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  • Jefferson Adams
    Jefferson Adams

    Kids with Celiac Disease Show Distinctive Microbial Signature

    Celiac.com 06/25/2010 - Recent scientific evidence suggests that gut microbiota may play a significant role in celiac disease. To further examine the role of gut microbiota in celiac disease, an Italian research team conducted a study of children with celiac disease.

    The research team included Serena Schippa, Valerio Iebba, Maria Barbato, Giovanni di Nardo,Valentina Totino, Monica Proietti Checchi, Catia Longhi, Giulia Maiella, Salvatore Cucchiara, Maria Pia Conte.

    To gain a better understanding of any role played by dominant duodenal microbiota, the team analyzed the mucosa-associated microbiota of 20 children with celiac disease, both before and after treatment with a gluten-free diet. The compared the results with a group of 10 control subjects.

    The team extracted total DNA from duodenal biopsies and amplification products of 16S ribosomal DNA. They then compared the results using temporal temperature gradient gel electrophoresis (TTGE). They assessed TTGE profiles by statistical multivariate analysis.

    They found that, on average, patients with active celiac disease showed a significantly higher number of bands in TTGE profiles (P<0.0001) (n.b. 16.7 +/- 0.7), compared to patients with treated, or inactive disease (n.b. 13.2 +/- 0.8) compared to control subjects (n.b. 3.7 +/- 1.3).

    Average inter-individual similarity indices were 54.9% +/- 14.9% for active disease patients, 55.6% +/- 15.7% for treated (inactive) celiac disease, and 21.8% +/- 30.16% for controls. Similarity index between celiac children before and after treatment with gluten-free diet was 63.9% +/- 15.8%.

    Variation in microbiota biodiversity between active and remission state was P=0.000224. Between active celiac disease and control subjects, variation was  P<0.001.

    Patients with celiac disease showed higher populations of Bacteroides vulgatus and Escherichia coli, compared to control subjects (P<0.0001).

    Overall, the results demonstrate a peculiar microbial TTGE array, coupled with substantially greater biodiversity of duodenal mucosa in children with celiac disease.

    Further study is needed to assess any possible pathophysiological role for these microbial differences.

    Source: BMC Microbiology 2010, 10:175



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    I'm having trouble deciding what this study implies. Can't tell whether it suggests that following a gluten-free diet returns the stomach to normal or not.

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    I think it's great I have had celiac since 1991. I hope we can get over this. Very hard to eat the food that we can normally.

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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

    Jefferson Adams
    Celiac.com 06/30/2008 - In the crypts of the small bowel, there is a group of small, granular epithelial cells, called Paneth cells, which play an important part in innate immune system. There has been some controversy about what role Paneth cells might play in complicating celiac disease, so team of Italian researchers set out to examine the distribution, proliferation, and function of paneth cells in adults with uncomplicated and complicated celiac disease.
    The research team was made up of P. Biancheri , Cdel V. Blanco, L. Cantoro, M. De Vincenzi, A. Di Sabatino, W. Dhaliwal, E. Miceli, R. Salerno, A. Vanoli,  T.T. Macdonald, and G.R. Corazza. The team is affiliated with the Celiac Specialty Center at the First Department of Medicine at University of Pavia in Pavia, Italy.
    Seeking to better understand the function and the numbers of Paneth cell adults with celiac disease (celiac disease), the team measured Paneth cells and human alpha-defensin (HD)-5 and HD-6 in 28 adults with uncomplicated celiac disease, 8 patients with complicated celiac disease (3 with ulcerative jejunoileitis, 2 with refractory sprue, and 3 with enteropathy-associated T-cell lymphoma), and 14 control subjects.
    Subjects with uncomplicated untreated and treated celiac disease showed similar numbers of Paneth cells, with similar cell proliferation, compared to the control group, while subjects with complicated celiac disease showed much fewer Paneth.
    Subjects with uncomplicated untreated celiac disease, and those with treated celiac disease showed similar levels of mucosal HD-5 and HD-6 compared to the control group, while cells taken from the biopsies of subjects with treated celiac disease and challenged with gliadin proteins showed no change in mucosal HD-5 and HD-6 transcripts.
    Furthermore, those subjects with uncomplicated celiac disease showed no reduction in mucosal Paneth cell numbers and alpha-defensins.
    Clearly, a small study such as this will not tell us exactly how a reduction in the numbers of Paneth cells might complicate celiac disease, but since the role of Paneth cells is so vital to healthy innate immune function, it does point to the need for further examination.
    Am J Clin Pathol. 2008 Jul;130(1):34-42.


    Jefferson Adams
    Celiac.com 06/30/2008 - The results of a Hungarian study published recently in the June issue of Pediatrics suggest that people with untreated celiac disease show abnormal resistance to the hepatitis B (HBV) vaccine, while celiac patients on a gluten-free diet show a near normal response to the vaccine.
    A team of doctors led by Dr. Eva Nemes, at the University of Debrecen, administered 2 to 3 doses of recombinant HBV vaccine to 128 patients with celiac disease and an age matched control group of 113 non-celiac patients within a 6-month period. Twenty-two of the celiac patients were following a gluten-free diet when they received the vaccine.
    One month after the last HBV vaccination, the team took blood samples to look for anti-HBV antibodies. The group of 22 patients who received the vaccination while on a gluten-free diet had a sero-conversion rate of 95.5%, which means that more than 9 out of 10 patients developed the desired resistance to hepatitis B.
    The other 106 patients with celiac disease, as well as the control group, were vaccinated at approximately 14 years of age, and their immune response was evaluated by measuring anti-HBV titers about two years later. Of the 106 subjects with celiac disease, seventy had been diagnosed and were maintaining a strict gluten-free diet when they were vaccinated, twenty-seven were undiagnosed and untreated, and nine were diagnosed, but not following a gluten-free diet.
    The seventy subjects with celiac disease that was diagnosed and treated showed a sero-conversion rate of 61.4%. Given the size of the study samples, that’s not significantly different from the 75.2% sero-conversion rate for the control group.
    The big difference arose in those subjects with undiagnosed celiac disease, who showed a response rate of just below 26%, which was substantially lower than the control group and the treated celiac patients. The nine patients with active celiac disease who were not faithfully following a gluten-free diet showed a response rate of 44.4%. The thirty-seven subjects with celiac disease who had failed to respond to the vaccine were placed on a gluten-free diet and given a follow-up vaccine. One month later 36 of them (over 97%) showed a positive response to the vaccine.
    The team concluded that the positive response to the vaccine by celiac patients who were following a gluten-free diet, and the high resistance shown by subjects with undiagnosed celiac disease, and those not following a gluten-free diet, indicates that active celiac disease may play a major role in a failure to respond to the vaccine.
    The team recommends that newly diagnosed patients be checked for resistance to the HBV vaccine, and that those showing resistance be placed on a gluten-free diet before receiving a follow-up dose. They did not go so far as to suggest that those showing resistance to the HBV vaccine be screened for celiac disease, but that would not seem unreasonable, given their results.
    Pediatrics 2008; 121:e1570-e1576.


    Jefferson Adams
    Celiac.com 04/22/2014 - Blood tests are highly valuable for diagnosing celiac disease. However, their role in gauging mucosal healing in celiac children who have adopted gluten-free diets is unclear.
    A team of researchers recently set out to compare the performance of antibody tests in predicting small-intestinal mucosal status in diagnosis and follow-up of pediatric celiac disease.
    The research team included Edith Vécsei, Stephanie Steinwendner, Hubert Kogler, Albina Innerhofer, Karin Hammer, Oskar A Haas, Gabriele Amann, Andreas Chott, Harald Vogelsang, Regine Schoenlechner, Wolfgang Huf, and Andreas Vécsei.
    They are variously affiliated with the Clinical Department of Pathology and the Department of Internal Medicine III of the Division for Gastroenterology and Hepatology, the Center for Medical Physics and Biomedical Engineering, the Department of Pediatrics and Pediatric Gastroenterology of St. Anna Children's Hospital, all at Medical University Vienna, and with the Institute of Pathology and Microbiology, Wilhelminenspital in Vienna, and with the Department of Food Science and Technology, Institute of Food Technology, University of Natural Resources and Life Sciences in Vienna, Austria.
    The team conducted a prospective cohort study at a tertiary-care center, where 148 children received biopsies either for symptoms ± positive celiac disease antibodies (group A; n = 95) or following up celiac disease diagnosed ≥ 1 year before study enrollment (group B; n = 53).
    Using biopsy (Marsh ≥ 2) as the criterion standard, they calculated areas under ROC curves (AUCs) and likelihood-ratios to gauge the performance of antibody tests against tissue transglutaminase (TG2), deamidated gliadin peptide (DGP) and endomysium (EMA).
    They found that AUC values were higher when tests were used for celiac disease diagnosis compared with follow-up: 1 vs. 0.86 (P = 0.100) for TG2-IgA, 0.85 vs. 0.74 (P = 0.421) for TG2-IgG, 0.97 vs. 0.61 (P = 0.004) for DPG-IgA, and 0.99 vs. 0.88 (P = 0.053) for DPG-IgG, respectively.
    Empirical power was 85% for the DPG-IgA comparison, and on average 33% (range 13–43) for the non-significant comparisons. A total of 88.7% of group B children showed mucosal healing, at an average of 2.2 years after primary diagnosis.
    Only the negative likelihood-ratio of EMA was low enough (0.097) to effectively rule out persistent mucosal injury. However, out of 12 EMA-positive children with mucosal healing, 9 subsequently tested EMA-negative.
    Among the celiac disease antibodies examined, negative EMA most reliably predict mucosal healing. In general, however, antibody tests, especially DPG-IgA, are of limited value in predicting the mucosal status in the early years after celiac diagnosis, though they may do better over a longer time.
    Source:
    BMC Gastroenterology 2014, 14:28. doi:10.1186/1471-230X-14-28

    Jefferson Adams
    Celiac.com 09/03/2014 - What’s potential celiac disease, and what happens to kids who have it and continue to eat a gluten-containing diet?
    Researchers define potential celiac disease as the presence of serum anti-tissue-transglutaminase (anti-TG2) antibodies with normal duodenal mucosa. That is, a positive blood screen, but no intestinal damage. However, not much is known about potential celiac disease because people who have it often show no obvious symptoms. Patients with potential celiac disease present some challenges for doctors trying to determine how likely it is that these patients will develop villous atrophy, the gut damage common in celiac disease patients exposed to gluten.
    A research team conducted a prospective longitudinal cohort study to follow patients with potential celiac disease up to 9 years, and explore the risk factors tied to mucosal damage. The research team included Renata Auricchio MD, PhD, Antonella Tosco MD, Emanuela Piccolo MD, Martina Galatola PhD, Valentina Izzo PhD, Mariantonia Maglio PhD, Francesco Paparo PhD, Riccardo Troncone MD, PhD, and Luigi Greco MD, PhD. They are affiliated with the Department of Medical Translational Science, European Laboratory for the Investigation of Food Induced Disease (ELFID), University Federico II, Naples, Italy.
    For their study, the team found two hundred and ten asymptomatic children with potential celiac disease. They kept 175 of them on a gluten-containing diet. To evaluate histological, immuno-histochemical, and anti-TG2 status, they checked blood antibody levels and clinical symptoms every 6 months, and took a small bowel biopsy every two years. They also genotyped all patients for HLA and non-HLA celiac-associated genes.
    Forty-three percent of patients showed persistently elevated anti-TG2 levels, 20% became negative during follow-up, and 37% showed variations in anti-TG2 course, with many patients testing at zero anti-TG2.
    After three years of follow-up, 86% of study patients continued to have potential celiac disease. After 6 and 9 years, respectively, 73% and 67% of study patients still had normal duodenal structure.
    Individuals prone to develop mucosal damage during the test period were predominantly male, had slight mucosal inflammation at study’s start, and fit a peculiar genetic profile.
    Nine years after follow-up, a large number of patients with asymptomatic potential celiac disease showed reduced antibody production, many even showing zero production, and many of these, with persistently positive anti-TG2, showed no mucosal damage.
    Given the results of this study, and noting that the celiac population is in fact made up of numerous individuals with diverse genetic and phenotypic makeup, the researchers are advising doctors to be cautious in prescribing a strict lifelong gluten-free diet for asymptomatic individuals with potential celiac disease.
    Source:
     The American Journal of Gastroenterology

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    Alaskaguy, the thing with the nightshades is inflammation. I've never heard of nightshades making anyone's dh flare or anything else. Seems like ppl avoid nightshades to stop their body from hurting.
    Thank you so much! and yes, I am aware of other allergies. I have leaky gut as well and have a food allergy to potatoes and corn as well and my mother eats those too. So very stressed out. I went downstairs and found a mini fridge and im going to start using that because like you said, handles, faucets, etc are too much. the stress does not help the body either, ive been getting sick three times a week. its very hard.  I am glad there are people who understand! Sounds like you were concerned too
    The cheese and avocado are fine, the gluten was not aerosolized anything like that. NOW if your allergic to wheat there could be some issues being around it like that (some severe cases of peanut allergies can go off if it is in the room) but you would be anaphylactic.  I get the paranoia, it gets to the point of being almost PTSD. You fear to get sick so bad because the weirdest things have bedridden you. I got glutened touching gluten residue on facets, fridge door handles, etc in my old
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