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      Frequently Asked Questions About Celiac Disease   04/07/2018

      This Celiac.com FAQ on celiac disease will guide you to all of the basic information you will need to know about the disease, its diagnosis, testing methods, a gluten-free diet, etc.   Subscribe to Celiac.com's FREE weekly eNewsletter   What are the major symptoms of celiac disease? Celiac Disease Symptoms What testing is available for celiac disease?  Celiac Disease Screening Interpretation of Celiac Disease Blood Test Results Can I be tested even though I am eating gluten free? How long must gluten be taken for the serological tests to be meaningful? The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-Free Is celiac inherited? Should my children be tested? Ten Facts About Celiac Disease Genetic Testing Is there a link between celiac and other autoimmune diseases? Celiac Disease Research: Associated Diseases and Disorders Is there a list of gluten foods to avoid? Unsafe Gluten-Free Food List (Unsafe Ingredients) Is there a list of gluten free foods? Safe Gluten-Free Food List (Safe Ingredients) Gluten-Free Alcoholic Beverages Distilled Spirits (Grain Alcohols) and Vinegar: Are they Gluten-Free? Where does gluten hide? Additional Things to Beware of to Maintain a 100% Gluten-Free Diet What if my doctor won't listen to me? An Open Letter to Skeptical Health Care Practitioners Gluten-Free recipes: Gluten-Free Recipes
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    CAN CELIAC DISEASE DISAPPEAR AFTER ALLOGENEIC BONE MARROW TRANSPLANT?


    Jefferson Adams

    Celiac.com 01/06/2014 - A team of researchers recently set out to clarify the role of the immune system and intestinal epithelium in the origins of celiac disease.


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    Bone Marrow Diagram: CC--Wikimedia CommonsThe research team included S. Ben-Horin, S. Polak-Charcon,I. Barshack, O. Picard, E. Fudim, M. Yavzori, C. Avivi, C. Mardoukh, A. Shimoni, Y Chowers, Y. and Maor, of the Department of Gastroenterology in Chaim Sheba Medical Center at Tel-Aviv University, Tel Hashomer in Tel-Aviv, Israel.

    For five years, the team followed a patient with childhood celiac disease who had undergone an allogeneic bone marrow transplant (BMT) for chronic myelogenous leukemia, and subsequently resumed consuming a gluten-containing diet.

    Using standard serology testing, along with CFSE-based proliferation assays of peripheral blood CD4+ cells and of intestinal LPL towards gliadin-TTG antigens, the team assessed immunological memory to gliadin epitopes in both the control patient and in 5 newly diagnosed celiac patients.

    They used combined immuno-histochemistry and fluorescent in-situ hybridiazation (FISH) to determine the origin of the intestinal lymphocytes.

    They found that the patient remained healthy for more than 5 years of follow-up after receiving BMT from a HLA-matched woman, and ceasing the gluten-free diet. The continued to show negative periodic antibodies tests and unremarkable serial duodenal biopsies.

    In vitro tests showed lack of a memory response of the patient's peripheral blood and lamina propria CD4+ T-cells towards TTG, gliadin or TTG-treated gliadin, whereas memory responses were common in the newly diagnosed celiac patients.

    Immuno-FISH of post-BMT duodenal mucosa showed that all the epithelial cells had the chromosomal phenotype of XY. In contrast, CD45+ lymphocytic lineage cells were all donor-derived XX cells, presumably originating in the transplanted bone marrow and re-populating the intestinal wall.

    The resolution of celiac disease after allogeneic BMT does occur, and is associated with absent gliadin-specific memory response, and with a dichotomous lymphocyte-epithelial chimeric intestine. These findings suggest that the origins of celiac disease are deeply connected to the immune system, rather than the epithelial area.

    Source:


    Image Caption: Bone Marrow Diagram: CC--Wikimedia Commons
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    Fascinating! Does make me question if I should be on the bone marrow transplant list of donors. I'd hate for someone to recover and then learn they have celiac disease instead of luekemia.

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    Guest sc'Que?

    Posted

    This study seems like it will have long-reaching effects in how celiac disease is researched in the future. Please follow up on this kind of study!

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    Jefferson! as usual you find the most interesting finds. This article and the study are something that gives hope to all of us with celiac disease. The science and reporting were excellent from the looks. Thanks again so much.

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    Guest Pussycat21

    Posted

    This article is very interesting as the coeliac disease is cured. For any researchers reading this post I have three coeliacs in my immediate family. My daughters also has Hashimotos and POCS. When my children were young they contracted Kawasaki Disease and were given gamma goblin blood products ( a mix of different peoples' immune systems). For the five years after the transfusion their autoimmune diseases improved immensely. Some research into this would be interesting as it may not take bone marrow to get a cure.

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    admin
    Scand J Gastroenterol. 2003 Jul;38(7):727-31.
    Effectiveness of the sorbitol H2 breath test in detecting histological damage among relatives of coeliacs.
    Tursi A, Brandimarte G, Giorgetti GM, Inchingolo celiac disease.
    Dept. of Emergency, L. Bonomo Hospital, Andria (BA), Italy.
    Celiac.com 08/07/2003 - An Italian study conducted by Dr. L. Bonomo and colleagues and published in the July 2003 edition of Scandinavian Journal of Gastroenterology concludes that A significant proportion of coeliacs may be missed if relatives are screened by serology only, while the efficacy of sorbitol H2-BT in screening relatives is confirmed. This study confirms that neither a breath test nor serology can replace intestinal biopsy, which remains the gold standard for the diagnosis of celiac disease, thus confirming the continued importance of performing biopsies for diagnosing celiac disease. The studys goal was to determine the diagnostic capabilities of serological tests (antigliadin (AGA), antiendomysium (EMA) and anti-tissue transglutaminase (anti-tTG)) and sorbitol H2 breath test (H2-BT) in the detection of celiac disease in first-degree relatives. The study screened 111 first-degree relatives of 37 celiac families using both test methods to determine candidates for small-bowel biopsy. First-degree relatives with abnormal test results underwent a small-bowel biopsy, as did those with negative serological and H2 breath test results who had clinical complaints or suspected that they may have celiac disease.
    The biopsy results were expressed using the Marsh classification system, and celiac disease was diagnosed in 49 of the 111 screened relatives of celiacs, or in 44.14%. A breakdown of the results is as follows: 5 showed Marsh IIIc, 8 Marsh IIIb, 16 Marsh IIIa, 13 Marsh II and 7 Marsh I lesions. 19 relatives showed the classical form of celiac disease, 20 showed the sub-clinical form, and 10 showed the silent form. The serological test results indicated an overall positivity of only 36.73%, with strong positive results only in those with severe intestinal damage and Marsh IIIb-c lesions. The sorbitol H2-BT breath test results showed an overall positivity of 83.67%, and showed strong positivity in patients with slight histological damage (Marsh I-IIIa).

    Jefferson Adams
    Celiac.com 04/14/2009 - A team of Finnish researchers is calling for a change in the criteria for diagnosing celiac disease, based on their findings that gluten intolerant patients who do not have clinical celiac disease get similar benefits from a gluten-free diet, and respond to the diet about as well as patients who do have clinical celiac disease.
    The research team recently set out to test their hypothesis that patients who showed only mild enteropathy, but positive endomysial anti-bodies, would benefit from a gluten-free diet in a manner similar to patients with more serious mucosal damage.
    The research team was made up of Kalle Kurppa, Pekka Collin, Mervi Viljamaa, Katri Haimila, Päivi Saavalainen, Jukka Partanen, Kaija Laurila, Heini Huhtala, Kaija Paasikivi, Markku Mäki, and Katri Kaukinen, and they are variously associated with Finland's University of Tampere and Tampere University Hospital, the Tampere School of Public Health, the Finnish Red Cross Blood Service, and the University of Helsinki.
    Among their findings are that patients with endomysial antibodies benefit from a gluten-free diet REGARDLESS of the level of intestinal tissue damage. That means that folks who have no symptoms whatsoever, but who have blood antibodies that are reacting to offending gluten proteins, should consider the benefits of a gluten-free diet. Moreover, it's likely that damage will eventually occur over time without a gluten-free diet.
    The current diagnostic criteria for celiac disease require the presence of small-bowel mucosal villous atrophy with crypt hyperplasia (Marsh III). So, no damage of this specific kind, no celiac disease, no gluten-free diet, no worries. Such has been the common medical practice up to the present.
    However, in many cases, damage to the intestine develops slowly over time. Also, most patients show some kind of clinical symptoms long before histologic changes show up. Endomysial antibodies happen to be strong and specific predictors of pending damage in the form of villous atrophy.
    To test their hypothesis, the research team performed small-bowel endoscopies, along with clinical evaluations, on 70 adults with positive endomysial antibodies. Of these, 23 showed only mild enteropathy (Marsh I–II). Researchers assigned members of this group to either gluten-free or gluten-inclusive diets at random.
    After 1 year, the team repeated all clinical, serologic, and histologic tests. A total of 47 participants showed small-bowel mucosal lesions consistent with celiac disease (Marsh III), and this group served as a control for the study.
    The results for the group that continued to consume gluten showed damage to the mucosal villous architecture in all cases, along with persistent symptoms and abnormal antibody levels.
    In contrast, the gluten-free group showed less damage, generally Marsh I–II, a retreat of symptoms, reduced antibody levels along with reductions in mucosal inflammation similar to controls (Marsh III).
    The team concluded that a gluten-free diet provides similar benefits for gluten intolerant patients without clinical celiac disease as for those with celiac disease, that the diagnostic criteria for celiac disease warrant re-evaluation,  that the presence of endomysial antibodies without mucosal damage should be included in chain of genetic gluten intolerance, and and finally that such cases merit treatment with gluten-free diet.

    GASTROENTEROLOGY 2009;136:816–823

    Jefferson Adams
    Celiac.com 02/26/2010 - Data increasingly supports an association between rs6822844 at the IL2-IL21 region and multiple autoimmune diseases in individuals of European descent. A number of autoimmune diseases share susceptibility genes, pointing to similar molecular mechanisms.
    A team of researchers recently set out to assess evidence for a general susceptibility locus by looking for association between rs6822844 at the Il2-Il21 region and numerous autoimmune diseases.
    The research team included Amit K. Maiti, Xana Kim-Howard, Parvathi Viswanathan, Laura Guillén, Adriana Rojas-Villarraga, Harshal Deshmukh, Haner Direskeneli, Güher Saruhan-Direskeneli, Carlos Cañas, Gabriel J. Tobön, Amr H. Sawalha, Alejandra C. Cherñavsky, Juan-Manuel Anaya, and Swapan K. Nath
    Their joint effort was underwritten by grants from the National Institutes of Health (NIH - Grant Number: 5R01-AI-063622, P20-RR-020143), Colciencias (Grant Number: 2213-04-16484), Rosario University School of Medicine, and the Colombian Association of Rheumatology.
    The goal of the study was to replicate the association between rs6822844 and 6 different immune-mediated diseases in non-European populations, and to conduct disease-specific and overall meta-analyses using data from previously published studies.
    The team evaluated case-control associations between rs6822844 and celiac disease in subjects from Argentina; rheumatoid arthritis, type 1 diabetes mellitus, primary Sjögren's syndrome, and systemic lupus erythematosus in subjects from Colombia; and Behçet's disease in subjects from Turkey.
    They compared allele and gene distribution between cases and controls. They conducted meta-analyses using data from the present study and previous studies.
    The team found significant associations of rs6822844 with systemic lupus erythematosus (P = 0.008), type 1 diabetes mellitus (P = 0.014), rheumatoid arthritis (P = 0.019), and primary Sjögren's syndrome (P = 0.033) but not with Behçet's disease (P = 0.34) or celiac disease (P = 0.98).
    Cases and controls from Argentina and Colombia showed little evidence of population differentiation (FST = 0.01), which suggests that association was not influenced by population substructure.
    Disease-specific meta-analysis shows strong association for rheumatoid arthritis (Pmeta = 3.61 × 10-6), inflammatory bowel disease (IBD; Crohn's disease and ulcerative colitis) (Pmeta = 3.48 × 10-12), type 1 diabetes mellitus (Pmeta = 5.33 × 10-5), and celiac disease (Pmeta = 5.30 × 10-3).
    Total meta-analysis across all autoimmune diseases supports association with rs6822844 (23 data sets; Pmeta = 2.61 × 10-25, odds ratio 0.73, with 95% confidence interval 0.69-0.78).
    The team concludes that an association exists between rs6822844 and multiple autoimmune diseases in non-European populations. Meta-analysis provides strong confirmation for strong association across multiple autoimmune diseases in populations of both European and non-European ancestry.
    Arthritis & Rheumatism; Volume 62 Issue 2, Pages 323 - 329

    http://www3.interscience.wiley.com/journal/123266977/abstract?CRETRY=1&SRETRY=0


    Gryphon Myers
    Celiac.com 09/03/2012 - Celiac disease numbers in Western countries are currently somewhere in the 1:100 range, but this does not account for a host of non-celiac gluten intolerant people. For many, it is common knowledge that gluten and wheat intolerance manifests in a variety of forms, and not all of them are diagnosable as celiac disease. This has not prevented scientific circles from debating the existence of such non-celiac wheat sensitivities though. A double-blind placebo-controlled study spanning 2001-2011 demonstrates that wheat sensitivity exists as a distinct clinical condition, separate from celiac disease.
    Many who go to their doctors seeking a celiac disease diagnosis are disappointed when they are told that they do not have celiac disease, but the more catch-all, and less conclusive IBS, even though they have self-diagnosed and know that gluten aggravates their symptoms. Such IBS-diagnosed patients who attended the outpatient center at the Department of Internal Medicine at the University Hospital of Palermo or the Department of Internal Medicine of the Hospital of Sciacca between January 2001 and June 2011 were considered for the study.
    After a number of diagnostic inclusion and exclusion criteria were applied, 920 patients were invited to participate in the study. Patients were monitored for 2-4 weeks while on a 30g minimum wheat-containing diet, then put on a standard elimination diet (no wheat, cow's milk, eggs, tomatoes or chocolate). Any further known food sensitivities were avoided as well.
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    Relevant markers to distinguish wheat sensitivity from IBS include anemia, weight loss and history of food allergy in infancy. Wheat sensitive patients also tended to have more coexistent atopic diseases.
    From this study, we know that non-celiac wheat sensitivity exists. Further studies will explore the distinction between the celiac-like and allergy-like types of the condition.
    Source:
    http://www.ncbi.nlm.nih.gov/pubmed/22825366

  • Recent Articles

    Jefferson Adams
    Celiac.com 04/23/2018 - A team of researchers recently set out to learn whether celiac disease patients commonly suffer cognitive impairment at the time they are diagnosed, and to compare their cognitive performance with non-celiac subjects with similar chronic symptoms and to a group of healthy control subjects.
    The research team included G Longarini, P Richly, MP Temprano, AF Costa, H Vázquez, ML Moreno, S Niveloni, P López, E Smecuol, R Mazure, A González, E Mauriño, and JC Bai. They are variously associated with the Small Bowel Section, Department of Medicine, Dr. C. Bonorino Udaondo Gastroenterology Hospital; Neurocience Cognitive and Traslational Institute (INECO), Favaloro Fundation, CONICET, Buenos Aires; the Brain Health Center (CESAL), Quilmes, Argentina; the Research Council, MSAL, CABA; and with the Research Institute, School of Medicine, Universidad del Salvador.
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    Source:
    J Clin Gastroenterol. 2018 Mar 1. doi: 10.1097/MCG.0000000000001018.

    Connie Sarros
    Celiac.com 04/21/2018 - Dear Friends and Readers,
    I have been writing articles for Scott Adams since the 2002 Summer Issue of the Scott-Free Press. The Scott-Free Press evolved into the Journal of Gluten Sensitivity. I felt honored when Scott asked me ten years ago to contribute to his quarterly journal and it's been a privilege to write articles for his publication ever since.
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    My following books will still be available at Amazon.com:
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    Jefferson Adams
    Celiac.com 04/20/2018 - A digital media company and a label data company are teaming up to help major manufacturers target, reach and convert their desired shoppers based on dietary needs, such as gluten-free diet. The deal could bring synergy in emerging markets such as the gluten-free and allergen-free markets, which represent major growth sectors in the global food industry. 
    Under the deal, personalized digital media company Catalina will be joining forces with Label Insight. Catalina uses consumer purchases data to target shoppers on a personal base, while Label Insight works with major companies like Kellogg, Betty Crocker, and Pepsi to provide insight on food label data to government, retailers, manufacturers and app developers.
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    Morris says the joint partnership will allow Catalina to “enhance our dataset and further increase our ability to target shoppers who are currently buying - or have shown intent to buy - in these emerging categories,” including gluten-free, allergen-free, and other free-from foods.
    The deal will likely make for easier, more precise targeting of goods to consumers, and thus provide benefits for manufacturers and retailers looking to better serve their retail food customers, especially in specialty areas like gluten-free and allergen-free foods.
    Source:
    fdfworld.com

    Jefferson Adams
    Celiac.com 04/19/2018 - Previous genome and linkage studies indicate the existence of a new disease triggering mechanism that involves amino acid metabolism and nutrient sensing signaling pathways. In an effort to determine if amino acids might play a role in the development of celiac disease, a team of researchers recently set out to investigate if plasma amino acid levels differed among children with celiac disease compared with a control group.
     
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    First, the team used liquid chromatography-tandem mass spectrometry (LC/MS) to analyze amino acid levels in fasting plasma samples from 141 children with celiac disease and 129 non-celiac disease controls. They then crafted a general linear model using age and experimental effects as covariates to compare amino acid levels between children with celiac disease and non-celiac control subjects.
    Compared with the control group, seven out of twenty-three children with celiac disease showed elevated levels of the the following amino acids: tryptophan; taurine; glutamic acid; proline; ornithine; alanine; and methionine.
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    This study shows that amino acids can influence inflammation and may play a role in the development of celiac disease.
    Source:
    PLoS One. 2018; 13(3): e0193764. doi: & 10.1371/journal.pone.0193764

    Jefferson Adams
    Celiac.com 04/18/2018 - To the relief of many bewildered passengers and crew, no more comfort turkeys, geese, possums or other questionable pets will be flying on Delta or United without meeting the airlines' strict new requirements for service animals.
    If you’ve flown anywhere lately, you may have seen them. People flying with their designated “emotional support” animals. We’re not talking genuine service animals, like seeing eye dogs, or hearing ear dogs, or even the Belgian Malinois that alerts its owner when there is gluten in food that may trigger her celiac disease.
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    So, to the relief of many bewildered passengers and crew, no more comfort turkeys, geese, possums or other questionable pets will be flying on Delta or United without meeting the airlines' strict new requirements for service and emotional support animals.
    Source:
    cnbc.com