scholarly journals Cytokine release and gastrointestinal symptoms after gluten challenge in celiac disease

2019 ◽  
Vol 5 (8) ◽  
pp. eaaw7756 ◽  
Author(s):  
Gautam Goel ◽  
Jason A. Tye-Din ◽  
Shuo-Wang Qiao ◽  
Amy K. Russell ◽  
Toufic Mayassi ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Cytokine Production ◽  
Gastrointestinal Symptoms ◽  
Intradermal Injection ◽  
Fold Change ◽  
Cell Clones ◽  
Plasma Cytokines ◽  
Systemic Cytokine Production ◽  
Patients Experience ◽  
Multiplex Cytokine

Celiac disease (CeD), caused by immune reactions to cereal gluten, is treated with gluten -elimination diets. Within hours of gluten exposure, either perorally or extraorally by intradermal injection, treated patients experience gastrointestinal symptoms. To test whether gluten exposure leads to systemic cytokine production time -related to symptoms, series of multiplex cytokine measurements were obtained in CeD patients after gluten challenge. Peptide injection elevated at least 15 plasma cytokines, with IL-2, IL-8, and IL-10 being most prominent (fold-change increase at 4 hours of 272, 11, and 1.2, respectively). IL-2 and IL-8 were the only cytokines elevated at 2 hours, preceding onset of symptoms. After gluten ingestion, IL-2 was the earliest and most prominent cytokine (15-fold change at 4 hours). Supported by studies of patient-derived gluten-specific T cell clones and primary lymphocytes, our observations indicate that gluten-specific CD4+ T cells are rapidly reactivated by antigen -exposure likely causing CeD-associated gastrointestinal symptoms.

Celiac Disease in Kosovar Albanian Children: Evaluation of Clinical Features and Diagnosis

2020 ◽  
Vol 16 (3) ◽  
pp. 241-247
Author(s):  
Atifete Ramosaj-Morina ◽  
Alije Keka-Sylaj ◽  
Arbana Baloku Zejnullahu ◽  
Lidvana Spahiu ◽  
Virgjina Hasbahta ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Disease Onset ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Dominant Mode ◽  
Primary School Children ◽  
Cross Sectional ◽  
Classical Form ◽  
Wide Range ◽  
The Mean

Background: Celiac disease is an immune-mediated disorder characterized by variable clinical manifestations, specific antibodies, HLA-DQ2/DQ8 haplotypes, and enteropathy. Objectives: The aim of this study was to present the clinical spectrum and patterns of celiac disease in Kosovar Albanian children. Methods: A cross-sectional retrospective study was performed with Albanian children aged 0-18 years, treated for celiac disease in the Pediatric Clinic, University Clinical Center of Kosovo from 2005 to 2016. Results: During the study period, 63 children were treated for celiac disease. The mean age at diagnosis was 5.5 years (SD ± 3.31). The mean age at celiac disease onset was 3.3 years (SD ± 2.02), while the mean delay from the first symptoms indicative of celiac disease to diagnosis was 2.2 years (SD ± 2.09). More than 70% of the patients were diagnosed in the first 7 years of life, mainly presented with gastrointestinal symptoms, while primary school children and adolescents mostly showed atypical symptoms (p<0.001). The classical form of celiac disease occurred in 78% of the cases. Sixty (95%) patients carried HLA-DQ2.5, DQ2.2 and/or HLA-DQ8 heterodimers, and only three of them tested negative. Conclusions: Kosovo, as the majority of developing countries, is still facing the classical form of celiac disease as the dominant mode of presentation; as a result, most children with other forms of the celiac disease remain undiagnosed. : Physicians should be aware of the wide range of clinical presentations and utilize low testing thresholds in order to prevent potential long-term problems associated with untreated celiac disease.

scholarly journals Gliadin Sequestration as a Novel Therapy for Celiac Disease: A Prospective Application for Polyphenols

2021 ◽  
Vol 22 (2) ◽  
pp. 595
Author(s):  
Charlene B. Van Buiten ◽  
Ryan J. Elias
Keyword(s):  
Immune Response ◽  
Celiac Disease ◽  
Gastrointestinal Symptoms ◽  
Autoimmune Disorder ◽  
Treatment Method ◽  
Mucosal Damage ◽  
Protective Effects ◽  
Novel Therapy ◽  
Gluten Proteins ◽  
Prospective Application

Celiac disease is an autoimmune disorder characterized by a heightened immune response to gluten proteins in the diet, leading to gastrointestinal symptoms and mucosal damage localized to the small intestine. Despite its prevalence, the only treatment currently available for celiac disease is complete avoidance of gluten proteins in the diet. Ongoing clinical trials have focused on targeting the immune response or gluten proteins through methods such as immunosuppression, enhanced protein degradation and protein sequestration. Recent studies suggest that polyphenols may elicit protective effects within the celiac disease milieu by disrupting the enzymatic hydrolysis of gluten proteins, sequestering gluten proteins from recognition by critical receptors in pathogenesis and exerting anti-inflammatory effects on the system as a whole. This review highlights mechanisms by which polyphenols can protect against celiac disease, takes a critical look at recent works and outlines future applications for this potential treatment method.

scholarly journals Changes in Age at Diagnosis and Nutritional Course of Celiac Disease in the Last Two Decades

Nutrients ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 156 ◽  
Author(s):  
Mónica Villanueva ◽  
Amaya Oyarzún ◽  
Bárbara Leyton ◽  
Mónica González ◽  
Elizabeth Navarro ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Nutritional Status ◽  
Gastrointestinal Symptoms ◽  
Failure To Thrive ◽  
Age At Diagnosis ◽  
Pediatric Hospitals ◽  
Geographical Variations ◽  
Number Of Patients ◽  
Antiendomysial Antibodies

The frequency of celiac disease (CD) has increased along time, with relevant changes reported in geographical variations, clinical presentation and nutritional repercussions. In recent years, some celiac patients are presenting overweight/obesity, but it is unclear how frequent this is and to what extent undernutrition remains a concern. This is relevant because CD tends to be overlooked in overweight patients. With this in mind, we assessed age at diagnosis, clinical characteristics and nutritional status of 155 celiac patients diagnosed between 1994–2017 in four pediatric hospitals in Santiago, Chile. Since 2003, the number of patients diagnosed has increased (p < 0.0033), coinciding with antitransglutaminase and antiendomysial antibodies becoming available to public health systems. In 2000, 4.5% of patients were asymptomatic at diagnosis, suggesting that active search is not routinely applied. Gastrointestinal symptoms plus failure to thrive were significantly more frequent under 2 years (p = 0.0001). Nutritional status has improved at diagnosis and during follow up, but undernutrition remains more frequent in children <2 and <5 years (p < 0.002 and p < 0.0036, respectively). Overweight at diagnosis was reported in 2002 and obesity in 2010. After initiating treatment, since 2010, patients changing from undernourishment to overweight has sometimes been observed after only 6 months on a gluten-free diet.

Nutritional Management of Celiac Disease

2018 ◽  
Author(s):  
Ciarán P Kelly ◽  
Satya Kurada ◽  
Mariana Urquiaga
Keyword(s):  
Immune Response ◽  
Celiac Disease ◽  
Tight Junction ◽  
Villous Atrophy ◽  
Gastrointestinal Symptoms ◽  
Gluten Free Diet ◽  
Intestinal Biopsy ◽  
Nutritional Management ◽  
Gluten Free ◽  
Antigliadin Antibodies

Celiac disease (CD) is an autoimmune disorder characterized by an immune response to gluten peptides in wheat, barley, and rye. The diagnosis of celiac disease is confirmed by three important characteristics: consistent symptoms, positive celiac-specific serology, and small intestinal biopsy findings of inflammation, crypt hyperplasia, and villous atrophy. CD may present with overt gastrointestinal symptoms, including diarrhea (or constipation), weight loss, and abdominal bloating and discomfort, or covertly with micronutrient deficiencies such as iron deficiency with anemia. A gluten-free diet (GFD) remains the mainstay of treatment. The aim of this review is to highlight the pathogenesis of CD, concepts and challenges associated with a GFD, and nutritional management of CD applicable in clinical practice to internists, gastroenterologists, and dietitians. Patients should be referred to an expert celiac dietitian for education on adherence to a GFD to address gluten contamination in the diet, the psychosocial implications of following a GFD, and macro- and micronutrient disequilibria arising from celiac disease and the GFD. Several novel therapeutics are on the horizon in various stages of development, including glutenases, antigliadin antibodies, tight junction regulators, modulation of the immune response to gliadin, and efforts to engineer less toxic gluten-containing foodstuffs. This review contains 3 figures, 5 tables, and 61 references. Key words: celiac disease, genetic engineering, food engineering, gluten, glutenases, gluten-free diet, oats, IgY, nutrition, tight junction regulators, wheat

Nutritional Management of Celiac Disease

2017 ◽  
Author(s):  
Ciarán P Kelly ◽  
Satya Kurada ◽  
Mariana Urquiaga
Keyword(s):  
Immune Response ◽  
Celiac Disease ◽  
Tight Junction ◽  
Villous Atrophy ◽  
Gastrointestinal Symptoms ◽  
Gluten Free Diet ◽  
Intestinal Biopsy ◽  
Nutritional Management ◽  
Gluten Free ◽  
Antigliadin Antibodies

Celiac disease (CD) is an autoimmune disorder characterized by an immune response to gluten peptides in wheat, barley, and rye. The diagnosis of celiac disease is confirmed by three important characteristics: consistent symptoms, positive celiac-specific serology, and small intestinal biopsy findings of inflammation, crypt hyperplasia, and villous atrophy. CD may present with overt gastrointestinal symptoms, including diarrhea (or constipation), weight loss, and abdominal bloating and discomfort, or covertly with micronutrient deficiencies such as iron deficiency with anemia. A gluten-free diet (GFD) remains the mainstay of treatment. The aim of this review is to highlight the pathogenesis of CD, concepts and challenges associated with a GFD, and nutritional management of CD applicable in clinical practice to internists, gastroenterologists, and dietitians. Patients should be referred to an expert celiac dietitian for education on adherence to a GFD to address gluten contamination in the diet, the psychosocial implications of following a GFD, and macro- and micronutrient disequilibria arising from celiac disease and the GFD. Several novel therapeutics are on the horizon in various stages of development, including glutenases, antigliadin antibodies, tight junction regulators, modulation of the immune response to gliadin, and efforts to engineer less toxic gluten-containing foodstuffs. This review contains 3 figures, 5 tables, and 61 references. Key words: celiac disease, genetic engineering, food engineering, gluten, glutenases, gluten-free diet, oats, IgY, nutrition, tight junction regulators, wheat

IDIOPATHIC CELIAC DISEASE

PEDIATRICS ◽  
1953 ◽  
Vol 11 (3) ◽  
pp. 207-223
Author(s):  
DOROTHY H. ANDERSEN ◽  
PAUL A. DI SANT'AGNES
Keyword(s):  
New York ◽  
Celiac Disease ◽  
Vitamin A ◽  
Gastrointestinal Symptoms ◽  
Total Body Length ◽  
Prodromal Symptom ◽  
Total Serum Protein ◽  
Total Serum ◽  
Diagnostic Usefulness ◽  
Total Body

The acute phase of idiopathic celiac disease was studied in 58 patients. The criteria for selection of these cases are stated. The frequency and severity of gastrointestinal symptoms in siblings and other relatives appeared to exceed expectation unless the disease is familial. In the majority of patients studied, symptoms began before the age of 6 months, in 14 at birth. Vomiting was a frequent prodromal symptom. Breast feeding for more than two months was shown to delay the onset of diarrhea. The early onset of symptoms in the present series is believed to be related to the prevalence of formula feeding from early infancy in New York City at present. Severe retardation in growth of the skull was common and occurred at an earlier age than retardation in height. This, at times, led to disproportion between measurements for total body length and head circumference. Ultimate head measurements were normal. The following laboratory procedures were performed in the patients under consideration and their results recorded: pancreatic trypsin and amylase estimation on duodenal drainage, glucose tolerance tests, fecal fat determination, total serum protein, serum carotene and vitamin A levels and vitamin A absorption test. The diagnostic usefulness of these procedures is discussed. Various diseases of infancy which may lead to an erroneous diagnosis of idiopathic celiac disease are discussed.

scholarly journals Probiotics in Celiac Disease

Nutrients ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 1824 ◽  
Author(s):  
Fernanda Cristofori ◽  
Flavia Indrio ◽  
Vito Miniello ◽  
Maria De Angelis ◽  
Ruggiero Francavilla
Keyword(s):  
Celiac Disease ◽  
Gut Microbiota ◽  
Intestinal Microbiota ◽  
Gastrointestinal Symptoms ◽  
Human Microbiome ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Microbial Composition ◽  
Close Link ◽  
Host Protection

Recently, the interest in the human microbiome and its interplay with the host has exploded and provided new insights on its role in conferring host protection and regulating host physiology, including the correct development of immunity. However, in the presence of microbial imbalance and particular genetic settings, the microbiome may contribute to the dysfunction of host metabolism and physiology, leading to pathogenesis and/or the progression of several diseases. Celiac disease (CD) is a chronic autoimmune enteropathy triggered by dietary gluten exposure in genetically predisposed individuals. Despite ascertaining that gluten is the trigger in CD, evidence has indicated that intestinal microbiota is somehow involved in the pathogenesis, progression, and clinical presentation of CD. Indeed, several studies have reported imbalances in the intestinal microbiota of patients with CD that are mainly characterized by an increased abundance of Bacteroides spp. and a decrease in Bifidobacterium spp. The evidence that some of these microbial imbalances still persist in spite of a strict gluten-free diet and that celiac patients suffering from persistent gastrointestinal symptoms have a desert gut microbiota composition further support its close link with CD. All of this evidence gives rise to the hypothesis that probiotics might play a role in this condition. In this review, we describe the recent scientific evidences linking the gut microbiota in CD, starting from the possible role of microbes in CD pathogenesis, the attempt to define a microbial signature of disease, the effect of a gluten-free diet and host genetic assets regarding microbial composition to end in the exploration of the proof of concept of probiotic use in animal models to the most recent clinical application of selected probiotic strains.

scholarly journals Celiac disease in first degree relatives of celiac children

2012 ◽  
Vol 49 (3) ◽  
pp. 204-207 ◽  
Author(s):  
Andreia Oliveira ◽  
Eunice Trindade ◽  
Marta Tavares ◽  
Rosa Lima ◽  
Mariana Terra ◽  
...  
Keyword(s):  
Celiac Disease ◽  
High Risk ◽  
Screening Test ◽  
Tissue Transglutaminase ◽  
Gastrointestinal Symptoms ◽  
Rapid Test ◽  
Risk Groups ◽  
High Titre ◽  
High Risk Group ◽  
First Degree Relatives

CONTEXT - The first degree relatives of celiac patients represent a high risk group for the development of this disorder, so their screening may be crucial in the prevention of long-term complications. OBJECTIVE - In order to determine the prevalence of celiac disease in a group of first degree relatives of children with proven gluten intolerance, we conducted a prospective study that consisted in the screening of celiac disease, using a capillary immunoassay rapid test that allows a qualitative detection of IgA antibody to human recombinant tissue transglutaminase (IgA-TTG). METHODS - When the screening test was positive subjects were advised to proceed with further investigation. The screening test was performed in 268 first degree relatives (143 mothers, 89 fathers, 36 siblings) corresponding to 163 children with celiac disease. RESULTS - Screening test was positive in 12 relatives (4.5%), of which 1 refused to continue the investigation. In the remaining 11 relatives celiac disease was diagnosed in 7 cases (2.6%, 5 mothers, 2 fathers) who had a median age of 39 years (27-56 years), mild gastrointestinal symptoms, high titre of IgA-TTG and histology abnormalities confirming the diagnosis. All these patients are currently on a gluten-free diet. CONCLUSION - The prevalence of celiac disease among first degree relatives (2.6%) was 5 times higher than that in the general population. Although the recommendations for screening asymptomatic high risk groups, such as first degree relatives, are not unanimous the early diagnosis is crucial in preventing complications, including nutritional deficiency and cancer.

scholarly journals Chronic fatigue syndrome – revisited

2016 ◽  
Vol 15 (3) ◽  
pp. 326-328
Author(s):  
NS Neki
Keyword(s):  
Differential Diagnosis ◽  
Celiac Disease ◽  
Chronic Fatigue Syndrome ◽  
Medical Science ◽  
Gastrointestinal Symptoms ◽  
Chronic Fatigue ◽  
Neurological Symptoms ◽  
Fatigue Syndrome

Chronic fatigue syndrome (CFS) is a common and disabling problem; although most likely of biopsychosocial origin. The nature of the pathophysiological components remains unclear. It is an illness characterized by persistent and relapsing fatigue, often accompanied by numerous symptoms involving various body systems. The etiology of CFS remains unclear. Celiac disease can present with neurological symptoms in the absence of gastrointestinal symptoms; therefore, celiac disease should be included in the differential diagnosis of CFS.Bangladesh Journal of Medical Science Vol.15(3) 2016 p.326-328

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