scholarly journals Novel Therapeutic/Integrative Approaches for Celiac Disease and Dermatitis Herpetiformis

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Alessio Fasano
Keyword(s):  
Celiac Disease ◽  
Molecular Basis ◽  
Dermatitis Herpetiformis ◽  
Protein Component ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
New Concepts ◽  
Immune Mediated ◽  
New Treatments ◽  
Novel Therapeutic

Celiac disease (CD) is an immune-mediated enteropathy triggered by the ingestion of gluten in genetically susceptible individuals. Gluten is a protein component in wheat and other cereals like rye and barley. At present, the only available treatment is a strict gluten-free diet. Recent advances have increased our understanding of the molecular basis for this disorder. Last decade has seen new scientific developments in this disease and led to the formulation of new concepts of pathophysiology that offer possible targets for new treatments or interventions integrative to the gluten-free diet.

scholarly journals The Gluten-Free Diet for Celiac Disease and Beyond

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3993
Author(s):  
Bara Aljada ◽  
Ahmed Zohni ◽  
Wael El-Matary
Keyword(s):  
Celiac Disease ◽  
Dermatitis Herpetiformis ◽  
Cognitive Disorders ◽  
Gluten Free Diet ◽  
Nutritional Deficiencies ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Immune Mediated ◽  
The Brain

The gluten-free diet (GFD) has gained popularity beyond its main medical indication as the treatment for gluten-induced immune-mediated disorders such as celiac disease (CD), dermatitis herpetiformis, gluten ataxia, wheat allergy, and non-celiac gluten sensitivity. However, the diet carries some disadvantages such as elevated costs, nutritional deficiencies, and social and psychological barriers. The present work aims to review indications, proven benefits, and adverse events of a gluten-free diet. Close follow-up with patients following the diet is recommended. More data is needed to assess the effectiveness of the diet in managing mental and cognitive disorders and to establish a connection between the brain and gluten.

Celiac Disease and the Gluten-Free Diet: Consequences and Recommendations for Improvement

2015 ◽  
Vol 33 (2) ◽  
pp. 175-182 ◽  
Author(s):  
Thimmaiah G. Theethira ◽  
Melinda Dennis
Keyword(s):  
Celiac Disease ◽  
Critical Role ◽  
Nutrition Therapy ◽  
Gluten Free Diet ◽  
Nutritional Deficiencies ◽  
Gluten Free ◽  
Immune Mediated ◽  
Macro And Micronutrients ◽  
Medical Nutrition

Background: Celiac disease (CD) is a chronic small intestinal immune-mediated enteropathy precipitated by exposure to dietary gluten in genetically susceptible individuals. CD-related enteropathy leads to multiple nutritional deficiencies involving macro- and micronutrients. Currently, medical nutrition therapy consisting of the gluten-free diet (GFD) is the only accepted treatment for CD. Key Messages: The GFD is the cornerstone of treatment for CD. Prior published studies have concluded that maintenance of the GFD results in improvement of the majority of nutritional deficiencies. In the past, counseling for CD focused mainly on the elimination of gluten in the diet. However, the GFD is not without its inadequacies; compliance to the GFD may result in certain deficiencies such as fiber, B vitamins, iron, and trace minerals. Paucity of fortified gluten-free foods may be responsible for certain deficiencies which develop on the GFD. Weight gain and obesity have been added to the list of nutritional consequences while on the GFD and have been partially attributed to hypercaloric content of commercially available gluten-free foods. Follow-up of patients diagnosed with CD after starting the GFD has been reported to be irregular and, hence, less than ideal. Conclusions: Monitoring of the nutritional status using blood tests and use of appropriate gluten-free supplementation are integral components in the management of CD. The ideal GFD should be nutrient-dense with naturally gluten-free foods, balanced with macro- and micronutrients, reasonably priced, and easily accessible. Rotation of the pseudo-cereals provides a good source of complex carbohydrates, protein, fiber, fatty acids, vitamins and minerals. Fortification/enrichment of commonly consumed gluten-free commercial grain products should be encouraged. Dietitians specializing in CD play a critical role in the education and maintenance of the GFD for patients with CD.

Celiac disease evolving into dermatitis herpetiformis in patients adhering to normal or gluten-free diet

2015 ◽  
Vol 50 (4) ◽  
pp. 387-392 ◽  
Author(s):  
Teea T. Salmi ◽  
Kaisa Hervonen ◽  
Kalle Kurppa ◽  
Pekka Collin ◽  
Katri Kaukinen ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Dermatitis Herpetiformis ◽  
Gluten Free Diet ◽  
Gluten Free

scholarly journals Missing Insight Into T and B Cell Responses in Dermatitis Herpetiformis

2021 ◽  
Vol 12 ◽  
Author(s):  
Esko Kemppainen ◽  
Teea Salmi ◽  
Katri Lindfors
Keyword(s):  
T Cells ◽  
Celiac Disease ◽  
Small Bowel ◽  
B Cell ◽  
Plasma Cells ◽  
Dermatitis Herpetiformis ◽  
Gluten Free Diet ◽  
Cell Populations ◽  
Gluten Free ◽  
Cell Responses

Dermatitis herpetiformis is a cutaneous form of celiac disease manifesting as an itching rash typically on the elbows, knees and buttocks. It is driven by the ingestion of gluten-containing cereals and characterized by granular deposits of immunoglobulin A in the papillary dermis. These antibodies target transglutaminase (TG) 3 and in the majority of patients they are also found in circulation. The circulating antibodies disappear and skin symptoms resolve as a result of gluten-free diet but the cutaneous anti-TG3 IgA deposits may persist for several years. In dermatitis herpetiformis, plasma cells secreting antibodies against TG3 are located in the intestinal mucosa similarly to those producing TG2 antibodies characteristic for celiac disease. In fact, both TG2- and TG3-specific plasma cells and gluten responsive T cells are found in dermatitis herpetiformis patients but the interplay between these cell populations is unknown. The small bowel mucosal damage in celiac disease is believed to be mediated by co-operation of cytotoxic intraepithelial T cells and the inflammatory milieu contributed by gluten-reactive CD4+ T cells, whereas the skin lesions in dermatitis herpetiformis appear to be devoid of gluten reactive T cells. Thus, how celiac disease-type intestinal T and B cell responses develop into an autoimmune condition affecting the skin is still incompletely understood. Finally, the skin and small bowel lesions may reappear upon reintroduction of gluten in patients treated with gluten-free diet but virtually nothing is known about the long-lived B cell and memory T cell populations activating in response to dietary gluten in dermatitis herpetiformis.

scholarly journals Development of Dermatitis Herpetiformis in Chronic Plaque Psoriasis

2021 ◽  
pp. 141-147
Author(s):  
Ruby Lee ◽  
Yolanka Lobo ◽  
Lynda Spelman
Keyword(s):  
Celiac Disease ◽  
Plaque Psoriasis ◽  
Dermatitis Herpetiformis ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Chronic Plaque Psoriasis ◽  
Autoimmune Bullous Diseases ◽  
Associated Symptoms ◽  
History Of ◽  
Bullous Diseases

Chronic plaque psoriasis is often associated with autoimmune bullous diseases. Dermatitis herpetiformis (DH) is a rare immunobullous disease that has been linked to celiac disease (CD). To our knowledge, the coexistence of psoriasis and DH is uncommon, and has only been described in anecdotal reports. We report a case of chronic plaque psoriasis complicated by DH in a 60-year-old patient with no known history of CD or associated symptoms. In our patient, DH presented atypically as multiple vesicles along the edges of psoriatic plaques located on the back and hips, and as vesiculobullous eruptions on the fingers. The patient was successfully treated with a combination of dapsone and a gluten-free diet for DH, and secukinumab for psoriasis. This case highlights the importance of screening for CD in patients with psoriasis, as well as other concomitant autoimmune diseases. A gluten-free diet should be trialled in psoriatic patients with positive CD serology.

scholarly journals Celiac Disease Associated with a Benign Granulomatous Mass Demonstrating Self-Regression after Initiation of a Gluten-Free Diet

2017 ◽  
Vol 11 (2) ◽  
pp. 473-479
Author(s):  
Abhinav Tiwari ◽  
Himani Sharma ◽  
Khola Qamar ◽  
Zubair Khan ◽  
Umar Darr ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Small Bowel ◽  
Stromal Cells ◽  
Needle Aspiration ◽  
Tissue Reaction ◽  
Gluten Free Diet ◽  
Small Bowel Adenocarcinoma ◽  
Gluten Free ◽  
Inflammatory Mass ◽  
Immune Mediated

Celiac disease is a chronic immune-mediated enteropathy in which dietary gluten induces an inflammatory reaction predominantly in the duodenum. Celiac disease is known to be associated with benign small bowel thickening and reactive lymphadenopathy that often regresses after the institution of a gluten-free diet. A 66-year-old male patient with celiac disease presented with abdominal pain and diarrheal illness. Computerized tomography of the abdomen revealed a duodenal mass. Endoscopic ultrasound-guided fine needle aspiration of the mass revealed bizarre stromal cells which represent a nonspecific tissue reaction to inflammation. This inflammatory mass regressed after the institution of a gluten-free diet. This case report describes a unique presentation of celiac disease in the form of a granulomatous self-regressing mass. Also, this is the first reported case of bizarre stromal cells found in association with celiac disease. In addition to lymphoma and small bowel adenocarcinoma, celiac disease can present with a benign inflammatory mass, which should be serially monitored for resolution with a gluten-free diet.

scholarly journals Challenges of Monitoring the Gluten-Free Diet Adherence in the Management and Follow-Up of Patients with Celiac Disease

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2274
Author(s):  
Herbert Wieser ◽  
Ángela Ruiz-Carnicer ◽  
Verónica Segura ◽  
Isabel Comino ◽  
Carolina Sousa
Keyword(s):  
Celiac Disease ◽  
Clinical Symptoms ◽  
Poor Quality ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Free Products ◽  
Immunogenic Peptides ◽  
Immune Mediated ◽  
Strict Diet

Celiac disease (CD) is a chronic gluten-responsive immune mediated enteropathy and is treated with a gluten-free diet (GFD). However, a strict diet for life is not easy due to the ubiquitous nature of gluten. This review aims at examining available evidence on the degree of adherence to a GFD, the methods to assess it, and the barriers to its implementation. The methods for monitoring the adherence to a GFD are comprised of a dietary questionnaire, celiac serology, or clinical symptoms; however, none of these methods generate either a direct or an accurate measure of dietary adherence. A promising advancement is the development of tests that measure gluten immunogenic peptides in stools and urine. Causes of adherence/non-adherence to a GFD are numerous and multifactorial. Inadvertent dietary non-adherence is more frequent than intentional non-adherence. Cross-contamination of gluten-free products with gluten is a major cause of inadvertent non-adherence, while the limited availability, high costs, and poor quality of certified gluten-free products are responsible for intentionally breaking a GFD. Therefore, several studies in the last decade have indicated that many patients with CD who follow a GFD still have difficulty controlling their diet and, therefore, regularly consume enough gluten to trigger symptoms and damage the small intestine.

scholarly journals S2279 Resolution of Itchy Feet With a Gluten-Free Diet: A Case of Celiac Disease Presenting as Dermatitis Herpetiformis

2020 ◽  
Vol 115 (1) ◽  
pp. S1205-S1205
Author(s):  
Katherine Park ◽  
Michael Abdo ◽  
Nikunj Divecha ◽  
Pedro Manibusan ◽  
Alexander J. Peckham
Keyword(s):  
Celiac Disease ◽  
Dermatitis Herpetiformis ◽  
Gluten Free Diet ◽  
Gluten Free

scholarly journals Cutaneous and Mucosal Manifestations Associated to Celiac Disease

2018 ◽  
Author(s):  
Luis Rodrigo ◽  
Valia-Patricia Beteta ◽  
Nuria Álvarez ◽  
Celia Gómez de Castro ◽  
Álvaro de Dios ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Skin Diseases ◽  
Dermatitis Herpetiformis ◽  
Wide Spectrum ◽  
Gastrointestinal Symptoms ◽  
The Other ◽  
Gluten Free ◽  
Cutaneous Manifestations ◽  
Immune Mediated ◽  
Associated Conditions

Celiac disease (CD) is an immune-mediated gluten-induced enteropathy that affects predisposed individuals of all ages. Many patients with CD do not report gastrointestinal symptoms making it difficult to reach an early diagnosis. On the other hand, CD is related to a wide spectrum of extra-intestinal manifestations, being dermatitis herpetiformis (DH) the best characterized. These associated conditions may be the clue for reaching the diagnosis of CD. Over the last years, there have been multiple reports of the association between CD and several cutaneous manifestations that may improve with a gluten-free diet (GFD). The presence of some of these skin diseases, even in absence of gastrointestinal symptoms, should give rise to an appropriate screening for CD. The aim of this paper is to describe the different cutaneous manifestations that have been associated to CD and the possible mechanisms involved.

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