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Ciaccio EJ, Lee AR, Lebovits J, Wolf RL, Lewis SK. Physical and psychological symptoms and survey importance in celiac disease. World J Gastrointest Endosc 2024; 16:632-639. [PMID: 39735391 PMCID: PMC11669964 DOI: 10.4253/wjge.v16.i12.632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 09/20/2024] [Accepted: 10/24/2024] [Indexed: 12/12/2024] Open
Abstract
Celiac disease is an autoimmune condition that affects approximately 1% of the worldwide community. Originally thought to be confined mostly to the small intestine, resulting in villous atrophy and nutrient malabsorption, it has more recently been implicated in systemic manifestations as well, particularly when undiagnosed or left untreated. Herein, the physical and psychological symptoms of celiac disease are described and explored. An emphasis is placed on efforts to query prospective and confirmed celiac disease patients via the use of surveys. Suggestions are made regarding the development of efficacious surveys for the purpose of screening for celiac disease in undiagnosed persons, and monitoring efficacy of the gluten-free diet in persons diagnosed with celiac disease. There are broad categories of physical and psychological symptoms associated with celiac disease. There is also an essential interaction between such physical and the psychological symptoms. It is important to capture the association between symptoms, via queries directed toward suspected and confirmed persons with celiac disease. The use of anonymous online surveys can be helpful to determine the qualities and characteristics which may be associated with this condition. It is suggested that personal surveys should be given a greater role in screening and to lessen the time for diagnosis. Querying the subject directly via a survey can provide clues as to the types of symptoms being experienced by those with celiac disease currently, as well as to determine the salient aspects of the symptomatology, which will be useful for rapid screening and monitoring in future work.
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Affiliation(s)
- Edward J Ciaccio
- Celiac Disease Center at Columbia University Medical Center, Columbia University, New York, NY 10032, United States
| | - Anne R Lee
- Celiac Disease Center at Columbia University Medical Center, Columbia University, New York, NY 10032, United States
| | - Jessica Lebovits
- Celiac Disease Center at Columbia University Medical Center, Columbia University, New York, NY 10032, United States
| | - Randi L Wolf
- Department of Health Studies and Applied Educational Psychology, Columbia University, Teachers College, New York, NY 10027, United States
| | - Suzanne K Lewis
- Celiac Disease Center at Columbia University Medical Center, Columbia University, New York, NY 10032, United States
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Özkan A, LoGrande NT, Feitor JF, Goyal G, Ingber DE. Intestinal organ chips for disease modelling and personalized medicine. Nat Rev Gastroenterol Hepatol 2024; 21:751-773. [PMID: 39192055 DOI: 10.1038/s41575-024-00968-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2024] [Indexed: 08/29/2024]
Abstract
Alterations in intestinal structure, mechanics and physiology underlie acute and chronic intestinal conditions, many of which are influenced by dysregulation of microbiome, peristalsis, stroma or immune responses. Studying human intestinal physiology or pathophysiology is difficult in preclinical animal models because their microbiomes and immune systems differ from those of humans. Although advances in organoid culture partially overcome this challenge, intestinal organoids still lack crucial features that are necessary to study functions central to intestinal health and disease, such as digestion or fluid flow, as well as contributions from long-term effects of living microbiome, peristalsis and immune cells. Here, we review developments in organ-on-a-chip (organ chip) microfluidic culture models of the human intestine that are lined by epithelial cells and interfaced with other tissues (such as stroma or endothelium), which can experience both fluid flow and peristalsis-like motions. Organ chips offer powerful ways to model intestinal physiology and disease states for various human populations and individual patients, and can be used to gain new insight into underlying molecular and biophysical mechanisms of disease. They can also be used as preclinical tools to discover new drugs and then validate their therapeutic efficacy and safety in the same human-relevant model.
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Affiliation(s)
- Alican Özkan
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
| | - Nina Teresa LoGrande
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
| | - Jessica F Feitor
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
| | - Girija Goyal
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
| | - Donald E Ingber
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA.
- Vascular Biology Program and Department of Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.
- Harvard John A. Paulson School of Engineering and Applied Sciences, Cambridge, MA, USA.
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Lupu VV, Sasaran MO, Jechel E, Starcea IM, Ioniuc I, Mocanu A, Rosu ST, Munteanu V, Nedelcu AH, Danielescu C, Salaru DL, Knieling A, Lupu A. Celiac disease - a pluripathological model in pediatric practice. Front Immunol 2024; 15:1390755. [PMID: 38715620 PMCID: PMC11074362 DOI: 10.3389/fimmu.2024.1390755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 04/03/2024] [Indexed: 05/23/2024] Open
Abstract
Being defined as an autoimmune, chronic pathology, frequently encountered in any age group, but especially in pediatrics, celiac disease (also called gluten enteropathy), is gaining more and more ground in terms of diagnosis, but also interest in research. The data from the literature of the last decades attest the chameleonic way of its presentation, there may be both classic onset symptoms and atypical symptoms. Given the impact played by celiac disease, especially in the optimal growth and development of children, the current narrative review aims to highlight the atypical presentation methods, intended to guide the clinician towards the inclusion of the pathology in the differential diagnosis scheme. To these we add the summary presentation of the general data and therapeutic lines regarding the underlying condition and the existing comorbidities. In order to place the related information up to date, we performed a literature review of the recent articles published in international databases. We bring forward the current theories and approaches regarding both classic celiac disease and its atypical manifestations. Among these we note mainly constitutional, skin or mucous, bone, neuro-psychic, renal, reproductive injuries, but also disorders of biological constants and association with multiple autoimmunities. Knowing and correlating them with celiac disease is the key to optimal management of patients, thus reducing the subsequent burden of the disease.
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Affiliation(s)
- Vasile Valeriu Lupu
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Maria Oana Sasaran
- Faculty of Medicine, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology, Targu Mures, Romania
| | - Elena Jechel
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | | | - Ileana Ioniuc
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Adriana Mocanu
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Solange Tamara Rosu
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Valentin Munteanu
- Faculty of Medical Bioengineering, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Alin Horatiu Nedelcu
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Ciprian Danielescu
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Delia Lidia Salaru
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Anton Knieling
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Ancuta Lupu
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
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Rostami-Nejad M, Asri N, Bakhtiari S, Khalkhal E, Maleki S, Rezaei-Tavirani M, Jahani-Sherafat S, Rostami K. Metabolomics and lipidomics signature in celiac disease: a narrative review. Clin Exp Med 2024; 24:34. [PMID: 38340186 PMCID: PMC10858823 DOI: 10.1007/s10238-024-01295-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 01/12/2024] [Indexed: 02/12/2024]
Abstract
Celiac disease (CD) is a chronic immune-mediated inflammatory disease of the small intestine caused by aberrant immune responses to consumed gluten proteins. CD is diagnosed by a combination of the patients reported symptoms, serologic and endoscopic biopsy evaluation of the small intestine; and adherence to a strict gluten-free diet (GFD) is considered the only available therapeutic approach for this disorder. Novel approaches need to be considered for finding new biomarkers to help this disorder diagnosis and finding a new alternative therapeutic method for this group of patients. Metabolomics and lipidomics are powerful tools to provide highly accurate and sensitive biomarkers. Previous studies indicated a metabolic fingerprint for CD deriving from alterations in gut microflora or intestinal permeability, malabsorption, and energy metabolism. Moreover, since CD is characterized by increased intestinal permeability and due to the importance of membrane lipid components in controlling barrier integrity, conducting lipidomics studies in this disorder is of great importance. In the current study, we tried to provide a critical overview of metabolomic and lipidomic changes in CD.
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Affiliation(s)
- Mohammad Rostami-Nejad
- Celiac Disease and Gluten Related Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Nastaran Asri
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sajjad Bakhtiari
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ensieh Khalkhal
- Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepehr Maleki
- Department of Computer Science, University of Tabriz, Tabriz, Iran
| | - Mostafa Rezaei-Tavirani
- Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Somayeh Jahani-Sherafat
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kamran Rostami
- Department of Gastroenterology, MidCentral DHB, Palmerston North, 4442, New Zealand
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Dochat C, Afari N, Satherley RM, Coburn S, McBeth JF. Celiac disease symptom profiles and their relationship to gluten-free diet adherence, mental health, and quality of life. BMC Gastroenterol 2024; 24:9. [PMID: 38166645 PMCID: PMC10759532 DOI: 10.1186/s12876-023-03101-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 12/15/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND A subgroup of adults with celiac disease experience persistent gastrointestinal and extraintestinal symptoms, which vary between individuals and the cause(s) for which are often unclear. METHODS The present observational study sought to elucidate patterns of persistent symptoms and the relationship between those patterns and gluten-free diet adherence, psychiatric symptoms, and various aspects of quality of life (QOL) in an online sample of adults with celiac disease. U.S. adults with self-reported, biopsy-confirmed celiac disease (N = 523; Mage = 40.3 years; 88% women; 93.5% White) voluntarily completed questionnaires as part of the iCureCeliac® research network: (a) Celiac Symptoms Index (CSI) for physical symptoms and subjective health; (b) Celiac Dietary Adherence Test for gluten-free diet adherence; (c) PROMIS-29, SF-36, and Celiac Disease Quality of Life Survey for psychiatric symptoms and QOL. Symptom profiles were derived using latent profile analysis and profile differences were examined using auxiliary analyses. RESULTS Latent profile analysis of CSI items determined a four-profile solution fit best. Profiles were characterized by: (1) little to no symptoms and excellent subjective health (37% of sample); (2) infrequent symptoms and good subjective health (33%); (3) occasional symptoms and fair to poor subjective health (24%); (4) frequent to constant symptoms and fair to poor subjective health (6%). Profiles 2 and 3 reported moderate overall symptomology though Profile 2 reported relatively greater extraintestinal symptoms and Profile 3 reported relatively greater gastrointestinal symptoms, physical pain, and worse subjective health. Profiles differed on anxiety and depression symptoms, limitations due to physical and emotional health, social functioning, and sleep, but not clinical characteristics, gluten-free diet adherence, or QOL. Despite Profile 3's moderate symptom burden and low subjective health as reported on the CSI, Profile 3 reported the lowest psychiatric symptoms and highest quality of life on standardized measures. CONCLUSIONS Adults with celiac disease reported variable patterns of persistent symptoms, symptom severity, and subjective health. Lack of profile differences in gluten-free diet adherence suggests that adjunctive dietary or medical assessment and intervention may be warranted. Lower persistent symptom burden did not necessarily translate to better mental health and QOL, suggesting that behavioral intervention may be helpful even for those with lower celiac symptom burden.
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Affiliation(s)
- Cara Dochat
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.
| | - Niloofar Afari
- VA San Diego Healthcare System, San Diego, CA, USA
- University of California San Diego, La Jolla, CA, USA
| | | | - Shayna Coburn
- Children's National Health System, Washington, DC, USA
- George Washington University School of Medicine & Health Sciences, Washington, DC, USA
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Jafari E, Soleymani N, Hamidi M, Rahi A, Rezaei A, Azizian R. Celiac Disease: A Review from Genetic to Treatment. IRANIAN BIOMEDICAL JOURNAL 2024; 28:8-14. [PMID: 38444380 PMCID: PMC10994635 DOI: 10.61186/ibj.4028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 11/29/2023] [Indexed: 03/07/2024]
Abstract
Celiac disease (CD) is a complex disorder influenced by genetic and environmental factors. When people with a genetic predisposition to CD consume gluten, an inflammatory response is triggered in the small intestine, and this reaction can be alleviated by the elimination of gluten from the diet. The clinical manifestations of CD vary greatly from person to person and begin at a young age or in adulthood. Influence of genetic factors on CD development is evident in carriers of the DQ2 and/or DQ8 allele. HLA genotypes are associated with gut colonization by bacteria, particularly in individuals suffering from CD. In addition, beneficial gut microbes are crucial for the production of DPP-4, which plays a key role in immune function, as well as metabolic and intestinal health. Therefore, probiotics have been recommended as a complementary food supplement in CD.
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Affiliation(s)
- Erfaneh Jafari
- Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Niloufar Soleymani
- Department of Food Hygiene, Islamic Azad University (Science and Research Branch), Tehran, Iran
| | - Masoud Hamidi
- École Polytechnique de Bruxelles-BioMatter Unit, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Azar Rahi
- Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Rezaei
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Azizian
- Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Biomedical Innovation and Start-Up Association (Biomino), Tehran University of Medical Sciences, Tehran, Iran
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Noman SK, Jawad M, Rasool M, Jasim S. Evaluation and treatment of celiac disease in the central and south of Iraq. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2024; 77:1394-1400. [PMID: 39241138 DOI: 10.36740/wlek202407113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/08/2024]
Abstract
OBJECTIVE Aim: To estimate the differences between patients with celiac disease based on symptoms, diagnosis, treatment, and follow-up. PATIENTS AND METHODS Materials and Methods: A retrospective cross-sectional study carried out between July 1, 2022 and April 2023, enrolling 200 patients from different provinces of central and south Iraq with Celia disease, whose diagnosis depended on a specialized physician according to WHO guidelines with long-term follow-up. Participants were following up for three to six months in private clinics. Survey was written in English, and the questionnaire form contains 13 fields divided into three sections. Diagnosis of Celia before and after treatment parameters: Tissue Transglutaminase Antibody, IgG, Serum (tTg-Ig G), and tTg-IgA levels the fourth part included a glutin-free diet and symptomatic treatment. RESULTS Results: Females and ages below 20 were most affected. 176(88%) patients had detectable tTG levels; after 3 months, 72(36.0%) patients had an increase in their body weight but less than 5 kg, while 14(7.0%) of the patients showed an increase of more than 5 kg. But after 6 months, 73(36.5%) patients had an increase in their body weight less than 5 kg, while 45(22.5%) of patients showed an increase of more than 5 kg. CONCLUSION Conclusions: Celiac patient profile in central Iraq is not different from that in other parts of the world, with typical patient being female and under 30 years of age. The study highlighted to a certain degree that a gluten-free diet can have a modest and promising positive impact on BMI in some patients.
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Affiliation(s)
- Shathel Khalaf Noman
- DEPARTMENT OF PHARMACOLOGY, COLLEGE OF PHARMACY, TIKRIT UNIVERSITY, TIKRIT, IRAQ
| | - Mahmood Jawad
- DEPARTMENT OF PHARMACY, AL-ZAHRAWI UNIVERSITY COLLEGE, KARBALA, IRAQ
| | - Mohammed Rasool
- DEPARTMENT OF PHARMACOLOGY AND TOXICOLOGY, COLLEGE OF PHARMACY, UNIVERSITY OF KERBALA, KERBALA, IRAQ
| | - Samir Jasim
- DEPARTMENT OF PHARMACY, AL-ZAHRAWI UNIVERSITY COLLEGE, KARBALA, IRAQ
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Fiori Nastro F, Serra MR, Cenni S, Pacella D, Martinelli M, Miele E, Staiano A, Tolone C, Auricchio R, Strisciuglio C. Prevalence of functional gastrointestinal disorders in children with celiac disease on different types of gluten-free diets. World J Gastroenterol 2022; 28:6589-6598. [PMID: 36569268 PMCID: PMC9782836 DOI: 10.3748/wjg.v28.i46.6589] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/03/2022] [Accepted: 11/03/2022] [Indexed: 12/08/2022] Open
Abstract
BACKGROUND Functional gastrointestinal disorders (FGIDs) are common during the pediatric age. FGIDs are not related to biochemical or structural abnormalities. However, since they have a high prevalence, several studies have evaluated an overlap between FGIDs and organic diseases. Individuals with celiac disease (CD) have been shown to be at an increased risk for functional abdominal pain, even if they adhere well to a gluten-free diet (GFD). Little information is available for the pediatric age group. The aims of our study were to evaluate the prevalence of FGIDS in CD children 1 year after diagnosis and to compare the prevalence of FGIDs in CD children on a GFD with processed foods compared with those on a GFD with natural products.
AIM To assess the prevalence of FGIDs in children with CD after 1 year of follow-up and to compare the prevalence of FGIDs in children with CD on a GFD with processed foods and in children on a GFD with natural products.
METHODS We recruited pediatric patients aged 1-18 years with a new CD diagnosis. Participants were randomized to two groups: Group A on a GFD with processed foods (diet 1); and group B on a GFD with natural products (diet 2). Clinical monitoring, diet assessment and the questionnaire on pediatric gastrointestinal symptoms-Rome IV version were performed at diagnosis (T0) and after 12 mo of follow-up (T1). Dietary intake was assessed using a 3-d food diary record. Data from the diaries were evaluated using WinFood nutrient analysis software. We assessed the prevalence of FGIDs at T1 and the correlation with the type of GFD.
RESULTS We registered 104 CD children, with 55 patients in group A (53.0%) and 49 patients in group B (47.0%). Initially, 30 of the 55 (54.5%) CD children were symptomatic in group A, while 25 of 49 (51.0%) were symptomatic in group B. At T1, in spite of a low or negative serology for CD, FGIDs prevalence was 10/55 (18.0%) in group A and 8/49 (16.3%) in group B, with no statistically significant difference between the two groups (P = 0.780). At T1 the macro- and micronutrient intake was similar across the two groups with no significant differences in nutrient analysis. However, in both groups at T1 we found that a lower prevalence of FGIDs (P = 0.055) was associated with an inferior caloric (odds ratio = 0.99, 95% confidence interval: 0.99-1.00) and fat (odds ratio = 0.33, 95% confidence interval: 0.65-0.95) intake.
CONCLUSION Our results showed that CD children on a GFD have gastrointestinal symptoms with an elevated prevalence of FGIDs. Our study suggests that developing FGIDs may be linked to caloric intake and percentage of food fat, but it does not change between a GFD with processed foods or a GFD with natural products. However, long-term monitoring is required to evaluate a correlation between FGIDs and various types of GFDs.
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Affiliation(s)
- Francesca Fiori Nastro
- Department of Translational Medical Science, Section of Pediatrics, University of Naples “Federico II”, Naples 80100, Italy
| | - Maria Rosaria Serra
- Department of Translational Medical Science, Section of Pediatrics, University of Naples “Federico II”, Naples 80100, Italy
| | - Sabrina Cenni
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples 80100, Italy
| | - Daniela Pacella
- Department of Public Health, University of Naples “Federico II”, Naples 80100, Italy
| | - Massimo Martinelli
- Department of Translational Medical Science, Section of Pediatrics, University of Naples “Federico II”, Naples 80100, Italy
| | - Erasmo Miele
- Department of Translational Medical Science, Section of Pediatrics, University of Naples “Federico II”, Naples 80100, Italy
| | - Annamaria Staiano
- Department of Translational Medical Science, Section of Pediatrics, University of Naples “Federico II”, Naples 80100, Italy
| | - Carlo Tolone
- Department of Woman, Child and General and Specialistic Surgery, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Renata Auricchio
- Department of Translational Medical Science, Section of Pediatrics, University of Naples “Federico II”, Naples 80100, Italy
| | - Caterina Strisciuglio
- Department of Woman, Child and General and Specialistic Surgery, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
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Joukar F, Yeganeh S, Shafaghi A, Mahjoob A, Hassanipour S, Santacroce L, Mavaddati S, Mansour-Ghanaei F. The seroprevalence of celiac disease in patients with symptoms of irritable bowel syndrome: A cross-sectional study in north of Iran. Hum Antibodies 2022; 30:97-103. [PMID: 35342083 DOI: 10.3233/hab-211516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Celiac disease (CD) is a common cause of malabsorption that is definitively diagnosed by abnormal bowel biopsy, symptoms and histologic changes to gluten free diet. The symptoms of irritable bowel syndrome (IBS) are common in our community as the majority of people in Guilan, north of Iran, consume rice daily. Also, a number of celiac patients are unknown, and IBS are mistakenly diagnosed. OBJECTIVE This study aimed to evaluate the prevalence of CD among IBS patients. METHODS A total of 475 consecutive patients with IBS, confirmed by Rome IV, underwent celiac serological tests antitissue transglutaminase antibodies (IgA-tTG, IgG-tTG) after obtaining a written consent form. In case of positive serological tests, biopsy was performed from small intestine after endoscopyRESULTS: Thirty-one (6.53%, 95% CI: 4.55-9.22) patients were positive for celiac serology. Based on Marsh-Oberhuber criteria, out of 9 patients with positive pathology 77.78% (95% CI: 40.19-96.05) had marsh IIIc. In IBS patients cramp (0.009) and stomach fullness (0.021) were two statistically significant IBS symptoms. CONCLUSIONS We suggest physicians to consider celiac examinations for all patients with IBS symptoms, even for patients with no obvious celiac symptoms.
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Affiliation(s)
- Farahnaz Joukar
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.,Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Sara Yeganeh
- Caspian Digestive Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.,Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Afshin Shafaghi
- GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Alireza Mahjoob
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Soheil Hassanipour
- GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Luigi Santacroce
- Department of Interdisciplinary Medicine, Microbiology and Virology Unit, University Hospital of Bari, Bari
| | | | - Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.,GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran
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Fanaeian MM, Alibeik N, Ganji A, Fakheri H, Ekhlasi G, Shahbazkhani B. Prevalence of migraine in adults with celiac disease: A case control cross-sectional study. PLoS One 2021; 16:e0259502. [PMID: 34788304 PMCID: PMC8598245 DOI: 10.1371/journal.pone.0259502] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 10/20/2021] [Indexed: 01/02/2023] Open
Abstract
AIM Celiac disease (CD) is an immune-mediated disorder with various manifestations. The aim of this study was to evaluate the prevalence of gastrointestinal (GI) and extra-intestinal symptoms of celiac patients, especially migraine, and compare it with healthy individuals. METHODS We compared 1000 celiac subjects (CS) registered at our celiac center with the control group for headache-based on International Classification of Headache Disorders, third edition criteria and their GI symptoms. Besides, CS with migraine and non-migrainous headache were compared in terms of GI symptoms and accompanied conditions. RESULTS Headache was more common in CS than controls (34% vs 27% respectively, P value<0.001) and more prevalent in females (71.9% in females vs 28% in males, P value = 0.004). Moreover, the prevalence of migraine in CS was higher than controls (20.7 vs 11.9% respectively, P value<0.001). Furthermore, migraine was more prevalent in females with CD (80% in females vs 19% in males, P value = 0.033), and often without aura (76%). Abdominal pain (76.9%, P value = 0.025), diarrhea (54.9%, P value = 0.002), and constipation (42.9%, P value = 0.011) were the most common GI symptoms in CS with headache and more prevalent in CS with migraine. Conversely, type 1 diabetes mellitus was less common in CS with migraine than in CS with non-migrainous headache. (P value = 0.001). On multivariate logistic regression analysis, female sex (OR 1.50, 95%CI 1.22-1.83, P value < 0.001), and CD (OR 1.36, 95%CI 1.12-1.65, P value = 0.002) were independent predictors of headache, whereas age more than 60 years (OR 0.70, 95%CI 0.50-0.97, P value = 0.032) had a protective effect. CONCLUSION Headache especially migraine is more prevalent in CS than healthy controls. In addition, abdominal pain, diarrhea, and constipation are more common in CS with migraine than in CS with non-migrainous headaches. Therefore, evaluation of CD in patients with migraine and these simultaneous GI symptoms seems reasonable.
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Affiliation(s)
- Mohammad M. Fanaeian
- Division of Gastroenterology and Liver Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazanin Alibeik
- Clinical Research Development Center, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Azita Ganji
- Department of Gastroenterology and Hepatology, Mashhad University of Medical Sciences, Mashahd, Iran
| | - Hafez Fakheri
- Gut and Liver Research Center, Non-communicable Disease InstitueMazandaran University of Medical Sciences, Sari, Iran
| | - Golnaz Ekhlasi
- Golnaz Ekhlasi; Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bijan Shahbazkhani
- Department of Gastroenterology and Liver Diseases, Tehran University of Medical Sciences, Tehran, Iran
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Al-Bluwi GSM, AlNababteh AH, Östlundh L, Al-Shamsi S, Al-Rifai RH. Prevalence of Celiac Disease in Patients With Turner Syndrome: Systematic Review and Meta-Analysis. Front Med (Lausanne) 2021; 8:674896. [PMID: 34222285 PMCID: PMC8247446 DOI: 10.3389/fmed.2021.674896] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/26/2021] [Indexed: 01/15/2023] Open
Abstract
Introduction: Celiac disease (CD) is a multifactorial autoimmune disorder, and studies have reported that patients with Turner syndrome (TS) are at risk for CD. This systematic review and meta-analysis aimed to quantify the weighted prevalence of CD among patients with TS and determine the weighted strength of association between TS and CD. Methods: Studies published between January 1991 and December 2019 were retrieved from four electronic databases: PubMed, Scopus, Web of Science, and Embase. Eligible studies were identified and relevant data were extracted by two independent reviewers following specific eligibility criteria and a data extraction plan. Using the random-effects model, the pooled, overall and subgroup CD prevalence rates were determined, and sources of heterogeneity were investigated using meta-regression. Results: Among a total of 1,116 screened citations, 36 eligible studies were included in the quantitative synthesis. Nearly two-thirds of the studies (61.1%) were from European countries. Of the 6,291 patients with TS who were tested for CD, 241 were diagnosed with CD, with a crude CD prevalence of 3.8%. The highest and lowest CD prevalence rates of 20.0 and 0.0% were reported in Sweden and Germany, respectively. The estimated overall weighted CD prevalence was 4.5% (95% confidence interval [CI], 3.3–5.9, I2, 67.4%). The weighted serology-based CD prevalence in patients with TS (3.4%, 95% CI, 1.0–6.6) was similar to the weighted biopsy-based CD prevalence (4.8%; 95% CI, 3.4–6.5). The strength of association between TS and CD was estimated in only four studies (odds ratio 18.1, 95% CI, 1.82–180; odds ratio 4.34, 95% CI, 1.48–12.75; rate ratio 14, 95% CI, 1.48–12.75; rate ratio 42.5, 95% CI, 12.4–144.8). Given the lack of uniformity in the type of reported measures of association and study design, producing a weighted effect measure to evaluate the strength of association between TS and CD was unfeasible. Conclusion: Nearly 1 in every 22 patients with TS had CD. Regular screening for CD in patients with TS might facilitate early diagnosis and therapeutic management to prevent adverse effects of CD such as being underweight and osteoporosis.
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Affiliation(s)
- Ghada S M Al-Bluwi
- Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Asma H AlNababteh
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Linda Östlundh
- National Medical Library, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Saif Al-Shamsi
- Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Rami H Al-Rifai
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
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13
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Fauzi LS, Unadkat V, Abd Hadi SNB, Rinaldi C. Case of Kikuchi-Fujimoto disease associated with multiple myeloma. BMJ Case Rep 2021; 14:14/5/e241391. [PMID: 34016631 DOI: 10.1136/bcr-2020-241391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We present a 47-year-old, South-African origin, woman with a background of stable monoclonal gammopathy of unknown significance (MGUS) who attended A&E with a history of coryzal symptoms associated with persistent fever, lymphadenopathy and a new onset of rash, not responding to antibiotics and paracetamol. A trial of high-dose steroids resolved symptoms. Bone marrow biopsy confirmed a progression of MGUS into multiple myeloma and her axillary lymph node biopsy analysis supported a diagnosis of Kikuchi-Fujimoto disease (KFD). This is an unusual presentation where KFD has been noted alongside MGUS progression to multiple myeloma. Haematology follow-up is underway.
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Affiliation(s)
| | - Vidhi Unadkat
- Internal Medicine, Pilgrim Hospital, Boston, Lincolnshire, UK
| | | | - Ciro Rinaldi
- Department of Haematology, Pilgrim Hospital, Boston, Lincolnshire, UK
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14
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Characteristics of gluten-free potato dough and bread with different potato starch-protein ratios. INTERNATIONAL JOURNAL OF FOOD ENGINEERING 2021. [DOI: 10.1515/ijfe-2020-0287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Abstract
The poor retention of fermentation gases and air is a critical issue for gluten-free (GF) products. To better understand the effect of potato flour on the characteristics of GF bread, the mechanistic relations between potato starch and potato protein in different ratios at 9:1, 8:2, 7:3, 6:4 and 5:5 for GF dough were investigated for viscoelasticity, thermal properties, moisture, microstructures, and bread quality. The results reveal that potato starch had a relatively important role in both dough and bread. The viscous character of dough was highest at a proportion of 6:4, with a more compact microstructure and better bread color, volume, hardness, chewiness, resilience and springiness. With decreasing starch content, the gelatinization and retrogradation enthalpy decreased, and the relaxation time of immobilized water and free water increased significantly. These results are believed to be helpful for processors to develop and optimize GF breads with potato starch and potato protein.
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Sánchez-León S, Barro F. Engineering wheat for gluten safe. BIOTECHNOLOGICAL STRATEGIES FOR THE TREATMENT OF GLUTEN INTOLERANCE 2021:177-197. [DOI: 10.1016/b978-0-12-821594-4.00013-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2025]
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16
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Sánchez-León S, Giménez MJ, Comino I, Sousa C, López Casado MÁ, Torres MI, Barro F. Stimulatory Response of Celiac Disease Peripheral Blood Mononuclear Cells Induced by RNAi Wheat Lines Differing in Grain Protein Composition. Nutrients 2019; 11:nu11122933. [PMID: 31816892 PMCID: PMC6950052 DOI: 10.3390/nu11122933] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 11/27/2019] [Accepted: 11/29/2019] [Indexed: 12/13/2022] Open
Abstract
Wheat gluten proteins are responsible for the bread-making properties of the dough but also for triggering important gastrointestinal disorders. Celiac disease (CD) affects approximately 1% of the population in Western countries. The only treatment available is the strict avoidance of gluten in the diet. Interference RNA (RNAi) is an excellent approach for the down-regulation of genes coding for immunogenic proteins related to celiac disease, providing an alternative for the development of cereals suitable for CD patients. In the present work, we report a comparative study of the stimulatory capacity of seven low-gluten RNAi lines differing in grain gluten and non-gluten protein composition, relevant for CD and other gluten pathologies. Peripheral blood mononuclear cells (PBMCs) of 35 patients with active CD were included in this study to assess the stimulatory response induced by protein extracts from the RNAi lines. Analysis of the proliferative response and interferon-gamma (INF-γ) release of PBMCs demonstrated impaired stimulation in response to all RNAi lines. The lower response was provided by lines with a very low content of α- and γ-gliadins, and low or almost devoid of DQ2.5 and p31-43 α-gliadin epitopes. The non-gluten protein seems not to play a key role in PBMC stimulation.
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Affiliation(s)
- Susana Sánchez-León
- Departamento de Mejora Genética Vegetal, Instituto de Agricultura Sostenible, 14004 Córdoba, Spain; (S.S.-L.); (M.J.G.)
| | - María José Giménez
- Departamento de Mejora Genética Vegetal, Instituto de Agricultura Sostenible, 14004 Córdoba, Spain; (S.S.-L.); (M.J.G.)
| | - Isabel Comino
- Departamento de Microbiología y Parasitología, Facultad de Farmacia, Universidad de Sevilla, 41012 Sevilla, Spain; (I.C.); (C.S.)
| | - Carolina Sousa
- Departamento de Microbiología y Parasitología, Facultad de Farmacia, Universidad de Sevilla, 41012 Sevilla, Spain; (I.C.); (C.S.)
| | | | - María Isabel Torres
- Departamento de Biología Experimental, Campus Universitario Las Lagunillas, 23071 Jaén, Spain;
| | - Francisco Barro
- Departamento de Mejora Genética Vegetal, Instituto de Agricultura Sostenible, 14004 Córdoba, Spain; (S.S.-L.); (M.J.G.)
- Correspondence:
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Frommer L, Kahaly GJ. Autoimmune Polyendocrinopathy. J Clin Endocrinol Metab 2019; 104:4769-4782. [PMID: 31127843 DOI: 10.1210/jc.2019-00602] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 04/22/2019] [Indexed: 02/06/2023]
Abstract
CONTEXT This mini-review offers an update on the rare autoimmune polyendocrinopathy (AP) syndrome with a synopsis of recent developments. DESIGN AND RESULTS Systematic search for studies related to pathogenesis, immunogenetics, screening, diagnosis, clinical spectrum, and epidemiology of AP. AP (orphan code ORPHA 282196) is defined as the autoimmune-induced failure of at least two glands. AP is divided into the rare juvenile type I and the adult types II to IV. The prevalence is 1:100,000 and 1:20,000 for types I and types II to IV, respectively. Whereas type I (ORPHA 3453) is a monogenetic syndrome with an autosomal recessive transmission related to mutations in the autoimmune regulator (AIRE) gene, types II to IV are genetically complex multifactorial syndromes that are strongly associated with certain alleles of HLA genes within the major histocompatibility complex located on chromosome 6, as well as the cytotoxic T lymphocyte antigen 4 and the protein tyrosine phosphatase nonreceptor type 22 genes. Addison disease is the major endocrine component of type II (ORPHA 3143), whereas the coexistence of type 1 diabetes and autoimmune thyroid disease is characteristic for type III (ORPHA 227982). Genetic screening for the AIRE gene is useful in patients with suspected type I, whereas serological screening (i.e., diabetes/adrenal antibodies) is required in patients with monoglandular autoimmunity and suspected AP. If positive, functional endocrine testing of the antibody-positive patients as well as serological screening of their first-degree relatives is recommended. CONCLUSION Timely diagnosis, genetic counseling, and optimal long-term management of AP is best offered in specialized centers.
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Affiliation(s)
- Lara Frommer
- Orphan Disease Center for Autoimmune Polyendocrinopathy, Department of Medicine I, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - George J Kahaly
- Orphan Disease Center for Autoimmune Polyendocrinopathy, Department of Medicine I, Johannes Gutenberg University Medical Center, Mainz, Germany
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Chamani E, Sargolzaei J, Tavakoli T, Rezaei Z. microRNAs: Novel Markers in Diagnostics and Therapeutics of Celiac Disease. DNA Cell Biol 2019; 38:708-717. [DOI: 10.1089/dna.2018.4561] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Elham Chamani
- Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran
- Department of Biochemistry, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Javad Sargolzaei
- Department of Biology, Faculty of Sciences, Arak University, Arak, Iran
| | - Tahmineh Tavakoli
- Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran
- Gastroenterology Section, Department of Internal Medicine, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Zohreh Rezaei
- Department of Biology, University of Sistan and Baluchestan, Zahedan, Iran
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Scherdel P, Matczak S, Léger J, Martinez-Vinson C, Goulet O, Brauner R, Nicklaus S, Resche-Rigon M, Chalumeau M, Heude B. Algorithms to Define Abnormal Growth in Children: External Validation and Head-To-Head Comparison. J Clin Endocrinol Metab 2019; 104:241-249. [PMID: 30137417 DOI: 10.1210/jc.2018-00723] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 08/15/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Growth monitoring of apparently healthy children aims at early detection of serious conditions by use of both clinical expertise and algorithms that define abnormal growth. The seven existing algorithms provide contradictory definitions of growth abnormality and have a low level of validation. OBJECTIVE An external validation study with head-to-head comparison of the seven algorithms combined with study of the impact of use of the World Health Organization (WHO) vs national growth charts on algorithm performance. DESIGN With a case-referent approach, we retrospectively applied all algorithms to growth data for children with Turner syndrome, GH deficiency, or celiac disease (n = 341) as well as apparently healthy children (n = 3406). Sensitivity, specificity, and theoretical reduction in time to diagnosis for each algorithm were calculated for each condition by using the WHO or national growth charts. RESULTS Among the two algorithms with high specificity (>98%), the Grote clinical decision rule had higher sensitivity than the Coventry consensus (4.6% to 54% vs 0% to 8.9%, P < 0.05) and offered better theoretical reduction in time to diagnosis (median: 0.0 to 0.9 years vs 0 years, P < 0.05). Sensitivity values were significantly higher with the WHO than national growth charts at the expense of specificity. CONCLUSION The Grote clinical decision rule had the best performance for early detection of the three studied diseases, but its limited potential for reducing time to diagnosis suggests the need for better-performing algorithms based on appropriate growth charts.
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Affiliation(s)
- Pauline Scherdel
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center, Early Origins of the Child's Health and Development Team, Paris Descartes University, Villejuif, France
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center, Obstetrical, Perinatal, and Pediatric Epidemiology Research Team, Paris Descartes University, Paris, France
| | - Soraya Matczak
- Department of General Pediatrics, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France
| | - Juliane Léger
- Department of Pediatric Endocrinology and Diabetology, Robert-Debré Hospital, Assistance Publique-Hôpitaux de Paris, Paris Diderot University, Reference Centre for Endocrine Growth and Development Diseases, Paris, France
| | - Christine Martinez-Vinson
- Department of Pediatric Gastroenterology and Nutrition, Robert-Debré Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Diderot University, Paris, France
| | - Olivier Goulet
- Department of Pediatric Gastroenterology-Hepatology and Nutrition, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France
| | - Raja Brauner
- Unité d'Endocrinologie Pédiatrique, Fondation Ophtalmologique Adolphe de Rothschild, Paris Descartes University, Paris, France
| | - Sophie Nicklaus
- Centre des Sciences du Goût et de l'Alimentation, AgroSupDijon Centre National de la Recherche Scientifique, Institut National de la Recherche Agronomique, Université Bourgogne Franche-Comté, Dijon, France
| | - Matthieu Resche-Rigon
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center, Epidémiologie Clinique, Statistique, pour la Recherche en Santé, Service de Biostatistique et Information Médicale, Saint-Louis Hospital, Paris Diderot University, Paris, France
| | - Martin Chalumeau
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center, Obstetrical, Perinatal, and Pediatric Epidemiology Research Team, Paris Descartes University, Paris, France
- Department of General Pediatrics, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France
| | - Barbara Heude
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center, Early Origins of the Child's Health and Development Team, Paris Descartes University, Villejuif, France
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Medjeber O, Touri K, Rafa H, Djeraba Z, Belkhelfa M, Boutaleb AF, Arroul-Lammali A, Belguendouz H, Touil-Boukoffa C. Ex vivo immunomodulatory effect of ethanolic extract of propolis during Celiac Disease: involvement of nitric oxide pathway. Inflammopharmacology 2018. [PMID: 29516252 DOI: 10.1007/s10787-018-0460-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Celiac Disease (CeD) is a chronic immune-mediated enteropathy, in which dietary gluten induces an inflammatory reaction, predominantly in the duodenum. Propolis is a resinous hive product, collected by honeybees from various plant sources. Propolis is well-known for its anti-inflammatory, anti-oxidant and immunomodulatory effects, due to its major compounds, polyphenols and flavonoids. The aim of our study was to assess the ex vivo effect of ethanolic extract of propolis (EEP) upon the activity and expression of iNOS, along with IFN-γ and IL-10 production in Algerian Celiac patients. In this context, PBMCs isolated from peripheral blood of Celiac patients and healthy controls were cultured with different concentrations of EEP. NO production was measured using the Griess method, whereas quantitation of IFN-γ and IL-10 levels was performed by ELISA. Inducible nitric oxide synthase (iNOS) expression, NFκB and pSTAT-3 activity were analyzed by immunofluorescence assay. Our results showed that PBMCs from Celiac patients produced high levels of NO and IFN-γ compared with healthy controls (HC). Interestingly, EEP reduced significantly, NO and IFN-γ levels and significantly increased IL-10 levels at a concentration of 50 µg/mL. Importantly, EEP downmodulated the iNOS expression as well as the activity of NFκB and pSTAT-3 transcription factors. Altogether, our results highlight the immunomodulatory effect of propolis on NO pathway and on pro-inflammatory cytokines. Therefore, we suggest that propolis may constitute a potential candidate to modulate inflammation during Celiac Disease and has a potential therapeutic value.
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Affiliation(s)
- Oussama Medjeber
- Cytokines and NO Synthases Team, Laboratory of Cellular and Molecular Biology (LBCM), Faculty of Biological Sciences, University of Sciences and Technology Houari Boumediene (USTHB), BP 32 El-Alia Bab-Ezzouar, Algiers, Algeria
| | - Kahina Touri
- Cytokines and NO Synthases Team, Laboratory of Cellular and Molecular Biology (LBCM), Faculty of Biological Sciences, University of Sciences and Technology Houari Boumediene (USTHB), BP 32 El-Alia Bab-Ezzouar, Algiers, Algeria
| | - Hayet Rafa
- Cytokines and NO Synthases Team, Laboratory of Cellular and Molecular Biology (LBCM), Faculty of Biological Sciences, University of Sciences and Technology Houari Boumediene (USTHB), BP 32 El-Alia Bab-Ezzouar, Algiers, Algeria
| | - Zineb Djeraba
- Cytokines and NO Synthases Team, Laboratory of Cellular and Molecular Biology (LBCM), Faculty of Biological Sciences, University of Sciences and Technology Houari Boumediene (USTHB), BP 32 El-Alia Bab-Ezzouar, Algiers, Algeria
| | - Mourad Belkhelfa
- Cytokines and NO Synthases Team, Laboratory of Cellular and Molecular Biology (LBCM), Faculty of Biological Sciences, University of Sciences and Technology Houari Boumediene (USTHB), BP 32 El-Alia Bab-Ezzouar, Algiers, Algeria
| | | | - Amina Arroul-Lammali
- Cytokines and NO Synthases Team, Laboratory of Cellular and Molecular Biology (LBCM), Faculty of Biological Sciences, University of Sciences and Technology Houari Boumediene (USTHB), BP 32 El-Alia Bab-Ezzouar, Algiers, Algeria
| | - Houda Belguendouz
- Cytokines and NO Synthases Team, Laboratory of Cellular and Molecular Biology (LBCM), Faculty of Biological Sciences, University of Sciences and Technology Houari Boumediene (USTHB), BP 32 El-Alia Bab-Ezzouar, Algiers, Algeria
| | - Chafia Touil-Boukoffa
- Cytokines and NO Synthases Team, Laboratory of Cellular and Molecular Biology (LBCM), Faculty of Biological Sciences, University of Sciences and Technology Houari Boumediene (USTHB), BP 32 El-Alia Bab-Ezzouar, Algiers, Algeria.
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Kahrs CR, Magnus MC, Stigum H, Lundin KEA, Størdal K. Early growth in children with coeliac disease: a cohort study. Arch Dis Child 2017; 102:1037-1043. [PMID: 28611068 DOI: 10.1136/archdischild-2016-312304] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 03/27/2017] [Accepted: 04/25/2017] [Indexed: 01/11/2023]
Abstract
OBJECTIVES We aimed to study growth during the first 2 years of life in children later diagnosed with coeliac disease compared with children without, in a time with changing epidemiology and improved diagnostics. DESIGN A prospective population-based pregnancy cohort study. SETTING The nationwide Norwegian Mother and Child Cohort Study. PATIENTS 58 675 children born between 2000 and 2009 with prospectively collected growth data. Coeliac disease was identified through combined data from questionnaires and the Norwegian Patient Register. MAIN OUTCOME MEASURES The differences in height and weight at age 0, 3, 6, 8, 12, 15-18 and 24 months using internally standardised age and gender-specific z-scores. Linear regression and mixed models were used. RESULTS During a median follow-up of 8.6 years (range 4.6-14.2), 440 children (0.8%) were diagnosed with coeliac disease at a mean age of 4.4 years (range 1.5-8.5). Children with coeliac disease had significantly lower z-scores for height from 12 months (-0.09 standard deviation scores (SDS), 95% CI -0.18 to -0.01) and weight from 15 to 18 months of life (-0.09 SDS, 95% CI -0.18 to -0.01) compared with cohort controls. The longitudinal analysis from 0 to 24 months yielded a significant reduction in height z-score per year (-0.07 SDS, 95% CI -0.13 to -0.01) but not for weight among children with coeliac disease. Excluding children diagnosed before age 2 years gave similar results. CONCLUSIONS This study indicates that growth retardation in children later diagnosed with coeliac disease commonly starts at 12 months of age, and precedes clinical symptoms that usually bring the suspicion of diagnosis.
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Affiliation(s)
- Christian R Kahrs
- Department of Pediatrics, Østfold Hospital Trust, Grålum, Norway.,Department of Child Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Maria C Magnus
- Department of Non-Communicable Diseases, Norwegian Institute of Public Health, Oslo, Norway.,MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Hein Stigum
- Department of Non-Communicable Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Knut E A Lundin
- Department of Gastroenterology, Oslo University Hospital Rikshospitalet, Oslo, Norway.,Centre for Immune Regulation, University of Oslo, Oslo, Norway
| | - Ketil Størdal
- Department of Pediatrics, Østfold Hospital Trust, Grålum, Norway.,Department of Child Health, Norwegian Institute of Public Health, Oslo, Norway
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Complementing the dietary fiber and antioxidant potential of gluten free bread with guava pulp powder. JOURNAL OF FOOD MEASUREMENT AND CHARACTERIZATION 2017. [DOI: 10.1007/s11694-017-9578-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Valitutti F, Trovato CM, Montuori M, Cucchiara S. Pediatric Celiac Disease: Follow-Up in the Spotlight. Adv Nutr 2017; 8:356-361. [PMID: 28298278 PMCID: PMC5347098 DOI: 10.3945/an.116.013292] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The follow-up of celiac disease (CD) is challenging due to the scarcity of published data and the lack of standardized evidence-based protocols. The worldwide frequency and methods of CD follow-up appear to be heavily influenced by expert opinions of the individual physicians who assess children with CD. The aim of this review was to summarize the available studies on CD follow-up in children. We conducted a literature search with the use of PubMed, Medline, and Embase (from 1900 to 15 December 2016) for terms relevant to this review, including CD, follow-up, dietary adherence or dietary compliance, nutrition, comorbidities, complications, and quality of life. The aims of follow-up are as follows: to ensure strict adherence to a gluten-free diet, to ensure nutritional adequacy, to improve quality of life, and to prevent disease complications. For the correct evaluation of children with CD at follow-up, a clinical and biochemical evaluation is necessary on a regular basis. It is advisable to assess compliance, nutrition, comorbidities, or possible complications once a year at the referral center. Laboratory tests might be useful for a thorough evaluation of any patient with CD to rule out a micronutrient deficiency (full blood count, ferritin, folic acid, vitamin B-6, and vitamin B-12) and possible cardiovascular risk factors (glucose, LDL cholesterol, triglycerides). Biochemical evaluation is essential when there are clinical problems and should be customized on the basis of the specific clinical suspicion. Associated autoimmune thyroiditis should also be screened for yearly by measuring thyroid-stimulating hormone and thyroid autoantibody concentrations, regardless of symptoms, because hypothyroidism is often subtle and methods for early treatment are available and desirable. Although evidence-based recommendations for follow-up of pediatric patients with CD have not yet been established, we advise a yearly follow-up visit as the safest approach.
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Affiliation(s)
- Francesco Valitutti
- Pediatric Gastroenterology and Liver Unit, Department of Pediatrics, Sapienza University of Rome, Rome, Italy
| | - Chiara Maria Trovato
- Pediatric Gastroenterology and Liver Unit, Department of Pediatrics, Sapienza University of Rome, Rome, Italy
| | - Monica Montuori
- Pediatric Gastroenterology and Liver Unit, Department of Pediatrics, Sapienza University of Rome, Rome, Italy
| | - Salvatore Cucchiara
- Pediatric Gastroenterology and Liver Unit, Department of Pediatrics, Sapienza University of Rome, Rome, Italy
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Anemia in Pediatric Celiac Disease: Association With Clinical and Histological Features and Response to Gluten-free Diet. J Pediatr Gastroenterol Nutr 2017; 64:e1-e6. [PMID: 27035377 DOI: 10.1097/mpg.0000000000001221] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
GOALS The aim of the present study was to compare clinical, serological, and histological manifestations between children with anemia and without anemia at celiac disease (CD) diagnosis. BACKGROUND Despite being a common finding, the association between the presence of anemia and clinicohistopathological presentation of CD in children remains obscure. STUDY A total of 455 patients with CD <18 years of age were divided into those with anemia and those without anemia at diagnosis. The groups underwent comparisons of a variety of clinical, serological, and laboratory parameters and severity of small-bowel mucosal damage. Furthermore, adherence and clinical and serological response to the gluten-free diet (GFD) were compared. RESULTS Anemia was detected in 18.0% of the patients. Children with anemia had higher values for transglutaminase 2 antibodies (120.0 U/L vs 88.0 U/L, P < 0.001) and, by definition, lower values for hemoglobin (10.5 g/dL vs 12.8 g/dL, P < 0.001) and other iron parameters. They were also less often screen-detected (13.4% vs 34.6%), had more severe histological damage (P = 0.048), and poorer dietary adherence (78.3% vs 87.5%, P = 0.035) than the patients without anemia. A total of 92% of the patients recovered from anemia after a median of 1 year on a GFD, but hemoglobin values remained significantly lower compared with the nonanemic group (12.5 g/dL vs 13.2 g/dL, P = 0.045). There was no difference between the groups in the clinical and serological response to the GFD (P = 0.318). CONCLUSIONS Anemia at CD diagnosis is associated with more severe histological and serological presentation in children. Furthermore, low hemoglobin may not fully recover even after a median of 1 year on a strict GFD.
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Assessing the structural stability of gluten-free snacks with different dietary fiber contents from adsorption isotherms. Lebensm Wiss Technol 2016. [DOI: 10.1016/j.lwt.2016.06.042] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Tang H, He S, Peng F, Wang R, Li Q, Ma Y. The effects of milk fat globule membrane and its individual components on dough properties and bread quality. RSC Adv 2016. [DOI: 10.1039/c6ra21611k] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The aim of this study was to investigate the effects of milk fat globule membrane (MFGM), milk fat globule membrane protein (MFGMP) and milk fat globule membrane lipid (MFGML) on dough properties and bread quality.
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Affiliation(s)
- Haishan Tang
- Department of Food Science and Engineering
- School of Chemical Engineering and Technology
- Harbin Institute of Technology
- Harbin 150090
- China
| | - Shenghua He
- Department of Food Science and Engineering
- School of Chemical Engineering and Technology
- Harbin Institute of Technology
- Harbin 150090
- China
| | - Fangshuai Peng
- Department of Food Science and Engineering
- School of Chemical Engineering and Technology
- Harbin Institute of Technology
- Harbin 150090
- China
| | - Rongchun Wang
- Department of Food Science and Engineering
- School of Chemical Engineering and Technology
- Harbin Institute of Technology
- Harbin 150090
- China
| | - Qi Li
- Department of Food Science and Engineering
- School of Chemical Engineering and Technology
- Harbin Institute of Technology
- Harbin 150090
- China
| | - Ying Ma
- Department of Food Science and Engineering
- School of Chemical Engineering and Technology
- Harbin Institute of Technology
- Harbin 150090
- China
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Effect of Gum Type and Flaxseed Concentration on Quality of Gluten-Free Breads Made from Frozen Dough Baked in Infrared-Microwave Combination Oven. FOOD BIOPROCESS TECH 2015. [DOI: 10.1007/s11947-015-1615-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Nurminen S, Kivelä L, Taavela J, Huhtala H, Mäki M, Kaukinen K, Kurppa K. Factors associated with growth disturbance at celiac disease diagnosis in children: a retrospective cohort study. BMC Gastroenterol 2015; 15:125. [PMID: 26438321 PMCID: PMC4595273 DOI: 10.1186/s12876-015-0357-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 09/25/2015] [Indexed: 12/22/2022] Open
Abstract
Background Impaired growth is a well-known complication in celiac disease, but factors associated with it are poorly known. We investigated this issue in a large cohort of children. Methods 530 children with biopsy-proven celiac disease were included. The participants were divided into two groups on the basis of the presence (n = 182) or absence (n = 348) of growth disturbance at diagnosis. Histological, serological and clinical characteristics were compared between children with growth failure and those with normal growth. Further, patients with growth failure as the sole clinical presentation were compared to those with poor growth and concomitant other symptoms. Results Children with growth failure were younger (p < 0.001) and had lower hemoglobin (p = 0.016) and higher celiac antibody (p < 0.001), alanine aminotransferase (p = 0.035) and thyroid-stimulating hormone values (p = 0.013) than those with normal growth. Significantly associated with growth failure at diagnosis were age <3 years (OR 4.3 (95 % CI 2.5-7.5) vs older age), diagnosis before the year 2000 and in 2000–09 (OR 3.1 (1.8-5.4) and OR 1.8 (1.1-2.8) vs diagnosis in 2010–2013), presence of total and subtotal villous atrophy (OR 4.2 (2.5-7.0) and OR 2.0 (1.3-3.2) vs partial atrophy), severe symptoms (OR 3.4 (1.8-6.7) vs mild symptoms) and vomiting (OR 3.1 (1.5-6.3). The presence of abdominal pain reduced the risk (OR 0.5 (0.3-0.7)), while there was no effect of gender, diarrhea, constipation, other chronic diseases and celiac disease in the family. Children evincing poor growth as the sole clinical presentation were older (p < 0.001) and had higher hemoglobin (P < 0.001) and total iron (p = 0.010) values and lower TG2ab values (p = 0.009) than those with growth disturbance and other symptoms. Conclusions In particular young age and severe clinical and histological presentation were associated with growth disturbance at celiac disease diagnosis. Children with only poor growth are markedly different from those with other concomitant symptoms, suggesting different pathogenic mechanisms.
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Affiliation(s)
- Samuli Nurminen
- School of Medicine, University of Tampere, FIN-33014, Tampere, Finland. .,Tampere Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland.
| | - Laura Kivelä
- School of Medicine, University of Tampere, FIN-33014, Tampere, Finland. .,Tampere Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland.
| | - Juha Taavela
- Tampere Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland.
| | - Heini Huhtala
- School of Health Sciences, University of Tampere, Tampere, Finland.
| | - Markku Mäki
- Tampere Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland.
| | - Katri Kaukinen
- School of Medicine, University of Tampere, FIN-33014, Tampere, Finland. .,Department of Internal Medicine, Tampere University Hospital, Tampere, Finland.
| | - Kalle Kurppa
- School of Medicine, University of Tampere, FIN-33014, Tampere, Finland. .,Tampere Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland.
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van Hemert S, Breedveld AC, Rovers JMP, Vermeiden JPW, Witteman BJM, Smits MG, de Roos NM. Migraine associated with gastrointestinal disorders: review of the literature and clinical implications. Front Neurol 2014; 5:241. [PMID: 25484876 PMCID: PMC4240046 DOI: 10.3389/fneur.2014.00241] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 11/06/2014] [Indexed: 12/12/2022] Open
Abstract
Recent studies suggest that migraine may be associated with gastrointestinal (GI) disorders, including irritable bowel syndrome (IBS), inflammatory bowel syndrome, and celiac disease. Here, an overview of the associations between migraine and GI disorders is presented, as well as possible mechanistic links and clinical implications. People who regularly experience GI symptoms have a higher prevalence of headaches, with a stronger association with increasing headache frequency. Children with a mother with a history of migraine are more likely to have infantile colic. Children with migraine are more likely to have experienced infantile colic compared to controls. Several studies demonstrated significant associations between migraine and celiac disease, inflammatory bowel disease, and IBS. Possible underlying mechanisms of migraine and GI diseases could be increased gut permeability and inflammation. Therefore, it would be worthwhile to investigate these mechanisms further in migraine patients. These mechanisms also give a rationale to investigate the effects of the use of pre- and probiotics in migraine patients.
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Affiliation(s)
| | - Anne C Breedveld
- Division of Human Nutrition, Wageningen University , Wageningen , Netherlands
| | - Jörgen M P Rovers
- Department of Neurology, Gelderse Vallei Hospital , Ede , Netherlands
| | | | - Ben J M Witteman
- Department of Gastroenterology and Hepatology, Gelderse Vallei Hospital , Ede , Netherlands
| | - Marcel G Smits
- Department of Neurology, Gelderse Vallei Hospital , Ede , Netherlands
| | - Nicole M de Roos
- Division of Human Nutrition, Wageningen University , Wageningen , Netherlands
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Abu-Zeid YA, Jasem WS, Lebwohl B, Green PH, ElGhazali G. Seroprevalence of celiac disease among United Arab Emirates healthy adult nationals: A gender disparity. World J Gastroenterol 2014; 20:15830-15836. [PMID: 25400469 PMCID: PMC4229550 DOI: 10.3748/wjg.v20.i42.15830] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 05/10/2014] [Accepted: 05/26/2014] [Indexed: 02/07/2023] Open
Abstract
AIM: To determine celiac disease (CD) prevalence and associated manifestations or risk factors in healthy adult Emiratis.
METHODS: It is a cross-sectional prospective study, recruiting 1197 (573 women and 624 men) healthy Emiratis between September 2007 and April 2008 among those who went to Al Ain Hospital to undertake the prenuptial examination. Test for anti-tissue transglutaminase (tTG) IgA antibodies was used for CD diagnosis. Subjects with positive results in the anti tTG antibodies assay were also tested for anti-endomysial (EMA) IgA antibodies. A structured interview was used to collect basic demographic and clinical recall data including: information on name, contact address, age, gender, education status, previous diagnosis of CD, diagnosis of CD in 1st degree relatives and history of “chronic diarrhea, anemia, headache, hepatitis, diabetes, tumor, and thyroid disorder”.
RESULTS: Fourteen blood samples (1.17%; 14/1197) were seropositive for CD. The latent CD seropositive patients were 13 women and 1 man and therefore the seroprevalence of CD was 1:86 (14/1197) for adult Emiratis: 1:44 (13/573) for women and 1:624 for men. Binary logistic regression revealed that history of chronic anemia (crude OR = 7.09; 95%CI: 2.32-21.61; P = 0.003) and being a woman (OR = 14.46; 95%CI: 1.89-110.91; P = 0.001) were associated with CD seropositivity. Whereas, the thyroid disorder showed a positive association with CD seropositivity that approach statistical significance (OR = 11.30; 95%CI: 1.32-96.95; P = 0.09) and therefore was included in the multiple logistic regression analysis, which showed that CD seropositivity is independently associated only with history of chronic anemia (OR = 4.58; 95%CI: 1.45-14.48; P = 0.01) and being a woman person (OR = 10.47; 95%CI: 1.33-82.14; P = 0.026).
CONCLUSION: Compared to men the CD seroprevalence among women was remarkably higher. The CD association with women and chronic anemia is of importance from a public health perspective.
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Bone mineral density at diagnosis of celiac disease and after 1 year of gluten-free diet. ScientificWorldJournal 2014; 2014:173082. [PMID: 25379519 PMCID: PMC4213989 DOI: 10.1155/2014/173082] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 08/26/2014] [Accepted: 08/27/2014] [Indexed: 12/18/2022] Open
Abstract
Atypical or silent celiac disease may go undiagnosed for many years and can frequently lead to loss of bone mineral density, with evolution to osteopenia or osteoporosis. The prevalence of the latter conditions, in case of new diagnosis of celiac disease, has been evaluated in many studies but, due to the variability of epidemiologic data and patient features, the results are contradictory. The aim of this study was to evaluate bone mineral density by dual-energy X-ray absorptiometry in 175 consecutive celiac patients at time of diagnosis (169 per-protocol, 23 males, 146 females; average age 38.9 years). Dual-energy X-ray absorptiometry was repeated after 1 year of gluten-free diet in those with T-score value <−1 at diagnosis. Stratification of patients according to sex and age showed a higher prevalence of low bone mineral density in men older than 30 years and in women of all ages. A 1-year gluten-free diet led to a significant improvement in lumbar spine and femoral neck mean T-score value. We propose that dual-energy X-ray absorptiometry should be performed at diagnosis of celiac disease in all women and in male aged >30 years, taking into account each risk factor in single patients.
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Rodriguez Furlán LT, Pérez Padilla A, Campderrós ME. Improvement of gluten-free bread properties by the incorporation of bovine plasma proteins and different saccharides into the matrix. Food Chem 2014; 170:257-64. [PMID: 25306343 DOI: 10.1016/j.foodchem.2014.08.033] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Revised: 07/01/2014] [Accepted: 08/10/2014] [Indexed: 10/24/2022]
Abstract
The aim of this work was to improve the quality of gluten-free bread, incorporating plasma bovine proteins concentrated by ultrafiltration and freeze-dried with saccharides (inulin and sucrose). The influence of these compounds on textural properties and final bread quality was assessed. The textural studies revealed that with the addition of proteins and inulin, homogeneous and smaller air cells were achieved improving the textural properties while the bread hardness was comparable with breads with gluten. The volume of gluten-free breads increased with increasing proteins and inulin concentrations, reaching a maximum at a protein concentration of 3.5% (w/w). The addition of the enhancers improved moisture retention of the loaves after cooking and an increase of lightness of crumb with respect to the control was observed. The sensory analysis found no statistically significant difference in sensory attributes evaluated with respect to the control, so these ingredients do not negatively affect the organoleptic properties of bread.
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Affiliation(s)
- Laura T Rodriguez Furlán
- Instituto de Investigaciones en Tecnología Química (INTEQUI-CONICET), Facultad de Química, Bioquímica y Farmacia (UNSL), Chacabuco y Pedernera, 5700 San Luis, Argentina
| | - Antonio Pérez Padilla
- Instituto de Investigaciones en Tecnología Química (INTEQUI-CONICET), Facultad de Química, Bioquímica y Farmacia (UNSL), Chacabuco y Pedernera, 5700 San Luis, Argentina
| | - Mercedes E Campderrós
- Instituto de Investigaciones en Tecnología Química (INTEQUI-CONICET), Facultad de Química, Bioquímica y Farmacia (UNSL), Chacabuco y Pedernera, 5700 San Luis, Argentina.
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Long-standing iron-deficiency anemia in an atypical celiac disease - a case report. J Med Life 2014; 7 Spec No. 4:99-102. [PMID: 27057259 PMCID: PMC4813628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Celiac disease is a complex disorder characterized by digestive symptoms as well as extraintestinal manifestations, sometimes difficult to diagnose. Commonly described as a disease of childhood, adult celiac disease is a well known entity that should be taken into the differential diagnosis of a chronic diarrhea or of a malabsorption syndrome. The pathogenesis encompasses an autoimmune pathway that acts on a genetic background. The mucosa of the small intestine became damaged in reponse to foods that contain gluten in subjects with genetic susceptibility. The clinical presentation is variable, ranging from typical gastrointestinal symptoms to extradigestive and systemic manifestations. The simple withdrawal of the dietary gluten results in clinical improvement and healing of the intestinal mucosa. We report the case of an young women diagnosed with celiac disease after 7 years of iron deficiency anemia without a clear etiology.
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34
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Is Gluten a Cause of Gastrointestinal Symptoms in People Without Celiac Disease? Curr Allergy Asthma Rep 2013; 13:631-8. [PMID: 24026574 DOI: 10.1007/s11882-013-0386-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Pasha I, Saeed F, Sultan MT, Batool R, Aziz M, Ahmed W. Wheat Allergy and Intolerence; Recent Updates and Perspectives. Crit Rev Food Sci Nutr 2013; 56:13-24. [DOI: 10.1080/10408398.2012.659818] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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36
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Supplementation of gluten-free bread with non-gluten proteins. Effect on dough rheological properties and bread characteristic. Food Hydrocoll 2013. [DOI: 10.1016/j.foodhyd.2013.01.006] [Citation(s) in RCA: 134] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Ludvigsson JF, Leffler DA, Bai J, Biagi F, Fasano A, Green PHR, Hadjivassiliou M, Kaukinen K, Kelly C, Leonard JN, Lundin KE, Murray JA, Sanders DS, Walker MM, Zingone F, Ciacci C. The Oslo definitions for coeliac disease and related terms. Gut 2013; 62:43-52. [PMID: 22345659 PMCID: PMC3440559 DOI: 10.1136/gutjnl-2011-301346] [Citation(s) in RCA: 1128] [Impact Index Per Article: 94.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The literature suggests a lack of consensus on the use of terms related to coeliac disease (CD) and gluten. DESIGN A multidisciplinary task force of 16 physicians from seven countries used the electronic database PubMed to review the literature for CD-related terms up to January 2011. Teams of physicians then suggested a definition for each term, followed by feedback of these definitions through a web survey on definitions, discussions during a meeting in Oslo and phone conferences. In addition to 'CD', the following descriptors of CD were evaluated (in alphabetical order): asymptomatic, atypical, classical, latent, non-classical, overt, paediatric classical, potential, refractory, silent, subclinical, symptomatic, typical, CD serology, CD autoimmunity, genetically at risk of CD, dermatitis herpetiformis, gluten, gluten ataxia, gluten intolerance, gluten sensitivity and gliadin-specific antibodies. RESULTS CD was defined as 'a chronic small intestinal immune-mediated enteropathy precipitated by exposure to dietary gluten in genetically predisposed individuals'. Classical CD was defined as 'CD presenting with signs and symptoms of malabsorption. Diarrhoea, steatorrhoea, weight loss or growth failure is required.' 'Gluten-related disorders' is the suggested umbrella term for all diseases triggered by gluten and the term gluten intolerance should not to be used. Other definitions are presented in the paper. CONCLUSION This paper presents the Oslo definitions for CD-related terms.
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Affiliation(s)
- Jonas F Ludvigsson
- Department of Paediatrics, Örebro University Hospital, 701 85 Örebro, Sweden and Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, 171 76 Stockholm, Sweden
| | - Daniel A Leffler
- Correspondence and reprint requests: Daniel A Leffler, Division of Gastroenterology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA, 02215, USA,
| | - Julio Bai
- Department of Medicine, Dr C. Bonorino Udaondo Gastroenterology Hospital. Del Salvador University, Buenos Aires, (1264) Argentina
| | - Federico Biagi
- Coeliac Centre/1st Dept. of Internal Medicine, University of Pavia, Fondazione IRCCS Policlinico San Matteo, P.le Golgi, 19, Pavia, 27100 Italy
| | - Alessio Fasano
- Center for Coeliac Research University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Peter HR Green
- MD Coeliac Disease center at Columbia University, New York, NY, 10032, USA
| | | | - Katri Kaukinen
- School of Medicine, FIN-33014 University of Tampere, Finland
| | - Ciaran Kelly
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA
| | - Jonathan N Leonard
- Department of Dermatology, Imperial College NHS Healthcare Trust, St Mary’s Hospital, London W2 1NY, UK
| | - Knut E Lundin
- Dept of Gastroenterology and Centre for Immune Regulation, Oslo University Hospital, 0027 Oslo, Norway
| | | | - David S Sanders
- Gastroenterology and Liver Unit, Royal Hallamshire Hospital & University of Sheffield, Sheffield, 2JF UK
| | - Marjorie M Walker
- Centre for Pathology, Faculty of Medicine, Imperial College, St Mary’s Hospital, London W2 1NY, UK
| | - Fabiana Zingone
- Department of Clinical and Experimental Medicine, Federico II University of Naples, Naples, 80131, Italy
| | - Carolina Ciacci
- Chair of Gastroenterology, University of Salerno, Salerno, 84084 Italy
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Abstract
Bisphosphonates are pharmacological compounds that have been used for the prevention and treatment of several pathological conditions including osteoporosis, primary hyperparathyroidism, osteogenesis imperfecta, and other conditions characterized by bone fragility. Many studies have been performed to date to analyze their effects on inflammation and bone remodelling and related pathologies. The aim of this review is, starting from a background on inflammatory processes and bone remodelling, to give an update on the use of bisphosphonates, outlining the possible side effects and proposing new trends for the future. Starting from a brief introduction on inflammation and bone remodelling, we collect and analyze studies involving the use of bisphosphonates for treatment of inflammatory conditions and pathologies characterized by bone loss. Selected articles, including reviews, published between 1976 and 2011, were chosen from Pubmed/Medline on the basis of their content. Bisphosphonates exert a selective activity on inflammation and bone remodelling and related pathologies, which are characterized by an excess in bone resorption. They improve not only skeletal defects, but also general symptoms. Bisphosphonates have found clinical application preventing and treating osteoporosis, osteitis deformans (Paget's disease of bone), bone metastasis (with or without hypercalcaemia), multiple myeloma, primary hyperparathyroidism, osteogenesis imperfecta, and other conditions that feature bone fragility. Further clinical studies involving larger cohorts are needed to optimize the dosage and length of therapy for each of these agents in each clinical field in order to be able to maximize their properties concerning modulation of inflammation and bone remodelling. In the near future, although "old" bisphosphonates will reach the end of their patent life, "new" bisphosphonates will be designed to specifically target a pathological condition.
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Mishra K, Kumar P, Kumar R, Kaur S, Basu S, Dutta AK. Assessment of sexual maturity in a cohort of adolescents with celiac disease on gluten-free diet. Indian J Gastroenterol 2012; 31:130-2. [PMID: 22711365 DOI: 10.1007/s12664-012-0202-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Accepted: 05/25/2012] [Indexed: 02/04/2023]
Abstract
Delayed sexual maturation is a known complication of celiac disease (CD). There is paucity of data regarding the effect of gluten-free diet (GFD) on sexual maturity in patients with CD in India. We did a cross-sectional observational study to assess the sexual maturity in 30 adolescents with CD on GFD for at least 1 year, and evaluated factors which affect their sexual maturity. Sexual maturation was assessed using Tanner's stages of sexual development. All adolescents had completed 2 years of GFD and 53 % had completed 4 years of GFD. Sexual maturation was delayed in 30 %. Age at initiation of GFD was associated with attaining appropriate sexual maturity (p = 0.048). We conclude that delayed sexual maturation is not uncommon in adolescents with CD and may be corrected by early diagnosis and initiation of GFD.
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Affiliation(s)
- Kirtisudha Mishra
- Department Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi 110 001, India.
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Brigic E, Hadzic D, Mladina N. Early and correct diagnosis of celiac disease in the prevention of growth disorders and child development. Mater Sociomed 2012; 24:242-7. [PMID: 23678328 PMCID: PMC3633391 DOI: 10.5455/msm.2012.24.242-247] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 10/15/2012] [Indexed: 12/17/2022] Open
Abstract
Coeliac, in ordinary people known as "flour allergy" and in medicine world known as gluten enteropathy which means enteric damage caused by gluten. Data about incidence of gluten enteropathy is different in different countries around the World and depend on is it or is it not the right diagnosis for enteric disorder. Sometimes, this disease is unrecognized because of unspecific clinical signs. This disease is happening in every moment of a lifetime, most common during the childhood when the children try to eat any food which contains gluten. Anyway, if children had no symptoms it doesn't¢t mean that disease not exists, and that¢is because we have to do diagnostic tests to confirm gluten enteropathy. Gluten intolerance is chronic disease and demand use of the specific non gluten food during the lifetime. Early diagnosis is right way to prevent unregularly growth. Aim of this study was to show the influence of early diagnostic about growth. For each patient we had a permission of parents and we showed our original results for three month we investigated.
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Affiliation(s)
- Esad Brigic
- Clinic of Child Diseases, University Clinical Center Tuzla, Bosnia and Herzegovina
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Unexplained infertility as primary presentation of celiac disease, a case report and literature review. IRANIAN JOURNAL OF REPRODUCTIVE MEDICINE 2011; 9:135-40. [PMID: 25587261 PMCID: PMC4216449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2010] [Accepted: 10/31/2010] [Indexed: 11/04/2022]
Abstract
BACKGROUND Celiac sprue (gluten sensitive enteropathy) is an autoimmune disease which is hereditary and its pathology mainly bases on immunologic intolerance to gluten. It has a vast variety of signs and symptoms and its clinical features range from a silent disease to a typical gastrointestinal disorder. In this study we reviewed and summarized some other related issues about this disease and its relation with infertility. CASE The case is a 26 years old lady who had referred to a gynecologist because of infertility for 2 years and later it revealed that she has celiac sprue. CONCLUSION Screening for its silent or subtle types especially among suspicious cases such as unexplained infertility seems to be a cost effective action. Meanwhile, in time administration of a gluten-free diet can lead to an almost complete cure.
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Celiac disease diagnosis and gluten-free food analytical control. Anal Bioanal Chem 2010; 397:1743-53. [DOI: 10.1007/s00216-010-3753-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2010] [Revised: 04/09/2010] [Accepted: 04/13/2010] [Indexed: 01/14/2023]
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Witczak M, Korus J, Ziobro R, Juszczak L. The effects of maltodextrins on gluten-free dough and quality of bread. J FOOD ENG 2010. [DOI: 10.1016/j.jfoodeng.2009.07.022] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Dinler G, Atalay E, Kalayci AG. Celiac disease in 87 children with typical and atypical symptoms in Black Sea region of Turkey. World J Pediatr 2009; 5:282-6. [PMID: 19911143 DOI: 10.1007/s12519-009-0053-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2008] [Accepted: 03/10/2009] [Indexed: 12/31/2022]
Abstract
BACKGROUND Celiac disease presents with a spectrum of clinical disorders. The variety of clinical presentations largely depends on age and extraintestinal findings. This study aimed to determine typical and atypical cases according to presenting symptoms and to evaluate their biochemical and pathological parameters. METHODS Eighty-seven patients with celiac disease in our unit between 2000 and 2007 were reviewed. Their diagnosis was made by serological and histological examination. The patients were divided into two groups according to their typical or atypical symptoms. RESULTS The mean age of the patients at diagnosis was 8.2 years (range, 1-18 years), but patients presenting with typical symptoms were younger than those presenting with atypical symptoms. The patients in the two groups did not differ significantly in sex, weight and height Z scores except age. Diarrhea (96.3%), abdominal distention (65.4%) and failure to thrive (60%) were the most common clinical presentations in the typical group, and short stature (62.5%) and anemia (31.2%) were the most common in the atypical group. Total/subtotal villous atrophy was significantly higher in the typical group than in the atypical group. CONCLUSIONS Many children with celiac disease show an atypical form. The understanding of presentations of celiac disease may prevent delayed diagnosis. Celiac disease should be specially investigated in patients with recurrent iron deficiency anemia, short stature and autoimmune disorders.
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Affiliation(s)
- Gönül Dinler
- Unit of Pediatric Gastroenterology Hepatology and Nutrition, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
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Korus J, Witczak M, Ziobro R, Juszczak L. The impact of resistant starch on characteristics of gluten-free dough and bread. Food Hydrocoll 2009. [DOI: 10.1016/j.foodhyd.2008.07.010] [Citation(s) in RCA: 135] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Chronic inflammation and malabsorption in celiac disease (CD) can cause bone metabolism alterations and bone mineral loss in children and adults. Bone status before and after gluten-free diet, epidemiology of fractures, and possible treatment options for CD-related osteoporosis are presented. Controversial aspects of this complication of CD are discussed. The relationship between bone derangements and celiac disease (CD) was recognized almost 50 years ago, but many questions are still open. We are now aware that osteoporosis is a relatively frequent atypical presentation of CD, especially in adults, and that undiagnosed CD can be the cause of osteoporosis and related fractures. Chronic inflammatory intestinal diseases, including CD, can affect bone and mineral metabolism because of alterations in both systemic and local regulatory factors. The pathogenetic processes are still controversial, but two main mechanisms seem to be involved: intestinal malabsorption and the presence of chronic inflammation. This review analyzes the published data on bone involvement in children, adolescents, and adults either before or after a gluten-free diet. Special attention is paid to the epidemiology of fractures in celiac patients, considering that fractures are a major complication of osteoporosis and an important problem in the management of a chronic disease like CD. The usefulness of screening osteoporotic patients systematically for CD is still an open question, but some rules can be given. Finally, the current treatment options for children and adults are discussed. Recommendations for future clinical research are proposed.
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Affiliation(s)
- M-L Bianchi
- Bone Metabolism Unit, Istituto Auxologico Italiano IRCCS, Milan, Italy.
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