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      Frequently Asked Questions About Celiac Disease   04/24/2018

      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 is Celiac Disease and the Gluten-Free Diet? 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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    IMMUNE PHENOTYPE OF CHILDREN WITH NEWLY DIAGNOSED AND GLUTEN-FREE DIET-TREATED CELIAC DISEASE


    Jefferson Adams

    Celiac.com 09/13/2010 - What's happening in with the immune system when a child is first diagnosed with celiac disease? What happens when they are treated with a gluten-free diet?


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    Some recent studies have indicated that both the adaptive and the innate immune system play roles in celiac disease. However, until now, doctors haven't known much about the immune phenotype of children with celiac disease and how that phenotype might by affected by a gluten-free diet.

    To move toward a better understanding of these issues, a team of researchers recently studied immune phenotype in children with either newly diagnosed celiac disease, or celiac disease treated with a gluten-free diet.

    The research team included Áron Cseh, Barna Vásárhelyi, Balázs Szalay, Kriszta Molnár, Dorottya Nagy-Szakál, András Treszl, Ádám Vannay, András Arató, Tivadar Tulassay and Gábor Veres. The are affiliated with the First Department of Pediatrics in the Research Group for Pediatrics and Nephrology at Semmelweis University and Hungarian Academy of Sciences, in Budapest, Hungary.

    For their study, the team described the status of major players within the adaptive and innate immune system in peripheral blood of children with newly diagnosed celiac disease. They then looked to see how the phenotype might have changed
    once the symptoms improved following treatment with a gluten-free diet.

    The team drew peripheral blood samples from ten children with biopsy-proven celiac disease at the time of diagnosis and again after once clinical symptoms subsided with treatment by gluten-free diet. They also drew blood samples from a control group of 15 children who suffered from functional abdominal pain.

    They measured the prevalence of cells of adaptive and innate immunity by means of labeled antibodies against surface markers and intracellular FoxP3 using a flow cytometer.

    They found that patients with celiac disease had lower T helper, Th1 and natural killer (NK), NKT and invariant NKT cell prevalence and with higher prevalence of activated CD4+ cells, myeloid dendritic cells (DC) and Toll-like receptor (TLR) 2 and TLR-4 positive DCs and monocytes compared to controls.

    Most of these deviations returned to normal, once symptoms subsided with gluten-free diet treatment. However, prevalence of NK and NKT cell, DC and TLR-2 expressing DCs and monocytes remained abnormal.

    The immune phenotype in childhood celiac disease indicates that both adaptive and innate immune systems are playing a role in celiac disease.

    Treatment with a gluten-free diet reverses immune abnormalities, but the mechanics of the reversal likely varies among cell types.

    Source:


    Image Caption: New research on immune phenotypes and kids with celiac disease
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    Guest jeannie lindsay

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    Very much appreciate this information and assume the same phenomena occur in adults with celiac. Hope to see future studies on the consequences of this in regard to the incidence of other disease processes.

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    admin

    The following was sent to me from Rio de Janeiro by Dr. José Cesar da Fonseca Junqueira. If you have any questions you can e-mail him at: cjunqueira@ax.apc.org.br
    Rio de Janeiro - 05/27/96 - Celiac Disease. A Comparative study of two periods. Junqueira JC, Calçado AC, Percope S. 1996 Federal University of Rio de Janeiro Martagão Gesteira - Institute of Pediatrics. The aim of this study was to compare cases of celiac disease diagnosed in outpatients with malabsortion cases. The study was conducted at the Pediatric Gastroenterology Service of the Pediatric Institute Martagão Gesteira at the Federal University of Rio de Janeiro Brazil. It was done in two phases: from 1975 -1984 and from 1985 - 1994 (group 1, N=31 and group 2, N=21). Patients were selected based on the results of jejunal biopsy (group IV) and the favorable reaction to a gluten free diet. Data from the first interview (age, sex, nutritional status and prevalent symptoms) were analyzed. The number of biopsies and the level of compliance with the diet were also observed. The data collected was processed in a computer using EPI INFO 6.03 (January 1996)as software. The frequency of celiac disease over the studied years was compared with international data. There were no significant differences between the two groups in our study. However, the cases free of gastroenterological symptoms (atypical celiac disease) were not observed. The average age difference between the groups (group um X=24,39 months; group 2 X=32,03) was not statistically significant. A bigger study must be carried out to prove this theory. The analysis of nutritional status of the groups reveals the existence of severely undernourished patients. The number of biopsies and the level of compliance with diet were similar in the two groups. The decrease in the number of cases as well the increase in the age of patients were observed in group 2. These phenomena were probably due to a delayed exposure to gluten and to the expansion of the period of breast feeding. Other causes should be analyzed in a bigger research program. The conclusion of this study shows that there has been no change in the clinical features of the disease and points to the need for serological screening so that the entire spectrum of the disease can be established.
    Both groups had malabsorption and were very under-nourished (over 45%). One patient was diagnosed as having Diabetes Mellitus several years after and an other one is under investigation for poliarthrites. Serological investigation is not available in our country. The final conclusion is that we must have such serological screening to know the real spectrum of the disease. Adult celiac disease is not diagnosed in our country, mainly because the adult doctors do not know the full spectrum of celiac disease.
    Ill be presenting this work as a thesis at the University on May 29, 1996.

    admin

    Paul V, Henkerr J, Todt H, Eysold R.
    Z.Klin.Med., 1985; 40: 707-709.
    In this study 90 EEGs were performed on 58 celiac children. Researchers concluded that abnormal brain waves resulted from the ingestion of gluten by celiac children. They also concluded that a gluten challenge should not be given before a child reaches the age of 6 years old, and the challenge should not last longer than 5 months. The researchers main concern seems to be the risk of permanent brain damage that they believe could be caused in a celiac child who eats gluten for a prolonged period of time.

    Jefferson Adams
    Celiac.com 03/15/2010 - A team of researchers recently set out to investigate mucosal expression of claudins 2, 3 and 4 in the proximal and distal parts of duodenum in children with celiac disease. The team included Dorottya Nagy Szakál, Hajnalka GyÅ‘rffy, András Arató, Áron Cseh, Kriszta Molnár, Mária Papp, Antal DezsÅ‘fi, and Gábor Veres. They are variously associated with the Department of Pediatrics, and the Department of Pathology at Semmelweis University in Budapest, Hungary, and the Department of Medicine at the University of Debrecen in Debrecen, Hungary.
    Duodenal biopsy is an important tool for properly diagnosing celiac disease. However, the issue of finding the best site for taking biopsy samples that will give the best results for diagnosing celiac disease is still not fully resolved.
    Claudins (CLDNs), belong to a large group of related adherent junction proteins, which are known to express characteristic patterns in inflammatory disorders. However, doctors presently know nothing about CLDN expression in people with celiac disease. To address the situation, the team performed a comparative study to examine the CLDN 2, 3 and 4 expressions in both the proximal and distal parts of duodenum in children with celiac disease and in control subjects.
    For the study, they enrolled a total of forty-seven children. Thirty-three had newly diagnosed celiac disease, while fourteen healthy children served as control subjects. The team took biopsies from proximal and distal part of duodenum, and used immunohistochemistry to detect CD3+ intraepithelial lymphocytes and CLDN 2, 3 and 4 protein expressions.
    Whether taken from proximal or distal part of duodenum, biopsies revealed no differences under macroscopic imaging, routine histology and Marsh grading.
    However, in comparison to controls, patients with severe celiac disease showed significantly higher CLDN 2 expression in bulb and in distal duodenum, while non-severe celiac patients showed higher distal CLDN 2 expression. The data showed similar associations regarding CLDN 3 expression. All groups showed similar expression of CLDN 4.
    The data showed that both proximal and distal mucosal duodenal biopsies are suitable for diagnosing villous atrophy in patients with celiac disease.
    Finally, the team noted that increased expressions of CLDN 2 and 3 imply structural changes of tight junction in celiac disease, which may play a role in increased permeability and proliferation observed in celiac disease.
    Source:

    Virchows Archive, Volume 456, Number 3 / March, 2010

    Jefferson Adams
    Celiac.com 07/20/2010 - Anyone who's tried to maintain a gluten-free diet for celiac disease or other reasons can likely tell stories about the difficulties and challenges they face on a regular basis. Still, very little research has been done regarding the psychological and social challenges faced by people with celiac disease who are attempting to follow a gluten-free diet.
    Scientists in India recently conducted just such a study. A research team set out to assess psychological and social challenges faced by Indian children with celiac disease who are attempting to follow a gluten-free diet. The research team included Srikanta Basu, J. C. Chauhan, A. K. Dutta, Praveen Kumar, and Arun Kumar from the Division of Gastroenterology, Department of Pediatrics at Lady Hardinge Medical College and Associated Kalawati Saran Children Hospital in New Delhi, India.
    Their goal was to assess dietary compliance to gluten-free diet, to identify barriers to compliance, and to study the impact of diet on the psychosocial behavior of children with celiac disease.
    For the study, the team looked at children with clinically proven celiac disease, who had been observed for at least 6 months. They then evaluated the children for gluten-free diet compliance.
    Researchers who were blinded to initial results then interviewed patients using a self-administered questionnaire. The team measured psychosocial parameters using the standard 35-item Pediatric Symptom Checklist (PSC).
    To determine what factors might affect dietary compliance, the team compared the results of children who were compliant with their gluten-free diets to those who were not-compliant. They then compared the psychosocial parameters of both groups to those of healthy control subjects.
    The team measured a total of 70 patients for dietary compliance. They found 53 children to be compliant with a gluten-free diet (75%). They found 13 were non-compliant with a gluten-free diet (18%), while 4 children were likely non-compliant.
    A total of 64 children completed the full assessment. Final analysis showed that 4 of those children were likely non-compliant. Data for 2 patients with incomplete assessments was dropped.
    Younger kids showed higher compliance with a gluten-free diet than did teens. 80% of younger kids showed compliance with a gluten-free diet, compared with just 44% of teens. Gluten-free diet compliance was also higher in children with higher maternal education, and in parents with better knowledge and understanding of celiac disease, and in nuclear families. Higher family income raised compliance levels.
    Children with 2 or fewer siblings did better, with compliance rates of 68.3% and just 23% non-compliance. 72% of kids who were compliant with a gluten-free diet had presented classic symptoms of celiac disease, while only 15% of this group was non-compliant.
    Adjustment-related challenges, such as difficulty in maintaining diet at school, restaurants, trips, etc. are among the most common problems faced by celiac children. Nearly half (45%) of the children complained that teachers did not adequately understand the challenges of their condition. Researchers established a PSC cutoff point of 4 for children in the dietary non-compliant group.
    Generally, kids with celiac disease did not show higher levels of symptoms, such as complaints of aches and pains; being irritable/angry; not listening to rules, blaming other for mistakes; teasing others; refusing to share.
    The study findings show that about 1 in 5 (18%) people with celiac disease fail to comply with their gluten free diet, and that kids who comply with a gluten-free diet have better psychosocial parameters, as measured by PSC score. Also, adolescents, kids in joint families, and kids in larger families tend to have greater non-compliance levels.
    Successful treatment of celiac disease requires full compliance with a gluten-free diet. Non-compliance increases risk factors for numerous celiac-associated conditions. Knowing which factors are most likely to present challenges for maintaining compliance can provide celiac suffers and clinicians with useful tools for reducing those challenges and increasing compliance.
    Source:

    Indian Journal of Pediatrics 2010 Jun;77(6):649-54. DOI 10.1007/s12098-010-0092-3

  • Recent Articles

    Jefferson Adams
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    Jefferson Adams
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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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