):1867-1869.e2. doi: 10.1016/j.jid.2019.12.038. Epub 2020 Feb 7.

Authors

Suvi Kalliokoski 1 , Eriika Mansikka 2 , Andrea de Kauwe 3 , Heini Huhtala 4 , Päivi Saavalainen 3 , Kalle Kurppa 5 , Kaisa Hervonen 2 , Timo Reunala 2 , Katri Kaukinen 6 , Teea Salmi 2 , Katri Lindfors 7 Affiliations

• 1 Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. • 2 Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Dermatology, Tampere University Hospital, Tampere, Finland. • 3 Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland. • 4 Faculty of Social Sciences, Tampere University, Tampere, Finland. • 5 Center for Child Health Research, Tampere University, Tampere, Finland; Department of Paediatrics, Tampere University Hospital, Tampere, Finland; University Consortium of Seinäjoki and Seinäjoki University Hospital, Seinäjoki, Finland. • 6 Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Internal Medicine, Tampere University Hospital, Tampere, Finland. • 7 Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. Electronic address: [email protected].

• PMID: 32035923 • DOI: 10.1016/j.jid.2019.12.038

No abstract available

Full-text links

188. Refractory celiac disease type II: An atypical case highlighting limitations of the current classification system

Hematol Oncol. 2020 Aug;38(3):399-405. doi: 10.1002/hon.2720. Epub 2020 Feb 19. Authors

Craig R Soderquist 1 , Susan Hsiao 1 , Mahesh M Mansukhani 1 , Bachir Alobeid 1 , Peter H Green 2 , Govind Bhagat 1

Affiliations

• 1 Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA. • 2 Department of Medicine, Celiac Disease Center, Columbia University Irving Medical Center, New York, New York, USA.

• PMID: 32010998 • DOI: 10.1002/hon.2720

Abstract

Refractory celiac disease (RCD) is a rare condition associated with high morbidity that develops in individuals with celiac disease. It is known to be biologically heterogeneous, and currently two types are recognized based on immunophenotypic and molecular features, type I (RCD I) and type II (RCD II). Differentiating between RCD I and RCD II is critical, as patients with RCD II have substantially worse outcomes and a high risk of developing enteropathy- associated T-cell lymphoma. However, the current RCD classification is limited in scope, and atypical presentations and immunophenotypes are not recognized at present. Herein, we describe a unique case of RCD II with atypical clinical (primarily neurologic manifestations and lack of significant gastrointestinal symptoms), histopathologic (no villous atrophy), immunophenotypic (virtual absence of cytoplasmic CD3 expression), and molecular features (absence of clonal TR rearrangement and identification of pathogenic STAT3 and KMT2D mutations). This case highlights limitations of the current RCD classification system and the utility of next generation sequencing (NGS) studies in the diagnostic workup of RCD. Future algorithms need to recognize extraintestinal manifestations and incorporate atypical histopathologic and immunophenotypic features, as well as results of NGS analysis for RCD II classification. Keywords: clone; gene rearrangement; intraepithelial lymphocytes; phenotype; refractory celiac disease.

• 49 references

Publication types

• Case Reports

MeSH terms

• Aged • Biomarkers / analysis* • Celiac Disease / classification* • Celiac Disease / genetics • Celiac Disease / metabolism • Celiac Disease / pathology* • Gene Rearrangement* • Genes, T-Cell Receptor beta / genetics* • High-Throughput Nucleotide Sequencing • Humans • Immunophenotyping / standards* • Male

Substances

• Biomarkers

Full-text links

189. Is the level of diffusion restriction in celiac and cervico-thoracic sympathetic ganglia helpful in their proper recognition on PSMA ligand PET/MR?

Nuklearmedizin. 2020 Aug;59(4):300-307. doi: 10.1055/a-1079-3855. Epub 2020 Jan 31.

Authors

Ewa J Bialek 1 2 , Bogdan Malkowski 1 3

Affiliations

• 1 Department of Nuclear Medicine, The Franciszek Lukaszczyk Oncology Centre, Bydgoszcz, Poland. • 2 Department of Nuclear Medicine, Military Institute of Medicine, Warsaw, Poland. • 3 Department of Positron Emission Tomography and Molecular Diagnostics, Collegium Medicum of Nicolaus Copernicus University, Bydgoszcz, Poland.

• PMID: 32005043 • DOI: 10.1055/a-1079-3855

Abstract in En , German

Aim: To check if diffusion weighted imaging (DWI) might be helpful in proper recognition of celiac (CG) and cervicothoracic (CTG) sympathetic ganglia on the whole-body multimodal PSMA-ligand PET/MR imaging, in the view of their common misleading avidity on PET potentially suggestive of malignant lesions, including metastatic lymph nodes.

Methods: The thickness and the level of diffusion restriction was assessed qualitatively and quantitatively in 406 sympathetic ganglia (189 CTG in 101 males and 217 CG in 116 males) on DWI maps (b-value 0 and 800 s/mm2) and apparent diffusion coefficient (ADC) maps (mean ADC) of the whole-body PET/MR 68Ga-PSMA-11 PET/MR. To form a reference group of a matching ganglia size, the smallest lymph node was chosen from each patient with metastases and underwent the same procedure.

Results: Very low and low level of diffusion restriction was noted in the majority of sympathetic ganglia (81.0 % CTG, 67.3 % CG, and 73.6 % of all). In the majority (91.7 %) of metastatic lymph nodes the level of diffusion restriction was moderate to high.The mean ADC values in sympathetic ganglia were statistically significantly higher in CTG, CG and all ganglia than in metastatic lymph nodes (p < 0.001; the effect size was large).

Conclusions: Sympathetic celiac and cervicothoracic ganglia present very low and low level of diffusion restriction in visual DWI assessment, and significantly higher than metastatic lymph nodes mean ADC values in the majority of cases, which may serve as additional factors aiding differential diagnosis on multimodal PSMA-ligand PET/MR imaging.Therefore, PSMA- ligand PET/MR appears potentially superior to PSMA-ligand PET/CT in proper identification of sympathetic ganglia.

ZIEL: Überprüfung des Wertes der Diffusionsbildgebung (DWI) bei der korrekten Identifizierung von zöliakalen (CG) und zervikothorakalen (CTG) sympathischen Ganglien in der multimodalen Ganzkörper-PSMA-Liganden- PET/MRT, angesichts ihres häufig irreführenden Uptakes im PET, was möglicherweise für bösartige Läsionen wie Lymphknotenmetastasen sprechen kann.

Methoden: Die Dicke und der Grad der Diffusionsrestriktion wurde qualitativ und quantitativ in 406 sympathischen Ganglien (189 CTG bei 101 Männern und 217 CG bei 116 Männern) auf DWI-Maps (b-Wert 0 und 800s/mm2) und ADC (“apparent diffusion coefficient”)-Maps (mittlerer ADC) des Ganzkörper- PET/MR 68Ga-PSMA-11 PET/MR bewertet. Um eine Referenzgruppe mit übereinstimmender Gangliengröße zu bilden, wurde von jedem Patienten mit Metastasen der kleinste Lymphknoten ausgewählt und dem gleichen Verfahren unterzogen.

Ergebnisse: Bei der Mehrheit der sympathischen Ganglien (81,0 % der CTG, 67,3 % der CG und 73,6 % von allen) wurde eine sehr geringe bzw. niedrige Diffusionsrestriktion festgestellt. Bei den meisten Lymphknotenmetastasen (91,7 %) war der Grad der Diffusionsrestriktion moderat bis hoch. Die mittleren ADC-Werte in den sympathischen Ganglien waren in CTG, in CG und in allen Ganglien statistisch signifikant höher als in den Lymphknotenmetastasen (p < 0.001; bei großer Effektstärke).

Schlussfolgerungen: Sympathische zöliakale und zervikothorakale Ganglien zeigen in der visuellen DWI-Bewertung eine sehr niedrige bzw. niedrige Diffusionsrestriktion und in den meisten Fällen signifikant höhere mittlere ADC-Werte als Lymphknotenmetastasen und kann somit als zusätzliche Faktor bei der Differentialdiagnose in der multimodalen PSMA-Liganden-PET/MR- Bildgebung dienen. Daher scheint für eine korrekte Identifizierung von sympathischen Ganglien die PSMA-Liganden PET/MRT der PSMA-Liganden PET/CT potentiell überlegen zu sein.

Conflict of interest statement

The authors declare that they have no conflict of interest.

Full-text links

190. Nutrition Assessment, Interventions, and Monitoring for Patients with Celiac Disease: An Evidence Analysis Center Scoping Review

J Acad Nutr Diet. 2020 Aug;120(8):1381-1406. doi: 10.1016/j.jand.2019.09.019. Epub 2020 Jan 15.

Authors

Feon W Cheng, Deepa Handu

• PMID: 31953154 • DOI: 10.1016/j.jand.2019.09.019 Abstract

The objectives of this scoping review were to identify and characterize studies examining nutrition assessment, interventions, and measures to monitor gluten-free diet (GFD) adherence/compliance in patients with celiac disease (CD). An electronic literature search of four databases (Cochrane Database for systematic reviews, CINAHL, Embase, and Ovid MEDLINE) was conducted to identify articles examining nutrition care in CD individuals. Except for narrative review, grey literature, and case study/report, all types of peer-reviewed articles published between January 2007 and August 2018 were eligible. There were a total of 10,823 records; 10,368 were excluded during the first round of screening due to irrelevancy and/or duplication. Of the 455 full-text articles that were assessed, 292 met the criteria and were included. Most of the studies were observational studies (n=212), followed by experimental trials (n=50), evidence-based practice guideline (EBPG)/report/statement (n=16), and systematic review (SR) (n=14). Nine original studies examined assessment, focusing mainly on different tools/ways to assess GFD adherence. The majority of the included original articles (n=235) were in the nutrition intervention category with GFD, oats, and prebiotics/probiotics as the top- three most studied interventions. There were eight SRs on GFD and five on oats. One SR and 21 original studies investigated the effectiveness of different measures to monitor GFD adherence/compliance. Although recent CD EBPGs were identified, different methods with varying levels of rigor, in terms of literature search and assessment of evidence strength, were used. Based on this scoping review, interventions focused on gluten-free diet and oats have been significantly covered by either SRs or EBPGs. Studies related to prebiotics/probiotics and education program/counseling focused interventions, as well as assessment, in CD patients have increased in recent years. Thus, it might be beneficial to conduct SRs/EBPGs focused on these topics to guide practitioners.

Full-text links

191. Adolescents with chronic disease and social media: a cross-sectional study

Arch Dis Child. 2020 Aug;105(8):744-748. doi: 10.1136/archdischild-2019- 317996. Epub 2020 Jan 15.

Authors

Laura De Nardi 1 , Andrea Trombetta 2 , Sergio Ghirardo 1 , Maria Rita Lucia Genovese 1 , Egidio Barbi 1 3 , Valentina Taucar 3

Affiliations

• 1 Department of Medicine, Surgery and Health Sciences, Department of Pediatrics, University of Trieste, Trieste, Italy. • 2 Department of Medicine, Surgery and Health Sciences, Department of Pediatrics, University of Trieste, Trieste, Italy [email protected]. • 3 Institute for Maternal and Child Health IRCCS 'Burlo Garofolo', Trieste, Italy.

• PMID: 31941715 • DOI: 10.1136/archdischild-2019-317996

Abstract

Objective: This study aims to explore the attitude of adolescents with chronic diseases toward social media exposure, focusing in particular on Facebook.

Design: Cross-sectional study.

Setting: An anonymous semistructured survey was distributed to an Italian hospital-based cohort of adolescents with chronic disease to explore the role of Facebook in their daily life.

Patients: We recruited 212 adolescents (aged between 13 and 24 years) with a diagnosis of inflammatory bowel disease, coeliac disease, diabetes mellitus type 1 and cystic fibrosis. Results: Two hundred and seven of the 212 (97.6%) expressed the need of sharing their illness experience with friends, 201 out of 212 (94.8%) usually searched information on the internet to find new therapies and to discover their prognosis. One hundred and forty-nine out of 212 adolescents (70.3%) perceived dependence on their parents as the most negative aspect of having a chronic disease, and 200 out of 212 (94.3%) were looking for friends with the same disease on Facebook. Two hundred and ten out of 212 (99.1%) did not want their doctors or nurse on their social media platforms. During the active disease periods, the time spent with social media increased from an average of 5 to 11 hours.

Conclusions: This descriptive analysis focused on the Facebook impact on chronic disease perception among affected adolescents. It showed that they used to spend an increased amount of time on this platform during disease flare-up and highlighted their wish of keeping doctors and nurses away from their social dimension.

Keywords: Facebook; adolescent health; chronic disease; social networking.

Conflict of interest statement

Competing interests: None declared.

Full-text links

192. Small bowel adenocarcinoma: Results from a nationwide prospective ARCAD-NADEGE cohort study of 347 patients

Int J Cancer. 2020 Aug 15;147(4):967-977. doi: 10.1002/ijc.32860. Epub 2020 Jan 22. Authors

Thomas Aparicio 1 , Julie Henriques 2 , Sylvain Manfredi 3 , David Tougeron 4 , Olivier Bouché 5 , Denis Pezet 6 , Guillaume Piessen 7 , Romain Coriat 8 , Aziz Zaanan 9 , Jean-Louis Legoux 10 , Eric Terrebone 11 , Marc Pocard 12 , Jean-Marc Gornet 1 , Thierry Lecomte 13 , Catherine Lombard-Bohas 14 , Hervé Perrier 15 , Cédric Lecaille 16 , Sandrine Lavau-Denes 17 , Dewi Vernerey 2 , Pauline Afchain 18 , NADEGE Investigators

Affiliations

• 1 Department of Gastroenterology and Digestive Oncology, Saint Louis Hospital, APHP, University Paris Diderot, Paris, France. • 2 Methodology and Quality of Life Unit in Oncology, EA 3181, University Hospital, Besançon, France. • 3 Department of Gastroenterology, CHU Dijon, University of Bourgogne- Franche Comté, INSERM U1231, Dijon, France. • 4 Department of Gastroenterology, CHU Poitiers, Poitiers, France. • 5 Department of Gastroenterology, CHU Robert Debré, Reims, France. • 6 Department of Digestive and Hepatobiliary Surgery, University Hospital of Clermont-Ferrand, U1071 INSERM, Clermont-Auvergne University, Clermont-Ferrand, France. • 7 Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, University Lille, Lille, France. • 8 Department of Gastroenterology, CHU Cochin, APHP, Paris, France. • 9 Gastroenterology and Digestive Oncology, APHP, Georges Pompidou Hospital, APHP, University Paris Descartes, Paris, France. • 10 Department of Hepato-Gastroenterology and Digestive Oncology, CHR La Source, Orléans, France. • 11 Department of Gastroenterology, CHU Haut-Lévêque, Pessac, France. • 12 Department of Digestive Surgery, CHU Lariboisière, APHP, Paris, France. • 13 Department of Hepato-Gastroenterology and Digestive Oncology, Trousseau Hospital, CHU Tours, Tours, France. • 14 Department of Digestive Oncology, Edouard Herriot Hospital, CHU Lyon, Lyon, France. • 15 Department of Hepato-Gastroenterology, Saint Joseph Hospital, Marseille, France. • 16 Department of Gastroenterology, Polyclinic Bordeaux Nord, Bordeaux, France. • 17 Department of Oncology, CHU Dupuytren, Limoges, France. • 18 Department of Oncology, Saint Antoine Hospital, APHP, Paris, France.

• PMID: 31912484 • DOI: 10.1002/ijc.32860

Abstract

Small bowel adenocarcinoma (SBA) is a rare tumour. We conducted a prospective cohort to describe the prevalence, survival and prognostic factors in unselected SBA patients. The study enrolled patients with all stages of newly diagnosed or recurrent SBA at 74 French centres between January 2009 and December 2012. In total, 347 patients were analysed; the median age was 63 years (range 23-90). The primary tumour was in the duodenum (60.6%), jejunum (20.7%) and ileum (18.7%). The prevalence of predisposing disease was 8.7%, 6.9%, 1.7%, 1.7% and 0.6% for Crohn disease, Lynch syndrome, familial adenomatous polyposis, celiac disease and Peutz-Jeghers syndrome, respectively. At diagnosis, 58.9%, 5.5% and 35.6% of patients had localised and resectable, locally advanced unresectable and metastatic disease, respectively. Crohn disease was significantly associated with younger age, poor differentiation and ileum location, whereas Lynch syndrome with younger age, poor differentiation, early stage and duodenum location. Adjuvant chemotherapy (oxaliplatin-based in 89.9%) was performed in 61.5% of patients with locally resected tumours. With a 54-months median follow- up, the 5-year overall survival (OS) was 87.9%, 78.2% and 55.5% in Stages I, II and III, respectively. The median OS of patients with Stage IV was 12.7 months. In patients with resected tumours, poor differentiation (p = 0.047) and T4 stage (p = 0.001) were associated with a higher risk of death. In conclusion, our study showed that the prognosis of advanced SBA remains poor. Tumour characteristics differed according to predisposing disease. In SBA-resected tumours, the prognostic factors for OS were grade and T stage.

Keywords: Crohn disease; Lynch syndrome; cohort study; epidemiology; small intestine adenocarcinoma.

Grant support

• n° NA 2009/A.R.CA.D. • GERCOR

Full-text links

193. Withdrawing gluten-free food from prescriptions in England: a mixed-methods study to examine the impact of policy changes on quality of life

J Hum Nutr Diet. 2020 Aug;33(4):453-464. doi: 10.1111/jhn.12728. Epub 2019 Dec 26.

Authors

M Peters 1 , H Crocker 1 , C Jenkinson 1 , M Violato 1

Affiliation

• 1 Nuffield Department of Population Health, University of Oxford, Oxford, UK.

• PMID: 31876360 • PMCID: PMC7383817 • DOI: 10.1111/jhn.12728

Free PMC article Abstract

Background: Some local areas in England stopped have gluten-free prescriptions for coeliac disease. An explanatory mixed-methods study has investigated the impact of these changes. Methods: A cross-sectional survey with 1697 participants was followed by 24 qualitative interviews. The survey included questions on the use of prescriptions and healthcare services, as well as the Coeliac Disease Assessment Questionnaire (CDAQ) to assess quality of life. The survey data were analysed by descriptive statistics, analysis of variance and regression analysis, and the interviews were analysed by thematic analysis. Findings from the interviews guided the survey analysis.

Results: Dietary burden was significantly different between prescribing and nonprescribing areas, with little impact on other aspects of quality of life. Survey participants in nonprescribing areas who felt more impacted by the prescription changes reported a lower quality of life. Satisfaction with and use of services was lower in nonprescribing areas. Interviews indicated that, after initial frustrations, most people adapted to the changed prescription policy. However, there was a clear preference for gluten-free prescriptions to be available, in particular for staple foods.

Conclusions: The main quality of life impact was on Dietary burden. It is encouraging that most participants in the present study maintained a good quality of life. However, issues of worse experiences of care, lower follow-up opportunities and inequity arose, and these should be taken into consideration in decisions on gluten-free food prescriptions. The new guidelines for the National Health Service in England have retained prescriptions for bread and flour mixes, which is more limited than the range of staple foods preferred in the present study.

Keywords: coeliac disease; gluten-free diet; health services use; mixed methods; prescriptions; quality of life.

• 27 references

Grant support

• Coeliac UK

Full-text links

194. Metagenomics of the faecal virome indicate a cumulative effect of enterovirus and gluten amount on the risk of coeliac disease autoimmunity in genetically at risk children: the TEDDY study

Gut. 2020 Aug;69(8):1416-1422. doi: 10.1136/gutjnl-2019-319809. Epub 2019 Nov 19.

Authors

Katri Lindfors # 1 , Jake Lin # 2 3 , Hye-Seung Lee 4 , Heikki Hyöty 2 , Matti Nykter 2 , Kalle Kurppa 2 5 6 , Edwin Liu 7 8 , Sibylle Koletzko 9 10 , Marian Rewers 11 , William Hagopian 12 , Jorma Toppari 13 14 , Annette-Gabriele Ziegler 15 16 17 , Beena Akolkar 18 , Jeffrey P Krischer 4 , Joseph F Petrosino 19 , Richard E Lloyd 19 , Daniel Agardh 20 , TEDDY Study Group

Collaborators

• TEDDY Study Group:

Aaron Barbour, Kimberly Bautista, Judith Baxter, Daniel Felipe-Morales, Kimberly Driscoll, Brigitte I Frohnert, Marisa Stahl, Patricia Gesualdo, Michelle Hoffman, Rachel Karban, Jill Norris, Stesha Peacock, Hanan Shorrosh, Andrea Steck, Megan Stern, Erica Villegas, Kathleen Waugh, Olli G Simell, Annika Adamsson, Suvi Ahonen, Mari Åkerlund, Leena Hakola, Anne Hekkala, Henna Holappa, Anni Ikonen, Jorma Ilonen, Sinikka Jäminki, Sanna Jokipuu, Leena Karlsson, Jukka Kero, Miia Kähönen, Mikael Knip, Minna-Liisa Koivikko, Merja Koskinen, Mirva Koreasalo, Jarita Kytölä, Tiina Latva-Aho, Maria Lönnrot, Elina Mäntymäki, Markus Mattila, Maija Miettinen, Katja Multasuo, Teija Mykkänen, Tiina Niininen, Sari Niinistö, Mia Nyblom, Sami Oikarinen, Paula Ollikainen, Zhian Othmani, Sirpa Pohjola, Petra Rajala, Jenna Rautanen, Anne Riikonen, Eija Riski, Miia Pekkola, Minna Romo, Satu Ruohonen, Satu Simell, Maija Sjöberg, Aino Stenius, Päivi Tossavainen, Mari Vähä- Mäkilä, Sini Vainionpää, Eeva Varjonen, Riitta Veijola, Irene Viinikangas, Suvi M Virtanen, Jin-Xiong She, Desmond Schatz, Diane Hopkins, Leigh Steed, Jennifer Bryant, Katherine Silvis, Michael Haller, Melissa Gardiner, Richard McIndoe, Ashok Sharma, Stephen W Anderson, Laura Jacobsen, John Marks, Ezio Bonifacio, Anita Gavrisan, Cigdem Gezginci, Anja Heublein, Verena Hoffmann, Sandra Hummel, Andrea Keimer, Annette Knopff, Charlotte Koch, Claudia Ramminger, Roswith Roth, Marlon Scholz, Joanna Stock, Katharina Warncke, Lorena Wendel, Christiane Winkler, Åke Lernmark, Carin Andrén Aronsson, Maria Ask, Rasmus Bennet, Corrado Cilio, Helene Engqvist, Emelie Ericson-Hallström, Annika Fors, Lina Fransson, Thomas Gard, Monika Hansen, Hanna Jisser, Fredrik Johansen, Berglind Jonsdottir, Silvija Jovic, Helena Elding Larsson, Marielle Lindström, Markus Lundgren, Marlena Maziarz, Maria Månsson- Martinez, Maria Markan, Jessica Melin, Zeliha Mestan, Caroline Nilsson, Karin Ottosson, Kobra Rahmati, Anita Ramelius, Falastin Salami, Anette Sjöberg, Birgitta Sjöberg, Malin Svensson, Carina Törn, Anne Wallin, Åsa Wimar, Sofie Åberg, Michael Killian, Claire Cowen Crouch, Jennifer Skidmore, Masumeh Chavoshi, Rachel Hervey, Rachel Lyons, Arlene Meyer, Denise Mulenga, Jared Radtke, Matei Romancik, Davey Schmitt, Sarah Zink, Dorothy Becker, Margaret Franciscus, MaryEllen Dalmagro-Elias Smith, Ashi Daftary, Mary Beth Klein, Chrystal Yates, Sarah Austin- Gonzalez, Maryouri Avendano, Sandra Baethke, Rasheedah Brown, Brant Burkhardt, Martha Butterworth, Joanna Clasen, David Cuthbertson, Stephen Dankyi, Christopher Eberhard, Steven Fiske, Jennifer Garmeson, Veena Gowda, Kathleen Heyman, Belinda Hsiao, Christina Karges, Francisco Perez Laras, Qian Li, Shu Liu, Xiang Liu, Kristian Lynch, Colleen Maguire, Jamie Malloy, Cristina McCarthy, Aubrie Merrell, Hemang Parikh, Ryan Quigley, Cassandra Remedios, Chris Shaffer, Laura Smith, Susan Smith, Noah Sulman, Roy Tamura, Dena Tewey, Michael Toth, Ulla Uusitalo, Kendra Vehik, Ponni Vijayakandipan, Keith Wood, Jimin Yang, Michael Abbondondolo, Lori Ballard, David Hadley, Wendy McLeod, Steven Meulemans, Liping Yu, Dongmei Miao, Polly Bingley, Alistair Williams, Kyla Chandler, Olivia Ball, Ilana Kelland, Sian Grace, Masumeh Chavoshi, Jared Radtke, Sarah Zink, Nadim J Ajami, Matthew C Ross, Jacqueline L O'Brien, Diane S Hutchinson, Daniel P Smith, Matthew C Wong, Xianjun Tian, Tulin Ayvaz, Auriole Tamegnon, Nguyen Truong, Hannah Moreno, Lauren Riley, Eduardo Moreno, Tonya Bauch, Lenka Kusic, Ginger Metcalf, Donna Muzny, HarshaVArdhan Doddapaneni, Richard Gibbs, Sandra Ke, Niveen Mulholland, Kasia Bourcier, Thomas Briese, Suzanne Bennett Johnson, Eric Triplett

Affiliations

• 1 Faculty of Medicine and Health Techology, Tampere University, Tampere, Finland [email protected]. • 2 Faculty of Medicine and Health Techology, Tampere University, Tampere, Finland. • 3 Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland. • 4 Morsani College of Medicine, University of South Florida, Tampa, Florida, USA. • 5 Center for Child Health Research, Tampere University and Tampere University Hospital, Tampere, Finland. • 6 The University Consortium of Seinäjoki, Seinäjoki, Finland. • 7 University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado, USA. • 8 Digestive Health Institute, Children's Hospital Colorado, Aurora, United States. • 9 Ludwig-Maximilians-Universitat Munchen, Munchen, Bayern, Germany. • 10 Division of Paediatric Gastroenterology and Hepatology, Dr von Hauner Children's Hospital, Munchen, Germany. • 11 Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, Denver, Colorado, USA. • 12 Pacific Northwest Research Institute, Seattle, Washington, USA. • 13 Research Centre for Integrative Physiology and Phamacology, Institute of Biomedicine, University of Turku, Turku, Finland. • 14 Department of Paediatrics, Turku University Hospital, Turku, Finland. • 15 Kliikum Rechts der Isar, Technische Universität München, Munchen, Bayern, Germany. • 16 Institute of Diabetes Research, Helmholtz Zentrum München, Germany. • 17 Forschergruppe Diabetes e.V, Neuherberg, Germany. • 18 National Institute of Diabetes and Digestive and Kidney Disease, National Institutes of Health, Bethesda, Maryland, USA. • 19 Alkek Center for Metagenomics and Microbiome Research, Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas, USA. • 20 The Diabetes and Celiac Disease Unit, Department of Clinical Sciences, Lund University, Lund, Sweden.

# Contributed equally.

• PMID: 31744911 • PMCID: PMC7234892 • DOI: 10.1136/gutjnl-2019-319809

Free PMC article Abstract

Objective: Higher gluten intake, frequent gastrointestinal infections and adenovirus, enterovirus, rotavirus and reovirus have been proposed as environmental triggers for coeliac disease. However, it is not known whether an interaction exists between the ingested gluten amount and viral exposures in the development of coeliac disease. This study investigated whether distinct viral exposures alone or together with gluten increase the risk of coeliac disease autoimmunity (CDA) in genetically predisposed children.

Design: The Environmental Determinants of Diabetes in the Young study prospectively followed children carrying the HLA risk haplotypes DQ2 and/or DQ8 and constructed a nested case-control design. From this design, 83 CDA case-control pairs were identified. Median age of CDA was 31 months. Stool samples collected monthly up to the age of 2 years were analysed for virome composition by Illumina next-generation sequencing followed by comprehensive computational virus profiling.

Results: The cumulative number of stool enteroviral exposures between 1 and 2 years of age was associated with an increased risk for CDA. In addition, there was a significant interaction between cumulative stool enteroviral exposures and gluten consumption. The risk conferred by stool enteroviruses was increased in cases reporting higher gluten intake.

Conclusions: Frequent exposure to enterovirus between 1 and 2 years of age was associated with increased risk of CDA. The increased risk conferred by the interaction between enteroviruses and higher gluten intake indicate a cumulative effect of these factors in the development of CDA.

Keywords: coeliac disease; gluten; small bowel.

Conflict of interest statement Competing interests: HH is a shareholder and chairman of the board of Vactech Ltd, which develops vaccines against picornaviruses.

• Cited by 1 article • 39 references • 3 figures

Grant support

• U01 DK063821/DK/NIDDK NIH HHS/United States • UC4 DK063863/DK/NIDDK NIH HHS/United States • U01 DK063861/DK/NIDDK NIH HHS/United States • U01 DK063790/DK/NIDDK NIH HHS/United States • UL1 TR001082/TR/NCATS NIH HHS/United States • UL1 TR000064/TR/NCATS NIH HHS/United States • HHSN267200700014C/LM/NLM NIH HHS/United States • U01 DK063836/DK/NIDDK NIH HHS/United States • U01 DK063829/DK/NIDDK NIH HHS/United States • U01 DK063865/DK/NIDDK NIH HHS/United States • UC4 DK095300/DK/NIDDK NIH HHS/United States • UC4 DK063861/DK/NIDDK NIH HHS/United States • UC4 DK063829/DK/NIDDK NIH HHS/United States • UC4 DK063821/DK/NIDDK NIH HHS/United States • UC4 DK117483/DK/NIDDK NIH HHS/United States • UC4 DK063836/DK/NIDDK NIH HHS/United States • UC4 DK112243/DK/NIDDK NIH HHS/United States • UC4 DK063865/DK/NIDDK NIH HHS/United States • U01 DK063863/DK/NIDDK NIH HHS/United States • UC4 DK106955/DK/NIDDK NIH HHS/United States • UC4 DK100238/DK/NIDDK NIH HHS/United States

Full-text links

195. Effect of a Gluten-free Diet on Quality of Life in Patients With Nonclassical Versus Classical Presentations of Celiac Disease

J Clin Gastroenterol. 2020 Aug;54(7):620-625. doi: 10.1097/MCG.0000000000001277. Authors

Rok Seon Choung 1 , Abhinav Lamba, Eric V Marietta, Jacalyn A See, Joseph J Larson, Katherine S King, Carol T Van Dyke, Alberto Rubio-Tapia, Joseph A Murray

Affiliation

• 1 Divisions of *Gastroenterology and Hepatology †Endocrinology, Diabetes, Metabolism, and Nutrition ‡Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN.

• PMID: 31688364 • DOI: 10.1097/MCG.0000000000001277

Abstract

Background: Celiac disease (CD) often presents with symptoms of diarrhea and malabsorption, termed classical CD. However, it can also present as nonclassical CD, which is commonly associated with nongastrointestinal symptoms. Studies suggest that nonclassical CD tends to have less severe symptoms than classical CD, which may affect both adherence to a gluten-free diet (GFD) and psychological stress. Therefore, we compared adherence to a GFD and psychological measures, including quality of life (QOL) and somatization, between patients with nonclassical and classical presentations of CD.

Methods: Patients at a tertiary care center with biopsy-proven CD, who completed a Talley Bowel Disease Questionnaire and the Short Form-36 at diagnosis and who had been on a GFD for at least 1 year, were included in this study. Patients were further surveyed to assess gastrointestinal symptoms, QOL, Somatization Symptom Checklist (SSC), and adherence to a GFD. Results were compared between patients with classical versus nonclassical CD presentation.

Results: Among 122 patients included in this study, 62 had classical CD and 60 had nonclassical CD. At diagnosis, health-related QOL was lower in the classical CD group than in the nonclassical CD group. After following a GFD, both groups had improved QOL after following a GFD, and body mass index significantly increased in both groups. Most subscales of QOL, SSC scores, and adherence to the GFD were similar between the groups, except the Short Form-36 Mental Component summary scores that were still lower in the classical CD (48.4 vs. 52.6 nonclassical CD group; P=0.03).

Conclusions: Despite QOL at diagnosis being higher in those with nonclassical CD versus lower in those with classical CD, both groups had improved QOL and achieved a similar QOL after following a GFD.

• Cited by 1 article

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196. Zonulin in serum as a biomarker fails to identify the IBS, functional dyspepsia and non-coeliac wheat sensitivity

Gut. 2020 Sep;69(9):1-3. doi: 10.1136/gutjnl-2019-318664. Epub 2019 Sep 28.

Authors

Nicholas J Talley 1 , Gerald J Holtmann 2 3 , Michael Jones 4 , Natasha A Koloski 5 3 , Marjorie M Walker 6 , Grace Burns 5 7 , Michael D E Potter 5 , Ayesha Shah 3 8 , Simon Keely 7 9

Affiliations

• 1 Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia [email protected]. • 2 School of Medicine, The University of Queensland, Brisbane, Queensland, Australia. • 3 Department of Gastroenterology & Hepatology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia. • 4 Department of Psychology, Macquarie University, Ryde, New South Wales, Australia. • 5 Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia. • 6 Anatomical Pathology, University of Newcastle, Newcastle, New South Wales, Australia. • 7 School of Biomedical Science and Pharmacy, University of Newcastle, Newcastle, New South Wales, Australia. • 8 Faculty of Medicine and Biomedical Sciences, The University of Queensland, Brisbane, Queensland, Australia. • 9 Gastrointestinal Research Group, Hunter Medical Research Institute, Newcastle, New South Wales, Australia.

• PMID: 31563879 • DOI: 10.1136/gutjnl-2019-318664

No abstract available

Conflict of interest statement

Competing interests: NJT: Dr Talley reports personal fees from Allergans PLC (GI Development Programs), personal fees from Viscera Labs (IBS), personal fees from IM Health Sciences (FD), personal fees from Napo Pharmaceutical (IBS), personal fees from Outpost Medicine (IBS), from Progenity Inc San Diego (capsule SIBO), from Allakos (gastric eosinophilic disease), personal fees from Samsung Bioepis (IBD), personal fees from Synergy (IBS), personal fees from Takeda (gastroparesis), personal fees from Theravance (gastroparesis), grants and personal fees from Viscera USA (IBS), grants from Commonwealth Diagnostics (International) Inc (IBS), non-financial support from HVN National Science Challenge NZ (IBS), grants and personal fees from GI therapies (constipation), personal fees from Cadila Pharmaceuticals (CME), personal fees from Planet Innovation (Gas capsule), personal fees from Danone (Probiotic), personal fees from Pfizer (IBS), from Dr. Reddy's Laboratories (Webinar), personal fees from Arlyx (IBS), personal fees from Sanofi (Probiotic), outside the submitted work; In addition, Dr Talley has a patent Biomarkers of IBS licensed, a patent Licensing Questionnaires Talley Bowel Disease Questionnaires licensed to Mayo/Talley, a patent Nestec European Patent licensed, a patent Singapore Provisional Patent “Microbiota Modulation Of BDNF Tissue Repair Pathway” issued, and a patent Nepean Dyspepsia Index licensed to Talley copyright and Committees: Australian Medical Council (AMC) [Council Member]; Australian Telehealth Integration Programme; MBS Review Taskforce; NHMRC Principal Committee (Research Committee) Asia Pacific Association of Medical Journal Editors. Boards: GESA Board Member, Sax Institute, Committees of the Presidents of Medical Colleges. Community group: Advisory Board, IFFGD (International Foundation for Functional GI Disorders). Miscellaneous: Avant Foundation (judging of research grants). Editorial: Medical Journal of Australia (Editor in Chief), Up to Date (Section Editor), Precision and Future Medicine, Sungkyunkwan University School of Medicine, South Korea. GJH: Unrestricted educational support from Bayer and the Falk Foundation. Research support was provided via the Princess Alexandra Hospital, Brisbane, by GI Therapies, Takeda Development Center Asia, Eli Lilly Australia, F Hoffmann-La Roche, MedImmune, Celgene, Celgene International II Sarl, Gilead Sciences, Quintiles, Vital Food Processors, Datapharm Australia, Commonwealth Laboratories, Prometheus Laboratories, FALK GmbH & Co KG, Nestle and Mylan. Patent holder: A biopsy device to take aseptic biopsies (US 20150320407 A1). MJ: Consultancies with GI Therapies (abdominal stimulation in constipation) and SFI (prokinetics). NAK: None to disclose. MMW: Grant/research support: Prometheus Laboratories (IBS Diagnostic) and Commonwealth Diagnostics International (biomarkers for FGIDs). GB: None to disclose. MDEP: None to disclose. AS: None to disclose. SK: Grant/research support: Cancer Institute NSW (Career Development Fellowship), National Health and Medical Research Council (Project Grant APP1128487), Commonwealth Diagnostics International (biomarkersfor FGIDs) and Syntrix Biosystems (contract research—drug delivery).

• Cited by 1 article

Publication types

• Letter

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197. Nonceliac Gluten and Wheat Sensitivity

Clin Gastroenterol Hepatol. 2020 Aug;18(9):1913-1922.e1. doi: 10.1016/j.cgh.2019.04.009. Epub 2019 Apr 10.

Authors Anam Khan 1 , Milena Gould Suarez 2 , Joseph A Murray 3

Affiliations

• 1 Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, Texas. Electronic address: [email protected]. • 2 Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, Texas. • 3 Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.

• PMID: 30978535 • DOI: 10.1016/j.cgh.2019.04.009

Abstract

Non-celiac gluten and/or wheat sensitivity (NCGS) is thought to be an immune-mediated reaction to gluten or other components of wheat (eg, fructans or amylase trypsin inhibitors) with intestinal and extraintestinal symptoms which improve once gluten and/or wheat is eliminated from the diet and after a diagnosis of celiac disease and wheat allergy have been excluded with appropriate testing. However, there is a great deal of skepticism within the scientific community questioning the existence of NCGS as a distinct clinical disorder. There are no strict diagnostic criteria and a placebo- controlled rechallenge trial has been recommended for diagnosis. In research settings, a double-blind placebo-controlled rechallenge trial has been recommended for diagnosis. There are limited studies estimating the prevalence of NCGS using this study design. The existing studies have variable results likely due to the lack of a uniform diagnostic criterion, a great deal of dependence on the patient's perception of symptoms and a large nocebo effect in existing studies. In clinical practice, a single blind placebo-controlled rechallenge trial has been recommended for diagnosis. The pathogenesis of NCGS is unclear and there is no known biomarker or diagnostic histologic lesion for this condition. It is important to adopt a multidisciplinary team approach to patients with suspected NCGS with involvement of the primary care doctor, gastroenterologist, pathologist and nutritionist who may play an important role in diagnosis and treatment. There may especially be a role in elimination of food containing high quantity of both gluten and fructans. Furthermore, patients should be educated on the nutritional implications of consuming a long-term gluten-free diet.

Keywords: Gluten; diet; gluten-related disorders; non-celiac gluten sensitivity; nutrition.

• Cited by 2 articles

Publication types

• Review

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198. Association of ADHD and Celiac Disease: What Is the Evidence? A Systematic Review of the Literature

J Atten Disord. 2020 Aug;24(10):1371-1376. doi: 10.1177/1087054715611493. Epub 2016 Jan 29.

Authors

Emine Ertürk 1 , Sara Wouters 1 , Lindita Imeraj 1 , Annik Lampo 1

Affiliation

• 1 Universitair Ziekenhuis Brussel, Belgium.

• PMID: 26825336 • DOI: 10.1177/1087054715611493

Abstract

Objective: This article tries to answer the question whether or not there is evidence for a relationship between celiac disease (CD) and ADHD. A review of the current literature on this topic is provided. Method: PUBMED/MEDLINE, Web of Science, and Google scholar were searched to include all published trials on ADHD and CD (no date limitation, both noncontrolled and controlled trials). In addition, the reference list of included studies was screened to find other relevant articles. Results: Eight studies report a possible association between CD and ADHD; however, the results are inconsistent. Only three out of eight studies report a positive correlation between ADHD and CD. Conclusion: Up till now, there is no conclusive evidence for a relationship between ADHD and CD. Therefore, it is not advised to perform routine screening of CD when assessing ADHD (and vice versa) or to implement gluten-free diet as a standard treatment in ADHD.

Keywords: ADD/ADHD; ADHD; ADHD-associated problems; celiac disease.

• Cited by 2 articles

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