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  • Jefferson Adams

    Celiac Disease: Antibody Response and Mucosal Change in the Small-bowel After Gluten Exposure

    Jefferson Adams
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    Reviewed and edited by a celiac disease expert.

    Celiac.com 03/08/2012 - Eating gluten-free for an entire lifetime is no easy task. Many people with celiac disease and gluten-sensitivities would love an alternative to a gluten-free diet, and a number of companies are looking to develop alternative therapies that would enable people to consume gluten without suffering damage.

    Photo: CC--tiny.ccEven though nearly all drug-development programs include gluten challenges, very little is known about the duration of gluten challenge and gluten dosage. That is, how quickly does gluten cause damage, and at what dosages?



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    A team of researchers recently studied the ways in which antibodies respond and mucosa change when the small bowel is exposed to gluten in people with celiac disease. The study team included Marja-Leena Lähdeaho, Markku Mäki, Kaija Laurila, Heini Huhtala, and Katri Kaukinen.  

    To assess the amount of gluten-exposure needed to cause some small-bowel mucosal deterioration, the team conducted a gluten-challenge on twenty-five adult celiac patients. Each patient received either a low (1-3 g) or moderate (3-5g) doses of gluten daily for 12 weeks.

    The team assessed patient symptoms, including small-bowel morphology, densities of CD3+ intraepithelial lymphocytes (IELs) and celiac serology.

    Their results showed that both moderate and low amounts of gluten induced small-bowel damage in 67% of celiac patients. However, moderate gluten doses also caused mucosal inflammation and gastrointestinal symptoms in seven patients that lead to their premature withdrawal from the study. Interestingly, 22% of patients who developed significant small-intestinal damage showed no symptoms.

    The team concludes that, for most people with celiac disease, even low amounts of gluten can cause significant mucosal changes. However, since many people with celiac disease show no such response, sample sizes must be large enough to be statistically significant.

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    I am a celiac with DH. I have a constant problem with my facial skin. It would be nice to see an article on how much these antibodies damage our skin. After a gluten attack, I go through weeks of red face and skin peeling but my intestine seems to remain normal.

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    I was diganosed with celiac disease at the age of 59 yrs. old. I was sick for over 6 1/2 months with cronic diarherra until I was sent to a gastro-intestinal doctor and given the blood test first then the scope with the biopsies for definite results.

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    Thank you Jefferson for researching this! I think every celiac, myself included, need to remember this. Now if they could come up with something to help the bowel recover more quickly after hidden or overt gluten ingestion. Thanks again, Hilary Adams

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    Wish I had known this 10 years ago. I might have been able to save myself from years of "IBS & ulcerative colitis" and I might still have my large colon - had I gone gluten-free.

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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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