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  • Jefferson Adams

    Can Steroids Help Treat Celiac Disease?

    Jefferson Adams
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    Reviewed and edited by a celiac disease expert.

    Photo: CC--Liz West
    Caption: Photo: CC--Liz West

    Celiac.com 05/19/2014 - A research team recently examined the effects of prednisolone and a gluten-free diet on mucosal epithelial cell regeneration and apoptosis in celiac disease.

    Photo: CC--Liz WestThe team included Shalimar, P. Das, V. Sreenivas, S. Datta Gupta, S.K. Panda, and G.K. Makharia. They are with the Department of Gastroenterology and Human Nutrition at the All India Institute of Medical Sciences in Ansari Nagar in New Delhi, India.



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    For their pilot randomized, controlled trial, the team looked at thirty-three untreated patients with celiac disease. They randomly assigned 17 of them to a gluten-free diet alone, and the other 16 to a gluten-free diet + prednisolone. Gluten intake was 1 mg/kg for 4 weeks.

    The team conducted duodenal biopsies at the start, and at 4 and 8 weeks following treatment. They recruited six patients with functional dyspepsia as control subjects.

    The team stained all biopsies for markers of intrinsic apoptotic pathway (AIF, H2AX, p53), common apoptotic pathway (CC3, M30), apoptotic inhibitors (XIAP, Bcl2), and epithelial proliferation (Ki-67). They then compared apoptotic (AI) and proliferation indices (PI).

    Initial duodenal biopsies showed the end apoptotic products H2AX and M30 to be markedly higher.

    In comparison with those treated with GFD alone, after 4 weeks of GFD + prednisolone treatment, some markers of both intrinsic and common apoptotic pathways showed rapid decline.

    After prednisolone withdrawal, there was overexpression of H2AX, CC3, and p53 in the latter group. In comparison with those treated with only GFD, patients treated with prednisolone showed suppression of mucosal PI, which started rising again after withdrawal of prednisolone.

    Apoptosis takes place in mucosal epithelium in celiac disease.

    The take away here is that a short course of prednisolone quickly suppresses apoptosis. However, it also suppresses epithelial regeneration, an so should be used only for a short time, if at all.

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    I and my doctor thought I had a long standing case of secondary Addison's Disease, for which I had been treated with cortisone for about 33 years. I gradually got severely used to the cortisone and gradually it became less and less effective.

     

    Then we graduated to a longer acting steroid called; methelpredniussalone. Now it seem to not work right during the night, but is very effective during the daytime.

     

    A DNA cheek swab test shows that I have inherited gluten sensitivity from one of my parents.

     

    Although I have gone to essentially a gluten-free diet. Is there anything else I can do for the night time urinary "call of nature" and the need to take meds more often than in the daytime???

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    I have not been diagnosed officially with celiac disease but have most of the symptoms. I started pregnalone for perimenopause symptoms and felt so much better. But within about 8 months started having fever and then by 10 months stopped it completely as I felt terrible with really bad inflammation that has just escallated into more health issues. Article is very helpful to explain what happened. Interested to know what the time interval is for "short time" and is there is any long term research on what happens to someone staying on it for as long as I did. Thanks, T.

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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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