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  • Jefferson Adams
    Jefferson Adams

    HLA-typing Can Help Spot Celiac Disease in Patients with Type 1 Diabetes

      Can HLA-DQ2/DQ8 haplotypes help to spot celiac disease in type one diabetes patients? A new study says yes.

    Caption: Image: CC--Ninara

    Celiac.com 03/07/2019 - Researchers don’t have much good data on the distribution of the related alleles in the type 1 diabetes Iranian population. In an effort to generate better data, a team of researchers recently set out to assess the frequency of HLA DQ2 and DQ8 haplotypes in patients with type 1 diabetes, with and without celiac disease, and to compare them to the healthy population.

    The research team included Ali Moheb-Alian, Flora Forouzesh, Amir Sadeghia, Kamran Rostami, Elham Aghamohammadi, Mohammad Rostami-Nejad, Mostafa Rezaei-Tavirani, and Mohammad Reza Zali.

    The team looked at 70 type 1 diabetes patients who did not have celiac disease, 60 type 1 diabetes cases with celiac disease, and compared them with 150 healthy individuals. 

    They collected ten milliliter Gheparinized blood samples, extracted genomic DNA, and genotyped alleles in Real-time PCR using SYBR Green as a low-resolution method. 

    They found HLA-DQ2 genotypes in 51% of type 1 diabetes patients without celiac disease, and HLA-DQ8 in 23% of such patients. Just over twenty percent of those patients carried both alleles, while 5% carried neither allele. More than 70% of type 1 diabetes patients with celiac disease had DQ2, while nearly 12% carried DQ8.

    Compared to  diabetes patients without celiac disease and the control group, 14% carry both alleles, and 3% carrying neither allele. The frequencies of DQ2 and DQ8 alleles in Iranian healthy population were 19 and 5% respectively.

    The similarities in genetic background for celiac disease and type 1 diabetes show that HLA-typing can be serve as a helpful tool for spotting celiac disease in people with type one diabetes.

    Read more in the Journal of Diabetes and its Complicationshttps://doi.org/10.1016/j.jdiacomp.2018.10.001

     

    The researchers are variously affiliated with the Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran; the Department of Genetics, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran; the Department of Gastroenterology MidCentral District Health Board, Palmerston North Hospital, New Zealand; the Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran; and the Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.



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  • About Me

    Jefferson Adams earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in biology, anatomy, medicine, science, and advanced research, and scientific methods. He previously served as 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.

  • Related Articles

    Destiny Stone
    Celiac.com 07/01/2010 - Celiac disease is a genetic auto-immune disease which, until now,  has primarily been considered a Western epidemic. However, we are seeing a rise of celiac disease  in  Middle Eastern and North African countries.
    Celiac disease prevalence is grossly underestimated by the medical profession and as such, there is very little data available regarding malignant complications resulting from undiagnosed celiac.
    Once considered a Western epidemic, celiac is now acknowledged as a common disease among North African and Middle Eastern populations. A research team at the Division of Gastroenterology, department of Internal Medicine, American University of Beirut Medical Center, formally assess why celiac disease is rising in North Africa and the Middle East. The researchers use the electronic databases pubMed and Medline from 1950 through 2008 for the search engine, and “celiac disease” was used for a Mesh term. For this study, the perimeters of the search for celiac prevalence was limited to the Middle East and North African countries only.
    Celiac disease is demonstrated to be prevalent in first and second degree relatives of patients with celiac. In the US the prevalence is shown to be between 4% and 12% as assessed by biopsy. Studies in Algeria and Turkey showed a prevalence of 1.7% respectively among first degree relatives. Of the 381 first degree relatives that  were tested, 26 had positive serology,  and villous atrophy was found in 13 of the 16 patients that had biopsy's performed.  Celiac disease clusters among families were also present in Jordan and Algeria. It is noted that the high rate of consanguinity in Middle Eastern and North African countries may be responsible for generating a greater prevalence of celiac. However, further studies on this subject are needed .
    Clinical variations in presentation of celiac disease were also studied by the researchers. There are many variations when it comes to the results for clinical variations. It is suggested that the reason for the variations may be due to  the small number of patients studied, or delay in their presentation of symptoms.  Gastrointestinal discomfort is the  most common symptom of celiac disease, including diarrhea, constipation, bloating, flatulence, nausea and vomiting. Studies performed in Middle Eastern and North African countries had a celiac prevalence of 6.5%-21%. Patients with celiac disease in Iran, Lebanon, Iraq, Saudi Arabia and Kuwait had diarrhea as the most common symptom of celiac. 4.7% of Egyptian children exhibiting  diarrhea and failure to thrive, had celiac disease.
    Approximately one third of children with celiac in Western countries exhibit short stature. The highest prevalence of short stature is found in Jordan, where 26% of children with celiac disease also had rickets. In Turkey, 51% of patients with celiac had a height well below the standard mean. In the United States, 36% of Americans with celiac were previously diagnosed with irritable bowl syndrome (IBS) and in Iran 12% of those labeled with IBS were later diagnosed with celiac disease.
    Iron deficiency anemia (IDA) is the most common form of anemia, and is often sited as the only way to diagnose sub-clinical celiac disease in patients.  Worldwide, the prevalence of celiac among patients with IDA is 2.8% to 8.7%,  and possibly as high as 15%. In North Africa and the Middle East, anemia is found in 20%-80% of celiac patients. In Egypt, 4% of insulin dependent diabetes mellitus (IDDM) patients with anemia had celiac disease. In Saudi Arabia, the osteomalacia and IDA account for 43.5%  of celiac patients. The high prevalence of osteoporosis may be attributed to delays in celiac diagnosis.
    Approximately 30% of celiac patients have other autoimmune diseases like IDDM and autoimmune thyroiditis. IDDM has very high rates among those with celiac disease with rates from 6.7% to 18.5%.  The rates for autoimmune diseases are are a low 1.9% in Turkey, and a high 33% in Iran. Many of those patients were discovered to also have celiac disease after long delays.
    Whether or not prevalence of celiac is rising in Middle Eastern and North African countries is not clear, and more studies are required. More studies are also needed to determine the connections between celiac and other diseases. Reason's sited for the lack of data regarding celiac in Middle Eastern and North African countries,  are the inconsistencies with screening methods from different populations and socioeconomic back grounds,  the efficacy of treatment modalities employed, patient compliance, disease complications and response to treatments.
    Source:

    World J Gastroenterol. 2010 March 28; 16(12): 1449-1457.

    Jefferson Adams
    Celiac.com 04/08/2011 - A medical research team recently conducted an epidemiological review of celiac disease in Iran. The team included M. Rostami Nejad, K. Rostami, M. H. Emami, M. R. Zali, and R. Malekzadeh.
    They are associated variously with the Research Institute for Gastroenterology and Liver Diseases at Shahid Beheshti University of Medical Science, with the Digestive Disease Research Center,Tehran University of Medical Sciences, both in Tehran, Iran, with the Poursina Hakim Research Institute (PHRI), Isfahan University of MedicalSciences (IUMS), Isfahan, Iran, and with the School of Medicine, University of Birmingham, United Kingdom.
    Celiac disease has been traditionally believed to be a chronic  enteropathy, almost exclusively affecting people of European  origin. The use of new, simple, very sensitive and specific serological tests has revealed shown that celiac disease is as common in Middle Eastern countries as in Europe, Australia and New Zealand, where wheat is a major dietary staple.
    Celiac disease was presumed to be rare in Iran because of low awareness and a low index of suspicion. However new epidemiological data show that celiac disease is a common disorder in Middle Eastern countries, particularly Iran.
    In fact, studies have shown Iran to have high rates of celiac disease, in both the general population and the at-risk groups, i.e. patients with type 1 diabetes or irritable bowel syndrome (IBS).
    In developing countries, doing blood tests on at-risk groups is necessary for early identification of celiac patients.
    Clinical studies show that patients in the middle east present with non-specific symptoms or a lack of symptoms as often as in Europe.
    Since wheat is a major component of the Iranian diet and exposure to wheat proteins induces some degree of immune tolerance, leading to milder symptoms that may be mistaken with other GI disorders.
    Getting patients on a gluten free diet is a major challenge for both patients and clinicians in Iran, mainly because commercial gluten-free products are simply not available.
    Since it is possible that there is some variable frequency celiac disease in different parts of Iran, as is the case for India, the study team suggests the need for a more uniformly designed evaluation of celiac disease for the entire country,  a mapping of HLA DQ in the same areas, together with a gluten consumption assessment.
    Celiac disease rates are quite low in some areas of Iran, such as Shiraz Province, while a summary of the reviewed studies suggests a prevalence of 1% in the remaining areas of Iran, a rate similar to that found in Western European countries.

    SOURCE:
    Middle East Journal of Digestive Diseases/ Vol.3/ No.1/ March 2011


    Jefferson Adams
    Celiac.com 04/25/2011 - Research shows that celiac disease is associated with numerous gastric abnormalities. An international research team recently set out to examine the association between rates of celiac disease and Helicobacter pylori infection in an Iranian population of 250 patients.
    The research team included Mohammad Rostami Nejad BS1, Kamran Rostami MD PhD, Yoshio Yamaoka MD PhD, Reza Mashayekhi MD1, Mahsa Molaei MD, Hossein Dabiri PhD, David Al Dulaimi MD, Dariush Mirsattari MD, Homayoun Zojaji MD, Mohsen Norouzinia MD, and Mohammad Reza Zali MD FACG AGAF.
    The team members are variously affiliated with the Research Institute of Gastroenterology and Liver Disease, Shahid Beheshti University, M.C., in Tehran, Iran, the School of Medicine, University of Birmingham in the UK, the Department of Medicine-Gastroenterology, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine in Houston, Texas, and the Department of Gastroenterology, Alexandra Hospital, Redditch, UK.
    For the study, the team took topsides from the gastric antrum and duodenum. They assessed morphology and histology using the updated Sydney system and modified Marsh criteria, respectively.
    In order to simplify the assessment of gastric lesions, the team classified gastritis in both macroscopic and microscopic stages. They screened for anti-tissue transglutaminase antibody to determine the presence of celiac disease.
    Of the 250 patients, 232 (93%) showed histological evidence of Helicobacter pylori infection, while 24 patients (10%) showed histological abnormalities (Marsh I to IIIc). Of the 24 patients with histological abnormalities 20 (83%) showed Helicobacter pylori infection.
    Of the total 250 patients, 25 patients (10%) showed positive anti-tissue transglutaminase antibody screens, nine (3.6%) of whom showed microscopic and macroscopic enteritis (Marsh I to IIIc).
    Clinically, there was no way to distinguish the presentation of celiac disease from those cases infected with Helicobacter pylori. Histology, even in patients with positive antibody screens, was non-specific and not useful.
    The results also showed a high prevalence of Helicobacter pylori infection and chronic gastritis in the study group. However, neither was associated with celiac disease, but rather, matched average rates in Western population studies.
    Source:

    Archives of Iranian Medicine, March 2011

    Jefferson Adams
    Celiac.com 03/05/2019 - The mechanics of how celiac disease and gluten-related disorders develop is still poorly understood. In order to shed light on the subject, a team of researchers recently conducted a systematic review of the current epidemiological knowledge of gluten-related disorders. They focused on variations in reported cases and rates of gluten-related disorders in the Asia-Pacific region.
     
    The research team included Sara Ashtari, Mohamad Amin Pourhoseingholi, Kamran Rostami, Hamid Asadzadeh Aghdaei, Mohammad Rostami-Nejad, Luca Busani, Mostafa Rezaei Tavirani, and Mohammad Reza Zali.
    For their reviews, the team searched Medline, PubMed, Scopus, Web of Science and Cochrane database for material published from January 1991 to January 2018. They searched the following MeSH terms and keywords: celiac disease, wheat allergy, non-celiac gluten sensitivity (NCGS), dermatitis herpetiformis and gluten ataxia and the prevalence studies. Each article was cross-referenced with “Asia-Pacific region” and countries in this region such as Australia, New Zealand, India, Pakistan, Turkey, Iran and others.
    They found a total of 66 suitable studies that chronicled rates of gluten-related disorders in the Asia-Pacific region. They found celiac disease rates of 0.32%-1.41% in healthy children, and 0.05%-1.22% in the adult population, while rates in the high risk population ran as high as 11.8%. Earlier studies have shown few cases of dermatitis herpetiformis and gluten ataxia. Interestingly, even though wheat allergy is uncommon in most Asian-Pacific countries, it’s the most common cause of anaphylaxis. 
    This review emphasizes how little good information we have, and how much we need more and better epidemiological studies to reveal the origins and development of gluten-related disorders, and to better measure their effects upon health care delivery.
    Read more at: J Gastrointestin Liver Dis, March 2019 Vol. 28 No 1
     
    They are variously affiliated with the Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran; the Departments of Gastroenterology, Milton Keynes Hospital NHS Foundation Trust, Milton Keynes, UK; the Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran; the Department of Infectious Diseases, Istituto Superiore di Sanità, Roma, Italy; and the Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

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    Doritos does make a few gluten-free versions.     
    Just wanted to chime in. During my 2 plus years of healing I had joint pain and muscle pain with some of the nightshade mainly peppers and tomato. I stopped them. I can now eat them again. My theory is when my gut gets cc my holey gut dumps some of my food in my blood stream and my already ticked off immune system let's me know what is allowed. Apparently for a time nightshades  of potato, tomatos, and peppers were an issue. I was able to gradually introduce potatoes first and then tomatos, then
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