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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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    INCREASED LEVELS OF ANTIGLIADIN ANTIBODIES NOT FULLY EXPLAINED BY INTESTINAL BARRIER GENE VARIANTS


    Jefferson Adams

    Celiac.com 03/05/2010 - A team of researchers recently studied therelationship between increased levels of antigliadin antibodies andintestinal barrier gene variants.


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    The research team included V.M. Wolters, B. Z. Alizadeh, M. E. Weijerman, A. Zhernakova, I. M. vanHoogstraten, M. L. Mearin, M. C. Wapenaar, C.Wijmenga, M. W. Schreurs.They are affiliated with the Department of Pediatric Gastroenterology,UMC Utrecht, Utrecht, The Netherlands.

    Numerous genes may affectintestinal barrier function, including MAGI2, MYO9B, and PARD3, whichhave a close association with celiac disease. Gauging intestinalpermeability is tough to do, so researchers can test indirectly byusing antibodies against gliadin and Baker's yeast (anti-Saccharomycescerevisiae antibodies).

    The goal of the study was to determinewhether intestinal permeability, represented by antibodies againstgliadin, was connected to MAGI2, MYO9B, and PARD3.

    The teamanalyzed patients with Down syndrome, a population with suspectedincreased intestinal permeability. The team examined connectionsbetween AGA and ASCA.

    The team genotyped 126 Down syndromepatients for six single-nucleotide polymorphisms in MAGI2 (rs1496770,rs6962966, rs9640699), MYO9B (rs1457092, rs2305764), and PARD3(rs10763976).

    They then performed an allele dosage associationof these risk genes and AGA levels. They also found a strongcorrelation between AGA and ASCA (p < 0.01).

    Subjects withone or more risk genotypes showed lower average AGA levels (trend testp = 0.007) and made up a larger number of patients with normal AGAlevels (p = 9.3 x 10(-5)).

    Celiac-associated risk genotypesare associated with lower AGA values rather than higher AGA values.This all means that, regarding the increased prevalence of elevated AGAin patients with Down syndrome, there are other immunologic factors atplay. These may involve altered induction and/or maintenance oftolerance.

    Source:
    Hum Immunol. 2010 Feb 3.


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    BMJ 2004;328:322-323 (7 February) Celiac.com 02/18/2004 - A study conducted by researchers in the UK has found that 1% of all seven year old children in the UK have celiac disease, and most cases of celiac disease continue to remain undiagnosed. The researchers tested 5,470 "normal" children using a two stage screening that included an initial radioimmunoassay for antibodies to tissue transglutaminase (endomysial antigen), and a further testing of positive samples for IgA-EMA by indirect immunofluorescence. Children with tTG antibodies under the 97.5th percentile were defined as antibody negative. Out of those tested 54 were positive for IgA-EMA. Additionally: "IgA-EMA positive children were shorter and weighed less than those who tested negative for tTG antibody."
    The Researchers Comment:

    "At age 7, 1% of children were IgA-EMA positive and likely therefore to have sub clinical coeliac disease, though less than 0.1% were reported to be on a gluten-free diet. The prevalence of coeliac disease in these children is therefore comparable to that in UK adults. The benefit of early diagnosis of sub clinical coeliac disease remains unproven, but long term follow up of this cohort may help to resolve this. If screening is worth while, it should be started in childhood."
    "Since ALSPAC is an observational study based on analysis of anonymous samples, confirmatory biopsy was not possible...®eported clinical features were similar to those in adults with coeliac disease identified by screening. Gastrointestinal symptoms were not prominent, and the excess in girls mirrors that seen in affected adults. The most striking observation was that children with IgA-EMA were shorter by more than 0.76 standard deviation scores and lighter by 0.54 standard deviation scores than antibody negative children matched for date and place of birth. This equates to about 9 months growth and weight gain in an average child around this age. These features were independent of gastrointestinal symptoms and anemia and presumably unrelated to malabsorption."
    Conclusion:
    "Occult coeliac disease seems to start in childhood, even in those who are subsequently diagnosed as adults. The search for the trigger resulting in the breakdown of immune tolerance to gluten therefore needs to focus on infancy and intrauterine life."

    Jefferson Adams
    Celiac.com 02/03/2010 - Celiac disease increases production of IL-17A by cells that also make IFN-gamma. Recently, a research team set out to characterize the expression of IL-17A-producing cells in celiac disease.
    The team included I. Monteleone, M. Sarra, G. Del Vecchio Blanco, O. A. Paoluzi, E. Franzè, D. Fina, A. Fabrizi, T. T. Macdonald, F. Pallone, and G. Monteleone of the Department of Internal Medicine at the University of Tor Vergata in Rome, Italy.
    Infiltration of the mucosa with IFN-gamma-secreting Th1 cells is one of the features associated with celiac disease. Recent studies have shown the pathogenic effects previously attributed to Th1 cells may in fact be caused by a novel subset of T cells, termed Th17 cells, and noted for expressing high levels of IL-17A.
    In this study, the team set out to characterize the expression of IL-17A-producing cells in celiac disease. Using real-time PCR and ELISA, the team showed that expression of IL-17A RNA and protein is greater in active celiac disease biopsy specimens than in specimens from inactive celiac disease, and normal mucosal biopsies.
    Through flow cytometry, the team confirmed that the mucosa of celiac disease patients overproduces IL-17A, and that the main sources for this overproduction were CD4(+) and CD4(+)CD8(+) cells.  Most IL-17A-producing CD4(+) and CD4(+)CD8(+) cells co-expressed IFN-gamma but did not co-express CD161.
    Including a peptic-tryptic digest of gliadin to ex-vivo organ cultures of duodenal biopsy specimens taken from patients with inactive celiac disease enhanced IL-17A production 
    by both CD4(+) and CD4(+)CD8(+) cells.
    Since the team showed earlier that patients with celiac disease overproduced IL-21, a T cell-derived cytokine involved in the control of Th17 cell responses, they next determined whether IL-21 was responsible for regulating IL-17A expression.
    Blocking IL-21 action with a neutralizing IL-21 Ab lowered total IL-17A expression in cultures of active celiac disease and peptic-tryptic digest of gliadin-treated celiac disease biopsy specimens.
    From the data, the team concludes that celiac disease increases IL-17A, which is produced by cells that also produce IFN-gamma.
    Source: Journal of Immunology, 2010 Jan 8.


    Jefferson Adams
    Celiac.com 12/12/2012 - In duodenal biopsy samples from people with active celiac disease, the transferrin receptor, CD71, is up-regulated, and promotes retro-transport of secretory immunoglobulin A (SIgA)-gliadin complexes.
    To better understand how interactions between SIgA and CD71 promote transepithelial transport of gliadin peptides, a team of researchers set out to determine if interactions among secretory immunoglobulin A, CD71, and transglutaminase-2 affect permeability of intestinal epithelial cells to gliadin peptides.
    The research team included C. Lebreton, S. Ménard, J. Abed, I.C. Moura, R. Coppo, C. Dugave, R.C. Monteiro, A. Fricot, M.G. Traore, M. Griffin, C. Cellier, G. Malamut, N. Cerf-Bensussan, and M. Heyman. They are affiliated with the Mixed Research Unit 989 of the National Institute of Health and Medical Research (INSERM UMR989) in Paris, France.
    For their study, the team evaluated duodenal biopsy specimens from 8 adults and 1 child with active celiac disease. The team used fluorescence-labeled small interfering RNAs against CD71 to transfect Caco-2 and HT29-19A epithelial cell lines.
    They used flow cytometry, immunoprecipitation, and confocal microscopy to assess interactions among IgA, CD71, and transglutaminase 2 (Tgase2). They then assessed transcytosis of SIgA-CD71 complexes and intestinal permeability to the gliadin 3H-p31-49 peptide in polarized monolayers of Caco-2 cells.
    To assess physical interplay between SIgA and CD71 or CD71 and Tgase2 at the apical surface of enterocytes in biopsy samples and monolayers of Caco-2 cells, the team used fluorescence resonance energy transfer and in situ proximity ligation assays. They co-precipitated CD71 and Tgase2 with SIgA, bound to the surface of Caco-2 cells.
    They found that SIgA-CD71 complexes were internalized and localized in early endosomes and recycling compartments, but not in lysosomes.
    In the presence of celiac IgA or SIgA against p31-49, transport of intact 3H-p31-49 increased significantly across Caco-2 monolayers, while soluble CD71 or Tgase2 inhibitors interfered with transport.
    Once it binds to apical CD71, SIgA (with or without gliadin peptides) enters a recycling pathway and avoids lysosomal degradation; this process allows apical-basal transcytosis of bound peptides. This mechanism is assisted by Tgase2 and might be involved in the pathogenesis of celiac disease.
    Source:
    Gastroenterology. 2012 Sep;143(3):698-707.e1-4. doi: 10.1053/j.gastro.2012.05.051.

    Jefferson Adams
    Celiac.com 08/12/2013 - Here's a story that will likely interest many people living with celiac disease.
    Typical dietary grain options for people with celiac disease include gluten-free cereals like corn, rice, teff, quinoa, millet, buckwheat and sorghum.
    Until now, canary seed was off limits for humans and used only as birdseed. That's because tiny hairs on the seed made it inedible for humans.
    Researchers looking to broaden dietary options for people living with celiac disease are saying that a new, hairless variety of canary seeds bred specifically for human consumption would make an ideal gluten-free cereal for people with celiac disease, according to a study published in the American Chemical Society's Journal of Agricultural and Food Chemistry.
    In the article, Joyce Irene Boye and her team describe research on a new variety of "hairless," or glabrous canary seed that they have verified as gluten-free.
    Boye also noted that canary seeds have more protein than other common cereals, are rich in other nutrients and are suitable for making flour that can be used in bread, cookies, cakes and other products.
    The promise of better nutrition and good flour for baking could appeal to many people with celiac disease.
    What do you think? Sensible? Too wild? Would you try canary seeds as a gluten-free food option? For baking?
    Source:
    American Chemical Society

  • Recent Articles

    Jefferson Adams
    Celiac.com 04/26/2018 - Emily Dickson is one of Canada’s top athletes. As a world-class competitor in the biathlon, the event that combines cross-country skiing with shooting marksmanship, Emily Dickson was familiar with a demanding routine of training and competition. After discovering she had celiac disease, Dickson is using her diagnosis and gluten-free diet a fuel to help her get her mojo back.
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    Celiac.com 04/25/2018 - A team of Yale University researchers discovered that bacteria in the small intestine can travel to other organs and trigger an autoimmune response. In this case, they looked at Enterococcus gallinarum, which can travel beyond the gut to the spleen, lymph nodes, and liver. The research could be helpful for treating type 1 diabetes, lupus, and celiac disease.
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    This study indicates that gut bacteria may be the key to treating chronic autoimmune conditions such as systemic lupus and autoimmune liver disease. Numerous autoimmune conditions have been linked to gut bacteria.
    Read the full study in Science.

    Tammy Rhodes
    Celiac.com 04/24/2018 - Did you know in 2017 alone, the United States had OVER TENS OF THOUSANDS of people evacuate their homes due to natural disasters such as fires, floods, hurricanes, tornadoes and tsunamis? Most evacuation sites are not equipped to feed your family the safe gluten free foods that are required to stay healthy.  Are you prepared in case of an emergency? Do you have your Gluten Free Emergency Food Bag ready to grab and go?  
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    Then, my second brush with a natural disaster happened, without any notice, leaving us once again scrambling to find a safe place to shelter. It was a warm and muggy summer morning, and my husband was away on a business trip leaving my young daughter and me to enjoy our summer day. Our Severe Weather Alert Radio was going off, again, as I continued getting our daughter ready for gymnastics.  Having gotten used to the (what seemed to be daily) “Severe Thunderstorm warning,” I didn’t pay much attention to it. I continued downstairs with my daughter and our dog, when I caught a glimpse out the window of an incredibly black looking cloud. By the time I got downstairs, I saw the cover to our grill literally shoot straight up into the air. Because we didn’t have a fenced in yard, I quickly ran outside and chased the cover, when subsequently, I saw my neighbor’s lawn furniture blow pass me. I quickly realized I made a big mistake going outside. As I ran back inside, I heard debris hitting the front of our home.  Our dog was the first one to the basement door! As we sat huddled in the dark corner of our basement, I was once again thinking where are we going to go if our house is destroyed. I was not prepared, and I should have been. I should have learned my lesson the first time. Once the storm passed, we quickly realized we were without power and most of our trees were destroyed. We were lucky that our house had minimal damage, but that wasn’t true for most of the area surrounding us.  We were without power for five days. We lost most of our food - our gluten free food.
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    In 2017 alone, FEMA (Federal Emergency Management Agency) had 137 natural disasters declared within the United States. According to FEMA, around 50% of the United States population isn’t prepared for a natural disaster. These disasters can happen anywhere, anytime and some without notice. It’s hard enough being a parent, let alone being a parent of a gluten free family member. Now, add a natural disaster on top of that. Are you prepared?
    You can find my Gluten Free Emergency Food Bags and other useful products at www.allergynavigator.com.  

    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.
    Due to personal health reasons and restrictions, I find that I need to retire. My husband and I can no longer travel the country speaking at conferences and to support groups (which we dearly loved to do) nor can I commit to writing more books, articles, or menus. Consequently, I will no longer be contributing articles to the Journal of Gluten Sensitivity. 
    My following books will still be available at Amazon.com:
    Gluten-free Cooking for Dummies Student's Vegetarian Cookbook for Dummies Wheat-free Gluten-free Dessert Cookbook Wheat-free Gluten-free Reduced Calorie Cookbook Wheat-free Gluten-free Cookbook for Kids and Busy Adults (revised version) My first book was published in 1996. My journey since then has been incredible. I have met so many in the celiac community and I feel blessed to be able to call you friends. Many of you have told me that I helped to change your life – let me assure you that your kind words, your phone calls, your thoughtful notes, and your feedback throughout the years have had a vital impact on my life, too. Thank you for all of your support through these years.