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  • Jefferson Adams

    Bio-physical Characteristics of Gastrointestinal Mucosa of Celiac Patients: Comparison with Control Subjects and Effect of Gluten-Free Diet

    Jefferson Adams
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    Reviewed and edited by a celiac disease expert.

    Photo: CC -- spec-ta-cles
    Caption: Photo: CC -- spec-ta-cles

    Celiac.com 11/28/2011 - Celiac disease often results in "leaky" intestinal mucosa. This development may involve changes in hydrophobicity of the mucus surface barrier along with changes of the epithelial barrier.

    A team of researchers recently compared bio-physical aspects of gastrointestinal mucosa of celiac patients with control subjects, along with the effects of gluten free diet on each group.



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    Photo: CC -- spec-ta-clesThe research team included Stefania Bertolazzi, Francesco Lanzarotto, Barbara Zanini, Chiara Ricci, Vincenzo Villanacci, and Alberto Lanzini.

    The team set out to compare duodenal hydrophobicity as an index of mucus barrier integrity in 38 patients studied before and 68 patients during gluten-free diet, and in 90 control subjects. They also checked for regional differences of hydrophobicity in the gastro-intestinal tract.

    The team gauged hydrophobicity by measuring the contact angle (CA) (Rame Hart 100/10 goniometer) created by a single drop of water applied to intestinal mucosal biopsies.

    Once the team pooled the results and evaluated the control groups, patients with histologically normal duodenal biopsies showed significantly higher CA (620 + 90)  than patients with biopsies showing Marsh 1-2 (580 + 100; p<0.02) and Marsh 3 lesions (570+ 100; p<0.02).

    Among the control group, the action sequence of hydrofobicity along the gastrointestinal tract follows the pattern: gastric antrum> corpus> rectum> duodenum> oesophagus> ileum.

    From these results, the team concludes that people with celiac disease experience reduced hydrophobicity of duodenal mucous layer, and a reduced ability to repel luminal contents. This may may contribute to the increased intestinal permeability seen in celiac disease.

    This change in hydrofobicity corresponds to the severity of the mucosal lesions in the patient, and is not completely reversed by gluten-free diet.

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    For celiacs gluten can irreversibly damage the intestinal lining, so that its contents "leak" into the rest of the body, a set-up for eventual major disease. At the moment, eating fresh food only and keeping one's environment gluten-free, are one's best defense.

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    I understand that they are saying that we who are gluten-intolerant are not able to form a protective layer to keep the contents of our intestines inside (so some leaks out into the bloodstream). What do they mean, however, by that not being resolved by a gluten-free diet? Never? Do we always have a leaky gut? (I have heard that another gut gate-keeper that allows permeability, called Zonulin, also remains elevated in celiac disease--sounds like we're doomed!)

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    I agree. Layman's terms. Had to look up a number of words.....takes a great deal of time in this busy world.

    We do our best to update our glossary...note that you can click on many of the terms to get a definition.

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  • About Me

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,500 articles on celiac disease. His coursework includes studies in science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.


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