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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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    POSSIBLE CELIAC DISEASE DRUG TREATMENT ALV003 FAST TRACKED BY FDA


    Jefferson Adams

    Celiac.com 10/15/2012 - The drug ALV003, a potentially promising treatment celiac disease, made by Alvine Pharmaceuticals, Inc., has received Fast Track designation from the U.S. Food and Drug Administration (FDA).


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    Photo: Jefferson AdamsALV003 is an orally administered mix of two recombinant gluten-specific proteases, a cysteine protease (EP-B2) and a prolyl endopeptidase (PEP).

    ALV003 works by targeting gluten and breaking it down into tiny fragments, which, in tests has been show to greatly reduce its ability to trigger immune responded in people with celiac disease. ALV003 is being developed as a potential treatment for celiac disease patients in conjunction with a gluten-free diet and is currently in phase 2 clinical development.

    The Fast Track status is important for ALV003, because there are currently no approved therapeutic treatment options available to patients and their physicians," said Abhay Joshi, Ph.D., Alvine's President and Chief Executive Officer.

    Fast Track is part of the FDA Modernization Act, passed in 1997. It is designed to streamline the development and review of drugs that treat serious or life-threatening conditions, and which address unmet medical needs.

    Source:


    Image Caption: Photo: Jefferson Adams
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    I won't be a lab rat for this fast tracked drug. I will stay on my gluten free diet without taking it. Obviously, people who do take the drug will still have to eat gluten free, so why take a risk on having adverse reactions to it. Recombinent sounds like it might be genetically engineered, too. I really do hope the new drug is safe and effective. I will wait a few years, and see how other people who take the drug fare with it. Then decide if I want to try it myself.

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    Sounds like it may help at least with those of us who are highly sensitive, and react to slight cross-contamination. It's almost impossible to eliminate gluten completely, even by eating only foods labelled gluten-free.

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    Guest Christina

    Posted

    Very interesting that this drug is on the fast track. I feel as though people will be under the impression that they'll be able to eat gluten while taking it, but, what does the drug do for the long term effects of celiac disease? Does it work on all forms of gluten intolerance? If not, the testing, screening, and diagnosing of different forms of gluten intolerance must be refined. I have been on a 100% gluten-free diet for 4 years now and I am in the best health that I have ever been in. After much research and reading I have come to my own opinions about gluten and feel as though my body was not designed to ingest it. That said, if a drug ever did exist that would allow me to eat gluten with no consequences whatever, I would probably not take it. I think the FDA is ahead of themselves: there are other aspects of gluten intolerance that must be refined before we start to manufacture drugs.

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    Guest Johnnie Talley

    Posted

    I too question taking medication when staying on a gluten-free diet. The recalls of medications after the damage is done happens too many times for me to risk my health on a basically unproven medication. The gluten-free diet is a healthy one and medication free.

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    Guest Robert Geddes

    Posted

    As a Coeliac, I can say from the look of the comments already posted - you all seem quite smug that you manage to stay on 100% gluten-free diets at all times. I strive to stay 100% gluten-free as well - but do sometimes have to eat outside the safety of my own house and surrender food preparation to others that don't take gluten-free as seriously or just plain don't understand.

     

    If someone can produce a drug that can help with an accidental contamination, especially when away from my 'safe place', then I for one will gladly take it.

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    As a Coeliac, I can say from the look of the comments already posted - you all seem quite smug that you manage to stay on 100% gluten-free diets at all times. I strive to stay 100% gluten-free as well - but do sometimes have to eat outside the safety of my own house and surrender food preparation to others that don't take gluten-free as seriously or just plain don't understand.

     

    If someone can produce a drug that can help with an accidental contamination, especially when away from my 'safe place', then I for one will gladly take it.

    I would love to have something to help me when I am out and away from home. Yes, I totally agree.

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    Very interesting that this drug is on the fast track. I feel as though people will be under the impression that they'll be able to eat gluten while taking it, but, what does the drug do for the long term effects of celiac disease? Does it work on all forms of gluten intolerance? If not, the testing, screening, and diagnosing of different forms of gluten intolerance must be refined. I have been on a 100% gluten-free diet for 4 years now and I am in the best health that I have ever been in. After much research and reading I have come to my own opinions about gluten and feel as though my body was not designed to ingest it. That said, if a drug ever did exist that would allow me to eat gluten with no consequences whatever, I would probably not take it. I think the FDA is ahead of themselves: there are other aspects of gluten intolerance that must be refined before we start to manufacture drugs.

    Why must we refine other aspects of gluten intolerance? This is a potential treatment for celiac disease. The article plainly says "in conjunction with a gluten-free diet". Seeing as you wouldn't utilize a medication that would enable you to live a normal life even if there were no consequences whatsoever, why discourage others who want to?

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    I was recently diagnosed with celiac disease. I am having a hard time trying to figure out what to eat. I ate at a lot of restaurants and now have trouble picking the right ones that are actually 100% gluten-free. So yes, I will take this pill only when I eat outside to protect myself and not on a daily basis.

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    Guest Frances

    Posted

    As a Coeliac, I can say from the look of the comments already posted - you all seem quite smug that you manage to stay on 100% gluten-free diets at all times. I strive to stay 100% gluten-free as well - but do sometimes have to eat outside the safety of my own house and surrender food preparation to others that don't take gluten-free as seriously or just plain don't understand.

     

    If someone can produce a drug that can help with an accidental contamination, especially when away from my 'safe place', then I for one will gladly take it.

    I agree with you. No need for people to act condescending about their choice. My son has celiac disease and myasthenia Ggravis. It's important for us to keep him 100% gluten-free but it is also just as important to let him be a kid! We have well meaning friends that make accommodations for him and at birthday parties, etc. they make gluten-free cupcakes, cookies, etc. just for him. I love it! However, I'm worried about cross contamination from utensils, non certified foods, etc. I have even seen my mother in law excitedly preparing my son some gluten-free garlic bread but I had to explain that we would have to redo it with a clean pan and spatula because she had used them right before for regular bread. In cases like this, when we can't be 100% positive that our food is gluten-free then it would be a godsend to have a medication as back up!

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    I won't be a lab rat for this fast tracked drug. I will stay on my gluten free diet without taking it. Obviously, people who do take the drug will still have to eat gluten free, so why take a risk on having adverse reactions to it. Recombinent sounds like it might be genetically engineered, too. I really do hope the new drug is safe and effective. I will wait a few years, and see how other people who take the drug fare with it. Then decide if I want to try it myself.

    Same approach I've chosen to take with the gluten-free oats. I would still prefer to maintain a gluten-free diet, than contend with 'side effects' of a drug. That's the elegance of treating a disease by removing something, rather than adding complications by taking drugs.

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    As a Coeliac, I can say from the look of the comments already posted - you all seem quite smug that you manage to stay on 100% gluten-free diets at all times. I strive to stay 100% gluten-free as well - but do sometimes have to eat outside the safety of my own house and surrender food preparation to others that don't take gluten-free as seriously or just plain don't understand.

     

    If someone can produce a drug that can help with an accidental contamination, especially when away from my 'safe place', then I for one will gladly take it.

    There are some over the counter enzymes you can take that target the gluten. You might want to look into taking those when you eat out. That's what we do, and we are all highly sensitive (3 of us).

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    Very interesting that this drug is on the fast track. I feel as though people will be under the impression that they'll be able to eat gluten while taking it, but, what does the drug do for the long term effects of celiac disease? Does it work on all forms of gluten intolerance? If not, the testing, screening, and diagnosing of different forms of gluten intolerance must be refined. I have been on a 100% gluten-free diet for 4 years now and I am in the best health that I have ever been in. After much research and reading I have come to my own opinions about gluten and feel as though my body was not designed to ingest it. That said, if a drug ever did exist that would allow me to eat gluten with no consequences whatever, I would probably not take it. I think the FDA is ahead of themselves: there are other aspects of gluten intolerance that must be refined before we start to manufacture drugs.

    My thoughts exactly. The good side of this new 'drug'... there will be a huge increase in the diagnosing of this terribly under-diagnosed disorder. New tests to identify potential 'customers' !!

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    As a Coeliac, I can say from the look of the comments already posted - you all seem quite smug that you manage to stay on 100% gluten-free diets at all times. I strive to stay 100% gluten-free as well - but do sometimes have to eat outside the safety of my own house and surrender food preparation to others that don't take gluten-free as seriously or just plain don't understand.

     

    If someone can produce a drug that can help with an accidental contamination, especially when away from my 'safe place', then I for one will gladly take it.

    I agree. It is very easy to accidentally consume gluten. More detail in the article about exactly how this is supposed to work would be good. Is it to be taken after accidental known or suspected exposure, or all the time?

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    Isn't the whole point of taking a drug so that you can EAT gluten again? What's the point if I still need to keep the diet??

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    Think twice, act once. Let's watch first, this drug might be all it claims to be, then again...

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    Guest Cindy Purdy

    Posted

    I participated in a clinical trial 5 years ago for a drug Alba was developing on the "fast track." It's STILL in trials, so the fast track is really not that fast.

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    Guest Jeff Cutler

    Posted

    As a Coeliac, I can say from the look of the comments already posted - you all seem quite smug that you manage to stay on 100% gluten-free diets at all times. I strive to stay 100% gluten-free as well - but do sometimes have to eat outside the safety of my own house and surrender food preparation to others that don't take gluten-free as seriously or just plain don't understand.

     

    If someone can produce a drug that can help with an accidental contamination, especially when away from my 'safe place', then I for one will gladly take it.

    Robert, I completely agree with everything you said. I strive to stay on a 100% gluten-free diet but it is almost impossible because others just don't understand it. It's not like your meal is being watched every single second from when it starts to when it gets to your table. If there is a pill that will help with the effects of cross-contamination, I certainly welcome it.

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    As a Coeliac, I can say from the look of the comments already posted - you all seem quite smug that you manage to stay on 100% gluten-free diets at all times. I strive to stay 100% gluten-free as well - but do sometimes have to eat outside the safety of my own house and surrender food preparation to others that don't take gluten-free as seriously or just plain don't understand.

     

    If someone can produce a drug that can help with an accidental contamination, especially when away from my 'safe place', then I for one will gladly take it.

    Totally agree with you there... In conjunction with a gluten-free diet, it would greatly help those of us who occasionally get glutened by household members who just don't understand cross contamination even though you tell them a billion times not to use your butter for their toast. It would be a HUGE help when travelling or having to eat out in public when you can't be 100% sure that what you are getting is truly gluten-free.

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    Always gluten-free but know I am fooling myself thinking that some exposure is not there. Just have one awful attack of ingestion and ask yourself after much suffering if it is not a God Send for us celiacs to have something to help us along the journey and for goodness sakes, all, be happy that a drug company is looking into this no matter why. I am sick of those surprise attacks and the suffering and pain it brings. And to ignore anything that may be offered to us suffers for relief...WHY? After 18 years of knowing, yes, finally knowing what my problem was upon diagnosis - I have to look back at the years and remember a time when looking for gluten-free food was a big problem, period! Now we have so many wonderful products to help us along but they are allowed to put in a small amount of gluten and sometimes it can get yah, you know what I mean? I love progress and look forward for what the future will hold for our celiac condition.

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    William Dickey Department of Gastroenterology, Altnagelvin Hospital, Londonderry, Northern Ireland, UK
    Scandinavian Journal of Gastroenterology 1998; 33: 612-5.
    Abstract Background: Coeliac disease may present with dyspepsia or reflux. There are characteristic duodenal appearances associated with villous atrophy (mosaic pattern mucosa and loss, reduction in number or scalloping of duodenal folds) which may prompt small bowel biopsy during routine upper gastrointestinal endoscopy. These appearances were sought in patients referred by their general practitioners for open access endoscopy (OAE), to determine the prevalence and significance of coeliac disease as a cause of symptoms.
    Methods: Five hundred consecutive patients undergoing OAE by one consultant gastroenterologist were studied. Forceps biopsies from the distal duodenum were taken if appearances were suggestive. If villous atrophy was confirmed, the response of symptoms to dietary gluten exclusion was assessed.
    Results: Ten patients had suspicious endoscopic appearances of whom 8 had villous atrophy, giving a prevalence of coeliac disease of 1.6% (1:63). All 8 had mosaic pattern mucosa with three also having reduction of duodenal folds, and four having scalloped folds. All had serum endomysial antibodies (EmA). Apart from diarrhea, described by one patient, there were no symptoms of typical coeliac disease at diagnosis: three patients were overweight. After dietary gluten exclusion, all reported symptomatic improvement with disappearance of EmA in 5 patients to date.
    Conclusions- There is a high prevalence of coeliac disease among patients undergoing OAE, which is relevant to their clinical symptoms and which can be identified by careful endoscopic inspection of the duodenum.

    Jefferson Adams
    Celiac.com 03/18/2010 - An international research team recently conducted an assessment of the nutritional status of children with newly diagnosed celiac disease, and compared the results to a group of matched control subjects.
    The team included B. Aurangzeb, S.T. Leach, D. A. Lemberg, and A. S. Day. They are associated variously with the Children's Hospital, Pakistan Institute of Medical Sciences in Islamabad, Pakistan, the Department of Paediatrics at the University of Otago in Christchurch, New Zealand, the School of Women's and Children's Health at the University of New South Wales, and the Department of Gastroenterology at Sydney Children's Hospital in Randwick, both in Sydney, Australia.
    In addition to gaining a better understanding of nutritional status in children with newly diagnosed celiac disease, the team sought to clarify the relationship between and nutrition and patterns of presentation in children with celiac disease.
    The team assessed nutritional status for newly diagnosed celiac disease patients using
    anthropometry, Bioelectrical Impedance and serum leptin levels, which they compared against age and gender matched control subjects.
    For the study, the team enrolled twenty-five children with clinically proven celiac disease, averaging 8.2 years old (± 4.5 years), along with 25 healthy control subjects averaging 8.1 years old (± 4.4 years).  A total of thirteen children with celiac disease experienced gastrointestinal symptoms, and fourteen had a family history of celiac disease. At presentation 8.7% showed physical wasting, 4.2% showed stunted growth, and 20.8% were overweight, though none were obese. There was no difference between the groups with regard to average height and weight for age, other nutritional parameters and serum leptin; which correlated with BMI in both groups.
    From these results, the team concluded that children with celiac disease more commonly present with atypical symptoms than with classical features. Children with celiac disease may present with nutritional deficiencies and/or excesses at diagnosis, completely independent of obvious symptoms. Celiac disease did not change leptin levels.
    The findings reiterate the importance of conducting nutritional assessments in the diagnosis and treatment of children with celiac disease.
    Source:

    Acta Pædiatrica; 19 Feb 2010

    Jefferson Adams
    Celiac.com 04/27/2010 - A team of clinicians recently assessed the diagnostic value of confocal endomicroscopy in celiac disease.
    Clinicians U. Günther, S. Daum, F. Heller, M. Schumann, C. Loddenkemper, M. Grünbaum, M. Zeitz, and C. Bojarski made up the research team. They are variously affiliated with the  Medical Clinic of Gastroenterology, Rheumatology and Infectious Diseases, and with the Department of Pathology, Charité of the Campus Benjamin Franklin of University Medicine Berlin, Germany.
    Studies by Gutschmidt, by Henker and others have shown that, even in the face of greater awareness and more widespread blood testing, a number of countries suffer from low rates of celiac disease detection.
    Patchiness of the mucosal and submucosal changes associated with celiac disease impedes proper celiac diagnosis, and contributes to a small, but important sampling error among those assessed.
    Some clinicians feel that the problem might be resolved somewhat by modifying the endoscopic screening process to include real-time assessment of the duodenal morphology. Better endoscopic and imaging procedures will mean better diagnostic accuracy of biopsy specimens.
    One early step toward improved gathering of targeted biopsies in celiac disease patients lies in using magnification endoscopy, either alone, or together with high-resolution narrow-band imaging. This method offers better ability to detect patchy villous atrophy sites in the duodenum.
    However, neither magnification, nor narrow-band imaging techniques can detect increased number of intraepithelial lymphocytes (IELs).
    Confocal endomicroscopy (CEM) permits live, real-time histology with a 1000x magnification during endoscopy. Recently, a prospective pilot study for the first time showed CEM to enable effective live, real-time diagnosis and evaluation of celiac disease.  Researchers compared endomicroscopic findings during live, real-time endoscopy with histological findings graded according to Marsh classification.
    The research team used CEM to examine twenty-four patients with celiac disease and six patients with refractory celiac disease, all following a gluten-free diet.
    The team evaluated duodenal mucosa by CEM and by conventional histological analysis for villous atrophy, crypt hyperplasia, and increased numbers of intraepithelial lymphocytes (IELs > 40/100 enterocytes).
    They then compared the CEM to the histology results for sensitivity, specificity, and inter-observer variability using Marsh classification scores.
    As control subjects, the team used thirty patients without celiac disease, but who were undergoing routine upper gastrointestinal endoscopy.
    Using conventional histology on the 30 patients with celiac disease, the team found 23 cases with villous atrophy and crypt hyperplasia, and 27 cases of increased IELs.
    Using CEM, the team found 17 cases of villous atrophy, 12 cases of crypt hyperplasia, and 22 cases of increased IELs. The CEM results compared favorably to those of conventional histology for villous atrophy, for which CEM showed a sensitivity of 74%, and for increased numbers of IELs, for which CEM showed a sensitivity of 81%. However, the CEM results were lacking for detecting crypt hyperplasia, for which CEM showed a sensitivity of 52%. 
    The κ values for determination of inter-observer variability were 0.90 for villous atrophy, 1.00 for crypt hyperplasia, and 0.84 for IEL detection. For the 30 control patients, both traditional histology and CEM revealed normal duodenal architecture with overall specificity of 100%.
    From these results, the team concluded that the assessment of duodenal histology by CEM in patients with celiac disease is sensitive and specific in determining increased numbers of IELs and villous atrophy, but inadequate for detecting crypt hyperplasia. Until improvements are made, CEM is not suitable for use in diagnosing celiac disease.

    SOURCE: Endoscopy 2010; 42:197–202.


    Jefferson Adams
    Celiac.com 04/24/2013 - Doctors classify refractory celiac disease (RCD) depending on the presence or absence of monoclonal expansions of intraepithelial lymphocytes (IELs) with an aberrant immunophenotype.
    A team of researchers recently set out to determine whether IEL parameters have any connection with mortality and morbidity in cases of refractory celiac disease.
    The research team included C. Arguelles-Grande, P. Brar, P. H. Green, and G. Bhagat. They are variously affiliated with the Celiac Disease Center, and the Departments of Medicine, Pathology and Cell Biology, at Columbia University Medical Center in New York, NY.
    The team used immunohistochemistry to assess IEL phenotype and polymerase chain reaction to determine T-cell receptor (TCR) gene rearrangement in 67 patients with RCD type I, and six patients with RCD type II. They considered a monoclonal TCR gene rearrangement and presence of greater than 50% CD3 CD8 IELs to be abnormal.
    They used Kaplan-Meier and Cox proportional hazard analyses to determine the time to worsening of clinical symptoms and the predictors of worsening. The team found 30 patients with less than 50% CD3 CD8 IELs, and eight with monoclonal TCR rearrangements. Three patients died and 40 suffered clinical worsening despite treatment.
    Estimated 5-year survival rates were 100% in patients with greater than 50% CD3 CD8 IELs and polyclonal TCR, but just 88% in patients with less than 50% CD3 CD8 IELs and 50% in patients with monoclonal TCR.
    All patients with monoclonal TCR gene rearrangement with less than 50% CD3 CD8 IELs showed shorter average time to clinical worsening of symptoms (11 mo), when compared to patients with less than 50% CD3 CD8 IELs alone (21 mo), polyclonal TCR (38 mo), or greater than 50% CD3 CD8 IELs alone (66 mo).
    After the team adjusted for age and gender, they found that the presence of less than 50% CD3 CD8 IELs was the only factor associated with increased risk for clinical worsening, despite negative celiac blood screens (hazard ratio=4.879; 95% confidence interval, 1.785-13.336; P=0.002).
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    Overall, the assessment of IEL phenotype and TCR gene rearrangement can provide important information regarding morbidity and risk of death in cases of RCD.
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     J Clin Gastroenterol. 2013 Mar 6.

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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.
    That is when I knew we had to be prepared. No more winging it. We couldn’t take a chance like that ever again. We were “lucky” one too many times. We were very fortunate that we did not lose our home to the Los Angeles wildfire, and only had minimal damage from the severe storm which hit our home in Illinois.
      
    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.
    The team enrolled fifty adults with symptoms and indications of celiac disease in a prospective cohort without regard to the final diagnosis.  At baseline, all individuals underwent cognitive functional and psychological evaluation. The team then compared celiac disease patients with subjects without celiac disease, and with healthy controls matched by sex, age, and education.
    Celiac disease patients had similar cognitive performance and anxiety, but no significant differences in depression scores compared with disease controls.
    A total of thirty-three subjects were diagnosed with celiac disease. Compared with the 26 healthy control subjects, the 17 celiac disease subjects, and the 17 disease control subjects, who mostly had irritable bowel syndrome, showed impaired cognitive performance (P=0.02 and P=0.04, respectively), functional impairment (P<0.01), and higher depression (P<0.01). 
    From their data, the team noted that any abnormal cognitive functions they saw in adults with newly diagnosed celiac disease did not seem not to be a result of the disease itself. 
    Their results indicate that cognitive dysfunction in celiac patients could be related to long-term symptoms from chronic disease, in general.
    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.

    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.
    "Brands with very specific product benefits, gluten-free for example, require precise targeting to efficiently reach and convert their desired shoppers,” says Todd Morris, President of Catalina's Go-to-Market organization, adding that “Catalina offers the only purchase-based targeting solution with this capability.” 
    Label Insight’s clients include food and beverage giants such as Unilever, Ben & Jerry's, Lipton and Hellman’s. Label Insight technology has helped the Food and Drug Administration (FDA) build the sector’s very first scientifically accurate database of food ingredients, health attributes and claims.
    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.
     
    The research team included Åsa Torinsson Naluai, Ladan Saadat Vafa, Audur H. Gudjonsdottir, Henrik Arnell, Lars Browaldh, and Daniel Agardh. They are variously affiliated with the Institute of Biomedicine, Department of Microbiology & Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; the Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; the Department of Pediatric Gastroenterology, Hepatology and Nutrition, Karolinska University Hospital and Division of Pediatrics, CLINTEC, Karolinska Institute, Stockholm, Sweden; the Department of Clinical Science and Education, Karolinska Institute, Sodersjukhuset, Stockholm, Sweden; the Department of Mathematical Sciences, Chalmers University of Technology, Gothenburg, Sweden; the Diabetes & Celiac Disease Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden; and with the Nathan S Kline Institute in the U.S.A.
    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.
    The significance of the individual amino acids do not survive multiple correction, however, multivariate analyses of the amino acid profile showed significantly altered amino acid levels in children with celiac disease overall and after correction for age, sex and experimental effects.
    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