Do Alterations in Bone Mineral Density Go Beyond Borders in Adults with Celiac Disease?

June Alert 2019

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

Galli G1, Lahner E2, Annibale B2.

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

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2. Clin Immunol. 2019 Jul 4. pii: S1521-6616(19)30255-4. doi: 10.1016/j.clim.2019.07.001. [Epub ahead of print] Clinical manifestations and gastrointestinal pathology in 40 patients with autoimmune enteropathy.

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

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

Abstract

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

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3. J AOAC Int. 2019 Jul 5. doi: 10.5740/jaoacint.19-0081. [Epub ahead of print] Preparation of Validation Materials for Estimating Gluten Recovery by ELISA According to SMPR 2017.021. Wehling P1, Scherf KA2.

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

Abstract

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

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

Rondanelli M1,2, Faliva MA3, Gasparri C3, Peroni G3, Naso M3, Picciotto G3, Riva A4, Nichetti M3, Infantino V5, Alalwan TA6, Perna S7. Author information: 1. IRCCS Mondino Foundation, 27100 Pavia, Italy. 2. Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy. 3. Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona "Istituto Santa Margherita", University of Pavia, 27100 Pavia, Italy. 4. Research and Development Unit, Indena, 20139 Milan, Italy. 5. University of Bari, Department of Biomedical Science and Human Oncology, 70121 Bari, Italy. 6. Department of Biology, College of Science, University of Bahrain, Sakhir Campus P. O. Box 32038, Bahrain. 7. Department of Biology, College of Science, University of Bahrain, Sakhir Campus P. O. Box 32038, Bahrain. [email protected].

Abstract

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

Free Article

PMID: 31277328

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Conflict of interest statement

The authors declare no conflict of interest. Publication type

• Review 5. Foods. 2019 Jul 3;8(7). pii: E240. doi: 10.3390/foods8070240. Gluten-Free Bread with Cricket Powder- Mechanical Properties and Molecular Water Dynamics in Dough and Ready Product.

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

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

Abstract

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

Free Article

PMID: 31277294

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6. JGH Open. 2019 Jan 8;3(3):242-248. doi: 10.1002/jgh3.12134. eCollection 2019 Jun. Fatigue in celiac disease: A review of the literature.

Skjellerudsveen BM1, Omdal R1,2, Grimstad T1,2.

Author information: 1. Department of Internal Medicine Stavanger University Hospital Stavanger Norway. 2. Department of Clinical Science University of Bergen Bergen Norway.

Abstract

Fatigue is increasingly recognized as a significant problem in patients with chronic inflammatory and autoimmune diseases. In celiac disease, a chronic immune-mediated disease triggered by dietary gluten, conflicting opinions exist regarding both the size of the problem and the effect of a gluten- free diet (GFD) on fatigue. We reviewed the existing literature regarding fatigue in celiac disease. We conducted a systematic search in the Embase, Ovid Medline, and Cochrane databases using subject terms from controlled vocabularies. Articles were reviewed based on language, type of article, title, and abstract or full text. Eighteen articles were finally selected for review. Fatigue was significantly greater in patients with celiac disease compared to healthy control subjects. Fatigue prevalence ranged from 8 to 100%. Fatigue severity was assessed in six studies. The fatigue visual analogue scale was the most frequently used fatigue instrument with scores from 57 to 79 prior to starting a GFD and from 39 to 59 in patients on a GFD. Seven studies investigated the effect of a GFD on fatigue, including five studies that reported less fatigue while on the diet and two studies that showed no significant difference. This review concludes that fatigue is a substantial complaint in patients with celiac disease. A GFD seems to reduce fatigue, but existing data are limited.

PMCID: PMC6586565 Free PMC Article

PMID: 31276043

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Publication type

• Review

7. JGH Open. 2019 Mar 20;3(3):206-209. doi: 10.1002/jgh3.12138. eCollection 2019 Jun. Esophageal manometry, esophagogastroduodenoscopy, and duodenal mucosal histopathology in systemic sclerosis.

Adarsh MB1, Sharma SK1, Prasad KK2, Dhir V1, Singh S1, Sinha SK2.

Author information: 1. Department of Internal Medicine Postgraduate Institute of Medical Education and Research Chandigarh India. 2. Department of Gastroenterology Postgraduate Institute of Medical Education and Research Chandigarh India.

Abstract

Background and Aim:

Systemic sclerosis (SSc) is known to involve the gastrointestinal (GI) tract, resulting in dysmotility, gastroesophageal reflux disease, and mucosal changes causing significant morbidity. The study aimed to assess esophageal motility and duodenal mucosal changes in SSc.

Methods:

This is a prospective, cross-sectional, single-center study of 23 patients with SSc diagnosed on the basis of standard criteria. Clinical details including the GI symptoms were recorded. All of them underwent esophagogastroduodenoscopy with duodenal biopsy, and 21 underwent esophageal manometry.

Results:

Regurgitation, heartburn, and dysphagia were seen in 19 (82%), 16 (69%), and 10 (43%) patients, respectively. On endoscopy, 19 patients (83%) showed changes of reflux esophagitis (4 had grade C esophagitis), and 3 had esophageal candidiasis. Of the 21 patients who underwent esophageal manometry, 13 (62%) had absent peristalsis, 6 (28%) had ineffective peristalsis, and 10 (48%) had hypotensive lower esophageal sphincter (LES). Duodenal biopsy showed partial villous atrophy in 9 (39%) patients, increased intraepithelial lymphocytes in 18 (78%), and excess of mononuclear inflammatory cells in lamina propria in 21 (91%). Partial villous atrophy was seen more commonly in those with abnormal esophageal peristalsis and a hypotensive LES.

Conclusion: Most of the patients with SSc had esophageal dysmotility in the form of absent peristalsis, ineffective esophageal peristalsis, and hypotensive LES. Histology of descending duodenum demonstrated partial villous atrophy and chronic inflammatory infiltrates in most of the patients with SSc.

PMCID: PMC6586572 Free PMC Article

PMID: 31276037

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

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

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

Abstract

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

PMCID: PMC6582094 [Available on 2020-07-01]

PMID: 31274906

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Conflict of interest statement

Conflict of interestWe declare that there is no conflict of interest regarding the publication of this paper. 9. Clin Nucl Med. 2019 Jul 2. doi: 10.1097/RLU.0000000000002688. [Epub ahead of print] Celiac Disease on FDG PET/CT.

Cardin AJ1, Patel M, Ma D.

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

Abstract

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

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10. Am J Gastroenterol. 2019 Jul 4. doi: 10.14309/ajg.0000000000000310. [Epub ahead of print] A Clinician's Guide to Celiac Disease HLA Genetics. Brown NK1, Guandalini S2, Semrad C2, Kupfer SS2.

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

Abstract

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

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

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

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

Abstract

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

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

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

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

Abstract

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

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

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

Odineal DD1, Gershwin ME2.

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

Abstract

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

PMID: 31267472

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Publication type

• Review

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

Ravanbakhsh N1, Kesavan A2.

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

Abstract

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

PMCID: PMC6595934 Free PMC Article

PMID: 31263355

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Conflict of interest statement

Conflict of Interest: None Publication type

• Review

15. Gastroenterol Hepatol. 2019 Jun 28. pii: S0210-5705(19)30126-8. doi: 10.1016/j.gastrohep.2019.04.001. [Epub ahead of print] Metabolism of wheat proteins by intestinal microbes: Implications for wheat related disorders.

[Article in English, Spanish]

Caminero A1, Verdu EF2.

Author information: 1. Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada. Electronic address: [email protected]. 2. Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada.

Abstract

Wheat is a common cereal in the Western diet and an important source of protein as well as fiber. However, some individuals develop adverse reactions to a wheat-containing diet. The best characterized is celiac disease which develops after intake of gluten in individuals with genetic predisposition. Other wheat-related conditions are less well defined in terms of diagnosis, specific trigger and underlying pathways. Despite this, the overall prevalence of wheat-related disorders has increased in the last decades and the role of microbial factors has been suggested. Several studies have described an altered intestinal microbiota in celiac patients compared to healthy subjects, but less information is available regarding other wheat-related disorders. Here, we discuss the importance of the intestinal microbiota in the metabolism of wheat proteins and the development of inflammatory or functional conditions. Understanding these interactions will open new directions for therapeutic development using bacteria with optimal wheat protein degrading capacity.

PMID: 31262542

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Publication type

• Review

16. Food Chem. 2019 Jun 24;298:125068. doi: 10.1016/j.foodchem.2019.125068. [Epub ahead of print] Transformation of polyphenols found in pigmented gluten-free flours during in vitro large intestinal fermentation.

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

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

Abstract

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

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

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

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

Abstract

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

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18. Gastroenterology. 2019 Jun 28. pii: S0016-5085(19)41010-X. doi: 10.1053/j.gastro.2019.06.012. [Epub ahead of print] WHEN IS CELIAC DISEASE CELIAC DISEASE?

Green PH1, Guandalini S2.

Author information: 1. Celiac Disease Center, Columbia University Medical Center, 180 Fort Washington Ave, New York, NY 10032. 2. Celiac Disease Center, and Section of Pediatric Gastroenterology, Hepatology and Nutrition, University of Chicago, 5841 S. Maryland Ave., MC 4065, Chicago, IL 60637. PMID: 31260660

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Publication type

• Editorial

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

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

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

Abstract

BACKGROUND:

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

OBJECTIVE AND RATIONALE:

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

SEARCH METHODS:

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

OUTCOMES:

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

WIDER IMPLICATIONS:

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

PMCID: PMC6601386 Free PMC Article

PMID: 31260048

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20. Interact J Med Res. 2019 Jun 28;8(2):e10812. doi: 10.2196/10812. Perceptions of Food Hypersensitivity Expertise on Social Media: Qualitative Study.

Hamshaw RJT1, Barnett J1, Gavin J1, Lucas JS2.

Author information: 1. Department of Psychology, University of Bath, Bath, United Kingdom. 2. Clinical & Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.

Abstract

BACKGROUND:

Seeking and sharing information are the primary uses of the internet and social media. It is therefore vital to understand the processes individuals go through when engaging with information on these diverse platforms, especially in areas such as health- and risk-related information. One important element of such engagement is evaluating and attributing expertise to others.

OBJECTIVE:

This study aimed to explore how meanings around expertise in relation to food allergy and intolerance (food hypersensitivity) were constructed by 2 groups of social media users: (1) those who use platforms for reasons relating to food hypersensitivity and (2) those seen as experts by this community.

METHODS:

Survey participants were asked open-ended questions to identify potential experts in food hypersensitivity issues on social media and to discuss their reasoning for their choices (n=143). Subsequently, 8 adult social media users with experience of managing food hypersensitivity and 5 participants designated as experts by those users took part in email interviews. Survey and interview data were analyzed thematically using Braun and Clarke's approach.

RESULTS:

Judging expertise on social media is a complex and multifaceted process. Users might be judged as experts through their professional background or their experience living with food hypersensitivities. How users behave on social media and the traces of their Web-based activity can influence how others will see them. Such considerations are both measured and moderated through the social media community itself. Findings highlighted how social media often act as a supportive information tool following a diagnosis, but this also raised concerns regarding the scenario of patients not being able to access suitable vetted information.

CONCLUSIONS:

This work has implications for understanding how users perceive expertise on social media in relation to a health concern and how information assessments are made during the management of risks. Findings provide practical insights to both medical and organizational stakeholders involved in the support of those living with life-changing conditions, such as food hypersensitivities. ©Richard James Thomas Hamshaw, Julie Barnett, Jeff Gavin, Jane S Lucas. Originally published in the Interactive Journal of Medical Research (http://www.i-jmr.org/), 28.06.2019.

Free Article

PMID: 31254334

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21. Indian J Gastroenterol. 2019 Jun 28. doi: 10.1007/s12664-019-00958-3. [Epub ahead of print] Celiac disease: What the Indian pediatricians know about the disease.

Malik I1, Kumar K2, Hussain H3, Bhatia V3, Sibal A3, Malhotra S3.

Author information: 1. Department of Pediatrics, Government Medical College, Jammu and Kashmir, Bemina, Srinagar 190 010, India. 2. Pediatric Gastroenterology, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi 110 076, India. [email protected]. 3. Pediatric Gastroenterology, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi 110 076, India.

Abstract

To ascertain the knowledge, awareness, and practices pertaining to celiac disease (CD) among the Indian pediatricians. A survey link containing a questionnaire was shared through electronic mail using a pediatric database. The survey was kept active for 6 months; all responses received at the end of the survey were analyzed. Two hundred and seventy one pediatricians out of more than 10,000 chose to respond to the survey. Most pediatricians agreed that more patients with CD are being diagnosed than earlier. The reasons for higher detection of CD were perceived to be higher index of clinical suspicion by pediatricians (86.7%) followed by increased awareness among parents (45.8%). Most pediatricians opined that clinical manifestations which prompted to a diagnosis of CD were failure to thrive (96.2%) and chronic diarrhea (81.4%). Knowledge about atypical manifestations of celiac disease was low. Though knowledge about the common association of CD with type 1 diabetes (62.1%) and autoimmune hepatitis (55.8%) was there, awareness about its association with other uncommon conditions was lacking. Though 68% of the pediatricians were of the opinion that the confirmation of diagnosis by a mucosal biopsy is necessary, 26.5% of respondents believed that only a positive serology was sufficient for a diagnosis. A trial of gluten- free diet (GFD) was thought to be a logical step if serology was positive by 31.3% of respondents. While 87.7% of pediatricians advocated lifelong adherence to GFD, 12.3% felt that GFD could be discontinued in the future. This web-based survey revealed that though pediatricians are seeing increasing number of celiac disease patients, there is a need to increase awareness regarding the disease, its associated conditions, the need for mucosal biopsy to confirm the diagnosis and the necessity of lifelong adherence to GFD. PMID: 31254168

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22. Dig Liver Dis. 2019 Jun 26. pii: S1590-8658(19)30638-3. doi: 10.1016/j.dld.2019.06.001. [Epub ahead of print] Corrigendum to "Celiac disease or positive tissue transglutaminase antibodies in patients undergoing renal biopsies" [Dig Liver Dis (2018);50:27-31].

Nurmi R1, Metso M2, Pörsti I3, Niemelä O4, Huhtala H5, Mustonen J3, Kaukinen K6, Mäkelä S3.

Author information: 1. Celiac Disease Research Center, Faculty of Medicine and Life Sciences, University of Tampere, Finland. Electronic address: [email protected]. 2. Tampere University Hospital, Department of Internal Medicine, Tampere, Finland. 3. Tampere University Hospital, Department of Internal Medicine, Tampere, Finland; Faculty of Medicine and Life Sciences, University of Tampere, Finland. 4. Medical Research Unit, Seinäjoki Central Hospital, Finland; University of Tampere, Finland. 5. Faculty of Social Sciences, University of Tampere, Finland. 6. Celiac Disease Research Center, Faculty of Medicine and Life Sciences, University of Tampere, Finland; Tampere University Hospital, Department of Internal Medicine, Tampere, Finland.

Erratum for

• Celiac disease or positive tissue transglutaminase antibodies in patients undergoing renal biopsies. [Dig Liver Dis. 2018]

PMID: 31253487

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Publication type

• Published Erratum

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

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

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

Abstract

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

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

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

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

Abstract

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

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

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

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

Abstract

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

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26. Exp Clin Transplant. 2019 Jun 25. doi: 10.6002/ect.2019.0023. [Epub ahead of print] Maximizing Deceased-Donor Allograft Utilization: Management of a Celiac Artery Aneurysm in a Deceased-Donor Liver.

Slivca O1, Olowofela AS, Serrano OK, Pruett TL.

Author information: 1. From the Division of Transplantation, Department of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA.

Abstract

As the scarcity of transplantable organs continues to rise, compounded with an aging donor population, transplant surgeons are increasingly confronted with organ offers from less than ideal donors. The presence of a celiomesenteric aneurysm involving the vascular supply of a donor allograft may predispose to vascular complications in the transplanted liver. We present a 61-year- old brain-dead donor who was discovered to have a celiac artery aneurysm during organ recovery. After gross atherosclerotic or mycotic involvement was ruled out and after careful consideration of the vascular reconstructive options, the donor common hepatic artery was divided distal to the aneurysmal dilatation and anastomosed to the recipient bifurcation of the left and right hepatic artery in an end-to-end beveled anastomosis. The postoperative course was unre-markable, with normal blood flow through the anastomosis and no significant com-plications. The recipient is doing well 6 months after transplant. The presence of a celiomesenteric aneurysm should not discourage the use of an otherwise adequate liver graft. Careful vascular reconstruction is encouraged to increase the rate of marginal graft utilization and minimize vascular complications. Liberal postoperative imaging can enable early detection of vascular com-plication and prompt intervention. Through this case, we demons-trate the remarkable potential of less-than-ideal grafts with acceptable posttransplant outcomes.

Free Article

PMID: 31250741

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Publication type

• Case Reports

27. Mayo Clin Proc. 2019 Jun 12. pii: S0025-6196(19)30121-1. doi: 10.1016/j.mayocp.2018.11.036. [Epub ahead of print] Micronutrient Deficiencies Are Common in Contemporary Celiac Disease Despite Lack of Overt Malabsorption Symptoms.

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

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

Abstract

OBJECTIVE:

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

PATIENTS AND METHODS:

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

RESULTS:

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

CONCLUSION:

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

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28. PLoS One. 2019 Jun 27;14(6):e0218346. doi: 10.1371/journal.pone.0218346. eCollection 2019. A new microbial gluten-degrading prolyl endopeptidase: Potential application in celiac disease to reduce gluten immunogenic peptides.

Moreno Amador ML1, Arévalo-Rodríguez M2, Durán EM1, Martínez Reyes JC2, Sousa Martín C1.

Author information: 1. Departamento de Microbiología y Parasitología, Facultad de Farmacia, Universidad de Sevilla, Sevilla, Spain. 2. Biomedal S.L., Sevilla, Spain. Abstract

Gluten is a complex of proteins present in barley, wheat, rye and several varieties of oats that triggers celiac disease in genetically predisposed subjects. Gluten is notoriously difficult to digest by mammalian proteolytic enzymes and therefore, proline-rich digestion-resistant peptides contain multiple immunogenic epitopes. Prolyl endopeptidases (PEP) hydrolyse internal proline residues on the carboxyl side of peptides and have been proposed for food gluten detoxification and as oral enzyme supplementation for celiacs. The aim of this study was to identify new gluten-degrading microbial enzymes with the potential to reduce gluten immunogenicity by neutralizing its antigenic epitopes. Using a gluten-degrading colony screening approach, a bacterial isolate (2RA3) displaying the highest glutenase activity was selected, characterized and its genome completely sequenced. The identification through 16S rDNA gene sequencing showed a 99,1% similarity to Chryseobacterium taeanense. Hydrolysis of gluten immunogenic peptides (GIP) was further monitored, over a 48-hour period, by colony encapsulation in gliadin-containing microspheres, followed by detection with the G12 anti-GIP monoclonal antibody. Glutenase activity was detected in the extracellular medium of 2RA3 cultures, where gel electrophoresis and gliadin zymography revealed the presence of a ~50 kDa gluten-degrading enzyme. Nano-ESI-Q-TOF of the excised active band identified 7 peptides contained in the protein product predicted for an open reading frame (ORF) in the 2RA3 genome. Based on sequence similarity to the PEP family, the new enzyme was named PEP 2RA3. The PEP 2RA3 coding sequence was PCR-amplified from C. taeanense 2RA3, cloned and expressed in Escherichia coli as a C-terminally His-tagged recombinant protein and purified by Ni-NTA affinity chromatography. The recombinant protein, with predicted molecular mass and isoelectric point of 78.95 kDa and 6.8, respectively, shows PEP activity with standard chromogenic substrates, works optimally at pH 8.0 and 30°C and remains stable at pH 6.0 and 50°C, indicating a potential use in gluten-containing food process applications. The ability of the recombinant enzyme to degrade GIP in beer into smaller peptides was confirmed.

PMCID: PMC6597064 Free PMC Article

PMID: 31246975

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Conflict of interest statement

The commercial affiliation Biomedal S.L. does not alter our adherence to all PLOS ONE policies. 29. Front Immunol. 2019 Jun 11;10:1290. doi: 10.3389/fimmu.2019.01290. eCollection 2019. Dermatitis Herpetiformis: Novel Perspectives. Antiga E1, Maglie R1, Quintarelli L1, Verdelli A1, Bonciani D1, Bonciolini V1, Caproni M1.

Author information: 1. Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy.

Abstract

Dermatitis herpetiformis (DH) is an inflammatory disease of the skin, considered the specific cutaneous manifestation of celiac disease (CD). Both DH and CD occur in gluten-sensitive individuals, share the same Human Leukocyte Antigen (HLA) haplotypes (DQ2 and DQ8), and improve following the administration of a gluten-free diet. Moreover, almost all DH patients show typical CD alterations at the small bowel biopsy, ranging from villous atrophy to augmented presence of intraepithelial lymphocytes, as well as the generation of circulating autoantibodies against tissue transglutaminase (tTG). Clinically, DH presents with polymorphic lesions, including papules, vesicles, and small blisters, symmetrically distributed in typical anatomical sites including the extensor aspects of the limbs, the elbows, the sacral regions, and the buttocks. Intense pruritus is almost the rule. However, many atypical presentations of DH have also been reported. Moreover, recent evidence suggested that DH is changing. Firstly, some studies reported a reduced incidence of DH, probably due to early recognition of CD, so that there is not enough time for DH to develop. Moreover, data from Japanese literature highlighted the absence of intestinal involvement as well as of the typical serological markers of CD (i.e., anti-tTG antibodies) in Japanese patients with DH. Similar cases may also occur in Caucasian patients, complicating DH diagnosis. The latter relies on the combination of clinical, histopathologic, and immunopathologic findings. Detecting granular IgA deposits at the dermal-epidermal junction by direct immunofluorescence (DIF) from perilesional skin represents the most specific diagnostic tool. Further, assessing serum titers of autoantibodies against epidermal transglutaminase (eTG), the supposed autoantigen of DH, may also serve as a clue for the diagnosis. However, a study from our group has recently demonstrated that granular IgA deposits may also occur in celiac patients with non-DH inflammatory skin diseases, raising questions about the effective role of eTG IgA autoantibodies in DH and suggesting the need of revising diagnostic criteria, conceivably emphasizing clinical aspects of the disease along with DIF. DH usually responds to the gluten-free diet. Topical clobetasol ointment or dapsone may be also applied to favor rapid disease control. Our review will focus on novel pathogenic insights, controversies, and management aspects of DH.

PMCID: PMC6579917 Free PMC Article

PMID: 31244841

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Publication type

• Review 30. Cell Mol Immunol. 2019 Jun 26. doi: 10.1038/s41423-019-0256-7. [Epub ahead of print] Dysregulation of the PD-1/PD-L1 pathway contributes to the pathogenesis of celiac disease.

Ponce de León C1, Angel López-Casado M2, Lorite P1, Palomeque T1, Isabel Torres M3.

Author information: 1. Department of Experimental Biology, University of Jaén, Jaén, Spain. 2. Department of Pediatrics Gastroenterology, Hospital Virgen de las Nieves, Granada, Spain. 3. Department of Experimental Biology, University of Jaén, Jaén, Spain. [email protected]. PMID: 31243357

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31. Climacteric. 2019 Jun 26:1-6. doi: 10.1080/13697137.2019.1627315. [Epub ahead of print] Medical and gynecological comorbidities in adult women with Turner syndrome: our multidisciplinary clinic experience.

Farquhar M1, Jacobson M2,3, Braun C1, Wolfman W3,4, Kelly C5,6, Allen LM2,3,4,7, Lega IC1,6.

Author information: 1. a Women's College Research Institute , Toronto , ON , Canada. 2. b Department of Obstetrics and Gynecology , Women's College Hospital , Toronto , ON , Canada. 3. c Department of Obstetrics and Gynecology , University of Toronto , Toronto , ON , Canada. 4. d Department of Obstetrics and Gynecology , Mount Sinai Hospital , Toronto , ON , Canada. 5. e Department of Medicine , University of Toronto , Toronto , ON , Canada. 6. g Division of Endocrinology , Women's College Hospital , Toronto , ON. 7. f Department of Gynecology , The Hospital for Sick Children , Toronto , ON , Canada.

Abstract

Objective: Women with Turner syndrome (TS) are at increased risk for chronic health conditions. Reports describing the presence of comorbidities in older adult women with TS are limited. This study aimed to examine the prevalence of endocrine, gynecological, and other chronic medical conditions in a cohort of adult TS patients. Methods: A retrospective chart review was conducted on patients seen between 1 February 2015 and 1 July 2018 in a multidisciplinary TS clinic at a university-based ambulatory hospital in Toronto, Canada. All women seen at the TS clinic with a diagnosis of TS aged >18 years were included. The prevalence of diseases was determined overall and stratified by age (<40 and ≥40 years). Statistical comparisons were done using the chi-square test. The main study outcomes included the presence of comorbidities. Results: Of 122 adult women with TS, 24.5% had hypothyroidism, 16% had dysglycemia, and 27.9% had decreased bone mass. Hypothyroidism and dysglycemia were more common among older women (respectively age ≥40 years vs. age <40 years: 36.7% vs. 17.8%, p = 0.018; and 24.5% vs. 5.5%, p = 0.023). Gynecological conditions were identified in 35% of patients and were more common among older women (42.8% age ≥40 years vs. 13.7% age <40 years, p = 0.003). Overall, 41% had hearing impairment, 36.1% had cardiac abnormalities, 14.8% had hypertension, 18.8% had renal abnormalities, and 9% had celiac disease. Conclusions: The results of this study indicate a high prevalence of medical conditions in women with TS, especially those ≥40 years of age. Our study underscores the importance of multidisciplinary adult TS clinics for ongoing screening and management of comorbidities. PMID: 31241369

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32. Eur J Nutr. 2019 Jun 25. doi: 10.1007/s00394-019-02032-2. [Epub ahead of print] Association between grains, gluten and the risk of colorectal cancer in the Cancer Prevention Study-II Nutrition Cohort.

Um CY1, Campbell PT2, Carter B2, Wang Y2, Gapstur SM2, McCullough ML2.

Author information: 1. Behavioral and Epidemiology Research Group, American Cancer Society, 250 Williams St, Atlanta, GA, 30303, USA. [email protected]. 2. Behavioral and Epidemiology Research Group, American Cancer Society, 250 Williams St, Atlanta, GA, 30303, USA.

Abstract

PURPOSE:

Evidence supports a role of whole grains in colorectal cancer (CRC) prevention, but the association between gluten intake and CRC risk in healthy populations is unclear. We examined the association of grain and gluten intake with risk of CRC overall and by subsite among Cancer Prevention Study-II Nutrition Cohort participants.

METHODS:

In 1999, 50,118 men and 62,031 women completed food frequency questionnaires assessing grain intake. Gluten intake was estimated using the protein content of grain products. Multivariable- adjusted hazards ratio (HR) and 95% confidence interval (CI) of CRC risk were estimated using Cox proportional hazards regression.

RESULTS:

During follow-up through 2013, 1742 verified CRC cases occurred. For the highest vs. lowest quintiles of whole grain intake, HRs (95% CIs) of CRC risk were 0.77 (0.61-0.97; P trend = 0.03) among men and 1.10 (95% CI 0.88-1.36; P trend = 0.14) among women (P interaction by sex = 0.01). Men in the highest vs. lowest quintile of whole grain intake had a 43% lower risk of rectal cancer (HR = 0.57, 95% CI 0.35-0.93, P trend = 0.04). Gluten intake was not associated with CRC risk overall (HR = 1.10, 95% CI 0.93-1.32, P trend = 0.10), but was associated with risk of proximal colon cancer among men and women, combined (HR = 1.37, 95% CI 1.07-1.75, quintile 5 vs. 1, P trend = 0.001) and separately. Refined grains and grain-based sweets were not associated with CRC risk.

CONCLUSIONS:

We found that higher whole grain intake was associated with lower CRC risk among older US men, but not women. The positive association of gluten intake with the risk of proximal colon cancer deserves further study. PMID: 31240448

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33. Sci Rep. 2019 Jun 25;9(1):9217. doi: 10.1038/s41598-019-45679-x. Automatic classification of IgA endomysial antibody test for celiac disease: a new method deploying machine learning.

Caetano Dos Santos FL1, Michalek IM2, Laurila K3, Kaukinen K3,4, Hyttinen J5, Lindfors K3.

Author information: 1. Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. [email protected]. 2. Faculty of Social Sciences, Tampere University, Tampere, Finland. 3. Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. 4. Department of Internal Medicine, Tampere University Hospital, Tampere, Finland. 5. Computational Biophysics and Imaging Group, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.

Abstract

Widespread use of endomysial autoantibody (EmA) test in diagnostics of celiac disease is limited due to its subjectivity and its requirement of an expert evaluator. The study aimed to determine whether machine learning can be applied to create a new observer-independent method of automatic assessment and classification of the EmA test for celiac disease. The study material comprised of 2597 high-quality IgA-class EmA images collected in 2017-2018. According to standard procedure, highly-experienced professional classified samples into the following four classes: I - positive, II - negative, III - IgA deficient, and IV - equivocal. Machine learning was deployed to create a classification model. The sensitivity and specificity of the model were 82.84% and 99.40%, respectively. The accuracy was 96.80%. The classification error was 3.20%. The area under the curve was 99.67%, 99.61%, 100%, and 99.89%, for I, II, III, and IV class, respectively. The mean assessment time per image was 16.11 seconds. This is the first study deploying machine learning for the automatic classification of IgA-class EmA test for celiac disease. The results indicate that using machine learning enables quick and precise EmA test analysis that can be further developed to simplify EmA analysis.

PMCID: PMC6592927 Free PMC Article

PMID: 31239486

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34. Int J Biol Macromol. 2019 Jun 22;136:1018-1025. doi: 10.1016/j.ijbiomac.2019.06.160. [Epub ahead of print] Classification of starch-gluten networks into a viscoelastic liquid or solid, based on rheological aspects - A review.

Brandner S1, Becker T1, Jekle M2.

Author information: 1. Technical University of Munich, Institute of Brewing and Beverage Technology, Research Group Cereal Technology and Process Engineering, 85354 Freising, Germany. 2. Technical University of Munich, Institute of Brewing and Beverage Technology, Research Group Cereal Technology and Process Engineering, 85354 Freising, Germany. Electronic address: [email protected].

Abstract

A material structure determines its processing and product characteristics. Therefore, knowledge on the exact network character is also important in the case of wheat dough to control the process and the product quality. However, the high complexity of wheat dough makes the exact description of the network structure difficult. Several network models, which propose to transfer the observations resulting from rheological or microscopic measurements into structural relationships, exist. This review summarizes the classification features suitable for the characterization of polymer systems, especially food systems, present their typical properties, and verify transferability to wheat dough systems. Thereby, the ambivalent character of dough to behave as solid and liquid becomes evident. As with every polymer network, filler particles have a significant impact on the mechanical properties. Even if the particle content in dough is much higher than the percolation threshold that normally limits the filler usage in reinforced rubbery systems, the general effects of filler particles on the mechanical behavior are also applicable for dough systems.

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Publication type

• Review

35. Dermatol Ther. 2019 Jun 25:e13007. doi: 10.1111/dth.13007. [Epub ahead of print] Sulfasalazine - induced generalized vitiligo in a patient with dermatitis herpetiformis and celiac disease.

Turkowski Y1, Konnikov N1,2.

Author information: 1. Department of Dermatology, VA Boston Healthcare System, MA, USA. 2. Department of Dermatology, Tufts University School of Medicine, Boston, MA, USA. Abstract

Vitiligo is an acquired idiopathic pigmentary skin disorder characterized by the development of white macules and patches due to the loss of functioning melanocytes. In this report we describe a case of a patient with a longstanding history of dermatitis herpetiformis and celiac disease who developed rapidly progressing, biopsy-confirmed generalized vitiligo after 11 months of treatment with anti-inflammatory medication sulfasalazine, prescribed for the patient's dermatitis herpetiformis. This article is protected by copyright. All rights reserved.

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36. World J Gastrointest Oncol. 2019 Jun 15;11(6):499-508. doi: 10.4251/wjgo.v11.i6.499. Relationship between celiac artery variation and number of lymph nodes dissection in gastric cancer surgery.

Mu GC1, Huang Y2, Liu ZM3, Chen ZB1, Wu XH1, Qin XG1, Zeng YJ4.

Author information: 1. Department of Gastrointestinal Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China. 2. Department of Gastrointestinal Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China. [email protected]. 3. Department of General Surgery, the Second Affiliated Hospital of Guangxi Medical University, Nanning 530000, Guangxi Zhuang Autonomous Region, China. 4. Biomechanics and Medical Information Institute, Beijing University of Technology, Beijing 100124, China.

Abstract

BACKGROUND:

Radical D2 lymphadenectomy for advanced gastric cancer as a standard procedure has gained global consensus. Mounting studies have shown that the number of lymph nodes dissection directly affects the prognosis and recurrence of gastric cancer. Our previous study showed that there was no obvious lymph node around the abnormal hepatic artery derived from the superior mesenteric artery.

AIM:

To investigate the relationship between celiac artery variation and the number of lymph nodes dissection in gastric cancer surgery.

METHODS:

The clinicopathological data of 421 patients treated with radical D2 lymphadenectomy were analyzed retrospectively. The difference of the number of lymph nodes dissection between the celiac artery variation group and the normal vessels group and the relationship with prognosis were analyzed.

RESULTS:

Celiac artery variation was found in 110 patients, with a variation rate of 26.13%. Celiac artery variation, tumor staging, and Borrmann typing were factors that affected lymph node clearance in gastric cancer, and the number of lymph nodes dissection in patients with celiac artery variation was significantly less than that of non-variant groups (P < 0.05). Univariate analysis showed that there was no significant difference in survival time between the two groups (P > 0.05). Univariate and multiple Cox regression analysis showed that celiac artery variation was not a prognostic factor for gastric cancer (P > 0.05). Tumor staging, intraoperative bleeding, and positive lymph node ratio were prognostic factors for gastric cancer patients (all P < 0.05).

CONCLUSION:

The number of lymph nodes dissection in patients with celiac artery variation was reduced, but there was no obvious effect on prognosis. Therefore, lymph nodes around the abnormal hepatic artery may not need to be dissected in radical D2 lymphadenectomy.

PMCID: PMC6580319 Free PMC Article

PMID: 31236200

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Conflict of interest statement

Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article. 37. J Clin Med. 2019 Jun 21;8(6). pii: E885. doi: 10.3390/jcm8060885. Non-Invasive Biomarkers for Celiac Disease.

Singh A1, Pramanik A2, Acharya P3, Makharia GK4.

Author information: 1. Department of Gastroenterology and Human Nutrition; All India Institute of Medical Sciences, New Delhi-110029, India. [email protected]. 2. Department of Biochemistry, All India Institute of Medical Sciences, New Delhi-110029, India. [email protected]. 3. Department of Biochemistry, All India Institute of Medical Sciences, New Delhi-110029, India. [email protected]. 4. Department of Gastroenterology and Human Nutrition; All India Institute of Medical Sciences, New Delhi-110029, India. [email protected].

Abstract

Once thought to be uncommon, celiac disease has now become a common disease globally. While avoidance of the gluten-containing diet is the only effective treatment so far, many new targets are being explored for the development of new drugs for its treatment. The endpoints of therapy include not only reversal of symptoms, normalization of immunological abnormalities and healing of mucosa, but also maintenance of remission of the disease by strict adherence of the gluten-free diet (GFD). There is no single gold standard test for the diagnosis of celiac disease and the diagnosis is based on the presence of a combination of characteristics including the presence of a celiac-specific antibody (anti-tissue transglutaminase antibody, anti-endomysial antibody or anti-deamidated gliadin peptide antibody) and demonstration of villous abnormalities. While the demonstration of enteropathy is an important criterion for a definite diagnosis of celiac disease, it requires endoscopic examination which is perceived as an invasive procedure. The capability of prediction of enteropathy by the presence of the high titer of anti-tissue transglutaminase antibody led to an option of making a diagnosis even without obtaining mucosal biopsies. While present day diagnostic tests are great, they, however, have certain limitations. Therefore, there is a need for biomarkers for screening of patients, prediction of enteropathy, and monitoring of patients for adherence of the gluten-free diet. Efforts are now being made to explore various biomarkers which reflect different changes that occur in the intestinal mucosa using modern day tools including transcriptomics, proteomics, and metabolomics. In the present review, we have discussed comprehensively the pros and cons of available biomarkers and also summarized the current status of emerging biomarkers for the screening, diagnosis, and monitoring of celiac disease.

Free Article

PMID: 31234270

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Publication type

• Review

38. Gastroenterology. 2019 Jun 21. pii: S0016-5085(19)41031-7. doi: 10.1053/j.gastro.2019.06.024. [Epub ahead of print] Editorial: There is Something About Gluten - Will Science Sway Beliefs?

Halmos EP1, Gibson PR2.

Author information: 1. Department of Gastroenterology, Monash University and Alfred Health, Melbourne, Victoria, Australia. 2. Department of Gastroenterology, Monash University and Alfred Health, Melbourne, Victoria, Australia. Electronic address: [email protected]. PMID: 31233735

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Publication type

• Editorial

39. Medicine (Baltimore). 2019 Jun;98(25):e15949. doi: 10.1097/MD.0000000000015949. The role of CXCR3 and its ligands CXCL10 and CXCL11 in the pathogenesis of celiac disease.

Haghbin M1, Rostami-Nejad M2, Forouzesh F1, Sadeghi A2, Rostami K3, Aghamohammadi E4, Asadzadeh-Aghdaei H4, Masotti A5, Zali MR2.

Author information: 1. Department of Genetics, Faculty of Advanced Science and Technology, Tehran Medical Sciences, Islamic Azad University. 2. Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 3. Department of Gastroenterology MidCentral District Health Board, Palmerston North Hospital, New Zealand. 4. Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 5. Bambino Gesù Children's Hospital-IRCCS, Research Laboratories, Rome, Italy.

Abstract

The chemokine receptor CXCR3 and its ligands CXCL10 and CXCL11 have been suggested to give rise to the most relevant chemokine axis able to facilitate the entrance of immune cells into inflamed tissues and be activated in different inflammatory disorders, such as celiac disease (CD).The aim of this study was to investigate the expression level of CXCR3, CXCL10, and CXCL11 genes in celiac patients compared to healthy controls. Both cohorts have been recruited from the Iranian population.In this case-control study, biopsy specimens were collected from 71 celiac patients (60.5% female) and 90 control subjects (57% female) during 2016. Total RNA was extracted and mRNA expression levels of CXCR3, CXCL10, and CXCL11 genes were investigated by SYBR green qPCR.Based on qPCR and relative quantification method, the mRNA expression levels of CXCR3, CXCL10, and CXCL11 were significantly higher in duodenal biopsies of celiac patients compared to healthy controls in the study population (P = .038, P = .021, and P = .012 respectively).The result of this study showed that CXCR3/CXCL10/CXCL11 signaling axis is overexpressed in the small intestinal mucosa of CD patients compared to controls. This finding might explain the specific enrollment of the main cell populations that infiltrate the epithelium.

Free Article

PMID: 31232926 [Indexed for MEDLINE]

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MeSH terms

• Adult • Case-Control Studies • Celiac Disease/genetics* • Chemokine CXCL10/genetics* • Chemokine CXCL11/genetics* • Cohort Studies • European Continental Ancestry Group/genetics • Female • Gene Expression Regulation • Humans • Iran • Male • Receptors, CXCR3/genetics* Substances

• CXCL10 protein, human • CXCL11 protein, human • CXCR3 protein, human • Chemokine CXCL10 • Chemokine CXCL11 • Receptors, CXCR3

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

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

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

Abstract

OBJECTIVES:

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

METHODS:

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

RESULTS:

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

CONCLUSIONS:

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

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41. Am J Gastroenterol. 2019 Jun 20. doi: 10.14309/ajg.0000000000000301. [Epub ahead of print] Response to Forbes.

Lerner BA1, Lebwohl B1,2.

Author information: 1. Department of Medicine, Celiac Disease Center, and. 2. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA. PMID: 31232833

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42. Br J Nutr. 2019 Jun 24:1-9. doi: 10.1017/S0007114519001053. [Epub ahead of print] Gluten-free diet in French adults without coeliac disease: sociodemographic characteristics, motives and dietary profile. Perrin L1, Allès B1, Buscail C1, Ravel C2, Hercberg S1, Julia C1, Kesse-Guyot E1.

Author information: 1. Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS),Inserm U1153, Inra U1125, Cnam,Paris 13 University, Nutritional Epidemiology Research Team (EREN),Bobigny,France. 2. UMR INRA 1095 Genetics, Diversity and Ecophysiology of Cereals, Integrative Biology of Grain Composition Team, Clermont-Auvergne University,Clermont-Ferrand,France.

Abstract

The number of people avoiding gluten is growing in many Western countries. However, little information is available on their sociodemographic and dietary profiles. We aimed to describe sociodemographic, behavioural and dietary profiles of participants avoiding gluten in the NutriNet- Santé cohort. Participants of the NutriNet-Santé cohort - excluding coeliac patients - who completed a questionnaire about food exclusions, with complete data on sociodemographic characteristics and dietary intake were included (n 20 456). Food group consumptions and nutrient intakes according to self-reported avoidance of gluten were estimated using ANCOVA adjusted for age, sex and daily energy intake. Based on principal component analysis, three dietary patterns (DP) were identified. Association between DP and avoidance of gluten was investigated using multivariate logistic regression. All data were weighted on the French census. A total of 10·31 (95 % CI 9·90, 10·73) % of the participants declared avoiding gluten, of which 1·65 % totally. They were more likely to be women, older persons, non-smokers, to have a lower educational level and declared more food intolerances. They had higher consumption of fruit, vegetables and lower consumption of dairy products, salty/sweet and fatty foods and alcohol. After adjustments on confounders, a healthy dietary pattern was positively associated with total gluten avoidance (ORQuintile5vsQuintile1 = 14·44, 95 % CI 8·62, 24·19). Our study highlighted that, in this population, individuals who avoid gluten from their diet tend to have a diet more favourable to health. These results can serve as a basis for future studies investigating the potential consequences of a gluten-free diet in non-coeliac population. PMID: 31232248

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43. Clin Gastroenterol Hepatol. 2019 Jul;17(8):1509-1514. doi: 10.1016/j.cgh.2018.10.035. Epub 2018 Oct 26. Prevalence of and Risk Factors for Low Bone Mineral Density in Children With Celiac Disease. Webster J1, Vajravelu ME2, Choi C3, Zemel B4, Verma R5.

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

Abstract

BACKGROUND & AIMS:

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

METHODS:

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

RESULTS:

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

CONCLUSIONS:

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

PMID: 31230659

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Grant support

• K12 DK094723/DK/NIDDK NIH HHS/United States

44. Curr Dev Nutr. 2019 Jun 13;3(Suppl 1). pii: nzz039.FS10-02-19. doi: 10.1093/cdn/nzz039.FS10-02-19. eCollection 2019 Jun. Gluten Content of Brand Name Food Products in a Food and Nutrient Database That Includes Leading U.S. Food Brands (FS10-02-19).

Harnack L1, Jasthi B2, Pettit J2, Schmitz K2, Stevenson J2, Brejle K2.

Author information: 1. University of Minnesota School of Public Health. 2. University of Minnesota Nutrition Coordinating Center.

Abstract

Objectives:

Describe the gluten content of leading U.S. brands of cookies, crackers, hot cereals, ready-to-eat (RTE) cereals, specially formulated bars (e.g., Clif, Luna bars), granola bars, savory snacks, and candies.

Methods:

To address the needs of researcherers examining the role of gluten in gastrointestinal health, gluten was added to a U.S. food and nutrient database. Few foods have been chemically analyzed for their gluten content. Thus, gluten values were assigned to foods based on the assumptions that: 1) foods that do not include any gluten containing grains or their derivatives- wheat, rye or barley may be presumed to contain 0 grams of gluten; and 2) a specified fraction of vegetable protein found in wheat, rye, barley and their derivatives (0.75) may be presumed to be gluten (factor selected based on studies in which gluten content of some gluten containing grains were determined by chemical analysis). Gluten values were assigned to brand name products in the database, thus presenting a unique opportunity to describe the gluten content of brand name products in the U.S. marketplace. For each food category the % of products containing gluten was calculated, and the mean and range in gluten content among gluten containing products were determined.

Results:

Food categories with the highest proportion of products containing gluten were cookies (97.1%), crackers (82.7%), hot cereals (66.0%), and RTE cereals (64.8%). Categories with the lowest proportions were candies (15.7%) and savory snacks (25.0%). The mean gluten content among gluten containing products was highest for hot cereals (2.62 grams/serving), crackers (1.82 grams/serving), RTE cereals (1.76 grams/serving), and savory snacks (1.51 grams/serving). Granola bars and specially formulated bars had the lowest content (0.27 and 0.31 grams/serving respectively). The range in gluten content per serving for gluten containing products was lowest for granola bars (0.002-1.11 grams/serving) and highest for RTE cereals (0.001-7.03 grams/serving).

Conclusions:

There is considerable variation in the gluten content of brand name products in the categories examined in this study. Studies quantifying dietary gluten intake may need to consider using a dietary assessment method that captures product brand.

Funding Sources:

American Gastroenterological Association.

Supporting Tables Images and/or Graphs:

PMCID: PMC6577328 Free PMC Article

PMID: 31225064

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45. Curr Dev Nutr. 2019 Jun 13;3(Suppl 1). pii: nzz049.P19-014-19. doi: 10.1093/cdn/nzz049.P19-014- 19. eCollection 2019 Jun. Lactase Deficiency and Colonic Mucosal Eosinophilia (P19-014-19).

Singh M1, Friesen C1, Singh V1. Author information: 1. Children's Mercy Hospital.

Abstract

Objectives:

Immunological studies in patients with lactase deficiency (LD) have suggested a role of colonic mucosal inflammatory cells in causation of some of the symptoms. We hypothesized that since eosinophils are associated with symptoms of abdominal pain and diarrhea; and patients with LD frequently manifest these symptoms, there may be an increase of eosinophils in LD. Thus, our objective was to study children with LD to assess eosinophils in their colonic mucosa.

Methods:

We reviewed the pathology reports of mucosal biopsies of 86 children with LD who underwent esophagogastroduodenoscopy (EGD) and colonoscopy or only EGD. Data was abstracted from the pathology reports and analyzed. Lactase enzyme testing was performed at a reference laboratory on the mucosal biopsy specimen obtained from duodenum. The reference laboratory defined the normal range of lactase enzyme as 24.5+/- 8 micromoles per minute per gram of protein (micromoles/min), and abnormal level as <15 micromoles/min.

Results:

The subjects ranged in age from 1 to 17 years and 47 (55%) were female and all subjects had abdominal pain. The lactase enzyme levels in the study subjects ranged from 0 to 13.9. All 86 subjects underwent EGD, 6 (7%) of whom had celiac disease and 10 (12%) showed increased mucosal eosinophils in the duodenal mucosa. All subjects with celiac disease had very low (<7 micromoles/min) levels of lactase. There were 52 subjects who had colonoscopy as well, and 16 (31%) of them had increased colonic mucosal eosinophils (CME), whereas 32 (62%) showed no histopathological abnormality of colonic mucosa.

Conclusions:

Our study found that 31% of children with lactase deficiency manifest increased colonic mucosal eosinophils. Chemical mediators secreted by eosinophils are known to mediate abdominal pain. However, to fully understand the role of other inflammatory cells in the clinical presentation of children with LD, future studies on larger numbers of subjects that assess eosinophils and mast cells are needed.

Funding Sources:

Intra-departmental Funding.

PMCID: PMC6575059 Free PMC Article

PMID: 31224872

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46. Curr Dev Nutr. 2019 Jun 13;3(Suppl 1). pii: nzz035.P12-040-19. doi: 10.1093/cdn/nzz035.P12-040- 19. eCollection 2019 Jun. Iron Supplementation Necessities for Subjects with Celiac Disease in KSA -A Retrospective Study (P12-040-19).

Sudersanadas K1, Hamdy EM2, Hazazi KA2, Alanazi MG2, Altheyabi N2, Philip W2, Alkhormi AM3.

Author information: 1. King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS). 2. KSAU HS. 3. KAMC.

Abstract

Objectives:

To assess the iron (Fe) supplementation necessities for subjects with celiac disease (CD) in KSA.

Methods:

The study was conducted among the subjects with CD registered in King Abdulaziz Medical City (KAMC), KSA for medical care during 2008-18. Those who are pregnant/lactating or with blood loss due to non-CD causes/gastrointestinal (GI) abnormalities/chronic disease of liver/kidney/febrile diseases/cancer/metabolic disorders were excluded from the study. The design of the study was retrospective cross-sectional. The data of the subjects with CD entered in the Hospital Information system of KAMC was used. Accordingly, 71 subjects with CD were selected by using convenient sampling technique.Demography, clinical manifestations, hematological and Fe profile of the subjects were studied. SPSS Version 22 was used for data analysis. Frequencies, percentages and mean + SD, Student's t and non-parametric Mann-Whitney U tests were used. P-value of <0.05 considered as statistically significant. IRB of KAIMRC, Riyadh approved the study.

Results: Adults formed 54.8% of the subjects, children and females formed 31% and 78.9% respectively. Diarrhea and vomiting were the major clinical manifestations observed among 55% of the subjects. Anthropometric data indicated that 38.3% of them was malnourished. Reduced RBC counts perceived among 40.1% of the subjects. Among them, 88.23% were females while 18.3% were with low WBC count. Platelet counts < normal were exhibited by 12.7%. MCV, MCHC, and Hematocrit (HCT) values were lower congruently for 16.9, 69 and 41% (66.66% were females) of the subjects. Iron Deficiency Anemia (IDA) pointed out by low hemoglobin (Hb) level was observed in 38.02%. Of them, 88.19% were females. Abridged Serum iron was detected in 67.59% (85.41% are females) while increased TIBC values were shown by 22.9%. Of the subjects (22.53%) with low serum ferritin(SF) values 68.75% were females. There was a significant difference between the values of RBC count, MCV, MCHC, HCT, Hb and SF levels of both genders.

Conclusions:

The study signifies the importance of the provision of Fe supplements for subjects with CD. Females more than the males with CD are at risk for IDA.

Funding Sources:

NIL.

Supporting Tables Images and/or Graphs:

PMCID: PMC6575055 Free PMC Article

PMID: 31224868

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47. Curr Dev Nutr. 2019 Jun 13;3(Suppl 1). pii: nzz035.P12-003-19. doi: 10.1093/cdn/nzz035.P12-003- 19. eCollection 2019 Jun. Nutrition Assessment, Interventions, and Monitoring for Patients with Celiac Disease: An Evidence Scoping Review (P12-003-19).

Cheng F1, Handu D1.

Author information: 1. Academy of Nutrition and Dietetics. Abstract

Objectives:

To conduct an evidence scoping review to determine the need/scope for a systematic review (SR) and evidence-based practice guideline (EBPG). Main objectives were: To identify and characterize studies examining nutrition assessment, interventions, and measures to monitor adherence/compliance in patients with celiac disease (CD).

Methods:

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 patients. All types of peer-reviewed articles, except for narrative review, grey literature, and case study/report, published between January 2007 and August 2018 were eligible. Two content advisors reviewed the search plan and findings.

Results:

The literature search resulted in 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. The majority of the studies were observational studies (n = 212), followed by experimental trials (n = 50), EBPG/report/statement (n = 16), and SR (n = 14). Nine original studies examined assessment, focusing mainly on different tools/ways to assess gluten-free diet (GFD) adherence. Most of the included original articles (n = 235) were in the nutrition intervention category with GFD, oat, and prebiotics/probiotics as the top-three most studied interventions. There were eight SRs on GFD and five on oat. 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.

Conclusions:

Based on the scoping review, interventions focused on gluten-free diet and oats have been significantly covered by either SRs or EBPGs. In recent years, evidence related to prebiotics/probiotics and education program/counseling focused interventions, as well as assessment, in CD patients has increased. Thus, it might be beneficial to conduct SRs/EBPG focused on these topics to guide practitioners.

Funding Sources:

Academy of Nutrition and Dietetics.

PMCID: PMC6573982 Free PMC Article

PMID: 31223838

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48. Clin Gastroenterol Hepatol. 2019 Jun 17. pii: S1542-3565(19)30651-2. doi: 10.1016/j.cgh.2019.06.013. [Epub ahead of print] Increased Prevalence of Celiac Disease in School-age Children in Italy.

Gatti S1, Lionetti E1, Balanzoni L2, Verma AK1, Galeazzi T1, Gesuita R3, Scattolo N4, Cinquetti M2, Fasano A5, Catassi C6; Celiac Screening Team, Annibali R1, Del Baldo G1, Franceschini E1, Palpacelli A1, Monachesi C1, Catassi GN1, Trevisan MT2, Anton G2, Colombari AM2.

Author information: 1. Department of Pediatrics, Marche Polytechnic University, Ancona, Italy. 2. Department of Pediatrics, "G.Fracastoro" Hospital, AULSS9 Verona, Italy. 3. Department of Biostatistics and Medical Information Technology, Marche Polytechnic University, Ancona, Italy. 4. Department of Clinical Chemistry, "G.Fracastoro" Hospital, AULSS9 Verona, Italy. 5. Mucosal Immunology and Biology Research Center, Division of Pediatric Gastroenterology and Nutrition, Massachusetts General Hospital, Boston, USA. 6. Department of Pediatrics, Marche Polytechnic University, Ancona, Italy; Mucosal Immunology and Biology Research Center, Division of Pediatric Gastroenterology and Nutrition, Massachusetts General Hospital, Boston, USA. Electronic address: [email protected].

Abstract

BACKGROUND & AIMS:

Celiac disease is one of the most common diseases worldwide, with an apparent trend of increasing prevalence. We investigated the prevalence of celiac disease in children in Italy in 2015-2016 and compared that with data from 25 years ago.

METHODS:

We screened 4570 children (5-11 years old, 80.1% of the eligible population) from metropolitan areas of Ancona and Verona for HLA genes associated with increased risk of celiac disease, and for total serum levels of IgA, and IgA class anti-tissue transglutaminase in HLA positives. Diagnoses of celiac disease were confirmed by detection of anti-endomysial antibody and analysis of intestinal biopsies. The prevalence of celiac autoimmunity and celiac disease were calculated and compared with values from the same geographical area during the years 1993-1995, after adjustment for the different diagnostic algorithm.

RESULTS:

We identified 1960 children with celiac disease-associated haplotypes (43% of children screened; 95% CI, 40.8%-45.2%). The prevalence of celiac disease autoimmunity in the HLA-positive subjects was 96/1706 (5.62%; 95% CI, 4.53%-6.71%) and 54 of these children satisfied the diagnostic criteria for celiac disease. In the eligible population there were other 23 known cases of celiac disease. The overall estimated prevalence of celiac disease was 1.58% (95% CI, 1.26%-1.90%); this value is significantly higher than the 1993-1995 adjusted prevalence (0.88%; 95% CI, 0.74%-1.02%).

CONCLUSIONS:

We found the prevalence of celiac disease in children in Italy to be greater than 1.5%; this value has increased significantly over the past 25 years. Studies are needed to determine the causes of this large increase.

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49. J Pediatr Gastroenterol Nutr. 2019 Jun 18. doi: 10.1097/MPG.0000000000002418. [Epub ahead of print] The Risk of Autoimmune Disorders in Treated Celiac Disease Patients in Olmsted County, Minnesota.

Khan MR1, Nellikkal SS1, Barazi A1, Larson JJ2, Murray JA3, Absah I1,3.

Author information: 1. Division of Pediatric Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota. 2. Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota. 3. Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.

Abstract BACKGROUND:

Patients with autoimmune disorders (ADs) are at increased risk for celiac disease (CD), but data is conflicting on the risk of ADs in treated patients with CD. We aimed to assess the incidence of ADs in treated CD patients.

METHODS:

Using the Rochester Epidemiology Project, we retrospectively searched for the medical records at Mayo Clinic and Olmsted Medical Center from January 1997 to December 2015 for CD patients who met accepted diagnostic criteria. For each CD patient, we identified 2 age and sex matched controls during the same study period. The incidence rate of AD diagnosis 5 years after index date was calculated using Kaplan-Meier analysis for the CD cases and controls and compared using the log- rank test.

RESULTS:

We identified 249 treated patients with CD during the study period and 498 matched controls, with mean (SD) ages of 32 (22) years and 33 (22) years, respectively. One-third of patients (n = 85) and controls (n = 170) were male. Five years after the index date, 5.0% of CD patients and 1.3% of controls had a de novo AD diagnosis (P = 0.006). In the presence of a prior AD, the cumulative risk of a de novo or additional AD was significantly higher in the CD group vs controls (P < 0.001). Children had a significantly higher risk of AD development compared with adults (P = 0.010).

CONCLUSION:

Treated CD patients are at higher risk for the development of ADs. The risk of a new AD is higher in children, especially when more than one AD diagnosis exists. PMID: 31219935

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50. J Pediatr Gastroenterol Nutr. 2019 Jun 18. doi: 10.1097/MPG.0000000000002417. [Epub ahead of print] Should We Assess Vitamin D Status in Pediatric Patients with Celiac Disease?

Ahlawat R1, Weinstein T1, Markowitz J1, Kohn N2, Pettei MJ1.

Author information: 1. Division of Pediatric Gastroenterology, Hepatology & Nutrition, Steven and Alexandra Cohen Children's Medical Center, NY. 2. Department of Biostatistics, Feinstein Institute for Medical Research, NY.

Abstract

OBJECTIVES:

Screening for vitamin D status in celiac disease (CD) has been recommended but the literature provides varying support. We sought to assess the vitamin D status in newly-diagnosed children with CD and in a non-CD control population and relate them to vitamin D intake.

METHODS:

In a cross-sectional study serum 25-hydroxyvitamin D (25-OHD) levels were drawn in children with newly-diagnosed CD and compared to pediatric outpatients with functional abdominal complaints. Anthropometric data as well as vitamin D intake based on milk and multivitamin ingestion were collected.

RESULTS:

38 newly-diagnosed CD patients (10.4 ± 3.0 years old; 50% F) and 82 controls (11.2 ± 4.2 years old; 58.5% F) were studied. Both groups were similar except for average daily D intake and Body Mass Index (BMI). There was no statistical difference in mean 25-OHD levels between CD (26.4 ± 8.0 ng/ml) and controls (23.5 ± 8.2 ng/ml) [p ≤ 0.07]. Both groups had high percentages of suboptimal D status (65.8% CD and 79.3% controls). 25-OHD levels significantly correlated with age (r = -0.262; p < 0.0038) and estimated vitamin D intake (r = 0.361; p < 0.0001).

CONCLUSIONS:

No significant difference in 25-OHD levels was noted between newly diagnosed CD and controls, but inadequate 25-OHD levels were common in both. 25-OHD levels were highly associated with vitamin D intake demonstrating similar vitamin D absorption between patients and controls. Since CD is associated with bone disease and D status is frequently low, efforts at optimizing D such as screening levels at diagnosis need to be conducted. PMID: 31219934

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51. J Pediatr Gastroenterol Nutr. 2019 Jun 18. doi: 10.1097/MPG.0000000000002424. [Epub ahead of print] Diagnostic Delays in Children with Coeliac Disease in the Central European Region.

Riznik P1, De Leo L2, Dolinsek J3, Gyimesi J4, Klemenak M1, Koletzko B5,6, Koletzko S7, Korponay-Szabó IR4,8, Krencnik T1, Not T2, Palcevski G9, Sblattero D10, Vogrincic M11, Werkstetter KJ7, Dolinsek J1,12.

Author information: 1. University Medical Centre Maribor, Department of Paediatrics, Gastroenterology, Hepatology and Nutrition Unit, Maribor, Slovenia. 2. IRCCS Burlo Garofolo Trieste, Institute for Maternal and Child Health, Trieste, Italy. 3. Municipality of Maribor, Project Office, Maribor, Slovenia. 4. Heim Pál National Paediatric Institute, Coeliac Disease Centre, Budapest, Hungary. 5. Stiftung Kindergesundheit (Child Health Foundation), Munich, Germany. 6. Division of Metabolic Diseases and Nutritional Medicine, Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany. 7. Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany: Department of Pediatrics, Gastroenterology and Nutrition, School of Medicine Collegium Medicum University of Warmia and Mazury, Olsztyn, Poland. 8. University of Debrecen, Faculty of Medicine, Department of Paediatrics, Debrecen, Hungary. 9. University Hospital Rijeka, Department for Gastroenterology, Paediatric clinic, Rijeka, Croatia. 10. University of Trieste, Trieste, Italy. 11. University Medical Centre Maribor, Department of Informatics, Maribor, Slovenia. 12. Medical Faculty, Department of Paediatrics, University of Maribor, Maribor, Slovenia.

Abstract

OBJECTIVES:

Coeliac disease (CD) is a systemic autoimmune disorder affecting about 1% of the population. Many patients remain undiagnosed or are diagnosed with substantial delay. We assessed diagnostic delays in symptomatic CD children in Central Europe (CE).

METHODS:

Paediatric gastroenterologists in five CE countries retrospectively reported data of their patients diagnosed in 2016. Age at first CD related symptom(s), first visit to paediatric gastroenterologist and confirmed diagnosis were used to determine diagnostic delays.

RESULTS:

Data from 393 children (65% female, median age 7 years, range 7m-18.5y) from Croatia, Hungary, Germany, Italy and Slovenia were analysed. Median duration from first symptom(s) to visit to paediatric gastroenterologist was 5 months (range 0-10y; preschool 4m, school-aged 5m), and further duration until final diagnosis was 1 month (range 0-5y) with significant regional differences (p < 0.001). Median diagnostic delay was 6 months (range 0-10y; preschool 5m, school-aged 7m). Type of clinical presentation had little, however significant effect on delays. Reduced body mass in delays longer than 3 years compared to delays shorter than 1 year was found (z-score -0.93 vs -0.39, p < 0.05).

CONCLUSIONS:

Time from first symptoms to CD diagnosis in children in five CE countries is slightly shorter compared to few other small paediatric studies, and significantly shorter than reported for adults. Nevertheless, delays of more than 3 years in 6.6% of children are worrisome. Raising awareness about the variable symptoms and implementation of reliable diagnostic tools will further reduce diagnostic delays. PMID: 31219933

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52. Curr Opin Pulm Med. 2019 Jun 18. doi: 10.1097/MCP.0000000000000598. [Epub ahead of print] Clustering of immune-mediated diseases in sarcoidosis.

Terwiel M1, Grutters JC1,2, van Moorsel CHM1,2.

Author information: 1. Department of Pulmonology, St Antonius ILD Center of Excellence, St Antonius Hospital, Nieuwegein. 2. Division of Heart and Lung, University Medical Center Utrecht, Utrecht, The Netherlands.

Abstract

PURPOSE OF REVIEW:

Sarcoidosis is an immune-mediated disease of unknown cause. Immune-mediated diseases appear to cluster in patients and in families. We review what is known on this topic for sarcoidosis, and what factors may underlie disease clustering.

RECENT FINDINGS:

In populations of patients with sarcoidosis, relative risk estimates of Sjögren's syndrome, systemic lupus erythematosus, autoimmune hepatitis, ankylosing spondylitis, multiple sclerosis (MS), celiac disease, autoimmune thyroid disease, and ulcerative colitis, varied between 2.1 and 11.6. In relatives of patients with sarcoidosis, relative risk estimates varied between 1.3 and 5.8 for sarcoidosis, MS, celiac disease, type 1 diabetes, Graves' disease, rheumatoid arthritis, Crohn's disease, and ulcerative colitis. Shared risk loci in key immunological pathways provide evidence for a contribution to development of multiple diseases. Identical changes in the immune status, epigenetic alterations, and environmental triggers have been detected in several diseases, and drug- induced disease is likely responsible for a small portion of co-occurring disease.

SUMMARY:

Clustering of sarcoidosis and other immune-mediated diseases in patients and in their relatives occurs for sarcoidosis, MS, celiac disease, Graves' disease, and ulcerative colitis. Further research is needed to substantiate causal links and risk estimates in patients and their relatives. PMID: 31219835

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53. J Evid Based Med. 2019 Jun 20. doi: 10.1111/jebm.12355. [Epub ahead of print] Celiac disease and risk of sarcoidosis: A systematic review and meta-analysis.

Wijarnpreecha K1,2, Panjawatanan P3, Corral JE2, Lukens FJ2, Ungprasert P4.

Author information: 1. Department of Internal Medicine, Bassett Medical Center, Cooperstown, New York. 2. Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Mayo Clinic, Jacksonville, Florida. 3. Faculty of Medicine, Department of Biochemistry, Chiang Mai University, Chiang Mai, Thailand. 4. Clinical Epidemiology Unit, Faculty of Medicine Siriraj Hospital, Department of Research and Development, Mahidol University, Bangkok, Thailand.

Abstract

BACKGROUND/OBJECTIVES:

Several epidemiologic studies have suggested that patients with celiac disease may be at an increased risk of sarcoidosis but the results were inconsistent. This systematic review and meta- analysis was conducted with the aim to better characterize this risk by summarizing all available data. METHODS:

A literature review was performed using MEDLINE and EMBASE database from inception to February 2019. Studies that compared the risk of sarcoidosis among patients with celiac disease versus individuals without celiac disease were included. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method.

RESULTS:

Of 426 retrieved studies, four studies with 693 639 participants met the eligibility criteria and were included in meta-analysis. The risk of sarcoidosis among patients with celiac disease was higher than individuals without celiac disease with the pooled OR of 7.16 (95% CI, 1.48-34.56). The statistical heterogeneity of this study was high (I2 = 95%).

CONCLUSIONS:

This systematic review and meta-analysis found a significantly higher risk of sarcoidosis among patients with celiac disease.

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54. Glob Adv Health Med. 2019 Jun 11;8:2164956119853777. doi: 10.1177/2164956119853777. eCollection 2019. A 12-Week Pilot Exercise Program for Inactive Adults With Celiac Disease: Study Protocol.

Dowd AJ1, Kronlund L1, Parmar C1, Daun JT1, Wytsma-Fisher K1, Reimer RA1,2,3, Millet GY1, Culos-Reed SN1,4.

Author information: 1. Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada. 2. Department of Biochemistry & Molecular Biology, Cumming School of Medicine, Calgary, Alberta, Canada. 3. Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada. 4. Department of Oncology, Cumming School of Medicine, Calgary, Alberta, Canada.

Abstract

Background:

Individuals with celiac disease must follow a strict gluten-free diet (GFD) in order to avoid negative short- and long-term health consequences. Unfortunately, many people with celiac disease report poor quality of life (QoL) despite following a strict GFD, and up to 30% still report negative symptoms (eg, gastrointestinal upset).

Purpose:

The purpose of the MOVE-C (understanding the relationship between the MicrobiOme, Vitality, and Exercise in Celiac disease) pilot study is to explore the effects of a 12-week supervised progressive high-intensity interval training (HIIT) and lifestyle intervention on physiological, behavioral, and psychosocial outcomes among inactive adults with celiac disease.Methods/Design: Sixty inactive adults diagnosed with celiac disease will be randomized to HIIT+ or waitlist control (WLC). Participants in the HIIT+ will engage in a 12-week HIIT + lifestyle education program. HIIT sessions will be comprised of 2 workouts per week, working up to 14 × 30-second intervals at 90% maximal heart rate (HRmax) followed by 2 minutes recovery at 50% HRmax. The 6 biweekly lifestyle sessions will involve education on the promotion of a whole foods GFD, sleep hygiene, psychosocial coping skills (eg, self-compassion), and self-regulatory skills to master changes in behaviors. Assessments will occur at pre and post 12-week intervention and 3-month follow-up. WLC participants will be offered a 12-week HIIT program + online lifestyle education sessions after completing the final assessment. The primary outcomes are QoL and gut microbiota composition assessed with 16S rRNA sequencing. The secondary outcomes are markers of metabolic syndrome (waist circumference, fasting glucose, serum lipids, blood pressure, and body composition), gastrointestinal symptoms, sleep quality, adherence to a GFD, exercise behavior, self-regulatory efficacy, and self-compassion. It is hypothesized that participants in the HIIT+ will experience improvements in all outcomes when compared to those in the WLC. These improvements are expected to be maintained at the 3-month follow-up.

Discussion:

The findings from this study will advance the knowledge regarding the effects of HIIT and lifestyle education on key outcomes for an at-risk chronic disease population. Furthermore, the findings can be used to inform future programs to improve fitness and physical and mental health outcomes for people with celiac disease.

PMCID: PMC6563390 Free PMC Article

PMID: 31218116

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55. Food Sci Technol Int. 2019 Jun 19:1082013219856784. doi: 10.1177/1082013219856784. [Epub ahead of print] The use of high-in-β-glucan oat fibre powder as a structuring agent in gluten-free yeast- leavened cake.

Karp S1, Wyrwisz J1, Kurek MA1, Wierzbicka A1.

Author information: 1. Department of Technique and Food Development, Warsaw University of Life Sciences, Poland.

Abstract

The biggest challenge in the production of gluten-free baked products is creating a structure without gluten while maintaining physicochemical and sensory properties. The aim of this study was to evaluate the possibility of applying oat β-glucan as the thickening and structure-making agent instead of xanthan (control sample), due to its pro-health technological properties, in yeast- leavened gluten-free cake. Thus, high-in-β-glucan oat fibre powder was incorporated into cake formulations as 5, 10, 15 and 20% replacement of rice or corn flour. The complex analysis of physicochemical and sensory properties was conducted, where texture and rheological aspects were the most important. An analysis of the correlation between rheological and physical properties was also conducted. Corn and rice cakes differed, but the results showed the increase of β-glucan, total dietary fibre, springiness, cohesiveness, storage (G') and loss (G″) modulus and the decrease of firmness and lightness. Improvement of porosity and volume was also noticed. Significant correlation was observed among G', G″, specific volume and texture components. Accelerated texture changes were noticed after 24 h of storage. To sum up, it is justified to incorporate oat fibre into gluten-free baked products, both to increase nutritional value and improve cake structure. PMID: 31216185

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56. Diabetes Care. 2019 Jun 18. pii: dc190315. doi: 10.2337/dc19-0315. [Epub ahead of print] Age, HLA, and Sex Define a Marked Risk of Organ-Specific Autoimmunity in First-Degree Relatives of Patients With Type 1 Diabetes.

Winkler C1,2, Jolink M1, Knopff A1, Kwarteng NA1, Achenbach P1,2,3, Bonifacio E4,5, Ziegler AG6,2,3.

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

Abstract

OBJECTIVE:

Autoimmune diseases can be diagnosed early through the detection of autoantibodies. The aim of this study was to determine the risk of organ-specific autoimmunity in individuals with a family history of type 1 diabetes.

RESEARCH DESIGN AND METHODS:

The study cohort included 2,441 first-degree relatives of patients with type 1 diabetes who were prospectively followed from birth to a maximum of 29.4 years (median 13.2 years). All were tested regularly for the development of autoantibodies associated with type 1 diabetes (islet), celiac disease (transglutaminase), or thyroid autoimmunity (thyroid peroxidase). The outcome was defined as an autoantibody-positive status on two consecutive samples.

RESULTS:

In total, 394 relatives developed one (n = 353) or more (n = 41) of the three disease-associated autoantibodies during follow-up. The risk by age 20 years was 8.0% (95% CI 6.8-9.2%) for islet autoantibodies, 6.3% (5.1-7.5%) for transglutaminase autoantibodies, 10.7% (8.9-12.5%) for thyroid peroxidase autoantibodies, and 21.5% (19.5-23.5%) for any of these autoantibodies. Each of the three disease-associated autoantibodies was defined by distinct HLA, sex, genetic, and age profiles. The risk of developing any of these autoantibodies was 56.5% (40.8-72.2%) in relatives with HLA DR3/DR3 and 44.4% (36.6-52.2%) in relatives with HLA DR3/DR4-DQ8.

CONCLUSIONS:

Relatives of patients with type 1 diabetes have a very high risk of organ-specific autoimmunity. Appropriate counseling and genetic and autoantibody testing for multiple autoimmune diseases may be warranted for relatives of patients with type 1 diabetes.

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57. Eur J Obstet Gynecol Reprod Biol. 2019 Jun 15. pii: S0301-2115(19)30262-3. doi: 10.1016/j.ejogrb.2019.05.040. [Epub ahead of print] Autoantibodies common in patients with gastrointestinal diseases are not found in patients with endometriosis: A cross- sectional study.

Ek M1, Roth B2, Valentin L3, Nordengren J3, Ohlsson B2.

Author information: 1. Department of Clinical Sciences, Division of Internal Medicine, Skåne University Hospital, Lund University, Malmö, Sweden. Electronic address: [email protected]. 2. Department of Clinical Sciences, Division of Internal Medicine, Skåne University Hospital, Lund University, Malmö, Sweden. 3. Department of Obstetrics and Gynecology, Lund University, Skåne University Hospital, Malmö, Sweden.

Abstract

OBJECTIVES:

Gastrointestinal symptoms are common in endometriosis, but the mechanisms behind these symptoms are yet poorly understood. Associations between endometriosis and irritable bowel syndrome (IBS), celiac disease, and various autoimmune diseases have been reported. These diseases express characteristic autoantibodies. The aim of the current study was to investigate autoantibodies against gonadotropin-releasing hormone 1 (GnRH1) and luteinizing hormone (LH) and their receptors, tenascin-C, matrix metalloproteinase-9, deamidated gliadin peptide, and tissue transglutaminase in a cohort of women with endometriosis, compared to controls and women with IBS or enteric dysmotility.

STUDY DESIGN:

One hundred seventy-two women with laparoscopy-verified endometriosis completed questionnaires regarding socio-demographics, lifestyle habits, medical history, and gastrointestinal symptoms, and sera were analyzed with ELISA for the abovementioned antibodies. Healthy female blood donors (N = 100) served as controls, and women with IBS or enteric dysmotility (N = 29) were used for comparison.

RESULTS:

A non-significantly higher prevalence of IgM antibodies directed at tenascin-C (7.6% vs. 2.0%; p = 0.06) was the only observed difference in autoantibody levels in endometriosis compared to controls. Antibody presence was not associated with any clinical parameters. Patients with IBS or enteric dysmotility expressed higher levels of IgM antibodies against GnRH1 compared to both patients with endometriosis (p = 0.004) and healthy controls (p = 0.002), and higher levels of tenascin-C antibodies compared to healthy controls (17.2% vs. 2.0%; p = 0.006).

CONCLUSIONS:

Women with endometriosis do not express higher prevalence of autoantibodies found to be characteristic in other patient groups with gastrointestinal symptoms.

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58. Foods. 2019 Jun 12;8(6). pii: E208. doi: 10.3390/foods8060208. Gluten-Free Alternative Grains: Nutritional Evaluation and Bioactive Compounds.

Niro S1, D'Agostino A2, Fratianni A3, Cinquanta L4, Panfili G5.

Author information: 1. Dipartimento di Agricoltura, Ambiente e Alimenti, Università degli Studi del Molise, Via De Sanctis, 86100 Campobasso, Italy. [email protected]. 2. Dipartimento di Agricoltura, Ambiente e Alimenti, Università degli Studi del Molise, Via De Sanctis, 86100 Campobasso, Italy. [email protected]. 3. Dipartimento di Agricoltura, Ambiente e Alimenti, Università degli Studi del Molise, Via De Sanctis, 86100 Campobasso, Italy. [email protected]. 4. Dipartimento Scienze Agrarie, Alimentari e Forestali, Università di Palermo, Viale delle Scienze 4, 90128 Palermo, Italy. [email protected]. 5. Dipartimento di Agricoltura, Ambiente e Alimenti, Università degli Studi del Molise, Via De Sanctis, 86100 Campobasso, Italy. [email protected].

Abstract

Interest in gluten-free grains is increasing, together with major incidences of celiac disease in the last years. Since to date, knowledge of the nutritional and bioactive compounds profile of alternative gluten-free grains is limited, we evaluated the content of water-soluble (thiamine and riboflavin) and liposoluble vitamins, such as carotenoids and tocols (tocopherols and tocotrienols), of gluten-free minor cereals and also of pseudocereals. The analysed samples showed a high content of bioactive compounds; in particular, amaranth, cañihua and quinoa are good sources of vitamin E, while millet, sorghum and teff (Eragrostis tef, or William's Lovegrass) are good sources of thiamine. Moreover, millet provides a fair amount of carotenoids, and in particular of lutein. These data can provide more information on bioactive compounds in gluten-free grains. The use of these grains can improve the nutritional quality of gluten-free cereal-based products, and could avoid the monotony of the celiac diet.

Free Article

PMID: 31212866

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Conflict of interest statement

The authors declare no conflict of interest. 59. United European Gastroenterol J. 2019 Jun;7(5):709-715. doi: 10.1177/2050640619826419. Epub 2019 Jan 19. Serum zonulin is elevated in IBS and correlates with stool frequency in IBS-D.

Singh P1, Silvester J1,2, Chen X1, Xu H1, Sawhney V1, Rangan V1, Iturrino J1, Nee J1, Duerksen DR3, Lembo A1. Author information: 1. Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, United States of America. 2. Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, United States of America. 3. Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.

Abstract

Background:

Studies have shown increased intestinal permeability in irritable bowel syndrome. Validating serum biomarkers for altered intestinal permeability in irritable bowel syndrome will facilitate research and pathophysiology-based therapy.

Objective:

To measure serum zonulin and intestinal fatty acid binding protein levels in diarrhea-predominant irritable bowel syndrome and constipation-predominant irritable bowel syndrome and compare with healthy controls and celiac disease.

Methods:

Serum zonulin and intestinal fatty acid binding protein levels were measured using enzyme-linked immunosorbent assays in constipation-predominant irritable bowel syndrome (n = 50), diarrhea- predominant irritable bowel syndrome (n = 50), celiac disease (n = 53) and healthy controls (n = 42). Irritable bowel syndrome symptom severity was measured using the irritable bowel syndrome- symptom severity scale.

Results:

Patients with constipation-predominant irritable bowel syndrome and diarrhea-predominant irritable bowel syndrome had higher zonulin levels compared with healthy controls (p = 0.006 and 0.009 respectively), which was comparable to those with active celiac disease. Although zonulin levels did not correlate with the overall irritable bowel syndrome symptom severity scale, it positively correlated with stool frequency per week (p = 0.03) and dissatisfaction with bowel habits (p = 0.007) in diarrhea-predominant irritable bowel syndrome. Patients with diarrhea-predominant irritable bowel syndrome and constipation-predominant irritable bowel syndrome had lower intestinal fatty acid binding protein levels compared with celiac patients (p = 0.005 and p = 0.047 respectively).

Conclusion:

Serum zonulin is upregulated in irritable bowel syndrome and the levels are comparable to those in celiac disease. Zonulin levels correlated with severity of bowel habits in diarrhea-predominant irritable bowel syndrome. Intestinal fatty acid binding protein levels in irritable bowel syndrome patients were not increased suggesting no significant increase in enterocyte death.

PMCID: PMC6545708 Free PMC Article

PMID: 31210949

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60. United European Gastroenterol J. 2019 Jun;7(5):583-613. doi: 10.1177/2050640619844125. Epub 2019 Apr 13. European Society for the Study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten-related disorders.

Al-Toma A1, Volta U2, Auricchio R3, Castillejo G4, Sanders DS5, Cellier C6, Mulder CJ7, Lundin KEA8,9.

Author information: 1. Department of Gastroenterology, St. Antonius Hospital, Nieuwegein, The Netherlands. 2. Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy. 3. Department of Translational Medical Science, Section of Paediatrics, University of Naples, Naples, Italy. 4. Department of Paediatric Gastroenterology, Hospital Universitari Sant Joan de Reus, Universitat Rovira I Virgili, IISPV, Reus, Spain. 5. Gastroenterology and Liver Unit, Royal Hallamshire Hospital & University of Sheffield, Sheffield, UK. 6. Gastroenterology Department, Hôpital Européen Georges Pompidou, Paris, France. 7. Department of Gastroenterology, VU Medical Centre, Amsterdam, The Netherlands. 8. Department of Gastroenterology, Oslo University Hospital Rikshospitalet, Oslo, Norway. 9. KG Jebsen Coeliac Disease Research Centre, University of Oslo, Oslo, Norway.

Abstract

This guideline presents recommendations for the management of coeliac disease (CD) and other gluten-related disorders both in adults and children. There has been a substantial increase in the prevalence of CD over the last 50 years and many patients remain undiagnosed. Diagnostic testing, including serology and biopsy, should be performed on a gluten-containing diet. The diagnosis of CD is based on a combination of clinical, serological and histopathological data. In a group of children the diagnosis may be made without biopsy if strict criteria are available. The treatment for CD is primarily a gluten-free diet (GFD), which requires significant patient education, motivation and follow-up. Slow-responsiveness occurs frequently, particularly in those diagnosed in adulthood. Persistent or recurring symptoms necessitate a review of the original diagnosis, exclude alternative diagnoses, confirm dietary adherence (dietary review and serology) and follow-up biopsy. In addition, evaluation to exclude complications of CD, such as refractory CD or lymphoma, should be performed. The guideline also deals with other gluten-related disorders, such as dermatitis herpetiformis, which is a cutaneous manifestation of CD characterized by granular IgA deposits in the dermal papillae. The skin lesions clear with gluten withdrawal. Also, less well-defined conditions such as non-coeliac gluten sensitivity (NCGS) and gluten-sensitive neurological manifestations, such as ataxia, have been addressed. Newer therapeutic modalities for CD are being studied in clinical trials but are not yet approved for use in practice.

PMCID: PMC6545713 Free PMC Article

PMID: 31210940

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Publication type

• Review

61. United European Gastroenterol J. 2019 Jun;7(5):581-582. doi: 10.1177/2050640619849370. Epub 2019 Jun 1. Updated guidelines by the European Society for the Study of Coeliac Disease.

Rubio-Tapia A1, Murray JA1.

Author information: 1. Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, USA.

PMCID: PMC6545712 Free PMC Article

PMID: 31210939

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Publication type • Editorial

62. Lab Med. 2019 Jun 18. pii: lmz037. doi: 10.1093/labmed/lmz037. [Epub ahead of print] Utilization of Laboratory Testing Algorithms for Celiac Disease in a Pediatric Hospital.

Ali M1, Danner DJ2, Fishman DS3, Devaraj S2,3.

Author information: 1. Department of Pathology, SUNY Upstate Medical University, Syracuse, New York. 2. Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas. 3. Division of Clinical Chemistry, Department of Pathology and Immunology, Texas Children's Hospital, Houston, Texas.

Abstract

BACKGROUND:

At Texas Children's Hospital in Houston, numerous celiac tests are ordered from a wide range of nonspecialty healthcare providers.

OBJECTIVE:

To retrospectively examine the ordering of celiac tests before and after a test ordering initiative at our institution, to determine whether the initiative impacted appropriate usage of those tests and affected costs.

METHODS:

We carefully scrutinized all orders for comprehensive celiac testing from July 2016 through September 2017, implemented an in-house celiac-disease screening cascade, and reflexed it to the comprehensive celiac testing panel if an abnormal screening result was obtained.

RESULTS:

A total of 60 celiac test orders were issued during the 14-month study period. The ordering physician was a gastroenterologist in 6 cases and a nongastroenterologist in 54 cases. Of the 60 orders, only 4 were approved for sending out for comprehensive celiac testing; in 52 of the 60 cases, the order was altered to celiac screening. In the remaining 4 cases, the tests were canceled as a result of incorrect orders. Only 1 of the 52 celiac screenings yielded a positive result and thus was reflexed to the comprehensive panel. CONCLUSIONS:

We were able to induce appropriate celiac test usage by implementing a celiac-reflexive cascade. Also, our strategy proved to be extremely cost effective.

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63. Microorganisms. 2019 Jun 14;7(6). pii: E173. doi: 10.3390/microorganisms7060173. The Revival of the Battle between David and Goliath in the Enteric Viruses and Microbiota Struggle: Potential Implication for Celiac Disease.

Lerner A1, Ramesh A2, Matthias T3.

Author information: 1. AESKU.KIPP Institute, Mikroforum Ring 2, 55234 Wendelsheim, Germany. [email protected]. 2. AESKU.KIPP Institute, Mikroforum Ring 2, 55234 Wendelsheim, Germany. [email protected]. 3. AESKU.KIPP Institute, Mikroforum Ring 2, 55234 Wendelsheim, Germany. [email protected].

Abstract

The human gut is inhabited by overcrowded prokaryotic communities, a major component of which is the virome, comprised of viruses, bacteriophages, archaea, eukaryotes and bacteria. The virome is required for luminal homeostasis and, by their lytic or synergic capacities, they can regulate the microbial community structure and activity. Dysbiosis is associated with numerous chronic human diseases. Since the virome can impact microbial genetics and behavior, understanding its biology, composition, cellular cycle, regulation, mode of action and potential beneficial or hostile activities can change the present paradigm of the cross-talks in the luminal gut compartment. Celiac disease is a frequent autoimmune disease in which viruses can play a role in disease development. Based on the current knowledge on the enteric virome, in relation to celiac disease pathophysiological evolvement, the current review summarizes the potential interphases between the two. Exploring and understanding the role of the enteric virome in gluten-dependent enteropathy might bring new therapeutic strategies to change the luminal eco-event for the patient's benefit.

Free Article

PMID: 31207872

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Publication type

• Review

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

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

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

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65. J Food Sci Technol. 2019 Jun;56(6):2949-2958. doi: 10.1007/s13197-019-03769-8. Epub 2019 Apr 10. Production of prebiotic gluten-free bread with red rice flour and different microbial transglutaminase concentrations: modeling, sensory and multivariate data analysis.

Gusmão TAS1, de Gusmão RP1, Moura HV1, Silva HA1, Cavalcanti-Mata MERM1, Duarte MEM1.

Author information: 1. Department of Food Engineering, Federal University of Campina Grande, Campina Grande, 58410- 743 Brazil.

Abstract

The aim of this study was to develop gluten-free bread formulated with red rice flour and microbial transglutaminase and prebiotic (inulin). First, the physicochemical analysis of minerals present in red rice flour was performed. Response surface methodology was used to analyze the effects of microbial transglutaminase (MTgase) [0.5; 1.0 and 1.5%] in combination with fermentation time (FT) [60; 80 and 100 min] on the quality parameters of gluten-free bread. Acceptance test was used to evaluate the sensory characteristics of breads together with multivariate analysis of data. The addition of MTgase increased bread volume, hardness and chewiness. However, the cohesiveness and springiness of all breads remained unaffected. The formulation (1.0% MTgase and 80 min FT) presented the best sensory attributes through PCA (principal component analysis) and greater acceptance. Overall, red rice flour, prebiotic and MTgase are promisingly useful ingredients for the production of gluten-free quality bread.

PMCID: PMC6542973 [Available on 2020-06-01]

PMID: 31205350

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66. J Food Sci Technol. 2019 Jun;56(6):2863-2873. doi: 10.1007/s13197-019-03730-9. Epub 2019 Apr 24. Effect of ingredients on the quality of gluten- free steamed bread based on potato flour.

Liu X1, Mu T2, Sun H2, Zhang M2, Chen J2,3, Fauconnier ML3.

Author information: 1. 1School of Food and Biological Engineering, Zhengzhou University of Light Industry, Zhengzhou, 450000 People's Republic of China. 2. 2Key Laboratory of Agro-Products Processing, Ministry of Agriculture and Rural Affairs; Institute of Food Science and Technology, Chinese Academy of Agricultural Sciences, 2 Yuanmingyuan west road, Haidian, Beijing, 100193 People's Republic of China. 3. 3Laboratory of General and Organic Chemistry, University of Liege, Gembloux Agro-Bio Tech, Passage des Déportés, 2-5030 Gembloux, Belgium.

Abstract

Response surface methodology was used to analyze effects of the amounts of pregelatinized potato flour (PGPF), hydroxypropylmethylcellulose (HPMC), egg white protein (EWP), and water on the dough fermentation and physical properties of gluten-free (GF) steamed bread based on potato flour. The results showed that PGPF, HPMC, EWP, and water at the appropriate amounts improved the maximum dough height (H m), specific volume (SV) and hardness, as well as H m correlated with SV (R 2 = 0.6993) and hardness (R 2 = 0.7273). Moreover, the optimal formulation contained 4.84 g/100 g PGPF, 1.68 g/100 g HPMC, 5.87 g/100 g EWP, and 69.69 g/100 g water, potato flour basis. Furthermore, the dietary fiber, total polyphenol content, antioxidant activity, and estimated glycemic index of the steamed GF bread were, respectively, 3.17-, 1.56-, 1.44-, and 0.75-fold of those of steamed wheat bread. The optimized steamed GF bread was found to be acceptable according to the results of sensory analysis. Information collected within this study may provide further insight for optimizing the formulation of steamed GF bread based on potato flour.

PMCID: PMC6542968 [Available on 2020-06-01]

PMID: 31205342

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67. J Food Sci Technol. 2019 Jun;56(6):2825-2835. doi: 10.1007/s13197-019-03688-8. Epub 2019 May 16. Effect of amino and thiol groups of wheat gluten on the quality characteristics of Chinese noodles.

Li H1, Wang J1, Pan L1, Lu Q1.

Author information: 1. College of Food Science and Technology, Henan University of Technology, Zhengzhou, 450001 Henan People's Republic of China.

Abstract

Wheat protein contains a large number of side chain groups, amino, hydroxyl groups and sulfydryl, which influence on the quality of Chinese noodles has not been reported. Amino and thiol groups of wheat gluten were modified by chemical reactions, and acetylated gluten (AG) and reduced gluten with anhydrous sodium sulfite (SG) were obtained. Two types of noodles were made by addition of AG and SG, and the effects of AG and SG on texture and cooking properties were investigated. With the increase of AG amount in the original flour, the sedimentation value of reconstituted flour and the tensile force of fresh and cooked noodles decreased, whereas the hardness and adhesiveness increased. The gluten index and springiness of the reconstituted flour did not vary significantly compared to those of the original flour. In addition, most of the texture and cooking quality properties of the two types of noodles decreased except the adhesiveness and tensile force of fresh noodles with a rising trend along with the increase of SG. Furthermore, the cooking yield was reduced, whereas the cooking and protein losses increased along with the elevation of modified gluten levels. Our results indicated that significant differences (p < 0.05) were present between the texture and cooking properties of Chinese noodles made by flour with AG and SG and those of unmodified samples, except for the springiness of AG noodles, and the reduction of disulfide bond was disadvantageous for the quality of noodles. Therefore, the results of the present study indicate that amino and sulfhydryl groups of wheat gluten have an important role in obtaining high-quality noodles.

PMCID: PMC6543045 [Available on 2020-06-01]

PMID: 31205338

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68. Am J Gastroenterol. 2019 Jun 13. doi: 10.14309/ajg.0000000000000299. [Epub ahead of print] Improving the Treatment of Celiac Disease.

Forbes GM1.

Author information: 1. Faculty of Health and Medical Sciences, University of Western Australia. PMID: 31205132

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69. Orv Hetil. 2019 Jun;160(25):980-986. doi: 10.1556/650.2019.31421. [Quality of life of consumers following a gluten-free diet. Results of a questionnaire survey in Hungary and Romania]. [Article in Hungarian; Abstract available in Hungarian from the publisher]

Szűcs V1, Fazakas Z2, Farr A2, Tarcea M2.

Author information: 1. Nemzeti Agrárgazdasági Kamara Budapest, Fehérvári út 89-95., 1119. 2. Pharmacy, Sciences and Technology of Targu-Mures, University of Medicine Targu-Mures, Romania.

Abstract

Introduction and aim: With the rising consumer's health awareness, especially towards patients with celiac disease, gluten has become a food ingredient to be avoided by many people expecting various positive health effects. The strict adherence of diet requires serious abandonments and lifestyle changes that affect directly their quality of life. The aim of the present study was to recognise the quality of life of Hungarian and Romanian consumers following a gluten-free diet as well as to explore the negative effects on them. Method: An online questionnaire survey was conducted upon 1155 Hungarian and Romanian respondents. Results: For gluten-free consumers, self-control was relatively easy to overcome, but their lifestyle was negatively affected by social events and dining out. In addition, diet adherence was a burden from both lifestyle and financial point of view. For Hungarian consumers, external factors such as price, choice, taste and availability of products had become a major obstacle, while Romanian ones were more likely to be affected by internal factors (product information, diet knowledge, lifestyle, self-control). Mandatory labelling of substances and products causing allergies and intolerances has achieved its purpose, as it has made it easier for consumers on diet to choose food and increased their confidence. Conclusions: The study points out that dieters' quality of life can be enhanced not only by general actions (improving the preparedness of out-of-home meal services and rationalising the price of products), but also through country- specific community intervention. Orv Hetil. 2019; 160(25): 980-986. PMID: 31203642

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Publication type

• English Abstract

70. Food Chem Toxicol. 2019 Jun 13;131:110579. doi: 10.1016/j.fct.2019.110579. [Epub ahead of print] Hydrolyzed wheat gluten alleviates deoxynivalenol-induced intestinal injury by promoting intestinal stem cell proliferation and differentiation via upregulation of Wnt/β-catenin signaling in mice.

Zhou JY1, Zhang SW1, Lin HL1, Gao CQ1, Yan HC1, Wang XQ2.

Author information: 1. College of Animal Science, South China Agricultural University/Guangdong Provincial Key Laboratory of Animal Nutrition Control/National Engineering Research Center for Breeding Swine Industry, Guangzhou, Guangdong, 510642, China. 2. College of Animal Science, South China Agricultural University/Guangdong Provincial Key Laboratory of Animal Nutrition Control/National Engineering Research Center for Breeding Swine Industry, Guangzhou, Guangdong, 510642, China. Electronic address: [email protected].

Abstract

Disintegration of the intestine caused by deoxynivalenol (DON), which is a fungal metabolite found in cereal grain-based human and animal diets, triggers severe intestinal inflammatory disease. Hydrolyzed wheat gluten (HWG) can promote the development of intestine. Therefore, HWG was administered orally to male mice on 1-14 days, and DON was administered to them on 4-11 days. Feed, water intake and body weight were recorded all over the experimental period. Blood samples were collected then the mice were sacrificed to collect the jejunum for crypt isolation and culture. The intestinal morphology was observed by electron microscopy, and Western blotting was used to investigate intestinal stem cell (ISC) proliferation and differentiation, as well as the primary regulatory mechanism of the Wnt/β-catenin signaling. The results showed that HWG increased the average daily gain and average daily water intake of mice under DON-induced injury conditions, and increased the jejunum weight, villous height in the jejunum, and promoted jejunal crypt cell expansion. The DON-induced decrease in Wnt/β-catenin activity, the expression of Ki67, PCNA and KRT20 were rescued by HWG in the jejunum, crypt and enteroid, as well as the number of goblet cells and Paneth cells. Furthermore, HWG increased jejunum diamine oxidase (DAO) activity. In conclusion, HWG alleviates DON-induced intestinal injury by enhancing ISC proliferation and differentiation in a Wnt/β-catenin-dependent manner.

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

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

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

Abstract

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

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72. Mol Biol Rep. 2019 Jun 14. doi: 10.1007/s11033-018-04576-8. [Epub ahead of print] Effect of gluten diet on blood innate immune gene expressions and stool consistency in Spix's Saddleback Tamarin (Leontocebus fuscicollis) raised in captivity.

Almeida TTG1, Monteiro MVB2, Guimarães RC3, Casseb AR3, Huffman MA4, Gonçalves EC2, Monteiro FOB3, Silva Filho E5.

Author information: 1. Departamento de Nutrição, Escola Superior da Amazônia, Belém, PA, Brazil. 2. Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA, Brazil. 3. Instituto da Saúde e Produção Animal, Universidade Federal Rural da Amazônia, Belém, PA, Brazil. 4. Primatology Research Institute (PRI), Kyoto University, Inuyama, Japan. 5. Instituto da Saúde e Produção Animal, Universidade Federal Rural da Amazônia, Belém, PA, Brazil. [email protected].

Abstract

The callitrichids are non-human primates that feed on insects and plant matter in nature, but in captivity, they are fed mostly an artificial diet containing amounts of gluten, in their toxic forms in items such as wheat, barley and rye. The aim of this research was to estimate the blood β-defensin and Toll like receptor 5 (TLR5) gene expressions and to analyze the stool consistency (firm, soft, diarrheic) in Leontocebus fuscicollis raised in captivity. Blood samples of animals under gluten-free and gluten diets were collected and their fecal output quality was periodically monitored and classified during the course of the study. Gene expression was evaluated using real-time PCR. The stool consistencies of individuals fed a gluten diet were most frequently soft or diarrheic, while it was mostly normal in individuals fed a gluten-free diet. β-Defensin expression increased in individuals fed a gluten diet, but decreased after 15 days. Expression normalized between 30 and 45 days on a gluten-free diet. However, expression of the TLR5 gene did not change under a gluten diet. A gluten diet affects stool quality, and brings about an immediate increase in blood β-defensin expression in the beginning but decreases after 15 days. PMID: 31201676

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73. JAMA Netw Open. 2019 Jun 5;2(6):e195822. doi: 10.1001/jamanetworkopen.2019.5822. Assessment of Machine Learning Detection of Environmental Enteropathy and Celiac Disease in Children.

Syed S1,2, Al-Boni M3, Khan MN1, Sadiq K2, Iqbal NT2, Moskaluk CA4, Kelly P5,6, Amadi B6, Ali SA2, Moore SR1, Brown DE7.

Author information: 1. Division of Pediatric Gastroenterology and Hepatology, Department of Pediatrics, University of Virginia, Charlottesville. 2. Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan. 3. Systems and Information Engineering, University of Virginia, Charlottesville. 4. Deparment of Pathology, University of Virginia, Charlottesville. 5. Blizard Institute, Barts and The London School of Medicine, Queen Mary University of London, London, United Kingdom. 6. Tropical Gastroenterology and Nutrition Group, University of Zambia School of Medicine, Lusaka, Zambia. 7. Data Science Institute, University of Virginia, Charlottesville.

Abstract

Importance:

Duodenal biopsies from children with enteropathies associated with undernutrition, such as environmental enteropathy (EE) and celiac disease (CD), display significant histopathological overlap.

Objective:

To develop a convolutional neural network (CNN) to enhance the detection of pathologic morphological features in diseased vs healthy duodenal tissue.

Design, Setting, and Participants:

In this prospective diagnostic study, a CNN consisting of 4 convolutions, 1 fully connected layer, and 1 softmax layer was trained on duodenal biopsy images. Data were provided by 3 sites: Aga Khan University Hospital, Karachi, Pakistan; University Teaching Hospital, Lusaka, Zambia; and University of Virginia, Charlottesville. Duodenal biopsy slides from 102 children (10 with EE from Aga Khan University Hospital, 16 with EE from University Teaching Hospital, 34 with CD from University of Virginia, and 42 with no disease from University of Virginia) were converted into 3118 images. The CNN was designed and analyzed at the University of Virginia. The data were collected, prepared, and analyzed between November 2017 and February 2018. Main Outcomes and Measures:

Classification accuracy of the CNN per image and per case and incorrect classification rate identified by aggregated 10-fold cross-validation confusion/error matrices of CNN models.

Results:

Overall, 102 children participated in this study, with a median (interquartile range) age of 31.0 (20.3- 75.5) months and a roughly equal sex distribution, with 53 boys (51.9%). The model demonstrated 93.4% case-detection accuracy and had a false-negative rate of 2.4%. Confusion metrics indicated most incorrect classifications were between patients with CD and healthy patients. Feature map activations were visualized and learned distinctive patterns, including microlevel features in duodenal tissues, such as alterations in secretory cell populations.

Conclusions and Relevance:

A machine learning-based histopathological analysis model demonstrating 93.4% classification accuracy was developed for identifying and differentiating between duodenal biopsies from children with EE and CD. The combination of the CNN with a deconvolutional network enabled feature recognition and highlighted secretory cells' role in the model's ability to differentiate between these histologically similar diseases.

PMCID: PMC6575155 Free PMC Article

PMID: 31199451

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74. Funct Integr Genomics. 2019 Jun 13. doi: 10.1007/s10142-019-00686-z. [Epub ahead of print] Rapid evolution of α-gliadin gene family revealed by analyzing Gli-2 locus regions of wild emmer wheat.

Huo N1,2, Zhu T2, Zhang S3, Mohr T1, Luo MC2, Lee JY4, Distelfeld A5, Altenbach S1, Gu YQ6.

Author information: 1. United States Department of Agriculture-Agricultural Research Service USDA-ARS, Western Regional Research Center, 800 Buchanan Street, Albany, CA, 94710, USA. 2. Department of Plant Sciences, University of California, Davis, CA, 95616, USA. 3. Hena Institute of Science and Technology, Xinxiang, Hena Province, 453003, China. 4. National Institute of Agricultural Sciences, RDA, Jeonju, 54874, South Korea. 5. Institute for Crop Improvement, Tel Aviv University, Tel Aviv-Yafo, Israel. 6. United States Department of Agriculture-Agricultural Research Service USDA-ARS, Western Regional Research Center, 800 Buchanan Street, Albany, CA, 94710, USA. [email protected].

Abstract

α-Gliadins are a major group of gluten proteins in wheat flour that contribute to the end-use properties for food processing and contain major immunogenic epitopes that can cause serious health-related issues including celiac disease (CD). α-Gliadins are also the youngest group of gluten proteins and are encoded by a large gene family. The majority of the gene family members evolved independently in the A, B, and D genomes of different wheat species after their separation from a common ancestral species. To gain insights into the origin and evolution of these complex genes, the genomic regions of the Gli-2 loci encoding α-gliadins were characterized from the tetraploid wild emmer, a progenitor of hexaploid bread wheat that contributed the AABB genomes. Genomic sequences of Gli-2 locus regions for the wild emmer A and B genomes were first reconstructed using the genome sequence scaffolds along with optical genome maps. A total of 24 and 16 α-gliadin genes were identified for the A and B genome regions, respectively. α-Gliadin pseudogene frequencies of 86% for the A genome and 69% for the B genome were primarily caused by C to T substitutions in the highly abundant glutamine codons, resulting in the generation of premature stop codons. Comparison with the homologous regions from the hexaploid wheat cv. Chinese Spring indicated considerable sequence divergence of the two A genomes at the genomic level. In comparison, conserved regions between the two B genomes were identified that included α-gliadin pseudogenes containing shared nested TE insertions. Analyses of the genomic organization and phylogenetic tree reconstruction indicate that although orthologous gene pairs derived from speciation were present, large portions of α-gliadin genes were likely derived from differential gene duplications or deletions after the separation of the homologous wheat genomes ~ 0.5 MYA. The higher number of full-length intact α-gliadin genes in hexaploid wheat than that in wild emmer suggests that human selection through domestication might have an impact on α-gliadin evolution. Our study provides insights into the rapid and dynamic evolution of genomic regions harboring the α-gliadin genes in wheat. PMID: 31197605

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Grant support

• IOS 1238231/National Science Foundation (US)/ • RDA PJ013149 and PDA PJ013159/Next-generation BioGreen 21/ • 31571667 and U1204315/National Natural Science Foundation of China/ • 2030-21430-014/Agricultural Research Service/

75. Eur Radiol. 2019 Jun 13. doi: 10.1007/s00330-019-06288-4. [Epub ahead of print] Correction to: Anatomical variations in the origins of the celiac axis and the superior mesenteric artery: MDCT angiographic findings and their probable embryological mechanisms.

Wang Y1, Cheng C2, Wang L2, Li R2, Chen JH2, Gong SG3.

Author information: 1. Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China. [email protected]. 2. Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China. 3. Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China. [email protected].

Erratum for

• Anatomical variations in the origins of the celiac axis and the superior mesenteric artery: MDCT angiographic findings and their probable embryological mechanisms. [Eur Radiol. 2014]

Abstract

The original version of this article, published on 24 May 2014, unfortunately contained a referencing omission. PMID: 31197443

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Publication type

• Published Erratum

76. BMC Gastroenterol. 2019 Jun 13;19(1):91. doi: 10.1186/s12876-019-1014-0. Influence of HLA on clinical and analytical features of pediatric celiac disease.

Martínez-Ojinaga E1, Fernández-Prieto M2, Molina M1, Polanco I1, Urcelay E2, Núñez C3.

Author information: 1. Servicio de Gastroenterología y Nutrición Pediátrica, Hospital Universitario La Paz, Madrid, Spain. 2. Laboratorio de investigación en Genética de enfermedades complejas, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), C/ Profesor Martín Lagos s/n 28040, Madrid, Spain. 3. Laboratorio de investigación en Genética de enfermedades complejas, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), C/ Profesor Martín Lagos s/n 28040, Madrid, Spain. [email protected].

Abstract

BACKGROUND:

Celiac disease (CD) is triggered by gluten and related prolamines in genetically susceptible individuals. We aimed to investigate the influence of HLA-DQ genotypes in clinical, serological and histological features related to CD.

METHODS:

A retrospective observational study was performed including 463 Spanish patients with biopsy- proven CD. Clinical, serological, histological and HLA-DQ genetic data were collected from each participant. The presence of a family history of CD was also considered. Bivariate (chi-square tests or the Fisher's exact test) and multivariate (logistic regression after adjusting for age and sex) analyses were performed to assess the association between clinical and laboratory parameters with HLA-DQ.

RESULTS:

A predominance of females (62%), classical clinical presentation (86%) and positive anti- transglutaminase 2/endomysium antibodies (99%) was observed in our sample, with a mean age at onset of 2.6 ± 0.1 years. Five percent of our patients were first-degree relatives of subjects with CD, with HLA-DQ genetics showing increased homozygosity of HLA-DQ2.5 (p = 0.03) and HLA-DQ8 (p = 0.09). In the non-CD family history group, an association between delayed disease onset and HLA-DQ8 carriage was observed (p < 0.001), besides an influence of HLA-DQB1*02 gene dosage on clinical presentation and severity of histological damage (after adjusting for age and sex, p = 0.05 and p = 0.02, respectively) and a trend towards presence of specific antibodies (p = 0.09). These associations could not be evaluated properly in the group of patients with affected first-degree relatives due to the small sample size.

CONCLUSIONS: HLA-DQ genotypic frequencies differ slightly between CD patients depending on their family history of CD. In patients lacking CD first-degree relatives, carriage of HLA-DQ2.5 with double dose of HLA- DQB1*02 seems to be associated with classical clinical presentation and more severe histological damage.

PMCID: PMC6567567 Free PMC Article

PMID: 31196071

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Grant support

• PI15/01186-Fondo Europeo de Desarrollo Regional (FEDER)/Instituto de Salud Carlos III/

77. Nutrients. 2019 Jun 5;11(6). pii: E1276. doi: 10.3390/nu11061276. A Population Survey of Dietary Attitudes towards Gluten.

Croall ID1, Trott N2, Rej A3, Aziz I4, O'Brien DJ5, George HA6, Hossain MY7, Marks LJS8, Richardson JI9, Rigby R10, Hadjivassiliou M11, Hoggard N12, Sanders DS13.

Author information: 1. University of Sheffield, Academic Unit of Radiology, Royal Hallamshire Hospital, Sheffield S10 2JF, UK. [email protected]. 2. Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK. [email protected]. 3. Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK. [email protected]. 4. Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK. [email protected]. 5. Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK. [email protected]. 6. Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK. [email protected]. 7. Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK. [email protected]. 8. Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK. [email protected]. 9. Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK. [email protected]. 10. Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK. [email protected]. 11. Department of Neurology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, S10 2JF, UK. [email protected]. 12. University of Sheffield, Academic Unit of Radiology, Royal Hallamshire Hospital, Sheffield S10 2JF, UK. [email protected]. 13. Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK. [email protected].

Abstract

It is unclear how the prevalence of people who believe the gluten-free diet (GFD) to be generally healthy ("Lifestylers") is impacting the overall rates of self-reported gluten sensitivity (GS). We repeated a population survey from 2012 in order to examine how attitudes towards GS have changed over time. Our survey (N = 1004) was administered in Sheffield (UK) in 2015, replicating the 2012 experiment. The questionnaire included a food frequency survey and assessed self-reported GS as well as associated variables (prevalence, current diet, pre-existing conditions, etc.). The overall rates of key variables and chi-squared analysis in comparison to the previous survey were as follows: self-reported GS was 32.8% (previously 12.9%, p < 0.001), pre-existing coeliac disease (CD) was 1.2% (previously 0.8%, p = 0.370), following a GFD was 3.7% (previously 3.7%, p = 0.997). Self-reported GS was positively associated with some pre-existing conditions, including anxiety, depression, chronic fatigue, headaches, and other food allergies/intolerances (including irritable bowel syndrome (IBS); chi-squared analyses, all p < 0.001). Over a 3-year period, the fraction of people who self-reported GS increased by over 250%. Despite this, arguably more meaningful indications of underlying physiological GS remained comparable. This research suggests that the public perception of gluten is causing a marked increase in the number of people who erroneously believe they are sensitive to it.

Free Article

PMID: 31195638

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78. Heliyon. 2019 Jun 4;5(6):e01805. doi: 10.1016/j.heliyon.2019.e01805. eCollection 2019 Jun. Determination of thermal transitions of gluten-free chestnut flour doughs enriched with brown seaweed powders and antioxidant properties of baked cookies. Arufe S1, Sineiro J1, Moreira R1.

Author information: 1. Department of Chemical Engineering, Universidade de Santiago de Compostela, rúa Lope Gómez de Marzoa, Santiago de Compostela, E-15782, Spain.

Abstract

A protocol for determining the characteristic temperatures of thermomechanical transitions on gluten-free flour doughs is proposed. This protocol is based on the mathematical analysis of experimental curve of storage modulus (G') vs temperature obtained by means of Dynamic Mechanical Thermal Analysis (DMTA) technique. Doughs at constant consistency of chestnut flour with different levels (3, 6 and 9% flour basis, f.b.) of brown seaweed (Bifurcaria bifurcata, Fucus vesiculosus and Ascophyllum nodosum) powders addition, 2% f.b. of guar gum and 1.8% f.b. of salt with different water absorption were used to test the proposed protocol. The ranges of temperatures corresponding to starch gelatinization (59-97 °C), amylopectin crystallites melting (82- 101 °C), reversible dissociation of lipid-amylose complexes (107-128 °C) and amylose melting (133- 171 °C) showed a strong dependence with water absorption of samples. Doughs with the same water absorption submitted to starch gelatinization during mixing were also analysed to corroborate the protocol suitability. Total polyphenols content and radical scavenging activity of extracts from chestnut flour-seaweed powder blends and seaweed-enriched chestnut cookies baked at 180 °C were determined. Extraction assisted with ultrasounds was carried out employing acetone-water (70:30 v/v) solution as solvent during 4 min with a liquid/solid ratio of 30 w/w. Seaweed powder addition had a positive effect on antioxidant properties of doughs before baking. However, the seaweed powder addition effect on baked products (cookies) is not clear due to antioxidant activity is overlapped by Maillard's products generated during baking.

PMCID: PMC6551486 Free PMC Article

PMID: 31194051

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79. Anim Nutr. 2019 Jun;5(2):148-151. doi: 10.1016/j.aninu.2018.10.001. Epub 2018 Oct 25. Pre-cecal phosphorus digestibility for corn, wheat, soybean meal, and corn gluten meal in growing Japanese quails from 28 to 32 d of age. Ghazaghi M1, Hassanabadi A1, Mehri M2.

Author information: 1. Department of Animal Science, Faculty of Agriculture, Ferdowsi University of Mashhad, Mashhad 91775-1163, Iran. 2. Department of Animal Sciences, University of Zabol, Zabol 98661-5538, Iran.

Abstract

The optimization of dietary phosphorus (P) depends on precise details of the P availability in feed ingredients to avoid excess or deficient P in a mixed diet. This study was carried out to measure the apparent ileal digestibility of P for corn, wheat, soybean meal, and corn gluten meal in growing Japanese quails from 28 to 32 d posthatch. A total of 400 quail chicks were randomly distributed across 5 treatments with 4 replicates and 20 birds in each floor pen. The P-free diet (PFD) was formulated based on cornstarch to measure the basal endogenous P losses (EPL). Digestibility coefficients were determined by ileal digesta sampling using TiO2 as an indigestible marker. The EPL was estimated at 384 mg/kg DMI. The apparent ileal P digestibility (AIPD) for corn, soybean meal, wheat, and corn gluten meal were determined to be 0.38, 0.53, 0.38, and 0.78, respectively. The corresponding values for true ileal P digestibility (TIPD) were 0.48, 0.61, 0.50, and 0.83, respectively. The t-test analysis showed that the difference of AIPD and TIPD values for corn (P = 0.031) and wheat (P = 0.015) were statistically significant, however, no significant differences were observed for corn gluten meal (P = 0.318) and soybean meal (P = 0.104). In conclusion, the correction of AIPD coefficients for EPL in low-P ingredients such as corn and wheat may be much more important than that in high-P feedstuffs such as corn gluten meal and soybean meal in growing quails.

PMCID: PMC6544747 Free PMC Article

PMID: 31193941

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80. J Vasc Surg Cases Innov Tech. 2019 May 31;5(2):197-199. doi: 10.1016/j.jvscit.2018.07.001. eCollection 2019 Jun. Inferior mesenteric artery aneurysm in the setting of celiac and superior mesenteric artery occlusion.

Tan C1, Reul R2. Author information: 1. Division of Cardiothoracic Surgery, Baylor College of Medicine/Texas Heart Institute, Houston, TX, USA. 2. Department of Cardiovascular Surgery, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA.

Abstract

Inferior mesenteric artery (IMA) aneurysm is a rare type of visceral aneurysm. We present the case of a 77-year-old woman with an IMA aneurysm in the setting of chronic complete occlusion of the origins of her celiac artery and superior mesenteric artery. The patient was managed successfully with surgical excision of the IMA aneurysm with an end-to-side anastomosis of the IMA to the left common iliac artery. The case report is followed by a discussion based on a literature review of the few previously reported occurrences of IMA aneurysm.

PMCID: PMC6545348 Free PMC Article

PMID: 31193925

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Publication type

• Case Reports

81. Am J Physiol Gastrointest Liver Physiol. 2019 Jun 12. doi: 10.1152/ajpgi.00099.2019. [Epub ahead of print] Celiac disease: Should we care about microbes?

Caminero A1, Verdu EF2.

Author information: 1. McMaster University, Canada. 2. Medicine, McMaster University, Canada.

Abstract

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

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

Chen CY1, Li JN.

Author information: 1. Department of Gastroenterology, Key Laboratory of Gut Microbiota Translational Medicine Research, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China. PMID: 31188159

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83. Int J Immunogenet. 2019 Jun 11. doi: 10.1111/iji.12441. [Epub ahead of print] HLA-DQB1*02 allele in children with celiac disease: Potential usefulness for screening strategies. Poddighe D1,2, Capittini C3, Gaviglio I2, Brambilla I2, Marseglia GL2.

Author information: 1. Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan City (Astana), Kazakhstan. 2. Department of Pediatrics, University of Pavia, Pavia, Italy. 3. Department of Clinical Epidemiology and Biometrics, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy.

Abstract

Through a retrospective analysis of a real-life cohort of children with celiac disease (CD), who underwent HLA-DQ genotyping, we supported our previous findings indicating the presence of HLA- DQB1*02 allele in at least 90%-95% of pediatric patients. In the present study, reporting the HLA-DQ analysis from 184 children (age range: 1-16 years) diagnosed with CD in a single centre, we found that 97.29% of all these CD children (n = 179 out of 184 genotyped patients) resulted to be carriers of at least one copy of HLA-DQB1*02 allele. If a widened screening for CD should result to be appropriate in the pediatric population after further clinical research, this observation might be potentially exploited to consider a two-step screening strategy, starting with the HLA-DQB1*02 targeted analysis followed by the specific serology for CD in these predisposed patients only. However, additional and larger studies are needed to support our findings.

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

Guandalini S1.

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

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Publication type

• Editorial

85. Am J Med Genet A. 2019 Jun 10. doi: 10.1002/ajmg.a.61258. [Epub ahead of print] Gastrointestinal disorders in Down syndrome.

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

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

Abstract

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

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86. Indian J Gastroenterol. 2019 Jun 10. doi: 10.1007/s12664-019-00952-9. [Epub ahead of print] Interpretation and implementation of the revised European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) guidelines on pediatric celiac disease amongst consultant general pediatricians in Southwest of England.

Paul SP1,2, Adams HL3,4, Basude D3,4; Collaborators.

Collaborators: (9)

Rushforth A, Knight C, Vaina C, Gowda G, Hart J, Ne-Ron L, Thorpe M, Cordingley R, Broad S.

Author information: 1. Department of Paediatrics, Torbay Hospital, Lowes Bridge, Torquay, TQ2 7AA, UK. [email protected]. 2. Department of Paediatric Gastroenterology, Bristol Royal Hospital for Children, Bristol, UK. [email protected]. 3. Department of Paediatric Gastroenterology, Bristol Royal Hospital for Children, Bristol, UK. 4. Medical School, University of Bristol, Bristol, UK.

Abstract

BACKGROUND:

Celiac disease (CD) is a lifelong condition with significant morbidity and requires an accurate diagnosis. Guidelines for pediatric CD were revised by the European and British Societies of Paediatric Gastroenterology Hepatology and Nutrition in 2012 and 2013, respectively. New recommendations introduced non-biopsy pathway (NBP) of diagnosis for a selective group of symptomatic children whose anti-tissue transglutaminase (anti-tTG) antibody titer is greater than ten times upper limit of normal. A clear understanding of the guidelines amongst consultant pediatricians will ensure all children with suspected CD receive a prompt and secure diagnosis. The aim of this study was to establish the interpretation and implementation of the revised guideline for CD amongst consultant general pediatricians in Southwest England (SWE) during the study period.

METHODS: Telephone/email survey was conducted amongst consultant general pediatricians (n ≈ 140) working in 12 secondary care hospitals across SWE. The survey included eight questions incorporating three main themes: understanding of diagnostic pathway particularly for non-biopsy diagnosis, awareness of laboratory tests involved, and variations in practice in relation to the revised guidelines.

RESULTS:

Responses were available from 101/140 (72%). One hundred respondents were aware of the revised guidelines for diagnosing CD. However, only 17 respondents stated all the criteria of the guideline required for diagnosis by NBP, with further 17 seeking immediate advice from a specialist. Forty- four listed both the criteria for HLA-DQ2/DQ8 testing applicable to pediatricians. Forty-nine out of 100 pediatricians would commence gluten-free diet only after all the results were available. Thirty- three pediatricians also considered asymptomatic children with high anti-tTG titer eligible for diagnosis of CD by NBP.

CONCLUSIONS:

There is a need for improved understanding of revised CD guidelines amongst consultant general pediatricians especially while using the NBP and requesting HLA-DQ2/DQ8 testing. PMID: 31183842

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87. Iran J Immunol. 2019 Jun;16(2):117-126. doi: 10.22034/IJI.2019.80255. Cell Density Counts of the Intestinal Intraepithelial Lymphocytes in the Celiac Patients.

Hossein-Nataj H1, Masjedi M, Emami MH, Mokhtari M, Alsahebfosoul F.

Author information: 1. Department of Immunology, Mazandaran University of Medical Sciences, Sari, Iran.

Abstract

BACKGROUND:

Increased number of intestinal intraepithelial lymphocytes (IELs) is a key histological finding in the diagnosis of celiac disease (CD); however, the number of IELs in celiac patients and healthy subjects may vary from one region to another. Additionally, there are some seronegative celiac patients with a borderline histology.

OBJECTIVE:

To determine the number of the CD3+ and CD8+ IELs T-cells in the celiac patients and healthy subjects (controls) in Isfahan.

METHODS:

The duodenal biopsies were obtained from the celiac patients (n=15) and the controls (n=19). The total number of IELs/100 epithelial cells (ECs) were counted using the hematoxylin-eosin (H&E) staining method, and that of CD3+ and CD8+ IELs/100 ECs were counted using the immunohistochemistry (IHC) staining method.

RESULTS:

This study defined the upper normal limit for each variable as mean + 2SD. Accordingly, the upper normal limits of the total IELs, CD3+ IELs, and CD8+ IELs/100 ECs were calculated as 37 (95% confidence intervals, CI: 33-41), 22 (95% CI: 19-25) and 12 (95% CI: 10-14), respectively. In 3 clinically CD diagnoses, the total IELs counts/100 ECs were below the upper normal limit, and the histopathological and serologic assays were negative. Nevertheless, the CD8+ IELs T-cells counts/100 ECs showed borderline values. Interestingly, these patients responded to a gluten-free diet (GFD).

CONCLUSIONS:

The study findings suggest that in the clinically diagnosed celiac disease, IELs count/100 ECs below the upper normal limit as well as negative histopathological and serologic assays and the cell density counts of the CD8+ IELs T-cells/100 ECs could be a useful parameter in CD diagnosis and make a decision to put them on a GFD.

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PMID: 31182686

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88. Arab J Gastroenterol. 2019 Jun;20(2):95-98. doi: 10.1016/j.ajg.2019.05.005. Epub 2019 Jun 7. Serological screening for coeliac disease in patients with juvenile idiopathic arthritis. Sahin Y1, Sahin S2, Barut K2, Cokugras FC3, Erkan T3, Adrovic A2, Kutlu T3, Kasapcopur O2.

Author information: 1. Department of Paediatric Gastroenterology, Cerrahpasa Medical School, Istanbul University, Turkey. Electronic address: [email protected]. 2. Paediatric Rheumatology, Cerrahpasa Medical School, Istanbul University, Turkey. 3. Department of Paediatric Gastroenterology, Cerrahpasa Medical School, Istanbul University, Turkey.

Abstract

BACKGROUND AND STUDY AIMS:

Juvenile idiopathic arthritis (JIA) is characterized by autoimmune aetiology. A gene locus 4q27 related to rheumatoid arthritis, psoriatic arthritis, and coeliac disease is associated with susceptibility to JIA. There are reports indicating several patients with JIA had been diagnosed with CD. We aimed to assess the frequency of coeliac disease (CD) in patients with juvenile idiopathic arthritis (JIA).

PATIENTS AND METHODS:

This prospective study was carried out from October 2015 to August 2016 and included 96 patients with JIA. All patients were evaluated in terms of clinical and laboratory findings of CD. Levels of total IgA and tissue transglutaminase antibody (tTG) IgA were measured in all patients. Those with increased level of tTG IgA were further tested for anti-endomysium IgA antibodies (EMA). Gastroduodenoscopy were planned for a definite diagnosis of CD in patients with positive EMA.

RESULTS:

Of the 96 patients in our study, 34 (35.4%) had oligoarticular form of JIA, 29 (30.2%) had polyarticular form, 12 (12.5%) had ERA form, 11 (11.5%) had systemic form, and 10 (10.4%) had psoriatic form. Sixteen of our patients (16.6%) were not using any drugs during the study. Neither EMA IgA antibodies were analysed nor gastro-duodenoscopy was performed because no patients were positive for tTG IgA. There was no difference in terms of tTG levels between the patients using NSAIDs or other drugs.

CONCLUSION:

We did not find CD in children with JIA. Long term studies with more JIA patients are needed to provide more precise interpretation.

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

El-Salhy M1, Gilja OH2, Hatlebakk JG2.

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

Abstract

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

PMCID: PMC6580027 Free PMC Article

PMID: 31180516

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90. Allergol Int. 2019 Jun 5. pii: S1323-8930(19)30057-7. doi: 10.1016/j.alit.2019.04.007. [Epub ahead of print] Anti-gluten IgE titer is associated with severity of provocation test-evoked symptoms in wheat-dependent exercise- induced anaphylaxis.

Sugiyama A1, Kishikawa R2, Honjo S2, Nishie H3, Iwanaga T2, Furue M4.

Author information: 1. Department of Dermatology, National Hospital Organization Fukuoka National Hospital, Fukuoka, Japan; Department of Clinical Research, National Hospital Organization Fukuoka National Hospital, Fukuoka, Japan. Electronic address: [email protected]. 2. Department of Clinical Research, National Hospital Organization Fukuoka National Hospital, Fukuoka, Japan. 3. Department of Dermatology, National Hospital Organization Fukuoka National Hospital, Fukuoka, Japan; Department of Clinical Research, National Hospital Organization Fukuoka National Hospital, Fukuoka, Japan. 4. Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

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PMID: 31176598

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Publication type

• Letter

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

Verbauwhede AE1, Lambrecht MA2, Fierens E3, Shegay O4, Brijs K5, Delcour JA6.

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

Abstract

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

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

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

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

Abstract

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

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93. Clin Gastroenterol Hepatol. 2019 Jun 4. pii: S1542-3565(19)30597-X. doi: 10.1016/j.cgh.2019.05.046. [Epub ahead of print] Rate, Risk Factors and Outcomes of Non- adherence in Pediatric Patients with Celiac Disease: a Systematic Review.

Myléus A1, Reilly NR2, Green PHR3.

Author information: 1. Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden; Department of Epidemiology and Global Health, Umeå Univeristy, Umeå, Sweden. Electronic address: [email protected]. 2. Department of Pediatrics, Celiac Disease Center, Columbia University College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Medicine, Celiac Disease Center, Columbia University College of Physicians and Surgeons, Columbia University, New York, NY, USA. 3. Department of Medicine, Celiac Disease Center, Columbia University College of Physicians and Surgeons, Columbia University, New York, NY, USA.

Abstract

BACKGROUND AND AIMS:

The only treatment for celiac disease is strict adherence to a gluten-free diet (GFD). We performed a systematic review to investigate the rate of adherence to a GFD in children with celiac disease, risk factors that affect adherence, and outcomes of non-adherence.

METHODS:

We searched PubMed, Cochrane Library, EBSCO, and Scopus for studies through January 2019. We included observational studies of ≥50 children diagnosed with celiac disease and recommended for placement on a GFD. We collected data on adherence assessment (self-report, serology tests, structured dietary interview, biopsies, or assays for gluten immunogenic peptides), risk factors, and outcomes related to adherence. Findings were presented with medians, range, and a narrative synthesis.

RESULTS:

We identified 703 studies; of these, 167 were eligible for full-text assessment and 49 were included in the final analysis, comprising 7850 children. Rates of adherence to a GFD ranged from 23% to 98%. Comparable rates (median rates of adherence, 75%-87%) were found irrespective of how assessments were performed. Adolescents were at risk of non-adherence and children whose parents had good knowledge about celiac disease adhered more strictly. Non-adherence associated with patient growth, symptoms, and quality of life. CONCLUSION:

In a systematic review of 49 studies of children with celiac disease, we found substantial variation in adherence to a GFD among patients. Rate of adherence was not associated with method of adherence measurement, so all methods appear to be useful, with lack of consensus on the ideal metric. Studies are needed to determine the best method to ensure adherence and effects on long- term health.

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Publication type

• Review

94. J Investig Allergol Clin Immunol. 2019 Jun 7:0. doi: 10.18176/jiaci.0421. [Epub ahead of print] Celiac disease and wheat allergy may coexist: two case reports.

Lombardi C1, Savi E2, Passalacqua G3.

Author information: 1. Departmental Unit of Allergology, Clinical Immunology & Pneumology, Fondazione Poliambulanza, Brescia, Italy. 2. Departimental Unit of Allergology, G.Da Saliceto Hospital, Piacenza, Italy. 3. Allergy and Respiratory Diseases, Policlinico San Martino-University of Genoa, Italy.

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PMID: 31172953

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95. Diabetes Care. 2019 Jun 4. pii: dc182376. doi: 10.2337/dc18-2376. [Epub ahead of print] Abnormal Cortical and Trabecular Bone in Youth With Type 1 Diabetes and Celiac Disease.

Pham-Short A1,2, Donaghue KC1,2, Ambler G1,2, Briody J2,3, Garnett S1,2, Munns CF1,2, Craig ME4,2,5.

Author information: 1. Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia. 2. Children's Hospital Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia. 3. Department of Nuclear Medicine, The Children's Hospital at Westmead, Westmead, New South Wales, Australia. 4. Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia [email protected] [email protected]. 5. School of Women's and Child's Health, University of New South Wales, Sydney, New South Wales, Australia.

Abstract

OBJECTIVE:

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

RESEARCH DESIGN AND METHODS:

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

RESULTS:

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

CONCLUSIONS:

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

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96. An Bras Dermatol. 2019 Apr;94(2 Suppl 1):48-55. doi: 10.1590/abd1806-4841.2019940208. Epub 2019 Jun 3. Consensus on the treatment of autoimmune bullous dermatoses: dermatitis herpetiformis and linear IgA bullous dermatosis - Brazilian Society of Dermatology.

Vale ECSD1, Dimatos OC2, Porro AM3, Santi CG4.

Author information: 1. Dermatology Service, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil. 2. Dermatology Service, Hospital Universitário Professor Polydoro Ernani de São Thiago, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil. 3. Department of Dermatology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil. 4. Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.

Abstract Dermatitis herpetiformis and linear IgA bullous dermatosis are autoimmune diseases that present with pruritic urticarial papules and plaques, with formation of vesicles and blisters of subepidermal location, mediated by IgA antibodies. Mucosal lesions are present only in linear IgA bullous dermatosis. The elaboration of this consensus consisted of a brief presentation of the different aspects of these dermatoses and, above all, of an updated literature review on the various therapeutic options that were discussed and compared with the authors' experience, aiming at the treatment orientation of these diseases in Brazil. Dermatitis herpetiformis is a cutaneous manifestation of celiac disease, and can be controlled with a gluten-free diet and dapsone. On the other hand, linear IgA bullous dermatosis arises spontaneously or is triggered by drugs, and can be controlled with dapsone, but often requires the association of systemic corticosteroids and eventually immunosuppressants.

PMCID: PMC6544034 Free PMC Article

PMID: 31166403 [Indexed for MEDLINE]

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Publication type

• Practice Guideline

MeSH terms

• Adrenal Cortex Hormones/therapeutic use • Anti-Inflammatory Agents • Brazil • Consensus* • Dapsone/therapeutic use • Dermatitis Herpetiformis/therapy* • Dermatology • Diet, Gluten-Free/methods • Humans • Linear IgA Bullous Dermatosis/drug therapy* • Prognosis • Societies, Medical

Substances

• Adrenal Cortex Hormones • Anti-Inflammatory Agents • Dapsone 97. Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2019 Jun 4:1-12. doi: 10.1080/19440049.2019.1616830. [Epub ahead of print] Detection of gluten in a pilot-scale barley- based beer produced with and without a prolyl endopeptidase enzyme.

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

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

Abstract

Immunochemical and mass spectrometric methods were used to examine the gluten composition of a gluten-reduced beer produced by brewing with barley malt in the presence of prolyl endopeptidase (PEP) and a final filtration treatment with diatomaceous earth and perlite. The competitive ELISA is generally considered appropriate for the analysis of hydrolysed gluten, but it is not considered a scientifically valid method for the quantification of gluten in fermented or hydrolysed foods due to the lack of an appropriate reference standard. As no single analytical method can capture the spectrum of gluten-derived products in beer, a comprehensive approach was employed to analyse the intact and hydrolysed fractions of gluten with complementary methods. The combination of PEP addition and diatomaceous earth/perlite filtration was more effective at reducing the concentration of detectable gluten than each of the treatments alone. However, gluten proteins and/or polypeptides were observed in filtered, PEP-treated beers using sandwich ELISA methods, western blot, and bottom-up mass spectrometry. In addition, mass spectrometry results showed that the number of hydrolysed gluten peptides was almost unaffected by the filtration process. Gluten peptides that contained potentially immunopathogenic sequences were identified in the filtered PEP-containing beers by MS. Variability in gluten composition was observed between three replicate pilot-scale productions, suggesting that the gluten profile in beer could differ from batch to batch. As there is uncertainty in the detection and quantification of gluten in hydrolysed and fermented foods, characterisation of hydrolysed gluten by complementary analytical methodologies is recommended. PMID: 31161918

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98. Anal Bioanal Chem. 2019 Jun 3. doi: 10.1007/s00216-019-01893-0. [Epub ahead of print] Western blot analysis of fermented- hydrolyzed foods utilizing gluten-specific antibodies employed in a novel multiplex competitive ELISA.

Panda R1, Garber EAE2.

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

Abstract

Horseradish peroxidase (HRP) conjugated gluten-specific antibodies (G12, R5, 2D4, MIoBS, and Skerritt), from nine commercial gluten ELISA test kits, previously utilized in the development of a multiplex competitive ELISA for the detection of fermented-hydrolyzed gluten, were utilized in western blot analyses of 59 fermented-hydrolyzed foods from four food groups (beer, soy-based sauces, vinegar, and sourdough bread). The protein/peptide profiles generated by the nine gluten- specific antibodies varied in size distribution and intensity dependent on the type of food, with minor differences between related products. Cluster analysis of the estimated gluten concentration values (based on western blot band intensities relative to intact gluten standards at 2.5 μg/mL and 100 μg/mL) and that of the relative response of the nine gluten-specific antibodies to different gluten proteins/peptides, distinguished among the different categories of fermented-hydrolyzed foods; comparable to what was observed in the multiplex competitive ELISA. Further, unlike the competitive ELISA, the western blot analyses distinguished between the presence of antigenic proteinaceous materials and false positives due to the presence of binding inhibitors (as observed with four soy-based sauces and one vinegar). Limitations of western blot analysis often include lower sensitivity than the comparable competitive ELISA and problems quantitating gluten-derived peptides and proteins. As a result, western blot analysis provides an orthogonal approach that can be used to both confirm the multiplex competitive ELISA while also providing additional insight into the protein/peptide profile of fermented-hydrolyzed foods. Graphical abstract. PMID: 31161323

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

[Article in German]

Ullrich N1, Metze D2, Luger TA2, Böhm M2.

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

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

Pennazio M1, Venezia L2, Cortegoso Valdivia P2, Rondonotti E3.

Author information: 1. University Division of Gastroenterology, Department of Medical Sciences, University of Turin, City of Health and Science, Italy. Electronic address: [email protected]. 2. University Division of Gastroenterology, Department of Medical Sciences, University of Turin, City of Health and Science, Italy. 3. Gastroenterology Unit, Valduce Hospital, Italy.

Abstract

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

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Publication type

• Review

101. Am J Gastroenterol. 2019 Jun;114(6):854-857. doi: 10.14309/ajg.0000000000000279. Evolving Paradigms in the Diagnosis of Adult Patients With Celiac Disease.

Bai JC1,2, Verdú EF3.

Author information: 1. Research Institutes, Universidad del Salvador, Buenos Aires, Argentina. 2. C. Bonorino Udaondo, Gastroenterology Hospital, Buenos Aires, Argentina. 3. Farncombe Family Digestive Health Research Institute, McMaster University Health Sciences Centre, Hamilton, Ontario, Canada. PMID: 31136311

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102. J Clin Immunol. 2019 Jul;39(5):470-475. doi: 10.1007/s10875-019-00647-y. Epub 2019 May 25. Clinical and Laboratory Features of 184 Italian Pediatric Patients Affected with Selective IgA Deficiency (SIgAD): a Longitudinal Single-Center Study.

Lougaris V1, Sorlini A2, Monfredini C2, Ingrasciotta G2, Caravaggio A2, Lorenzini T2, Baronio M2, Cattalini M2, Meini A3, Ruggeri L3, Salpietro A3, Pilotta A3, Grazzani L3, Prandi E3, Felappi B3, Gualdi G4, Fabiano A4, Fuoti M3, Ravelli A3, Villanacci V5, Soresina A3, Badolato R2, Plebani A2.

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

Abstract

PURPOSE:

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

METHODS:

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

RESULTS:

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

CONCLUSIONS:

In conclusion, this is the first study to describe a large single-center pediatric cohort of patients affected with SIgAD, revealing that overall most patients do well with regard to infections. Many develop CD, at a rate much higher than the general population. A few normalize their IgA levels. A few progress to CVID. Thus, careful follow-up is suggested to diagnose and treat potential complications earlier for avoiding potential morbidities. PMID: 31129864

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

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

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

Abstract

OBJECTIVE:

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

METHODS:

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

RESULTS:

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

CONCLUSION:

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

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

Ciaccio EJ1.

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

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Publication type • Editorial

105. J Agric Food Chem. 2019 Jun 12;67(23):6508-6516. doi: 10.1021/acs.jafc.9b01649. Epub 2019 May 31. Development of Self-Healing Double- Network Hydrogels: Enhancement of the Strength of Wheat Gluten Hydrogels by In Situ Metal-Catechol Coordination.

Liu C1, McClements DJ2, Li M1, Xiong L1, Sun Q1.

Author information: 1. College of Food Science and Engineering , Qingdao Agricultural University , 700 Changcheng Road , Chengyang District, Qingdao , Shandong 266109 , People's Republic of China. 2. Department of Food Science , University of Massachusetts Amherst , Amherst , Massachusetts 01060 , United States.

Abstract

Wheat gluten, a byproduct of the wheat starch industry, is widely used as a dough strengthener and gelling agent. In this research, we developed novel double-network hydrogels by gelation of gluten using in situ metal-catechol coordination. The first network consisted of physically associated gluten molecules, while the second network consisted of Fe3+-cross-linked proanthocyanidins (PACs). Dynamic shear rheology experiments suggested that coordination of Fe3+ and PACs greatly enhanced the mechanical properties of the gluten hydrogels. The double- network hydrogels exhibited a 3-fold higher shear modulus than pure gluten hydrogels. The formation of bis- and tris-catechol-Fe3+ complexes between Fe3+ and PACs in the hydrogels was confirmed by ultraviolet-visible spectrometry and isothermal titration calorimetry (ITC). The ITC measurements of Fe3+ binding to PACs indicated a molar stoichiometry of 1:4 and a dissociation -9 constant ( KD) of 24.9 × 10 . When subject to repeated shear deformation-compression cycles, the hydrogels exhibited strong and rapid recovery of their rheological properties. The strong, self- healing characteristics of the double-network gluten hydrogels produced in this study may be useful for certain applications in the food, agriculture, biomedicine, and tissue-engineering industries. PMID: 31117498

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

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

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

Abstract

INTRODUCTION:

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

METHODS:

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

RESULTS:

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

CONCLUSIONS:

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

FUNDING:

Abbvie. PMID: 31102202

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

Lerner BA1, Green PHR1, Lebwohl B2,3.

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

Abstract

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

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Publication type

• Review

108. Endocr Connect. 2019 Jun 13;8(6):780-787. doi: 10.1530/EC-19-0146. Prevalence of celiac disease and celiac- related antibody status in pediatric patients with type 1 diabetes in Jordan

Odeh R1, Alassaf A1, Gharaibeh L2, Ibrahim S1, Khdair Ahmad F3, Ajlouni K4.

Author information: 1. Section of Pediatric Endocrinology, Department of Pediatrics, School of Medicine, University of Jordan, Amman, Jordan. 2. School of Pharmacy, University of Jordan, Amman, Jordan. 3. Section of Pediatric Gastroenterology, Department of Pediatrics, School of Medicine, University of Jordan, Amman, Jordan. 4. The National Center (Institute) for Diabetes, Endocrinology and Genetics (NCDEG), University of Jordan, Amman, Jordan.

Abstract

OBJECTIVE:

Scientific findings regarding the prevalence of celiac disease (CD) in pediatric patients with type 1 diabetes (T1D) in the Arab world are scarce. We aimed to determine the prevalence of biopsy- proven celiac disease (BPCD) among pediatric patients with T1D from Jordan. We also assessed the possible predictors for developing CD in this cohort of patients and we compared T1D patients who developed BPCD with those who had positive CD serology but negative histology and/or fluctuating CD serology.

METHODS:

Celiac serology and duodenal biopsy results from 2012 to 2017 were collected from patients with T1D. The outcome of positive celiac serology and the risk factors for CD in T1D patients were investigated.

RESULTS:

A total of 538 children of which 278 boys (51.7%) were included in the study. The prevalence of positive serology and the diagnosis of BPCD in this cohort of T1D patients were 16.6 and 9.1% respectively. Eighty percent of those with BPCD were asymptomatic and 47% were diagnosed with CD at onset of T1D. Spontaneous normalization of celiac serology occurred in 23.6% of those with positive serology.

CONCLUSION:

CD is prevalent in T1D pediatric patients from Jordan (9.1%). It is often asymptomatic and the majority of cases were diagnosed at onset or within 5 years of T1D diagnosis. Spontaneous normalization of CD serology occurred in some patients with T1D. Hence, a watchful follow-up is recommended in such patients.

PMCID: PMC6590199 Free PMC Article

PMID: 31085767

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

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

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

Abstract

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

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110. Steatorrhea [Internet].

Authors

Azer SA1, Sankararaman S2.

StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019-. 2019 Jun 4.

Author information: 1. King Saud University, King Khalid UH 2. University Hospitals Rainbow Babies & Children’s Hospital, Cleveland

Excerpt

The definition of steatorrhea is an increase in fat excretion in the stools. Steatorrhea is one of the clinical features of fat malabsorption and noted in many conditions such as exocrine pancreatic insufficiency (EPI), celiac disease, and tropical sprue. An increase in the fat content of stools results in the production of pale, large volume, malodorous, loose stools. Screening for steatorrhea may be carried out by examining stool samples for the presence of fat by Sudan III staining. However, quantitative fecal fat estimation is required to confirm the diagnosis. Among the macronutrients, digestion and absorption of fat involve a complex mechanism. Fat absorption requires bile acids, digestive enzymes, and a normally functioning small intestinal mucosa. Dietary lipids, mostly as triacylglycerols, are initially emulsified by bile acids and then hydrolyzed by the pancreatic lipases and colipases into free fatty acids and monoglycerides. In the proximal small bowel, these hydrolyzed lipids form micelles by the action of bile acids. The micelles are then absorbed across the intestinal villi and transported as chylomicrons via the intestinal lymphatics. Therefore, any defects in the availability or function of bile acids, pancreatic digestive enzymes or absorptive villi will lead to steatorrhea.[1]

Free Books & Documents

PMID: 31082099

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

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

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

Abstract

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

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

Valitutti F1, Fasano A2,3.

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

Abstract

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

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

PMID: 31076989

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Publication type

• Review

Grant support

• R01 DK104344/DK/NIDDK NIH HHS/United States

113. Aliment Pharmacol Ther. 2019 Jun;49(12):1484-1492. doi: 10.1111/apt.15277. Epub 2019 May 10. Prospective longitudinal study: use of faecal gluten immunogenic peptides to monitor children diagnosed with coeliac disease during transition to a gluten-free diet.

Comino I1, Segura V1, Ortigosa L2, Espín B1, Castillejo G3, Garrote JA4, Sierra C5, Millán A1, Ribes- Koninckx C6, Román E7, Rodríguez-Herrera A1, Díaz J8, Silvester JA9,10, Cebolla Á1, Sousa C1.

Author information: 1. Sevilla, Spain. 2. Tenerife, Spain. 3. Reus, Spain. 4. Valladolid, Spain. 5. Málaga, Spain. 6. Valencia, Spain. 7. Madrid, Spain. 8. Ceuta, Spain. 9. Winnipeg, Canada. 10. Boston, Massachusetts.

Abstract

BACKGROUND:

Treatment for coeliac disease is a lifelong strict gluten-free diet. Although guidelines recommend regular follow-up with dietary interviews and coeliac serology, these methods may be inaccurate.

AIM: To evaluate the usefulness of faecal gluten immunogenic peptides to support the diagnosis and to determine the adherence to the gluten-free diet in coeliac children.

METHODS:

Multicentre prospective observational study including 64 coeliac children. Faecal gluten peptides, and tissue transglutaminase and deamidated gliadin peptide antibodies were analyzed at diagnosis, and 6, 12 and 24 months thereafter. Gluten consumption was estimated from gluten peptide levels.

RESULTS:

Most children (97%) had detectable gluten peptides at diagnosis. On a gluten-free diet, the rate of gluten peptides increased from 13% at 6 months to 25% at 24 months. Mean estimated gluten exposure dropped from 5543 mg/d at diagnosis to 144 mg/d at 6 months, then increased to 606 mg/d by 24 months. In contrast, deamidated gliadin peptide antibodies normalised and only 20% had elevated tissue transglutaminase antibody by 24 months. The elevation of tissue transglutaminase antibody was more prolonged in patients with detectable gluten peptides (P < 0.05). Nevertheless, absolute levels of tissue transglutaminase antibody had low sensitivity to identify patients with detectable gluten peptides (P > 0.1). Dietitian assessment was only moderately correlated with gluten peptide detection (κ = 0.5).

CONCLUSIONS:

Faecal gluten peptides testing may guide treatment of coeliac disease prior to diagnosis and during the assessment diet adherence. Further studies could determine if early identification of gluten exposure reduces the need for expensive/invasive investigations for non-responsive coeliac disease. ClinicalTrials.gov Number: NCT02711397.

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Secondary source ID

• ClinicalTrials.gov/NCT02711397

Grant support

• IPT-2011-0952-900000/Ministerio de Ciencia e Innovación/ • FEDER/ • 1737/0118/Corporación Tecnológica de Andalucía/

114. Genet Test Mol Biomarkers. 2019 Jun;23(6):418-422. doi: 10.1089/gtmb.2018.0329. Epub 2019 May 8. HLA-DQ Typing Kits in Diagnosis and Screening for Celiac Disease.

Rouvroye MD1, van Zijtveld S2, Bonnet P2, Spierings E3, Bontkes HJ2.

Author information: 1. 1 Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology and Metabolism Research Institute, Amsterdam, The Netherlands. 2. 2 Amsterdam UMC, Vrije Universiteit Amsterdam, Medical Immunology Laboratory, Department of Clinical Chemistry, Amsterdam Infection and Immunity Institute, Amsterdam, The Netherlands. 3. 3 Laboratory for Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.

Abstract

Aim: Celiac disease (CD) is strongly associated with HLA-DQ2.2, HLA-DQ2.5, and HLA-DQ8. Up to 99.7% of all CD patients are positive for either one or two of these genetic markers, demonstrating a high negative predictive value. This has led to the development of diagnostic kits that, instead of providing a full HLA-DQ typing, detect only these three HLA-DQ types. Our aim was to compare three different kits for their performance, utilization, and costs. Because 0.4-3.6% of all CD patients test positive for HLA-DQ7 and negative for the aforementioned types, information provided by the kits regarding DQ7 alpha and beta chains was evaluated as well. Materials and Methods: Fifty DNA samples previously typed with the SSCP method were analyzed using three commercial kits. Results and Discussion: All kits report hetero- or homozygosity for HLA-DQ2.5. The XeliGen kit directly detects HLA-DQ7, but is relatively expensive. The MLPA kit is the least expensive in terms of reagents and may indirectly detect HLA-DQ7. The CeliaSCAN kit is easy to use and provides indirect information about HLA-DQ7.5. Conclusion: All kits correctly identify the CD risk genes. The resources of the laboratory and the intended use should determine the preference for any of the HLA-DQ typing kits herein described. PMID: 31066583 [Indexed for MEDLINE]

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Publication type • Comparative Study

MeSH terms

• Alleles • Celiac Disease/diagnosis* • Celiac Disease/genetics • Female • Gene Frequency/genetics • Genetic Markers • Genetic Predisposition to Disease/genetics • Genetic Testing/methods • Genotype • HLA-DQ Antigens/genetics* • Histocompatibility Testing/methods* • Humans • Male • Reagent Kits, Diagnostic • Risk Factors

Substances

• Genetic Markers • HLA-DQ Antigens • Reagent Kits, Diagnostic

115. J Vasc Surg Cases Innov Tech. 2019 Apr 30;5(2):160-162. doi: 10.1016/j.jvscit.2018.12.002. eCollection 2019 Jun. Iliohepatic artery bypass for hepatic ischemia after repair of mycotic celiac artery aneurysm.

Lydon R1, Cavallo G2, Lazar A2, Shahbahrami K2, James K3.

Author information: 1. Albany Medical Center, Albany, NY. 2. Morristown Medical Center, Morristown, NJ. 3. Advanced Vascular Associates, Morristown, NJ.

Abstract An 81-year-old woman presented to our institution with a contained ruptured mycotic aortic aneurysm involving the takeoff of the celiac artery that required ligation of the celiac trunk, resulting in foregut ischemia and the need for revascularization. The technique of aortic reconstruction with delayed hepatic artery revascularization by a common iliac artery to hepatic artery bypass is described.

PMCID: PMC6495219 Free PMC Article

PMID: 31065613

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Publication type

• Case Reports

116. Clin Nutr ESPEN. 2019 Jun;31:88-94. doi: 10.1016/j.clnesp.2019.02.012. Epub 2019 Mar 11. Dietary and symptom assessment in adults with self-reported non-coeliac gluten sensitivity.

Skodje GI1, Minelle IH2, Rolfsen KL2, Iacovou M3, Lundin KEA4, Veierød MB5, Henriksen C2.

Author information: 1. Department of Clinical Services, Oslo University Hospital Rikshospitalet, 0424, Oslo, Norway; K.G. Jebsen Coeliac Disease Research Centre, University of Oslo, 0424, Oslo, Norway. Electronic address: [email protected]. 2. Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, 0316, Oslo, Norway. 3. Department of Gastroenterology, Monash University, Melbourne, Victoria, Australia. 4. K.G. Jebsen Coeliac Disease Research Centre, University of Oslo, 0424, Oslo, Norway; Department of Gastroenterology, Oslo University Hospital Rikshospitalet, 0424, Oslo, Norway. 5. Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, 0317, Oslo, Norway.

Abstract

BACKGROUND & AIMS: The mechanisms behind non-coeliac gluten sensitivity (NCGS) are not fully understood although clinical symptoms have shown to subside after wheat withdrawal. Self-prescription of a gluten-free diet (GFD) without medical supervision is common in NCGS subjects, resulting in dietary restrictions that can cause macro- and micronutrient deficiencies. The primary aim was to describe dietary intake, including FODMAP, in subjects with self-reported gluten sensitivity on GFD in whom coeliac disease (CD) and wheat allergy were excluded. Secondary, clinical symptoms and health- related quality of life (HR-QoL) were examined.

METHODS:

Baseline characteristics were obtained from 65 adults with self-reported NCGS on GFD recruited to a randomised placebo-controlled challenge trial at Oslo University Hospital. Dietary intake was obtained by a seven-day food record and symptoms recorded by questionnaires.

RESULTS:

Mean proportions of energy were 43 E% from fat, 40 E% from carbohydrate and 17 E% from protein. Intakes of vitamin D, folic acid, calcium, iodine and iron were lower than recommended, mean (SD) 7.3 (5.8) μg, 235 (105) μg, 695 (309) mg, 81 (52) μg and 9.6 (7.5) mg, respectively. Mean (SD) intake of FODMAP was 11.6 g (8.7). Gastrointestinal symptoms as scored by 100 mm visual analogue scale (VAS) were all below 15 mm of which wind and bloating were the most expressed. Tiredness, concentration difficulties, fatigue and muscle/joint pain were scored highest among extra-intestinal symptoms. Gastrointestinal symptoms as scored by gastrointestinal symptom rating scale - irritable bowel syndrome version (GSRS-IBS) were correlated with mild depression (r = 0.43) and inversely correlated with five sub-domains of HR-QoL (-0.29 < r < -0.26).

CONCLUSION:

Subjects with self-reported NCGS on GFD had high proportion of energy from fat and sub-optimal intakes of vitamin D, folic acid, calcium, iodine and iron. Despite GFD and moderate intake of FODMAP, the subjects reported various gastro- and extra-intestinal symptoms and reduced HR- QoL. The findings highlight the importance of dietary education and nutritional follow-up of subjects on GFD.

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

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

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

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

Mataya L1, Silvester J2, Jericho H1.

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

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119. Scand J Prim Health Care. 2019 Jun;37(2):174-181. doi: 10.1080/02813432.2019.1608043. Epub 2019 May 6. Comorbidity and health-related quality of life in Somali women living in Sweden.

Demeke T1, Osmancevic A2, Gillstedt M2, Krogstad AL2, Angesjö E3, Sinclair H4, El-Gawad GA5, Krantz E6, Trimpou P7, Landin-Wilhelmsen K7.

Author information: 1. a Angered Primary Health Care Centre , Gothenburg , Sweden. 2. b Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 3. c Brämhult Primary Health Care Centre , Borås , Sweden. 4. d Department of Geriatric Medicine , South Älvsborg Hospital , Borås , Sweden. 5. e Cleopatra Medical Centre , Gothenburg , Sweden. 6. f Department of Medicine , South Älvsborg Hospital , Borås , Sweden. 7. g Section for Endocrinology, Institution of Medicine , Sahlgrenska University Hospital at Sahlgrenska Academy University of Gothenburg , Gothenburg , Sweden.

Abstract

Objective: To explore the relationship between low serum vitamin D levels and comorbidity in Somali women, immigrants to Sweden. Design and setting: Cohort study in a Primary Health Care Center and a University Hospital. Subjects: Somali women skin type V, n = 114, aged 18-56 years, from latitude 0-10○ N, living in Sweden, latitude 57○ N > 2 years were compared with women from a population sample, skin type II-III, n = 69, aged 38-56 years, the WHO MONICA study, Gothenburg, Sweden. Main outcome measures: Serum (S)-25(OH)D, S-parathyroid hormone (PTH), comorbidity and Health-Related Quality of Life (HRQoL) using the Short Form-36 (SF-36) and part of the EQ-5D questionnaires. All calculations were corrected for age. Results: Vitamin D deficiency (S-25(OH)D < 25 nmol/l) was found in 73% of the Somali women and in 1% of the controls (p < .0001). S-PTH was elevated (>6.9 pmol/l) in 26% and 9%, respectively (p < .004). Somali women used less medication, 16% vs. 55%, p < .0001) but more allergy medication, 11% vs. 7% (p = .006), had fewer fractures, 2% vs. 28% (p < .0001) and lower HRQoL in 7 out of 9 scales (p < .05-.001), than native controls. There were no differences in the prevalence of diabetes mellitus, hypothyroidism, positive thyroid peroxidase antibodies, vitamin B12 deficiency, celiac disease or hypertension. Conclusions: Vitamin D deficiency was common in Somali women living in Sweden, 73%, but comorbidity was low. Both mental, and especially physical HRQoL scores were lower in the Somali women. The effects of long-lasting deficiency are unknown. Key points The aim was to explore the relationship between vitamin D deficiency (S-25(OH)D < 25 nmol/l) and comorbidity in immigrants. Vitamin D deficiency was common in Somali women living in Sweden, 73%, but comorbidity of hypothyroidism, diabetes mellitus, hypertension, fractures and use of medications was low. Both mental, and especially physical, Health-Related Quality of Life were lower in the Somali women than in native Swedish women. The effects of long-lasting deficiency are unknown.

PMCID: PMC6567019 Free PMC Article

PMID: 31057029

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

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

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

Abstract

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

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MeSH terms

• Animals • Anti-Infective Agents/chemistry • Anti-Infective Agents/pharmacology • Cell Line, Tumor • Cell Proliferation/drug effects • Chromatography, High Pressure Liquid • Diet, Gluten-Free • Fabaceae/chemistry* • Fabaceae/metabolism • Flour/analysis • Fruit/chemistry • Gram-Negative Bacteria/drug effects • Gram-Positive Bacteria/drug effects • Humans • Macrophages/cytology • Macrophages/drug effects • Macrophages/metabolism • Mice • Nitric Oxide/metabolism • Oryza/chemistry* • Oryza/metabolism • Phenols/analysis* • Phenols/pharmacology • RAW 264.7 Cells • Spectrometry, Mass, Electrospray Ionization • Tocopherols/analysis* • Tocopherols/pharmacology

Substances

• Anti-Infective Agents • Phenols • Nitric Oxide • Tocopherols

121. Gastroenterol Clin North Am. 2019 Jun;48(2):307-317. doi: 10.1016/j.gtc.2019.02.009. Epub 2019 Apr 1. Serologic Diagnosis of Celiac Disease: New Biomarkers.

Lerner A1, Ramesh A2, Matthias T2.

Author information: 1. B. Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; AESKU.KIPP Institute, Mikroforum Ring 2, Wendelsheim 55234, Germany. Electronic address: [email protected]. 2. AESKU.KIPP Institute, Mikroforum Ring 2, Wendelsheim 55234, Germany.

Abstract

Most patients affected by celiac disease (CD) are asymptomatic or hyposymptomatic and undiagnosed, and are at risk of preventable complications. Therefore, early diagnosis is highly recommended. Multiple diagnostic antibodies are available; the most frequently used is IgA to tissue transglutaminase (IgA-tTg). It may yield false results and, alone, does not address IgA deficiency. Recently, a new generation of anti-neo-epitope tTg check (IgG + IgA) has become available. It is highly sensitive and specific, covers IgA-deficient patients with CD, reflects intestinal damage, and has predictive potential in the diagnosis of CD.

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Publication type

• Review

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

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

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

Abstract

OBJECTIVE:

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

PATIENTS AND METHODS:

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

RESULTS:

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

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

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

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

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

Abstract

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

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Grant support

• 007_FC_2014/Fondazione Italiana Celiachia Onlus to LS/

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

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

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

Abstract

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

PMCID: PMC6548867 Free PMC Article

PMID: 31037572

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Grant support

• 221909/F20/Norges Forskningsråd/

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

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

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

Abstract

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

PMID: 31036362 [Indexed for MEDLINE]

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MeSH terms

• Chromatography, Liquid • Edible Grain/chemistry • Food Analysis/methods* • Glutens/analysis • Hordeum/chemistry* • Plant Proteins/analysis • Proteomics/methods* • Tandem Mass Spectrometry • Trypsin Inhibitors/analysis* • Trypsin Inhibitors/isolation & purification* • alpha-Amylases/antagonists & inhibitors*

Substances

• Plant Proteins • Trypsin Inhibitors • Glutens • alpha-Amylases

126. J Agric Food Chem. 2019 Jun 26;67(25):7120-7127. doi: 10.1021/acs.jafc.9b01063. Epub 2019 May 2. Effects of Starch on the Digestibility of Gluten under Different Thermal Processing Conditions.

Wen W1, Li S1, Gu Y1, Wang S2, Wang J1.

Author information: 1. State Key Laboratory of Food Nutrition and Safety , Tianjin University of Science & Technology , 29 Thirteenth Road , Tianjin Economy and Technology Development Area, Tianjin 300457 , People's Republic of China. 2. Medical College , Nankai University , 38 Tongyan Road , Jinnan District, Tianjin 300350 , People's Republic of China. Abstract

Gluten and starch are the primary ingredients of wheat. The complex reaction between gluten and starch will occur during thermal food processing, which will affect digestibility. The effects of proteins on the digestibility of starch have been reported, but the effects of starch on the digestibility of proteins have not been well-researched. In this paper, the effects of starch on gluten digestion during the heating process were studied by the gluten-starch simulated system, and it was found that starch can enhance gluten digestion. When the complex of 1:1 gluten-starch is heated at 100 °C, the digestibility of gluten is higher and more low-molecular-weight peptides are produced. Results from the digestibility and digestion peptide mapping of the gluten-starch complex at different conditions showed that the addition of starch during processing enhanced the digestion performance of gluten. Meanwhile, the secondary structure, intrinsic fluorescence, and microscopic structure of the gluten-starch complex were investigated to understand the mechanism of the enhancement. The digestion performance is related to the secondary structure variation during the thermal processing caused by the hydration increase and disulfide bond reduction. The gluten-starch complex spatial structure is looser than gluten after heating, which could expose more protease cleavage sites. These results suggest that starch can protect gluten from aggregation in water and destroy the spatial structure of gluten with the assistance of heating, exposing more cleavage sites and enhancing gluten digestion. PMID: 31026160

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127. Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2019 Jun;36(6):922-928. doi: 10.1080/19440049.2019.1595744. Epub 2019 Apr 22. Inorganic arsenic content in Ecuadorian rice- based products.

Gavilanes-Terán I1, Cano-Lamadrid M2, Idrovo-Novillo J1, García-García E3, Veloz-Mayorga N1, Erazo-Arrieta R4, Burló F2, Cruz-Paca F1, Carbonell-Barrachina ÁA2.

Author information: 1. a Facultad de Ciencias , Escuela Superior Politécnica De Chimborazo , Riobamba , Ecuador. 2. b Departamento de Tecnología Agroalimentaria, Grupo de Calidad y Seguridad Alimentaria , Universidad Miguel Hernández de Elche , Alicante , Spain. 3. c Instituto de Bioingenieria, Grupo Calidad y Seguridad Alimentaria , Alicante , Spain. 4. d Centro de Servicios Técnicos y Transferencia Tecnológica Ambiental , Escuela Superior Politécnica de Chimborazo , Riobamba , Ecuador.

Abstract Arsenic intake in the world is linked with drinking water and food; the main sources of inorganic As (i-As) exposure in food are rice and rice-based products. The consumption of rice in Ecuador is 53.2 kg year-1 and it is the most commonly used cereal for the preparation of many popular dishes especially for subjects with celiac disease. Objectives of this research were: (i) to determine the content of i-As in foods widely consumed by Ecuadorians with celiac disease, (ii) to calculate the i- As dietary intake, and (iii) to model and predict the health risks of the population under study as a result of their exposure to i-As from rice-based food. The estimated daily intakes of Ecuadorian children (below 3 years of age) and adults were established at 0.52 and 0.55 μg kg-1 body weight d- 1 , respectively. These values were above the lower BMDL01 value established for i-As established by the EFSA; consequently, it can be concluded that health risk cannot be excluded for the Ecuadorian population with celiac disease. PMID: 31009318 [Indexed for MEDLINE]

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MeSH terms

• Adult • Arsenic/analysis* • Child, Preschool • Ecuador • Female • Food Analysis* • Food Contamination/analysis* • Food Safety • Humans • Infant • Infant, Newborn • Male • Oryza/chemistry*

Substance

• Arsenic

128. Eur J Gastroenterol Hepatol. 2019 Jun;31(6):729-730. doi: 10.1097/MEG.0000000000001372. Protocol for the transition of pediatrics for adult medicine in celiac disease: a proposal approach. Peixoto A1,2,3, Reis E Melo A4,3, Trindade E4,3, Dias JA4,3, Macedo G1,2,3.

Author information: 1. Department of Gastroenterology. 2. WGO Porto Training Center. 3. Porto Medical School, University of Porto, Porto, Portugal. 4. Pediatric Gastroenterology and Nutrition Unit, São João Hospital Center. PMID: 31008803

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129. Food Res Int. 2019 Jun;120:568-576. doi: 10.1016/j.foodres.2018.11.007. Epub 2018 Nov 5. Comparison of gluten peptides and potential prebiotic carbohydrates in old and modern Triticum turgidum ssp. genotypes.

Ficco DBM1, Prandi B2, Amaretti A3, Anfelli I4, Leonardi A4, Raimondi S4, Pecchioni N5, De Vita P1, Faccini A6, Sforza S7, Rossi M8.

Author information: 1. CREA - Council for Agricultural Research and Economics, Research Centre for Cereal and Industrial Crops, Foggia, Italy. 2. Department of Food and Drug, University of Parma, Italy; Department of Human Sciences and Quality of Life Promotion, Telematic University San Raffaele Roma, Italy. 3. Department of Life Sciences, University of Modena and Reggio Emilia, Italy; Biogest-Siteia, Centro per il Miglioramento e la Valorizzazione delle Risorse Biologiche Agro-Alimentari, University of Modena and Reggio Emilia, Italy. 4. Department of Life Sciences, University of Modena and Reggio Emilia, Italy. 5. CREA - Council for Agricultural Research and Economics, Research Centre for Cereal and Industrial Crops, Foggia, Italy; Department of Life Sciences, University of Modena and Reggio Emilia, Italy; Biogest-Siteia, Centro per il Miglioramento e la Valorizzazione delle Risorse Biologiche Agro-Alimentari, University of Modena and Reggio Emilia, Italy. 6. Interdepartmental Center for Measurements, University of Parma, Italy. 7. Department of Food and Drug, University of Parma, Italy. 8. Department of Life Sciences, University of Modena and Reggio Emilia, Italy; Biogest-Siteia, Centro per il Miglioramento e la Valorizzazione delle Risorse Biologiche Agro-Alimentari, University of Modena and Reggio Emilia, Italy.. Electronic address: [email protected].

Abstract Old wheat genotypes are perceived by consumers as healthier than modern ones. The release of gluten peptides with in vitro digestion and the content of potentially prebiotic carbohydrates (i.e. resistant fraction of starch and cell-wall associated dietary fiber) were evaluated in tetraploid wheats, namely 9 old and 3 modern Triticum turgidum ssp. genotypes. Simulated digestion of wholemeal flours yielded 152 major peptides, 59 of which were attributed a sequence. Principal component analysis revealed that peptide profiles were variable in old genotypes, unlike in modern ones. Digestion of old genotypes generally yielded peptides in greater concentration. In particular, 5 peptides of γ-gliadin, known to trigger the adaptive immune reaction, and two peptides of α-gliadin, known to be toxic to celiac patients, were particularly abundant in some old varieties. Resistant starch (RS) was negligible in modern genotypes (<0.6%), but it was remarkably abundant in some old varieties, reaching the highest value in Dauno III (8.5%, P < 0.05). Dauno III also presented the highest amount of soluble fiber (4.2%, P < 0.05). Pasta was made with an old and a modern genotype (Dauno III and PR22D89, respectively) with opposite RS content. Pasta making and cooking affected starch digestibility, overtaking differences between genotypes and yielding the same amount of RS for both the varieties (approx. 1.7%). The data herein presented suggest that the wholemeal flours of old tetraploid wheat genotypes could not boast particular claims associated to a lower exposure to gluten peptides and, if cooked, to a prebiotic potential.

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130. Food Res Int. 2019 Jun;120:312-321. doi: 10.1016/j.foodres.2019.03.003. Epub 2019 Mar 5. In vitro large intestine fermentation of gluten-free rice cookies containing alfalfa seed (Medicago sativa L.) flour: A combined metagenomic/metabolomic approach.

Rocchetti G1, Senizza A2, Gallo A3, Lucini L2, Giuberti G4, Patrone V2.

Author information: 1. Department of Animal Science, Food and Nutrition, Università Cattolica del Sacro Cuore, Via Emilia Parmense 84, Piacenza 29122, Italy; Department for Sustainable Food Process, Università Cattolica del Sacro Cuore, Via Emilia Parmense 84, Piacenza 29122, Italy. 2. Department for Sustainable Food Process, Università Cattolica del Sacro Cuore, Via Emilia Parmense 84, Piacenza 29122, Italy. 3. Department of Animal Science, Food and Nutrition, Università Cattolica del Sacro Cuore, Via Emilia Parmense 84, Piacenza 29122, Italy. 4. Department for Sustainable Food Process, Università Cattolica del Sacro Cuore, Via Emilia Parmense 84, Piacenza 29122, Italy. Electronic address: [email protected].

Abstract

Alfalfa seed flour (ASF) at different inclusion levels (0% as control, 30% and 45% w/w) was used to prepare rice flour-based gluten-free (GF) cookies (CK). Samples underwent a simulated in vitro digestion and fermentation process. The comprehensive changes in the phenolic profiles were evaluated during 48 h of fermentation by means of untargeted UHPLC-QTOF mass spectrometry followed by multivariate statistics. Furthermore, the modifications in microbial profile and the production of short chain fatty acids (SCFA) were investigated. Cookies presenting 30% (30-CK) and 45% (45-CK) ASF possessed the greater total phenolic content when compared to the control, being 0.42 and 0.56 mg/g versus 0.15 mg/g, respectively. The orthogonal projection to latent structure discriminant analysis, applied to untargeted metabolomics-based data, showed a clear modulation of the profile in phenolic metabolites over time (from 8 up to 48 h of in vitro fermentation). In this regard, the in vitro fermentation of 30-CK and 45-CK resulted in the maximum increase in lignans and phenolic acids, whose bioaccessibility at 24 h of in vitro fermentation was 16.2% and 12.2%, respectively. In addition, the metagenomic sequencing approach allowed to identify in Clostridiaceae, Ruminococcaceae, Lachnospiraceae and Streptococcaceae the most represented bacterial populations during the in vitro fermentation. A greater total SCFA production (p < .05) was recorded overtime for all ASF-enriched cookies when compared to the control. Therefore, ASF proved to be an excellent alternative to common non- wheat cereal flours (such as pseudocereals or legumes) for improving possible health-promoting properties in GF cookie formulation.

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131. Food Res Int. 2019 Jun;120:167-177. doi: 10.1016/j.foodres.2019.02.037. Epub 2019 Feb 20. Effectiveness of proteolytic enzymes to remove gluten residues and feasibility of incorporating them into cleaning products for industrial purposes.

Fuciños C1, Estévez N2, Míguez M2, Fajardo P3, Chapela MJ3, Gondar D4, Rúa ML2. Author information: 1. Analytical and Food Chemistry Department, Faculty of Sciences, University of Vigo, As Lagoas, 32004 Ourense, Spain. Electronic address: [email protected]. 2. Analytical and Food Chemistry Department, Faculty of Sciences, University of Vigo, As Lagoas, 32004 Ourense, Spain. 3. Health, Nutrition and Pharma Unit, R&D Area, ANFACO-CECOPESCA, Colegio Universitario 16, Vigo, 36310 Pontevedra, Spain. 4. KEMEGAL, Pol. Ind. Pousadoiro, Parcela 11, Vilagarcía de Arousa 36600, Spain.

Abstract

The development of protocols for efficient gluten elimination is one of the most critical aspects of any allergen management strategy in the industry. The suitability of different proteolytic enzymes to be included in a cleaning formulation that allows the effective elimination of gluten residues was studied. Alcalase (ALC), neutrase (NEUT) and flavourzyme (FLAV) were selected from in silico analysis. The presence of 1% (v/v) of linear alkylbenzene sulphonate (LAS), a common anionic detergent, improved the gluten solubility, which may favour its elimination. Chromatographic analysis showed that the three enzymes studied were able to hydrolyse gluten in the presence of LAS. The highest percentage of short peptides (< 5 kDa) was achieved with ALC, what increases the probability of reducing the gluten antigenicity. Besides, in the presence of ALC and detergent LAS have detected the lowest levels of gluten with ELISA kits. So, effective amounts of ALC and LAS were added to a cleaning formulation, where its proteolytic activity was maintained above 90% after 37 days at 4 °C and 25 °C (under dark). Preliminary validation of the effectiveness enzymatic cleaning formulation to hydrolyse gluten was performed in a ready-to-eat/frozen food company, in which previous episodes of cross-contamination with gluten have been detected. The gluten content decreased to values below 0.125 μg/100 cm2 when the cleaning formulation was tested on different surfaces with different cleaning protocols, demonstrating the high suitability of the enzymatic cleaning formulation developed.

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132. Food Chem. 2019 Aug 30;290:64-71. doi: 10.1016/j.foodchem.2019.03.016. Epub 2019 Mar 8. Impact of altered starch functionality on wheat dough microstructure and its elongation behaviour. Hackenberg S1, Vogel C2, Scherf KA2, Jekle M3, Becker T1.

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

Abstract

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

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MeSH terms

• Bread/analysis* • Flour/analysis • Glutens/chemistry • Mechanical Phenomena • Starch/chemistry* • Triticum/chemistry*

Substances

• Glutens • Starch 133. Eur J Gastroenterol Hepatol. 2019 Jul;31(7):893-895. doi: 10.1097/MEG.0000000000001421. Anaphylaxis after wheat ingestion in a patient with coeliac disease: two kinds of reactions and the same culprit food.

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

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

Abstract

In recent years, the role of atopic dermatitis epidermal skin barrier defects in inducing a transcutaneous allergic sensitization is highly debated, possibly explaining why some children with eczema are sensitized to foods they have never eaten. In our specific situation, the association between coeliac disease and wheat allergy might be particularly harmful owing to unavoidable strict food avoidance. We describe the case of a young boy affected by coeliac disease who, after an occasional unexpected ingestion of gluten, experienced a complete anaphylactic reaction characterized by urticarial, labial angioedema, wheezing, and hypotension. To better investigate the state of allergic sensitization to wheat in our patient, we then performed the component resolved diagnosis, which showed Tri a19 2 kU/l and Tri a14 0.3 kU/l. These results demonstrated the association of IgE-mediated allergy to wheat and coeliac disease. The natural course of specific IgE in allergic patients who are on a food-free diet needs further investigation, such as the possible influence that the increasing popularity of gluten-free diets may have on the epidemiology of wheat allergy in westernized societies. National and International registers of cases of anaphylaxis may improve the still limited knowledge in this field. The final message of our contribution is that the decision to eliminate a food should to take into account a patient's awareness of possible consequences. PMID: 30994495

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134. Eur J Endocrinol. 2019 Jun 1;180(6):397-406. doi: 10.1530/EJE-18-0878. X chromosome gene dosage as a determinant of congenital malformations and of age-related comorbidity risk in patients with Turner syndrome, from childhood to early adulthood.

Fiot E1, Zénaty D1, Boizeau P2,3, Haignere J2,3, Dos Santos S1, Léger J1,4.

Author information: 1. Assistance Publique-Hôpitaux de Paris, Robert Debré University Hospital, Pediatric Endocrinology Diabetology Department, Reference Centre for Endocrine Growth and Development Diseases, Paris, France. 2. AP-HP, Hôpital Robert Debré University Hospital, Unit of Clinical Epidemiology, Paris, France. 3. Inserm, CIC-EC 1426, Paris, France. 4. Université de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM), UMR 1141, DHU Protect, F-75019 Paris, France.

Abstract

Objective Turner Syndrome is associated with several phenotypic conditions associated with a higher risk of subsequent comorbidity. We aimed to evaluate the prevalence of congenital malformations and the occurrence of age-related comorbid conditions and to determine whether the frequencies of congenital and acquired conditions depend on X chromosome gene dosage, as a function of karyotype subgroup. Design and methods This national retrospective observational cohort study includes 1501 patients. We evaluated the prevalence of congenital malformations and the cumulative incidence of subsequent specific comorbidities at five-year intervals, from the ages of 10 to 30 years, with stratification by karyotype subgroup: 45,X (n = 549), 45,X/46,isoXq (n = 280), 46,X,r(X)/46,XX (n = 106), 45,X/46,XX (n = 221), presence of Y (n = 87). Results Median age was 9.4 (3.7-13.7) years at first evaluation and 16.8 (11.2-21.4) years at last evaluation. Congenital heart (18.9%) malformations were more frequent in 45,X patients, and congenital renal (17.2%) malformations were more frequent in 45,X, 45,X/46,isoXq and 46,X,r(X)/46,XX patients than in those with 45,X/46,XX mosaicism or a Y chromosome (P < 0.0001). The cumulative incidence of subsequent acquired conditions, such as thyroid disease, hearing loss, overweight/obesity, dyslipidemia and, to a lesser extent, celiac disease, glucose intolerance/type 2 diabetes, hypertension and liver dysfunction increased with age, but less markedly for patients with mosaicism than for those with other karyotypes. Patients with a ring chromosome were more prone to metabolic disorders. Conclusion These data suggest that X gene chromosome dosage, particularly for Xp genes, contributes to the risk of developing comorbidities. PMID: 30991358 [Indexed for MEDLINE]

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Publication types

• Multicenter Study • Observational Study

MeSH terms

• Adolescent • Adult • Age Factors • Child • Chromosomes, Human, X/genetics* • Cohort Studies • Comorbidity • Congenital Abnormalities/epidemiology • Congenital Abnormalities/genetics* • Female • Gene Dosage* • Heart Defects, Congenital/epidemiology • Heart Defects, Congenital/genetics • Humans • Karyotype • Kidney/abnormalities • Kidney Diseases/congenital • Kidney Diseases/epidemiology • Kidney Diseases/genetics • Mosaicism • Retrospective Studies • Risk Factors • Turner Syndrome/classification • Turner Syndrome/complications • Turner Syndrome/genetics* • Young Adult

135. Radiol Case Rep. 2019 Apr 3;14(6):723-728. doi: 10.1016/j.radcr.2019.03.024. eCollection 2019 Jun. Successful endovascular treatment of a recurrent giant celiac artery aneurysm. Borzelli A1, Amodio F1, Paladini A2, de Magistris G1, Giurazza F1, Silvestre M1, Corvino F1, Corvino A3, Frauenfelder G4, Pane F3, Coppola M3, Zobel DB5, Paladini L6, Amodeo EM6, Cavaglià E1, Niola R1.

Author information: 1. Department of Interventional Radiology, AORN ``A. Cardarelli'', Via A. Cardarelli 9, 80131 Naples, Italy. 2. Department of Services Diagnosis and Therapies, Radiology Institute, Maggiore della Carità Hospital, University of Eastern Piedmont - UPO University, Corso G. Mazzini 18, 28100 Novara, Italy. 3. Dipartimento di scienze biomediche avanzate, Università degli studi di Napoli "Federico II", Via S.Pansini, 80131 Naples, Italy. 4. Department of Radiology, Campus Bio-medico University, Via Alvaro del Portillo, 200, 00100 Rome, Italy. 5. Division of Interventional Radiology, IFO Regina Elena National Cancer Institute, Via Elio Chianesi, 53, 00144 Rome, Italy. 6. Università Cattolica del Sacro Cuore, Rome- Fondazione Gemelli, Rome, Italy.

Abstract

Visceral artery aneurysms are very rare and aneurysms of the celiac trunk are the rarest ones: they are in most cases asymptomatic and their detection is frequently incidental. In this article we report the case of a man affected by severe abdominal pain with a huge aneurysm of the celiac trunk, first successfully treated with coil embolization, but, after 10 months, another endovascular embolization was required for deployment of the metallic coils previously released, ahead into the fund of the sac with recanalization of the aneurysm. A second endovascular treatment was performed with other coils and Amplatzer-Plug. The high risk of rupture makes treatment of such aneurysms mandatory and surgery is still considered the gold standard therapy of VAA, but, due to its high morbidity and mortality risks, in the last years, it has been widely replaced by endovascular embolization. An effective endovascular embolization requires not only the complete filling of the aneurysmal sac, but also the complete vascular exclusion of its in-flow and out-flow tracts, to reduce the risk of its anterograde or retrograde reperfusion.

PMCID: PMC6447743 Free PMC Article

PMID: 30988864

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Publication type

• Case Reports

136. Expert Rev Gastroenterol Hepatol. 2019 Jun;13(6):541-546. doi: 10.1080/17474124.2019.1607295. Epub 2019 Apr 23. Pneumococcal vaccination in celiac disease.

Casella G1, Ingravalle F2, Abbate G3, Monti C1, Bonetti F1, Bassotti G4, Mansueto P5, Villanacci V6, Carroccio A5,7.

Author information: 1. a ATS Lecco-Brianza , Limbiate (Monza Brianza) , Italy. 2. b University of Rome , Italy. 3. c Prevention and Vaccination Center , Corberi-Antonini Hospital - ASST Monza , Limbiate (Monza Brianza) , Italy. 4. d Gastroenterology, Hepatology and Digestive Endoscopy Section, Department of Medicine , University of Perugia - Medicine , Perugia , Italy. 5. e Dipartimento Biomedico di Medicina Interna e Specialistica (DiBiMIS) , University of Palermo , Palermo , Italy. 6. f Pathology Department , Spedali Civili Brescia , Brescia , Italy. 7. g Internal Medicine , Giovanni Paolo II Hospital, Sciacca (ASP Agrigento) , Italy.

Abstract

Celiac disease (CD) is an immune-mediated disorder associated with gluten exposure in genetically predisposed subjects. Areas covered: Infectious disease is one of the causes of morbidity and mortality in CD patients. Invasive streptococcus pneumoniae (pneumococcus) is a particularly dangerous morbid condition in both the general population and celiac patients. Pneumococcal vaccination is the most effective means for its prevention. Expert opinion: In CD, evaluation of spleen function should be useful to select patients who may benefit from vaccination to reduce the risk of pneumococcal disease. Different strategies could be employed: physicians could search for signs of hyposplenism on peripheral blood smear or abdominal ultrasound. However, the best strategy to identify which patients will benefit from pneumococcal vaccination has not yet been defined. PMID: 30987472

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137. Z Gastroenterol. 2019 Jun;57(6):734-739. doi: 10.1055/a-0825-2437. Epub 2019 Apr 15. [Primary bile acid diarrhea in a community gastroenterology practice].

[Article in German; Abstract available in German from the publisher] Wenzel H1.

Author information: 1. BAG Wenzel/Spelter/Mallach, Wuppertal, Germany.

Abstract

When first described in 1976, primary bile acid diarrhea (BAD Type 1) was regarded as a very rare cause of chronic diarrhea. Today, the incidence is estimated as > 1 %. Availability of diagnostic tools varies widely and, in Germany, there is no generally consented recommendation for their use. BAD is still widely underdiagnosed.Since the beginning of the '90 s, we have added a therapeutic trial with cholestyramine to our diagnostic approach of chronic diarrhea. Patients with a positive test were offered a Selenium-homocholic acid taurine (SeHCAT) test for confirmation of bile-acid- diarrhea (BAD), using a 7-day-retention of 20 % as cut-off value.From April 1991 to March 2017, after exclusion of other relevant causes for chronic diarrhea like IBD, celiac disease or microscopic colitis, 70 patients with a positive trial treatment of cholestyramine were identified for evaluation. Sixty of them had a SeHCAT test. Patients with BAD Type 1 and Type 3 were excluded, except for cholecystectomy.85 % (35/41) of patients with BAD Type 1 needed continued medical treatment (median follow-up time 8.3 (1 - 23.6) years). Among them, 68.6 % (24/35) took cholestyramine, 31.4 % (11/35) loperamide or another antidiarrheal treatment. 14.6 % (6/41) of patients reported a spontaneous remission after median 2.9 (0.7 - 5.7) years.In the group of patients with BAD after cholecystectomy, 82 % (8/11) still needed treatment after median 7.7 (1 - 24.5) years; 8 having taken cholestyramine, one patient nothing and two with spontaneous remissions.All (8/8) patients with a normal SeHCAT test (7-day retention > 20 %) had spontaneous relief after median 3.6 (1.2 - 6.3) months.Also, 70 % (7/10) of patients who had not been confirmed by the SeHCAT test still needed treatment after median 4.3 (3.7 - 18.3) years.Based on a trial treatment alone, diagnosis of BAD is possible but not assured. Due to its ubiquitous availability, it should be used consequently if other methods are not available. Despite the well-known shortcomings of cholestyramine, a therapeutic trial should be used more consequently. According to the current literature, using the SeHCAT test in the first place will give significantly better results and unnecessary follow-up examinations can be avoided. However, therapeutic consequences might be modest due to the well-known limitations of cholestyramine. A well-tolerated and licensed alternative to cholestyramine is urgently needed.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work. Publication type • English Abstract

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

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

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

Abstract

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

PMID: 30986085

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

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

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

Abstract

PROBLEM:

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

METHOD OF STUDY:

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

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140. Mol Genet Genomic Med. 2019 Jun;7(6):e688. doi: 10.1002/mgg3.688. Epub 2019 Apr 9. Maternal genetic markers for risk of celiac disease and their potential association with neural tube defects in offspring.

Hoang TT1, Lei Y2, Mitchell LE1, Sharma SV1, Swartz MD3, Waller DK1, Finnell RH2, Benjamin RH1, Browne ML4,5, Canfield MA6, Lupo PJ7, McKenzie P8, Shaw GM9, Agopian AJ1; National Birth Defects Prevention Study.

Author information: 1. Department of Epidemiology, Human Genetics, and Environmental Sciences, UTHealth School of Public Health, Houston, Texas. 2. Department of Molecular and Cellular Biology, Center for Precision Environmental Health, Baylor College of Medicine, Houston, Texas. 3. Department of Biostatistics and Data Science, UTHealth School of Public Health, Houston, Texas. 4. Congenital Malformations Registry, New York State Department of Health, Albany, New York. 5. Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Rensselaer, New York. 6. Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas. 7. Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, Texas. 8. Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas. 9. Department of Pediatrics, Stanford University School of Medicine, Stanford, California.

Abstract

BACKGROUND: We examined the association between the maternal genotype for celiac disease-associated variants and risk of neural tube defects (NTDs).

METHODS:

We conducted a case-control study, using data from the National Birth Defects Prevention Study. We evaluated 667 cases (women with an offspring with NTD) and 743 controls (women with an offspring without a birth defect). We classified women as having low, intermediate, or high risk of celiac disease based on human leukocyte antigen (HLA) variants. We used logistic regression to assess the relationship between HLA celiac risk group (low, intermediate, high) and risk of NTDs. Fifteen non-HLA variants (identified from genome-wide association studies of celiac disease) were individually evaluated and modeled additively.

RESULTS:

There was no association between HLA celiac risk group and NTDs (intermediate vs. low risk: aOR, 1.0; 95% CI, 0.8-1.3; high vs. low risk: aOR, 0.8; 95% CI, 0.5-1.3). Of the fifteen non-HLA variants, we observed five significant associations after accounting for multiple comparisons. Three negative associations were observed with rs10903122, rs13314993, rs13151961 (aOR range: 0.69-0.81), and two positive associations were observed with rs13003464 and rs11221332 (aOR range: 1.27-1.73).

CONCLUSION:

If confirmed, our results suggest that the maternal variants related to celiac disease may be involved in the risk of NTDs.

PMCID: PMC6565562 Free PMC Article

PMID: 30968606

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Grant support

• PRIME Award/UTHealth School of Public Health/ • DK56350/University of North Carolina Clinical Nutrition Research Center/ • U01 DD000494/DD/NCBDD CDC HHS/United States • 5U01DD000494-03/Centers for Disease Control and Prevention/ • P30 DK056350/DK/NIDDK NIH HHS/United States

141. Autoimmun Rev. 2019 Jun;18(6):645-646. doi: 10.1016/j.autrev.2019.02.008. Epub 2019 Apr 5. Diagnosis of gluten-related disorders: A new and challenging public health problem.

Sur LM1, Dascăl L2, Sur G1, Sur DG3, Floca E1, Aldea C1, Lupan I4, Samasca G5.

Author information: 1. Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Emergency Hospital for Children, Cluj-Napoca, Romania. 2. Emergency Hospital for Children, Cluj-Napoca, Romania. 3. Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; The Oncology Institute "Prof. Dr. Ion Chiricuță" Cluj-Napoca, Romania. 4. Babes Bolyai University, Cluj-Napoca, Romania. 5. Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Emergency Hospital for Children, Cluj-Napoca, Romania. Electronic address: [email protected]. PMID: 30959219

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Publication type

• Letter

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

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

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

Abstract

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

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MeSH terms

• Coix/metabolism* • Gels/chemistry • Glutens/chemistry* • Hydrogen Bonding • Hydrophobic and Hydrophilic Interactions • Rheology • Solubility • Spectrum Analysis, Raman • Starch/chemistry* • Temperature

Substances

• Gels • Glutens • Starch

143. Nutr Res. 2019 Jun;66:107-114. doi: 10.1016/j.nutres.2019.02.005. Epub 2019 Feb 22. Adults following a gluten-free diet report little dietary guidance in a pilot survey exploring relationships between dietary knowledge, management, and adherence in Nova Scotia, Canada.

Jamieson JA1, Gougeon L2.

Author information: 1. Department of Human Nutrition, St. Francis Xavier University, Antigonish, Nova Scotia, Canada. Electronic address: [email protected]. 2. Department of Human Nutrition, St. Francis Xavier University, Antigonish, Nova Scotia, Canada. Electronic address: [email protected].

Abstract

The strict nature of a gluten-free diet (GFD) poses a challenge for patient adherence and for clinicians to provide comprehensive client-centered care. Evidence on the relationship between nutrition knowledge, food skills, dietary management, and adherence can guide healthcare professionals counseling patients following this diet. In this explanatory pilot study, a province- wide survey (phase I) with 68 community-dwelling Nova Scotians following a GFD was conducted to investigate relationships between personal, social, and health care factors and dietary adherence using a mixed-methods approach. A sub-sample of 19 survey respondents were interviewed (phase II) to explore contextual experiences related to GFD knowledge, food skills, dietary management, and adherence using a food literacy lens. Here, we report findings from phase I, in which 37 participants with self-reported celiac disease (CD) and 31 participants reporting non-celiac reasons for wheat restriction (NCWR) completed a detailed 41-item online questionnaire. Self-reported data combined for both CD and NCWR respondents showed 76% perceived their health status as good to excellent. Most (62%) reported not receiving GFD advice from a health professional. Respondents with higher frequency of intentional consumption of gluten were more likely to have fewer correct answers to a food label quiz (ρ = -0.44; P = .0002). Most participants (75%) made at least one error in identifying gluten-free and gluten-containing foods, which may lead to unintentional gluten consumption and/or unnecessarily restricting safe foods. Findings from this exploratory study suggest patients may lack adequate referrals and support within the health care system and the community, adding to individual challenges of GFD adherence.

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

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

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

Abstract

Background:

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

Methods:

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

Results:

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

Limitations:

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

Conclusion:

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

Free Article

PMID: 30938127

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Conflict of interest statement

D. Kelly served as an advisor to Lundbeck and HLS Therapeutics. A. Fasano is the founder and a stock holder of Alba Therapeutics. R. Buchanan served on the advisory boards for Astellas Pharma, Avanir, Boehringer Ingelheim-RCV, ITI, Inc., Lundbeck and Roche. He was a consultant for Takeda and Upsher-Smith Laboratories and on the DSMB for Pfizer. W. Carpenter has served as an advisor to Boehringer Ingelheim, Allergan, Health Analytics and Teva. All other authors have nothing to disclose. 145. Plant Mol Biol. 2019 Jun;100(3):231-246. doi: 10.1007/s11103-019-00855-5. Epub 2019 Mar 25. Glutelin subtype-dependent protein localization in rice grain evidenced by immunodetection analyses.

Takahashi K1, Kohno H2, Kanabayashi T3, Okuda M2.

Author information: 1. National Research Institute of Brewing, 3-7-1 Kagamiyama, Higashi-hiroshima, Hiroshima, 739- 0046, Japan. [email protected]. 2. National Research Institute of Brewing, 3-7-1 Kagamiyama, Higashi-hiroshima, Hiroshima, 739- 0046, Japan. 3. Biopathology Institute Co., Ltd, 1200-2, Ohara Kunisakicho, Kunisaki-city, Oita, 873-0511, Japan.

Abstract

GluA and GluB-4/5 glutelin subfamilies are mainly localized to outer region of the endosperm, particularly in its ventral side, in rice grain, but GluC is localized to throughout the endosperm. The major seed storage protein in rice (Oryza sativa) is glutelin, which forms a vacuole-derived protein body type-II. Glutelins are encoded by multiple genes, and generally comprise four protein subfamilies, namely, GluA, GluB, GluC, and GluD: however, the localization pattern of glutelin in rice grains remains obscure. In this study, we investigated the localization pattern of five subtypes of the glutelin protein in rice grains using glutelin-subtype specific antibodies. Immunoblot analysis against sequentially polished rice flour fractions from three crop years and seven japonica rice varieties revealed that GluA was strongly localized in the outer region of the endosperm, including the subaleurone layer, whereas GluC was distributed throughout the endosperm. Among the glutelin subtypes, GluA was mostly found in the outer region of the rice grain, followed by GluB- 4/5, GluB-1, GluD, and GluC. Immunofluorescence labeling microscopy analysis using immature rice seeds clearly revealed that the localization pattern of GluC and GluD was completely different from that of GluA and GluB. Expression levels of all glutelins, particularly GluA, GluB-1, and GluB- 4/5, were stronger on the ventral than dorsal side in rice grains. These results provide strong and consistent evidence that glutelins localize to the rice grain in a subfamily-dependent manner.

PMCID: PMC6542783 Free PMC Article

PMID: 30911876 [Indexed for MEDLINE]

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MeSH terms

• Antibodies • Edible Grain/genetics • Edible Grain/metabolism* • Endosperm/metabolism • Epitopes/immunology • Escherichia coli/genetics • Gene Expression Regulation, Plant • Genes, Plant/genetics • Glutens/classification* • Glutens/genetics • Glutens/metabolism* • Immunoblotting/methods* • Oryza/cytology • Oryza/genetics • Oryza/growth & development • Oryza/metabolism* • Plant Proteins/genetics • Plant Proteins/metabolism • Protein Transport • Seeds/metabolism

Substances

• Antibodies • Epitopes • Plant Proteins • Glutens

Grant support

• 26850092/a Grant-in-Aid for Young Scientists (B)/

146. Clin Chem Lab Med. 2019 Jul 26;57(8):1207-1217. doi: 10.1515/cclm-2019-0088. Diagnostic accuracy of a fully automated multiplex celiac disease antibody panel for serum and plasma. Terryberry J1, Tuomi J2, Perampalam S3, Peloquin R3, Brouwer E3, Schuppan D4,5, Guandalini S6.

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

Abstract

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

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147. J Ethnopharmacol. 2019 Jun 12;237:92-107. doi: 10.1016/j.jep.2019.03.019. Epub 2019 Mar 11. Ribes orientale: A novel therapeutic approach targeting rheumatoid arthritis with reference to pro-inflammatory cytokines, inflammatory enzymes and anti- inflammatory cytokines.

Uttra AM1, Alamgeer2, Shahzad M3, Shabbir A4, Jahan S5, Bukhari IA6, Assiri AM7.

Author information: 1. Laboratory of Cardiovascular Research and Integrative Pharmacology, Department of Pharmacology, College of Pharmacy, University of Sargodha, Sargodha 40100, Pakistan. 2. Laboratory of Cardiovascular Research and Integrative Pharmacology, Department of Pharmacology, College of Pharmacy, University of Sargodha, Sargodha 40100, Pakistan. Electronic address: [email protected]. 3. Department of Pharmacology, University of Health Sciences, Lahore 54600, Pakistan. 4. Department of Pharmacy, The University of Lahore-Gujrat Campus, Gujrat 50700, Pakistan. 5. Department of Immunology, University of Health Sciences, Lahore 54600, Pakistan. 6. Department of Pharmacology, College of Medicine, King Saud University Riyadh, Saudi Arabia. 7. Prince Abdullah Ben Khaled Celiac Disease Research Chair, Department of Pediatrics, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia.

Abstract

ETHNOPHARMACOLOGICAL RELEVANCE:

The roots of Ribes orientale (Family Grossulariaceae) have long been used as a folk remedy to treat rheumatism and joints pain in Northern Areas of Pakistan.

AIM OF THE STUDY:

The purpose of study was to observe the preventive efficacy of roots of Ribes orientale (RO) aqueous ethanolic extract (30:70) and its aqueous and n-butanol fractions in treating rheumatoid arthritis and to determine its possible mechanism of action.

MATERIAL AND METHODS:

Arthritis was evaluated in vitro using heat induced bovine serum albumin and egg albumin denaturation and membrane stabilizing assays at 50-6400 μg/ml concentration of extract/fractions whereas, in vivo arthritis was evaluated at 50, 100, 200 mg/kg doses of extract/fractions in formaldehyde model by measuring rat paw volume/diameter. Moreover, highest effective dose (200 mg/kg) of extract/fractions was evaluated in Freünd complete adjuvant (FCA) model. Arthritis was induced in Sprague Dawley rats by immunization with 0.1 ml FCA in left footpad. RO extract/fractions at 200 mg/kg were orally administered from day 0, 30 min prior to adjuvant injection and sustained for 28 days. Paw volume/diameter, arthritic score, body weight, and hematological (WBC, RBC, ESR, Hb and Platelet count) and biochemical (AST, ALT, ALP, urea, creatinine, CRP and RF) parameters were observed. The mRNA expression levels of COX-2, IL-1β, IL- 6, NF-kB, TNF-α, IL-4 and IL-10 were measured by real time reverse transcription polymerase chain reaction (RT-PCR) whereas, PGE2 and TNF-α levels in serum samples were measured by Enzyme linked immunosorbent assay (ELISA). Furthermore, radiographs of hind paws and histological changes in ankle joint were analyzed in adjuvant injected rats. The anti-oxidant activity of plant extract and fractions was evaluated using DPPH and reducing power assays. In addition, phytochemistry, total phenolic and flavonoid contents, and HPLC analysis of most active fraction (aqueous fraction) were performed.

RESULTS:

Results showed that RO extract and fractions (notably aqueous fraction) significantly reduced protein denaturation and protected erythrocyte membrane in concentration dependent manner. Similarly, extract/fractions induced dose-dependent decrease in paw volume/diameter in the formaldehyde model. Plant extract and fractions significantly suppressed paw swelling and arthritic score, prevented cachexia and remarkably ameliorated hematological and biochemical changes. Furthermore, RO extract/fractions downregulated gene expression levels of PGE2, COX-2, IL-1β, IL- 6, NF-kB and TNF-α whereas, upregulated those of IL-4 and IL-10, compared with FCA control rats. The radiographic and histopathologic improvement in joint architecture was also observed in RO treated rats. Piroxicam, used as reference drug, also significantly suppressed arthritis. Additionally, plant exhibited notable anti-oxidant activity and phytochemical analysis revealed the presence of flavonoids and polyphenols.

CONCLUSION:

Results indicated that suppression of pro-inflammatory enzymes/cytokines, inhibition of protein denaturation, lysosomal membrane stabilizing abilities, and redox/free radical scavenging properties of RO extract and fractions support anti-arthritic and immunomodulatory property of Ribes orientale that might be due to its polyphenolic and flavonoid constituents. This suggests that Ribes orientale roots may be used as a therapeutic agent for treating human arthritis.

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148. Gluten And Associated Medical Problems [Internet].

Authors Akhondi H1, Ross AB2.

StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019-. 2019 Jun 4.

Author information: 1. University of Nevada 2. Michigan State University

Excerpt

Gluten is a recent topic of significant interest and research. It has become a media darling over the past few years for a variety of medical and non-medical reasons, and interest has led to a vast body of literature and information that is occasionally confusing and misleading. This review categorizes the diseases associated with gluten based on confirmed medical facts. Gluten (from Latin gluten meaning glue) is a composite of storage proteins termed prolamins and glutelins that are stored together with starch in various cereal (grass) grains. It is found in wheat, barley, rye, oat, related species and hybrids (such as spelled, Khorasan, emmer, among others) and the products of these, for example, such as malt. Gluten gives elasticity to dough, allowing for the puffy and chewy texture. About 80% of the protein in bread wheat is gluten. Pasta has a lesser degree of gluten. Imitation meats, beer, soy sauce, and occasionally, ice cream and ketchup have gluten from the included stabilizing agents. Contamination of other food products with gluten is also a common problem. Hair products and cosmetics sometimes contain gluten as well.[1][2] Gluten is significant for physicians since it has a spectrum of illnesses associated with it, for example, gluten-sensitive enteropathy or celiac disease (CD), non-celiac gluten sensitivity (NCGS), wheat or grain allergy, gluten ataxia, and dermatitis herpetiformis (DH).[3] History Aretaeus Cappadocia described a non- specific entity termed koiliakos in 250 AD. Koelia is Greek for the abdomen. Francis Adams translated this to English in 1856, using the term Coeliacs or celiacs. Samuel Gee famously said in 1888 that "to regulate the food is the main part of the treatment," and that "if the patient can be cured at all, it must be by means of diet."[4] Carnegie Brown in 1908 published a book and described peripheral neuritis in patients with CD. There was a discussion about "sprue" and ataxia, but it was hard to prove since the actual diagnosis could not be confirmed with certainty. Second World War II led to devastation and famine across the world. Most people suffered malnutrition and illnesses, but the subgroup with celiac improved and felt better. Dutch Pediatrician Willem- Karel Dicke noted that mortality of the disease decreased from 30% pre-war numbers to a lesser figure and that this was reversed after the war. His papers were some of the first that mentioned the effect of a wheat-free diet on children.[5] Eventually, small bowel biopsy methods were developed in the 1950s and 1960s, and diagnosis could be confirmed. In 1961, Taylor published an immunological study and linked the disease to circulating antibodies. Although it was thought to be a food allergy at first, the autoimmune theory was accepted, and HLA-DQ2 was linked to it. In 1966, enteropathy was noted in 9 of 12 patients with dermatitis herpetiformis. In the same year, it was noted that CD was associated with many neurological disorders.[6] In the 1980s the journal Gastroenterology coined the term “non-celiac gluten sensitivity.” This disease was very prevalent in Europe but not so much in the states. Alessio Fasano, who treated celiac patients in Europe, moved to Boston to work in Massachusetts General Hospital and found that it was a prevalent disease in the United States as well. His 2003 article in the Journal of American Medical Association started a process of recognizing the disease and paved the way for many more studies on the subject.[7] Studies in the 2000s and 2010s linked the disease to almost everything. Gluten was quickly vilified. The Food and Drug Administration (FDA) started to require the labeling of gluten- free products in 2013. Gluten-free mania ballooned the related global industry to a $3.5 billion per year figure with a forecast of $4.7 billion in 2020. Gluten-free pizza, cookbooks, apps, and restaurants have mushroomed rapidly since.[8]

Free Books & Documents

PMID: 30860740

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

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

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

Abstract PMID: 30859568

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

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

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

Abstract

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

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MeSH terms

• Chemical Phenomena • Food Quality* • Food Storage/methods* • Glutens/chemistry* • Polymers/chemistry*

Substances

• Polymers • polyol • Glutens

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

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

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

Abstract

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

PMID: 30839342

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152. Gastroenterology. 2019 Jun;156(8):2217-2229. doi: 10.1053/j.gastro.2019.02.039. Epub 2019 Mar 2. Association Between Antibiotics in the First Year of Life and Celiac Disease.

Dydensborg Sander S1, Nybo Andersen AM2, Murray JA3, Karlstad Ø4, Husby S5, Størdal K6.

Author information: 1. Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark. Electronic address: [email protected]. 2. Department of Public Health, University of Copenhagen, Copenhagen, Denmark. 3. Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota. 4. Department of Non-Communicable Diseases, Norwegian Institute of Public Health, Oslo, Norway. 5. Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark. 6. Department of Non-Communicable Diseases, Norwegian Institute of Public Health, Oslo, Norway; Department of Pediatrics, Ostfold Hospital Trust, Fredrikstad, Norway.

Abstract

BACKGROUND & AIMS:

The intestinal microbiota is believed to be involved in the pathogenesis of celiac disease, in addition to genetic variants and dietary gluten. The gut microbiota is strongly influenced by systemic antibiotics-especially in early life. We explored the association between exposure to a systemic antibiotic in the first year of life and risk of diagnosed celiac disease.

METHODS:

We performed an observational nationwide register-based cohort study. We included all children born in Denmark from 1995 through 2012 or Norway from 2004 through 2012. Children born in Denmark were followed until May 8, 2015 (age at end of follow-up was 2.3-20.3 years) and children born in Norway were followed until December 31, 2013 (age at end of follow-up was 1-10 years). We collected medical information from more than 1.7 million children, including 3346 with a diagnosis of celiac disease. Exposure to systemic antibiotics was defined as a dispensed systemic antibiotic in the first year of life.

RESULTS:

Exposure to systemic antibiotics in the first year of life was positively associated with diagnosed celiac disease in the Danish and Norwegian cohorts (pooled odds ratio 1.26, 95% confidence interval 1.16-1.36). We found a dose-dependent relation between an increasing number of dispensed antibiotics and the risk of celiac disease (pooled odds ratio for each additional dispensed antibiotic 1.08, 95% confidence interval 1.05-1.11). No specific type of antibiotic or age period within the first year of life was prominent. Adjustment for hospital admissions with an infectious disease in the first year of life did not change the estimates; adjustment for the number of maternally reported infections in the child in 2 large sub-cohorts decreased the association slightly (pooled odds ratio 1.18, 95% confidence interval 0.98-1.39).

CONCLUSION:

In a nationwide study of children in Denmark and Norway, we found exposure to systemic antibiotics in the first year of life to be associated with a later diagnosis of celiac disease. These findings indicate that childhood exposure to systemic antibiotics could be a risk factor for celiac disease.

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Publication types

• Multicenter Study • Observational Study • Research Support, N.I.H., Extramural • Research Support, Non-U.S. Gov't

MeSH terms

• Age Factors • Age of Onset* • Anti-Bacterial Agents/adverse effects* • Anti-Bacterial Agents/therapeutic use • Celiac Disease/chemically induced* • Celiac Disease/epidemiology* • Celiac Disease/physiopathology • Child • Child, Preschool • Cohort Studies • Denmark • Female • Gastrointestinal Microbiome/drug effects* • Humans • Incidence • Infant • Male • Norway • Proportional Hazards Models • Prospective Studies • Registries* • Risk Assessment • Severity of Illness Index

Substance

• Anti-Bacterial Agents

Grant support

• N01ES75558/ES/NIEHS NIH HHS/United States • U01 NS047537/NS/NINDS NIH HHS/United States

153. J Hum Nutr Diet. 2019 Jun;32(3):311-320. doi: 10.1111/jhn.12638. Epub 2019 Mar 5. Diminished quality of life among adolescents with coeliac disease using maladaptive eating behaviours to manage a gluten-free diet: a cross-sectional, mixed- methods study.

Cadenhead JW1, Wolf RL1, Lebwohl B2, Lee AR2, Zybert P1, Reilly NR2, Schebendach J3, Satherley R4, Green PHR2.

Author information: 1. Department of Health and Behavior Studies, Program in Nutrition, Teachers College, Columbia University, New York, NY, USA. 2. Department of Medicine, Celiac Disease Center, Columbia University Medical Center, Harkness Pavilion, New York, NY, USA. 3. Department of Psychiatry, Columbia University Medical Center, New York, NY, USA. 4. Faculty of Life Sciences and Medicine, School of Population Health & Environmental Sciences, King's College London, London, UK.

Abstract

BACKGROUND:

Certain approaches to managing a strict gluten-free diet (GFD) for coeliac disease (CD) may lead to impaired psychosocial well-being, a diminished quality of life (QOL) and disordered eating. The present study aimed to understand adolescents' approaches to managing a GFD and the association with QOL.

METHODS:

Thirty adolescents with CD (13-17 years old) following the GFD for at least 1 year completed the Celiac Dietary Adherence Test (CDAT) and QOL survey. Their approaches to GFD management were explored using a semi-structured interview, where key themes were developed using an iterative process, and further analysed using a psychosocial rubric to classify management strategies and QOL. CDAT ratings were compared across groups.

RESULTS:

Gluten-free diet management strategies were classified on a four-point scale. Adaptive eating behaviours were characterised by greater flexibility (versus rigidity), trust (versus avoidance), confidence (versus controlling behaviour) and awareness (versus preoccupation) with respect to maintaining a GFD. Approximately half the sample (53.3%) expressed more maladaptive approaches to maintaining a GFD and those who did so were older with lower CD-Specific Pediatric Quality of Life (CDPQOL) scores, mean subscale differences ranging from 15.0 points for Isolation (t = 2.4, P = 0.03, d.f. = 28) to 23.4 points for Limitations (t = 3.0, P = 0.01, d.f. = 28).

CONCLUSIONS:

Adolescents with CD who manage a GFD with maladaptive eating behaviours similar to known risk factors for feeding and eating disorders experience diminished QOL. In accordance with CD management recommendations, we recommend ongoing follow-up with gastroenterologists and dietitians and psychosocial support referrals, as needed.

PMCID: PMC6467807 [Available on 2020-06-01]

PMID: 30834587

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Grant support

• UL1 TR000040/TR/NCATS NIH HHS/United States • Provost Investment Fund at Teachers College Columbia University/ • UL1 TR000040/National Center for Advancing Translational Sciences/ • National Institutes of Health/

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

West J1, Otete H, Sultan AA, Crooks CJ.

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

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

Voi S1, Sainsbury K2.

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

Abstract

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

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

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

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

Abstract

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

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

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

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

Abstract

AIM:

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

PATIENTS AND METHOD:

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

RESULTS:

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

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

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

Fernández-Bañares F1, Esteve M.

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

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159. Gastroenterology. 2019 Jun;156(8):2266-2280. doi: 10.1053/j.gastro.2019.02.028. Epub 2019 Feb 22. Lactobacilli Degrade Wheat Amylase Trypsin Inhibitors to Reduce Intestinal Dysfunction Induced by Immunogenic Wheat Proteins. Caminero A1, McCarville JL1, Zevallos VF2, Pigrau M1, Yu XB3, Jury J1, Galipeau HJ1, Clarizio AV1, Casqueiro J4, Murray JA5, Collins SM1, Alaedini A3, Bercik P1, Schuppan D6, Verdu EF7.

Author information: 1. Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada. 2. Institute of Translational Immunology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany. 3. Department of Medicine, Columbia University, New York, New York; Institute of Human Nutrition, Columbia University, New York, New York. 4. Department of Microbiology, Universidad de Leon, Leon, Spain. 5. Division of Gastroenterology and Hepatology, Department of Immunology, Mayo Clinic College of Medicine, Rochester, Minnesota. 6. Institute of Translational Immunology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany; Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts. 7. Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada. Electronic address: [email protected].

Abstract

BACKGROUND & AIMS:

Wheat-related disorders, a spectrum of conditions induced by the ingestion of gluten-containing cereals, have been increasing in prevalence. Patients with celiac disease have gluten-specific immune responses, but the contribution of non-gluten proteins to symptoms in patients with celiac disease or other wheat-related disorders is controversial.

METHODS:

C57BL/6 (control), Myd88-/-, Ticam1-/-, and Il15-/- mice were placed on diets that lacked wheat or gluten, with or without wheat amylase trypsin inhibitors (ATIs), for 1 week. Small intestine tissues were collected and intestinal intraepithelial lymphocytes (IELs) were measured; we also investigated gut permeability and intestinal transit. Control mice fed ATIs for 1 week were gavaged daily with Lactobacillus strains that had high or low ATI-degrading capacity. Nonobese diabetic/DQ8 mice were sensitized to gluten and fed an ATI diet, a gluten-containing diet or a diet with ATIs and gluten for 2 weeks. Mice were also treated with Lactobacillus strains that had high or low ATI-degrading capacity. Intestinal tissues were collected and IELs, gene expression, gut permeability and intestinal microbiota profiles were measured.

RESULTS:

In intestinal tissues from control mice, ATIs induced an innate immune response by activation of Toll-like receptor 4 signaling to MD2 and CD14, and caused barrier dysfunction in the absence of mucosal damage. Administration of ATIs to gluten-sensitized mice expressing HLA-DQ8 increased intestinal inflammation in response to gluten in the diet. We found ATIs to be degraded by Lactobacillus, which reduced the inflammatory effects of ATIs.

CONCLUSIONS:

ATIs mediate wheat-induced intestinal dysfunction in wild-type mice and exacerbate inflammation to gluten in susceptible mice. Microbiome-modulating strategies, such as administration of bacteria with ATI-degrading capacity, may be effective in patients with wheat-sensitive disorders.

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Publication types

• Research Support, N.I.H., Extramural • Research Support, Non-U.S. Gov't

MeSH terms

• Amylases/antagonists & inhibitors • Animals • Celiac Disease/diet therapy • Celiac Disease/immunology* • Celiac Disease/physiopathology • Diet, Gluten-Free/methods* • Disease Models, Animal • Gastrointestinal Microbiome/immunology • Gliadin/adverse effects* • Gliadin/immunology • Humans • Immunity, Innate/drug effects • Lactobacillus/immunology* • Lactobacillus/metabolism • Mice • Mice, Inbred C57BL • Random Allocation • Reference Values • Sensitivity and Specificity • Triticum/adverse effects* • Triticum/immunology • Trypsin Inhibitors/immunology • Trypsin Inhibitors/pharmacology Substances

• Trypsin Inhibitors • Gliadin • Amylases

Grant support

• MOP 142773/CIHR/Canada • 143253/CIHR/Canada • UL1 TR000040/TR/NCATS NIH HHS/United States

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

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

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

Abstract

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

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MeSH terms

• Antioxidants/pharmacology* • Cicer/chemistry* • Cicer/drug effects • Cicer/growth & development • Germination/drug effects • Globulins/metabolism • Glutens/metabolism • Glutens/pharmacokinetics • Plant Proteins/chemistry • Plant Proteins/metabolism • Plant Proteins/pharmacokinetics* • Protein Hydrolysates/chemistry • Protein Hydrolysates/metabolism • Protein Hydrolysates/pharmacology* • Seeds/chemistry • Seeds/drug effects • Seeds/growth & development • Selenium/analysis • Sodium Selenite/pharmacology*

Substances

• Antioxidants • Globulins • Plant Proteins • Protein Hydrolysates • Glutens • Selenium • Sodium Selenite

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

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

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

Abstract

Objective: Celiac disease is an immune-mediated disease of the intestine triggered by gluten. Gluten elicits, in genetically susceptible individuals, cytokine responses that are then transmitted to the immunocompetent cells. Vegetables and fruit have anti-inflammatory and antioxidant properties with a protective effect on intestinal epithelium. Kiwifruit is known to have beneficial effects on the intestinal tissues, and it is the only plant food containing the peptide kissper, with anti-inflammatory properties. The aim of this study was the evaluation of the kissper effect on the gluten-induced inflammation in celiac disease. Methods: We used an in vitro model of intestinal culture explant from celiac disease patients and non-celiac disease patients, cultured for 24 hours with the toxic gliadin peptide P31-43 and kissper preincubation. Results: Our data showed HLA-DR and TG2 reduction in the celiac disease mucosa pretreated with kissper, as well as a reduction of COX-2 in two patients. No differences we observed for the TGF-b1 and IL-15 levels in supernatants upon kissper pretreatment. Conclusions: The preliminary results suggest that kissper has a potential anti-inflammatory role in celiac disease. PMID: 30794064

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

Gu Z1, Wang Y, Lin K, Wang X, Cheng W, Wang L, Zhang T, Liu H. Author information: 1. Department of Gastroenterology, Hepatology and Nutrition, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China.

Abstract

OBJECTIVE:

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

METHODS:

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

RESULTS:

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

CONCLUSIONS:

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

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163. Pediatr Diabetes. 2019 Jun;20(4):414-420. doi: 10.1111/pedi.12827. Epub 2019 Apr 3. Prevalence of celiac disease in a large cohort of young patients with type 1 diabetes.

Puñales M1,2, Bastos MD3,4, Ramos ARL5, Pinto RB5, Ott EA6, Provenzi V7, Geremia C1,2, Soledade MA1, Schonardie AP1, da Silveira TR3,8, Tschiedel B1.

Author information: 1. Institute for Children with Diabetes (ICD), Conceição Children Hospital (HCC), Conceição Hospital Group (GHC), Ministry of Health, Porto Alegre, RS, Brazil. 2. Pediatric Endocrinology Service, Conceição Children Hospital (HCC), Conceição Hospital Group (GHC), Ministry of Health, Porto Alegre, RS, Brazil. 3. Post-Graduation Program in Adolescent and Child Health, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil. 4. Medical Course, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, Brazil. 5. Pediatric Gastroenterology Service, Conceição Children Hospital (HCC), Conceição Hospital Group (GHC), Ministry of Health, Porto Alegre, RS, Brazil. 6. Endoscopy Service, Nossa Senhora da Conceição Hospital (HNSC), Conceição Hospital Group (GHC), Porto Alegre, RS, Brazil. 7. Pathology Service, Nossa Senhora da Conceição Hospital (HNSC), Conceição Hospital Group (GHC), Ministry of Health, Porto Alegre, RS, Brazil. 8. Santo Antônio Child Hospital, Santa Casa de Misericórdia, Porto Alegre, RS, Brazil.

Abstract

BACKGROUND:

Serological screening for celiac disease (CD) allows the identification of individuals genetically predisposed, as type 1 diabetes mellitus (T1DM). However, the diagnosis is confirmed by intestinal biopsy. The aim was to determine the prevalence of immunoglobulin-A anti-tissue transglutaminase antibodies (IgA-tTG) and CD in a large cohort of young T1DM patients.

METHODS:

Screening for CD was randomly conducted in 881 T1DM by IgA-tTG and total IgA. Individuals with positive antibodies were referred to endoscopy/duodenal biopsy.

RESULTS:

The age of the cohort at the screening was 14.3 ± 5.9 years and at T1DM onset was 7.9 ± 4.4 years. The prevalence of positive serology was 7.7%. Median IgA-tTG levels were 117.7 U/mL (interquartile range [IQR] 35.7-131.5 U/mL). Of the 62 duodenal biopsy, CD was diagnosed in 79.0%, yielding an overall prevalence of 5.6%. The mean age of CD patients was 15.6 ± 6.5 years and, at T1DM onset was 6.3 years (4.0-9.9 years). The modified Marsh-Oberhuber histological classification was 22.5% (3a), 36.7% (3b), and 40.8% (3c). In the biopsy-proven patients, T1DM onset occurred at slightly younger ages (6.3 vs 9.7 years, P = 0.1947), gastrointestinal (GI) manifestations, predominantly abdominal pain and distension, were more prevalent (71.4% vs 38.5%, P = 0.027) and higher IgA-tTG titers (128.0 vs 26.3 U/mL, P = 0.0003) were found than in those with negative-biopsies.

CONCLUSION:

Our results demonstrate the prevalence of 7.7% of IgA-tTG and 5.6% of CD in T1DM patients in South Brazil and, emphasize the importance of the screening in high-risk individuals. Furthermore, the presence of GI manifestations and higher IgA-tTG titers strongly suggest the diagnosis of CD.

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164. Food Chem. 2019 Jun 15;283:522-529. doi: 10.1016/j.foodchem.2019.01.068. Epub 2019 Jan 19. Effects of frozen storage on the quality characteristics of frozen cooked noodles.

Liu Q1, Guo XN2, Zhu KX1.

Author information: 1. State Key Laboratory of Food Science and Technology, Jiangnan University, 1800 Lihu Avenue, Wuxi 214122, Jiangsu Province, People's Republic of China; School of Food Science and Technology, Jiangnan University, 1800 Lihu Avenue, Wuxi 214122, Jiangsu Province, People's Republic of China. 2. State Key Laboratory of Food Science and Technology, Jiangnan University, 1800 Lihu Avenue, Wuxi 214122, Jiangsu Province, People's Republic of China; School of Food Science and Technology, Jiangnan University, 1800 Lihu Avenue, Wuxi 214122, Jiangsu Province, People's Republic of China. Electronic address: [email protected].

Abstract

The effects of frozen storage on the quality of frozen cooked noodles were investigated. Texture analysis showed hardness and tensile force reduced during frozen storage. An increasing cooking loss and a decreasing water uptake ratio were determined when testing cooking qualities. As storage time prolonged, differential scanning calorimetry (DSC) detected more freezable water, and an increased relaxation time was recorded by nuclear magnetic resonance (NMR). Magnetic resonance imaging (MRI) revealed water distribution was more heterogeneous. A ruptured microstructure with large pores of frozen cooked noodles was observed by scanning electron microscopy (SEM). The confocal laser scanning microscope (CLSM) photographs demonstrated gluten network lost its integrity and compactness. Size-exclusion high performance liquid chromatography (SE-HPLC) indicated the amount of SDS-soluble proteins increased. The present study showed water characteristics and protein network underwent some changes during frozen storage, which had major effects on the quality of frozen cooked noodles.

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MeSH terms

• Calorimetry, Differential Scanning • Chromatography, High Pressure Liquid/methods • Cooking* • Dietary Proteins/chemistry • Food Analysis/methods • Food Storage/methods* • Freezing • Glutens/chemistry • Magnetic Resonance Imaging • Microscopy, Confocal • Water/chemistry

Substances

• Dietary Proteins • Water • Glutens

165. Food Chem. 2019 Jun 15;283:454-461. doi: 10.1016/j.foodchem.2019.01.027. Epub 2019 Jan 14. Effects of microwave treatment of durum wheat kernels on quality characteristics of flour and pasta.

Padalino L1, Del Nobile MA2, la Gatta B1, Rutigliano M1, Di Luccia A1, Conte A1.

Author information: 1. University of Foggia, Department of Agricultural Sciences, Food and Environment, Via Napoli - 25, 71122 Foggia, Italy. 2. University of Foggia, Department of Agricultural Sciences, Food and Environment, Via Napoli - 25, 71122 Foggia, Italy. Electronic address: [email protected].

Abstract

The influence of microwave treatment of hydrated durum wheat kernels of two different cultivars (cv Aureo and Sfinge), on wholemeal flour and pasta quality was addressed. Size exclusion-HPLC and electrophoresis analysis were used to investigate changes in the gluten network arrangement as affected by the microwave treatment. Rheological properties of dough, cooking quality and sensory properties of pasta were also assessed. Results suggested that the microwave treatment on hydrated durum wheat kernels blocks gluten protein conformation through SS bonds formation and the free -SH are no longer able to create a strong network during pasta processing, due to the conformational changes. Rheological study of dough confirmed that the modifications induced by microwave treatment greatly affected pasta making characteristics of wheat flour, with significant negative consequences on product quality, especially for pasta cooking quality. Pasta from treated durum wheat showed low sensory quality, mainly due to high bulkiness and adhesiveness.

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MeSH terms

• Chromatography, High Pressure Liquid • Cooking • Disulfides/chemistry • Electrophoresis • Flour/analysis* • Glutens/chemistry • Microwaves* • Rheology • Triticum/chemistry • Triticum/metabolism*

Substances

• Disulfides • Glutens

166. Food Chem. 2019 Jun 15;283:353-358. doi: 10.1016/j.foodchem.2019.01.049. Epub 2019 Jan 18. The effects of phosphate salts on the pasting, mixing and noodle-making performance of wheat flour.

Chen M1, Wang L2, Qian H1, Zhang H1, Li Y1, Wu G1, Qi X1.

Author information: 1. State Key Laboratory of Food Science and Technology, Jiangnan University, 1800 Lihu Avenue, Wuxi 214122, China; School of Food Science and Technology, Jiangnan University, 1800 Lihu Avenue, Wuxi 214122, China; National Engineering Research Center for Functional Food, Jiangnan University, 1800 Lihu Avenue, Wuxi 214122, China. 2. State Key Laboratory of Food Science and Technology, Jiangnan University, 1800 Lihu Avenue, Wuxi 214122, China; School of Food Science and Technology, Jiangnan University, 1800 Lihu Avenue, Wuxi 214122, China; National Engineering Research Center for Functional Food, Jiangnan University, 1800 Lihu Avenue, Wuxi 214122, China. Electronic address: [email protected].

Abstract

The effects of five phosphate salts (PS) on the pasting properties of flour, mixing properties of dough and qualities of cooked noodles were investigated. Rapid Visco Analysis showed that all types of PS increased the peak and final viscosities of wheat flour. Trisodium phosphate (TSP) significantly increased pasting temperature with increasing concentration. The Farinograph characteristics indicated that TSP markedly increased stability time and progressively decreased the degree of softening of the dough. The cooking yield of the TSP, sodium pyrophosphate (TSPP) and disodium phosphate (DSP) groups clearly increased, and the cooking loss was reduced by adding 0.3% sodium tripolyphosphate (STPP), 0.1% TSPP or 0.1% TSP. Texture profile analysis revealed that the hardness of cooked noodles from STPP and TSP groups slightly decreased, while that of TSPP and DSP groups decreased significantly. Overall, PS improved the qualities of noodles mainly by promoting starch gelatinization and strengthening the gluten network.

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MeSH terms

• Flour/analysis* • Glutens/chemistry • Hydrogen-Ion Concentration • Phosphates/chemistry* • Salts/chemistry • Spectrophotometry • Sulfhydryl Compounds/analysis • Temperature • Triticum/chemistry* • Triticum/metabolism • Viscosity

Substances

• Phosphates • Salts • Sulfhydryl Compounds • Glutens • sodium phosphate

167. Food Chem. 2019 Jun 15;283:224-231. doi: 10.1016/j.foodchem.2019.01.048. Epub 2019 Jan 16. Comparative studies on physicochemical properties, starch hydrolysis, predicted glycemic index of Hom Mali rice and Riceberry rice flour and their applications in bread.

Thiranusornkij L1, Thamnarathip P2, Chandrachai A3, Kuakpetoon D4, Adisakwattana S5.

Author information: 1. Technopreneurship and Innovation Management Program, Graduate School, Chulalongkorn University, Thailand; KCG Excellence Center, KCG Corporation Co., Ltd., Thepharak Rd., Bangpleeyai, Bangplee, Samutprakarn 10540, Thailand. 2. KCG Excellence Center, KCG Corporation Co., Ltd., Thepharak Rd., Bangpleeyai, Bangplee, Samutprakarn 10540, Thailand. 3. Technopreneurship and Innovation Management Program, Graduate School, Chulalongkorn University, Thailand. 4. Department of Food Technology, Faculty of Science, Chulalongkorn University, Bangkok 10330, Thailand. 5. Department of Nutrition and Dietetics, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok 10330, Thailand. Electronic address: [email protected].

Abstract Physicochemical properties, predicted glycemic index (pGI) and bread qualities of a non-pigmented white rice flour (Hom Mali, HM) and a pigmented rice flour (Riceberry rice flour, RB) were investigated. In the present study, RB (15.3% amylose) contained higher total polyphenolics, anthocyanins, and ferric reduction activity power than HM (21.3% amylose). RB had lower swelling power and higher gelatinization temperatures. In addition, RB contained higher levels of beneficial resistant starch (RS) and lower levels of slowly digestible starch (SDS) with medium pGI. RB provided slower glucose release than HM. The pasting characteristics showed that peak and final viscosity, trough and setback value, and breakdown of RB was lower than HM. RB bread had lower cohesiveness, gumminess, chewiness and adhesiveness than HM bread. Furthermore, RB bread demonstrated lower starch hydrolysis and pGI than HM bread. These findings suggest that anthocyanin-rich RB could be used as an alternative food ingredient for gluten-free bread.

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Publication type

• Comparative Study

MeSH terms

• Amylose/chemistry • Antioxidants/analysis • Bread/analysis* • Chemical Phenomena* • Diet, Gluten-Free • Flour/analysis • Glycemic Index* • Hot Temperature • Hydrolysis • Oryza/chemistry* • Seeds/chemistry • Starch/metabolism* • Triticum/chemistry • Viscosity

Substances

• Antioxidants • Starch • Amylose 168. Food Chem. 2019 Jun 15;283:111-122. doi: 10.1016/j.foodchem.2019.01.019. Epub 2019 Jan 14. Gluten-starch interactions in wheat gluten during carboxylic acid deamidation upon hydrothermal treatment.

Liao L1, Zhang FL2, Lin WJ2, Li ZF2, Yang JY2, Hwa Park K3, Ni L2, Liu P4.

Author information: 1. Department of Food Science, Foshan University, Foshan, Guangdong 528000, People's Republic of China; College of Biological Science and Technology, Fuzhou University, Fuzhou, Fujian 350108, People's Republic of China. Electronic address: [email protected]. 2. College of Biological Science and Technology, Fuzhou University, Fuzhou, Fujian 350108, People's Republic of China. 3. College of Biological Science and Technology, Fuzhou University, Fuzhou, Fujian 350108, People's Republic of China; Center for Agricultural Biomaterials, Department of Food Science & Technology, College of Agriculture and Life Science, Seoul National University, San 56-1, Shillim-dong, Kwanak- gu, Seoul 151-921, Republic of Korea. 4. School of Chemistry and Chemical Engineering, Guangzhou University, Guangzhou 510000, People's Republic of China. Electronic address: [email protected].

Abstract

After carboxylic acid deamidation upon heating (CADH), wheat gluten still contains a total of ∼10% insoluble fractions, of which ∼10% is starch, which depreciate the values of wheat gluten. To elucidate gluten-starch interactions and their role in the deamidation behavior of gluten, the macrostructural characteristics of gluten citric acid suspensions of different concentrations (1% and 10%, w/v) and with different types of residual starch chains (achieved by enzyme hydrolyzed by α-amylase and/or glucoamylase assisted by sonication) were investigated. We found the degradation of long starch chains and branched short chains induced dramatic bond-cleavages in insoluble glutenins and gliadins. FTIR and SDS-PAGE analyses indicated that without these two types of chains in the precipitates, the insoluble deamidated wheat gluten exhibited minimal changes in the molecular force and the conformation. Their glycosylation, hydrophobic force and hydrogen bonds between amylopectin and small proteins, such as LMW-GS and α, β, γ-gliadins, were detected. FTIR suggested that the associations between gliadins and amylopectin were covalent. Gluten-starch interactions were likely to cause an incomplete dissolution of wheat gluten during CADH. A simple model was proposed to clarify the aggregation state and the relationships between starch granules and wheat gluten components during CADH.

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MeSH terms

• Amylases/metabolism • Carboxylic Acids/chemistry* • Gliadin/metabolism • Glutens/chemistry • Glutens/metabolism* • Hydrogen Bonding • Hydrolysis • Hydrophobic and Hydrophilic Interactions • Sonication • Spectroscopy, Fourier Transform Infrared • Starch/metabolism* • Triticum/metabolism*

Substances

• Carboxylic Acids • Glutens • Starch • Gliadin • Amylases • glutenin

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

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

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

The design and development of gluten-free foods requires a comprehensive understanding of the behavior of the raw materials to attain the same cooking and nutritional quality as gluten-based food. The objective of this study was to determine the optimal hot-air drying conditions for elaboration of cassava flour to be used in a gluten-free pasta formulation. The results showed that the operational conditions to minimize the hot-air drying time (57 min) to produce cassava flour with higher water holding capacity was 57 ℃ at 3 m/s. Then, the optimal formulation for the pasta was found to be cassava (26 g/100 g), amaranth flour (12 g/100 g), and carboxymethyl cellulose (0.23 g/100 g), which maximized the Aw (0.160), moisture content (3.10 g/100 g), hardness (5.02 N), and protein content (9.30 g/100 g), and it is used for the sensorial analysis, which showed that an earthy taste was the main problem with consumer satisfaction. PMID: 30714395

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170. Food Chem. 2019 Jun 1;282:134-140. doi: 10.1016/j.foodchem.2018.12.113. Epub 2019 Jan 10. Novel breads of non-wheat flours.

Torbica A1, Belović M2, Tomić J3.

Author information: 1. University of Novi Sad, Institute of Food Technology, Bulevar cara Lazara 1, Novi Sad, Serbia. Electronic address: [email protected]. 2. University of Novi Sad, Institute of Food Technology, Bulevar cara Lazara 1, Novi Sad, Serbia. Electronic address: [email protected]. 3. University of Novi Sad, Institute of Food Technology, Bulevar cara Lazara 1, Novi Sad, Serbia. Electronic address: [email protected].

Abstract

The aim of this study was to provide new approach in creating gluten-containing and gluten-free breads without additives by combining thermal and hydrothermal pretreatments of flours (rye, oat, sorghum and millet). The applied methodology included determinations of chemical composition of flours and breads, water absorption index, empirical and fundamental rheological measurements, and scanning electron microscopy, differential scanning calorimetry, colour, textural and sensory evaluations of breads. Novel rye, oat, sorghum and millet breads based on the blend of heat treated and extruded corresponding flours in ratio 70:30 were produced by conventional breadmaking process. All breads were characterized by increased fibre content and had appearance similar to common wheat bread. Gluten-free breads were harder, less elastic with more granular structure due to higher degree of starch crystallinity. Mixolab curves indicated on many possible ways for further breads optimisation.

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MeSH terms

• Adsorption • Avena/chemistry • Avena/metabolism • Bread/analysis* • Calorimetry, Differential Scanning • Flour/analysis* • Glutens/analysis • Microscopy, Electron, Scanning • Millets/chemistry • Millets/metabolism • Rheology • Secale/chemistry • Secale/metabolism • Sorghum/chemistry • Sorghum/metabolism

Substance

• Glutens

171. Eur J Clin Nutr. 2019 Jun;73(6):930-936. doi: 10.1038/s41430-018-0385-6. Epub 2019 Jan 15. Differences in the macronutrient and dietary fibre profile of gluten-free products as compared to their gluten-containing counterparts.

Calvo-Lerma J1,2, Crespo-Escobar P3, Martínez-Barona S3, Fornés-Ferrer V3, Donat E4, Ribes- Koninckx C3,4. Author information: 1. Instituto de Investigación Sanitaria La Fe, Avenida Fernando Abril Martorell 106, Torre A planta 0, 46026, Valencia, Spain. [email protected]. 2. Instituto de Ingeniería de Alimentos para el Desarrollo, Universitat Politècnica de València, Camino de Vera s/n, 46022, Valencia, Spain. [email protected]. 3. Instituto de Investigación Sanitaria La Fe, Avenida Fernando Abril Martorell 106, Torre A planta 0, 46026, Valencia, Spain. 4. Hospital Universitari i Politècnic La Fe. Avda, Fernando Abril Martorell 106, Torre C planta 2, 46026, Valencia, Spain.

Abstract

BACKGROUND/OBJECTIVES:

Gluten-free diet is the lifelong therapy for patients with coeliac disease. A wide range of gluten- free products (GFP) is available, which mimics the characteristics of their gluten-containing counterparts (GCC). The aim of this study was to compare the macronutrient and dietary fibre composition of GFP and GCC currently available in Spain.

SUBJECTS/METHODS:

A cross-sectional study analysing the nutritional differences between 621 GFP and 600 GCC based on labelling information was conducted. Food items were categorized in one of 14 food groups. The first six ingredients were noted for each food item. A linear regression model was used to explain differences in nutritional composition between GFP and GCC and three independent models were created for bread, pasta and biscuits.

RESULTS:

Results showed that GCC had higher protein content than GFP, especially in flour, bread, pasta and pizza. Bread had higher total and saturated fat contents in the GFP in which palm oil was the main fat used. Flours and starchy ingredients used in GFP formulation were mainly rice and corn flours and corn starch, and palm oil was the most commonly used fat.

CONCLUSIONS:

In conclusion, GFP cannot currently be considered as equivalent substitutes for their GCC. The reformulation of the GFP with more healthy ingredients and ingredients is encouraged, using a healthy oil, pseudocereals and whole flour. PMID: 30647439

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

Santos FG1, Aguiar EV1, Capriles VD1.

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

Abstract

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

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173. Minerva Gastroenterol Dietol. 2019 Jun;65(2):153-162. doi: 10.23736/S1121-421X.18.02519-9. Epub 2018 Dec 14. Gluten-free diet in non-celiac patients: beliefs, truths, advantages and disadvantages. Palmieri B1,2, Vadala' M1,2, Laurino C3,2.

Author information: 1. Department of Surgery, Dental and Morphological Sciences with Interest in Transplantation, Oncology and Regenerative Medicine, University of Modena e Reggio Emilia, Modena, Italy. 2. Second Opinion Medical Network, Modena, Italy. 3. Department of Surgery, Dental and Morphological Sciences with Interest in Transplantation, Oncology and Regenerative Medicine, University of Modena e Reggio Emilia, Modena, Italy - [email protected].

Abstract

A gluten-free diet is the safest treatment for the treatment of patient with celiac disease (CD) and other gluten-related disorders. However, in the last years, gluten-free diet is one of the most popular diet followed by the general population and by patients affected from others clinical conditions, such as non-celiac gluten sensitivity (NCGS), irritable bowel syndrome (IBS), autism, neurological, psychiatric and rheumatologic diseases and for improving sports practice. This review highlights some questions about the appropriateness of following this trend answering to some questions such as how safe are the current gluten-free products, what are the benefits and side effects of gluten-free diet and what are clinical conditions that might benefit from gluten avoidance. PMID: 30545212

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174. Acta Paediatr. 2019 Jun;108(6):1140-1143. doi: 10.1111/apa.14669. Epub 2018 Dec 14. Questionnaire showed that Swedish paediatric clinics complied well with the revised European guidelines for diagnosing coeliac disease.

Myléus A1,2, Stenhammar L3, Högberg L3, Browaldh L4, Daniels IM5, Fagerberg UL6, Gudjónsdóttir AH7, Malmquist M7, Sandström O1, Ivarsson A1.

Author information: 1. Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden. 2. Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden. 3. Department of Paediatrics and Department of Clinical and Experimental Medicine, Linköping University, Norrköping, Sweden. 4. Department of Clinical Science and Education, Karolinska Institutet and Paediatric Clinic, Södersjukhuset, Stockholm, Sweden. 5. Department of Paediatrics, Uppsala University Hospital, Uppsala, Sweden. 6. Department of Paediatrics, Centre for Clinical Research, Västmanland Hospital, Västerås and Karolinska Institutet, Stockholm, Sweden. 7. Department of Paediatric Gastroenterology, Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.

Abstract

AIM:

In 2012, revised criteria for diagnosing childhood coeliac disease were published by the European Society for Paediatric Gastroenterology, Hepatology and Nutrition and incorporated into the revised Swedish guidelines the same year. These made it possible, in certain cases, to diagnose coeliac disease without taking small bowel biopsies. This survey assessed the extent to which the new guidelines were implemented by Swedish paediatric clinics two years after their introduction.

METHODS:

In October 2014, we distributed a paper questionnaire including five questions on diagnostic routines to the 40 paediatric clinics in university or regional hospitals in Sweden that perform small bowel biopsies.

RESULTS:

All 36 (90%) clinics that responded used anti-tissue transglutaminase antibodies as the initial diagnostic test and some also used serological markers. Most clinics (81%) used endoscopy and took multiple duodenal biopsies, whereas only a few (19%) occasionally employed a suction capsule. Almost all clinics (86%) omitted taking small bowel biopsies in symptomatic children with repeatedly high coeliac serology and positive genotyping, thereby avoiding the need for invasive endoscopy under anaesthesia.

CONCLUSION:

The 2012 Swedish Paediatric Coeliac Disease Diagnostic Guidelines had been widely accepted and implemented in routine health care two years after their introduction.

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175. J Visc Surg. 2019 Jun;156(3):191-195. doi: 10.1016/j.jviscsurg.2018.10.006. Epub 2018 Nov 1. Does the degree of calcification of the celiac trunk and superior mesenteric artery on preoperative computerized tomography predict the risk of anastomotic leak after right colectomy? A single center retrospective study.

Postaire B1, Abet E2, Montigny P3, Vent PA4.

Author information: 1. Chirurgie digestive, centre hospitalier départemental de Vendée, 85000 La Roche-sur-Yon, France. 2. Chirurgie digestive, centre hospitalier départemental de Vendée, 85000 La Roche-sur-Yon, France. Electronic address: [email protected]. 3. Service de radiologie, centre hospitalier départemental de Vendée, 85000 La Roche-sur-Yon, France. 4. Chirurgie vasculaire, centre hospitalier départemental de Vendée, 85000 La Roche-sur-Yon, France.

Abstract

Anastomotic leak is a serious complication of colonic surgery. The aim of our study is to evaluate the impact of vascular calcifications of the celiac axis and superior mesenteric artery in patients undergoing elective right colectomy, and particularly their relationship to the risk of anastomotic leak.

MATERIALS AND METHODS:

We performed a retrospective analysis of preoperative abdominal computerized tomography (CT) scans of patients who underwent right colectomy at the Vendean Departmental Hospital (France) between January 2011 and December 2016. We established a calcification score, which was correlated to the incidence of anastomotic leak and to the patients' American Society of Anesthesiologists (ASA) score. RESULTS:

The charts of 250 patients were reviewed. Twenty-three patients had a postoperative anastomotic leak. A stratified analysis revealed that the risk of developing an anastomotic leak was statistically significantly increased in patients whose calcification score was equal to or greater than 3 (P<0.05). In these patients, the risk was increased by a factor of 3.48 [odds ratio: 3.48 (1.45-8.36)]. A second stratified analysis showed that a calcification score of 2 at the level of the celiac axis takeoff was correlated with a statistically significantly increased risk of anastomotic leak (P<0.01). There was a correlation between a calcification score≥3 and an ASA score≥3.

CONCLUSION:

A calcification score≥3 correlates to an increased risk of anastomotic leak. The analysis of CT findings is simple, easy and reproducible. This calcification score should be confirmed by a prospective study.

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176. Nanomedicine. 2019 Jun;18:282-291. doi: 10.1016/j.nano.2018.10.001. Epub 2018 Oct 21. Overcoming challenges in treating autoimmuntity: Development of tolerogenic immune-modifying nanoparticles.

Pearson RM1, Podojil JR2, Shea LD1, King NJC3, Miller SD2, Getts DR4.

Author information: 1. Research & Development, Cour Pharmaceuticals Development Company, Northbrook, IL, USA; Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA. 2. Research & Development, Cour Pharmaceuticals Development Company, Northbrook, IL, USA; Department of Microbiology-Immunology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. 3. Research & Development, Cour Pharmaceuticals Development Company, Northbrook, IL, USA; Bosch Institute and Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Medical Sciences Sydney Medical School, University of Sydney, Australia. 4. Research & Development, Cour Pharmaceuticals Development Company, Northbrook, IL, USA; Department of Microbiology-Immunology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. Electronic address: [email protected].

Abstract

Autoimmune diseases, such as celiac disease, multiple sclerosis, and type 1 diabetes, are leading causes of morbidity and mortality in the United States. In these disease states, immune regulatory mechanisms fail that result in T and B cell-mediated destruction of self-tissues. The known role of T cells in mediating autoimmune diseases has led to the emergence of numerous therapies aimed at inactivating T cells, however successful 'tolerance-inducing' strategies have not yet emerged for approved standard-of-care clinical use. In this review, we describe relevant examples of antigen- specific tolerance approaches that have been applied in clinical trials for human diseases. Furthermore, we describe the evolution of biomaterial approaches from cell-based therapies to induce immune tolerance with a focus on the Tolerogenic Immune-Modifying nanoParticle (TIMP) platform. The TIMP platform can be designed to treat various autoimmune conditions and is currently in clinical trials testing its ability to reverse celiac disease.

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Publication types

• Review • Research Support, N.I.H., Extramural

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

Asaumi Y1, Sakatoku M1, Okamoto J1, Hayashi S1, Ota N1, Yoshida K1, Sugahara H1, Tabata S1, Kaneki M1, Ietsugu K1, Kiyohara K1. Author information: 1. Department of Surgery, Tonami General Municipal Hospital, Toyama, Japan.

Abstract

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

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Publication type

• Case Reports

178. J Child Psychol Psychiatry. 2019 Jul;60(7):803-812. doi: 10.1111/jcpp.12958. Epub 2018 Sep 3. Bidirectional relationship between eating disorders and autoimmune diseases.

Hedman A1, Breithaupt L1,2, Hübel C1,3, Thornton LM4, Tillander A1,5, Norring C6, Birgegård A6, Larsson H1,7, Ludvigsson JF1,8, Sävendahl L9, Almqvist C1,10, Bulik CM1,4,11.

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

Abstract

BACKGROUND:

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

METHODS:

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

RESULTS:

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

CONCLUSIONS:

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

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Grant support

• 538-2013-8864/Swedish Research Council/ • Anorexia Nervosa Genetics Initiative (ANGI)/ • Klarman Family Foundation/ • Foundation of Hope: Research and Treatment of Mental Illness/ • 1000183151/National Science Foundation Graduate Research Fellowship/ • 340-2013-5867/Swedish Initiative for Research on Microdata in the Social and Medical Sciences (SIMSAM)/ • Stockholm County Council (ALF-projects)/

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

Julian T1, Hadjivassiliou M2, Zis P2.

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

Abstract

OBJECTIVE:

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

METHODOLOGY:

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

RESULTS:

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

CONCLUSION:

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

PMCID: PMC6586915 Free PMC Article

PMID: 30167878

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Publication type

• Review

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

Krysiak R1, Szkróbka W1, Okopień B1.

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

Abstract BACKGROUND:

Autoimmune thyroid disease is often accompanied by celiac disease.

OBJECTIVE:

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

METHODS:

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

RESULTS:

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

CONCLUSIONS:

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

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Conflict of interest statement

The authors declare that they have no conflict of interest. 181. Immediate Hypersensitivity Reactions [Internet].

Authors

Justiz Vaillant AA, Zito PM1.

StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019-. 2019 Jun 3.

Author information: 1. Walden University

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.[1] 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.[2][3] 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.[4] 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.[5] 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.[6] Allergic conjunctivitis Allergic conjunctivitis presents with rhinitis and is IgE-mediated. Itching and eye problems including watering, redness, and swelling always occur.[7] 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.[3] 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.[8] 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.[9] 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.[10] 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.[11] 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).[12] 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.[13] [14]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.[15] 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).[16][17] 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.[18] 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.[19][20]

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PMID: 30020687

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182. Nutr Res Rev. 2019 Jun;32(1):28-37. doi: 10.1017/S095442241800015X. Epub 2018 Jul 16. Non-coeliac gluten sensitivity and the spectrum of gluten-related disorders: an updated overview.

Dale HF1, Biesiekierski JR2, Lied GA1.

Author information: 1. 1Centre for Nutrition,Department of Clinical Medicine,University of Bergen,Bergen,Norway. 2. 3Department of Rehabilitation,Nutrition and Sport,La Trobe University,Melbourne,Australia.

Abstract

The spectrum of gluten-related disorders includes coeliac disease (CD), wheat allergy (WA) and the suggested entity of non-coeliac gluten sensitivity (NCGS). An increasing number of the world's population are avoiding gluten due to the assumption of health benefits and self-diagnosed gastrointestinal and/or extra-intestinal symptoms. Unlike CD and WA, NCGS is a relatively new entity with an unknown prevalence and mechanisms, complicated by recent literature suggesting that gluten is not the only food component that may trigger symptoms experienced by this group of patients. The term 'non-coeliac wheat sensitivity' has been proposed as a more accurate term, allowing inclusion of other non-gluten wheat components such as fructans and amylase-trypsin inhibitors. There is inconsistent evidence when evaluating the effects of a gluten challenge in patients with suspected NCGS and there is a need for a standardised procedure to confirm the diagnosis, ultimately enabling the optimisation of clinical care. The present review will give an overview of the different gluten-related disorders and discuss the most recent scientific evidence investigating NCGS. PMID: 30009718

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183. Clin Nutr. 2019 Jun;38(3):1373-1381. doi: 10.1016/j.clnu.2018.06.931. Epub 2018 Jun 18. Clinical intervention using Bifidobacterium strains in celiac disease children reveals novel microbial modulators of TNF-α and short-chain fatty acids.

Primec M1, Klemenak M2, Di Gioia D3, Aloisio I4, Bozzi Cionci N5, Quagliariello A6, Gorenjak M7, Mičetić-Turk D8, Langerholc T9.

Author information: 1. Department of Microbiology, Biochemistry, Molecular Biology and Biotechnology, Faculty of Agriculture and Life Sciences, University of Maribor, Pivola 10, 2311 Hoče, Slovenia. Electronic address: [email protected]. 2. Department of Pediatrics, University Clinical Center Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia. Electronic address: [email protected]. 3. Department of Agricultural and Food Sciences, University of Bologna, Viale Fanin 42, 40127 Bologna, Italy. Electronic address: [email protected]. 4. Department of Agricultural and Food Sciences, University of Bologna, Viale Fanin 42, 40127 Bologna, Italy. Electronic address: [email protected]. 5. Department of Agricultural and Food Sciences, University of Bologna, Viale Fanin 42, 40127 Bologna, Italy. Electronic address: [email protected]. 6. Human Microbiome Unit, Bambino Gesù Children Hospital, IRCCS, Viale di San Paolo 15, 00146 Rome, Italy. Electronic address: [email protected]. 7. Centre for Human Molecular Genetics and Pharmacogenomics, Department of Biochemistry and Nutrition, Faculty of Medicine, Taborska ulica 8, 2000 Maribor, Slovenia. Electronic address: [email protected]. 8. Department of Pediatrics, Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia. Electronic address: [email protected]. 9. Department of Microbiology, Biochemistry, Molecular Biology and Biotechnology, Faculty of Agriculture and Life Sciences, University of Maribor, Pivola 10, 2311 Hoče, Slovenia. Electronic address: [email protected].

Abstract

BACKGROUND & AIMS:

Celiac disease (CD) is an immune-mediated systemic disease, caused by ingestion of gluten in genetically predisposed individuals. Gut microbiota dysbiosis might play a significant role in pathogenesis of chronic enteropathies and its modulation can be used as an intervention strategy in CD as well. In this study, we aimed to identify correlations between fecal microbiota, serum tumor necrosis factor alpha (TNF-α) and fecal short-chain fatty acids (SCFAs) in healthy children and children with CD after administration of probiotic Bifidobacterium breve BR03 and B632.

METHODS:

A double-blind placebo-controlled study enrolled 40 children with CD (CD) and 16 healthy children (HC). CD children were randomly allocated into two groups, of which 20 belonged to the placebo (PL) group and 20 to the Probiotic (PR) group. The PR group received a probiotic formulation containing a mixture of 2 strains, B. breve BR03 (DSM 16604) and B. breve B632 (DSM 24706) in 1:1 ratio for 3 months. Subsequently, for statistical analysis, blood and fecal samples from CD children (on enrolment - T0 and after 3 months, at the end of intervention with probiotic/placebo - T1) and HC children were used. The HC group was sampled only once (T0).

RESULTS:

Verrucomicrobia, Parcubacteria and some yet unknown phyla of Bacteria and Archaea may be involved in the disease, indicated by a strong correlation to TNF-α. Likewise, Proteobacteria strongly correlated with fecal SCFAs concentration. The effect of probiotic administration has disclosed a negative correlation between Verrucomicrobia, some unknown phyla of Bacteria, Synergistetes, Euryarchaeota and some SCFAs, turning them into an important target in microbiome restoration process. Synergistetes and Euryarchaeota may have a role in the anti- inflammatory process in healthy human gut.

CONCLUSIONS:

Our results highlight new phyla, which may have an important relation to disease-related parameters, CD itself and health.

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

Di Stefano M1, Bergonzi M1, Benedetti I1, De Amici M2, Torre C2, Brondino N3, Miceli E1, Pagani E1, Marseglia GL2, Corazza GR1, Di Sabatino A1.

Author information: 1. Departments of Internal Medicine. 2. Pediatrics, IRCCS "S. Matteo" Hospital Foundation. 3. Department of Psychiatry, University of Pavia, Pavia, Italy.

Abstract

BACKGROUND:

A clinically meaningful impairment of bone mass secondary to malabsorption is frequent in untreated celiac disease. In adult patients, a rigorous gluten-free diet (GFD) significantly improves, but does not always normalize, bone mineral density (BMD). The reason for this marginal response is unclear. Accordingly, we evaluated the role of both local and systemic factors for bone loss in celiac patients on long-term GFD.

STUDY:

In a prospective cohort, 22 patients with low lumbar and/or femoral BMD and 22 with normal BMD underwent bone and mineral metabolism evaluation: we tested calcium, phosphate, parathyroid hormone, and vitamin D; telopeptide of type I collagen, a bone resorption index; propeptide of type I procollagen, a bone neoformation index; receptor antagonist of NF-kB ligand, an osteoclast- stimulating factor; osteoprotegerin (OPG), a decoy receptor for RANKL. Sunlight exposure and physical exercise were measured.

RESULTS:

Patients with bone loss showed prevalently osteopenia, severe osteoporosis was rare. In comparison with normal BMD patients, they showed higher serum OPG, telopeptide, and lower serum propeptide, suggesting an increased bone turnover. Lumbar T-score was negatively correlated with OPG, telopeptide and RANKL and positively with propeptide. Propeptide was negatively correlated with OPG and telopeptide. OPG was positively correlated with telopeptide.

CONCLUSIONS:

The persistent activation of inflammation should be considered the main pathophysiological mechanism for bone defect in celiac disease patients with bone loss on long-term GFD. High levels of OPG, an attempt at protective mechanism, and low levels of propeptide of type I procollagen, reflecting an insufficient matrix production, characterize this subgroup of patients. PMID: 29672438

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185. G Ital Dermatol Venereol. 2019 Jun;154(3):370-371. doi: 10.23736/S0392-0488.18.05789-9. Epub 2018 Feb 7. Telomere shortening and TNF-α: gateway for psoriasis in celiac disease?

Mormile R1.

Author information: 1. Division of Pediatrics and Neonatology, Moscati Hospital, Aversa, Caserta, Italy - [email protected]. PMID: 29417795

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