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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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    STUDY FINDS WHEAT-BASED SOURDOUGH BREAD STARTED WITH SELECTED LACTOBACILLI IS TOLERATED BY CELIAC DISEASE PATIENTS


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    Appl Environ Microbiol. 2004 Feb;70(2):1088-1096


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    Celiac.com 02/26/2004 - Please note that the sourdough bread used in this study is not your garden-variety sourdough bread, and as far as I know it is not commercially available. Even though this study had very promising results, it was conducted on a relatively small number of people, and larger studies need to be carried out before reaching any conclusions about the long-term safety of celiacs consuming this type of sourdough bread. -Scott Adams

    Researchers in Europe conducted a novel study which utilized a highly specialized sourdough lactobacilli containing peptidases that have the ability to hydrolyze Pro-rich peptides, including the 33-mer peptide, which is the main culprit in the immune response associated with celiac disease. The sourdough bread in the study was made from a dough mixture that contained 30% wheat flour and other nontoxic flours including oat, millet, and buckwheat, which was then started with the specialized lactobacilli. After 24 hours of fermentation all 33-mer peptides and low-molecular-mass, alcohol-soluble polypeptides were almost totally hydrolyzed.

    For the next step in the study the researchers extracted proteins fro the sourdough and used them to produce a "peptic-tryptic digest" for in vitro agglutination tests on human K 562 subclone cell. The agglutinating activity of the sourdough proteins was found to be 250 times higher that that of normal bakers-yeast or lactobacilli started breads.

    A double blind test was then conducted in which 17 celiac disease patients were given 2 grams of gluten-containing bread started with bakers yeast or lactobacilli. Thirteen of them showed distinct, negative changes in their intestinal permeability after eating the bread, and 4 of them did not show any negative effects. The specially prepared sourdough bread was then given to all 17 patients and none of them had intestinal permeability reactions that differed from their normal baseline values.

    The researchers conclude: "These results showed that a bread biotechnology that uses selected lactobacilli, nontoxic flours, and a long fermentation time is a novel tool for decreasing the level of gluten intolerance in humans."


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    Guest cindy trim

    Posted

    I had read a similar article in the British Journal of Medicine sometime ago but they failed to mention it was a specialized sourdough. Both my daughters with celiac tried eating regular sourdough and both seem to tolerate it in spite of the fact it is 100% wheat based. They did notice the more sour the taste, the better it is tolerated. Now I wonder if they should continue eating it.

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    Thanks for this great article. I thought it was a miracle when I had some sourdough bread in a weak (and hungry) moment and had none of my usual reactions. Since then I have read that people with celiac may be able to tolerate sourdough made with a slow process (several days of proofing). Some commercial sourdough starters are quick-proofed and used within hours for baking. The longer process (proofing for up to a week allows the bacteria to break down the gluten making it easier to digest. This may be why Cindy's daughters can tolerate it better the more "sour" it tastes. I recommend trying to make your own sourdough bread at home with a starter that is fed for a 5 days to a week before being used.

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    Guest Cary MacDonald

    Posted

    Hello,

    I am a gluten intolerant person who can tolerate sprouted whole grain breads. Generally, bread is more tolerated when it's toasted; apparently, the extra cooking helps to break down the offending proteins a bit more. I am very interested in the sourdough findings and would appreciate receiving an email that points me in the direction of more data and studies about this.

     

    It has occurred to me, and to many other observant people, that mankind almost always prepared its breads from fermented doughs. This is still true in Russia, the former bread basket of the world, although I've heard that the modern version of quick bread making is now popular. This re-discovery regarding bread making is extremely important to every bread eater in the world. People who do not know about gluten intolerance are suffering the consequences nevertheless of eating modern breads. They do not realize that slowly, over many years, these poorly made breads are leading them down the road to various "old age" illnesses, such as, rheumatoid arthritis, weakened digestion, insulin resistance and Type 2 diabetes, to name a few.

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    Guest barbara

    Posted

    I was encouraged by this article, although as I looked up more about it, it seems that whey/lactic acid may have been in the starter. What about a person who has an allergy to the protein in milk (whey/casein)? Is there a starter that could be used for their sourdough wheat bread and still be free of the side effects of wheat? Who has the phone number of the people who did the

    experiment so that I may ask them?

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    Barbara -- whey/lactic acid isn't used in sourdough starter. Lactobacilli is a bacteria, and completely dairy free. I own a bakery, and our sourdough and 7 Grain bread is fermented over 15 hours, and many people who are gluten intolerant can digest it easily.

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    Barbara -- whey/lactic acid isn't used in sourdough starter. Lactobacilli is a bacteria, and completely dairy free. I own a bakery, and our sourdough and 7 Grain bread is fermented over 15 hours, and many people who are gluten intolerant can digest it easily.

    Please note that celiacs should not eat any of this bread, but perhaps further research will lead to bread like this that celiacs can eat.

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    Thanks for this great article. I thought it was a miracle when I had some sourdough bread in a weak (and hungry) moment and had none of my usual reactions. Since then I have read that people with celiac may be able to tolerate sourdough made with a slow process (several days of proofing). Some commercial sourdough starters are quick-proofed and used within hours for baking. The longer process (proofing for up to a week allows the bacteria to break down the gluten making it easier to digest. This may be why Cindy's daughters can tolerate it better the more "sour" it tastes. I recommend trying to make your own sourdough bread at home with a starter that is fed for a 5 days to a week before being used.

    I come from Cyprus and I know that people used to make their own bread in the old times by using a sourdough starter that they kept from their previous batch of baking. They used to make bread once a week and hence their starter was fed for 5-7 days and there was no such thing as gluten intolerance in those days. It makes one wonder really whether this once a week business was the reason why. It seems that gluten intolerance has increased after the invention of commercialization of bread making. Perhaps time to honor our ancestors' know-how!

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    Guest aaimyep@hotmail.com

    Posted

    I had read a similar article in the British Journal of Medicine sometime ago but they failed to mention it was a specialized sourdough. Both my daughters with celiac tried eating regular sourdough and both seem to tolerate it in spite of the fact it is 100% wheat based. They did notice the more sour the taste, the better it is tolerated. Now I wonder if they should continue eating it.

    Just because they experienced no symptoms does not mean it did them no damage.

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    Guest Gluten intolerant

    Posted

    Sorry to say, doesn't work for me. Gluten intolerant and sourdough (fermented properly and prepared appropriately) still glutens me up. So disappointing.

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    Guest Michelle

    Posted

    I am happy to say I can tolerate sourdough bread, I get it at a local bakery there which has been around for years. Although if I go on a sourdough free for all, it can cause some stomach bloating and gas. So a slice here and there is fine!!!

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    I am happy to say I can tolerate sourdough bread, I get it at a local bakery there which has been around for years. Although if I go on a sourdough free for all, it can cause some stomach bloating and gas. So a slice here and there is fine!!!

    This is a very bad idea--don't do it.

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    I am NCGS. I read the articles on sourdough a couple of years ago and tried it. If it is truly sourdough, It does not give me the same symptoms as any other bread. Also, and this is IMPORTANT, some commercially-prepared sourdough is actually white quick bread with lemon added to give it that flavor. If you do try sourdough, in the states try Panera sourdough first (if you don't have the luxury of being in San Francisco). Panera's starter is quite ancient.

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    I am NCGS. I read the articles on sourdough a couple of years ago and tried it. If it is truly sourdough, It does not give me the same symptoms as any other bread. Also, and this is IMPORTANT, some commercially-prepared sourdough is actually white quick bread with lemon added to give it that flavor. If you do try sourdough, in the states try Panera sourdough first (if you don't have the luxury of being in San Francisco). Panera's starter is quite ancient.

    We at Celiac.com would definitely NOT recommend that any celiacs try a wheat-based sour dough bread, no matter what this study shows. Cross contamination at the bakery would occur no matter the outcome.

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    admin
    The following Medline abstract describes a unique study that was done on the quality of life of two groups of people with celiac disease: One that was diagnosed as the result of having symptoms, and the other which had little or no symptoms and whose diagnosis was reached via screen-detection. Both groups were treated for one year with a gluten-free diet, and were then studied to determine their overall response, including their psychological response. Here is the abstract:
    Eff Clin Pract 2002 May-Jun;5(3):105-13
    Mustalahti K, Lohiniemi S, Collin P, Vuolteenaho N, Laippala P, Maki M.
    Department of Pediatrics, Tampere University Hospital, Finland.
    CONTEXT: Since the advent of serologic testing for celiac disease, most persons who receive a diagnosis of celiac disease have few or no symptoms. Although pathologic changes of celiac disease resolve on a gluten-free diet, how a gluten-free diet affects the quality of life for patients with screen-detected celiac disease is unclear.
    OBJECTIVE: To evaluate the effect of a gluten-free diet on the quality of life of patients with screen-detected celiac disease.
    DESIGN: Prospective study of patients before and 1 year after initiating a gluten-free diet.
    PARTICIPANTS: 19 patients with screen-detected celiac disease (found by serologically testing first-degree relatives of celiac patients) and 21 consecutive patients with symptom-detected disease. In all cases, celiac diagnosis was confirmed by finding villous atrophy and crypt hyperplasia on small-bowel biopsy.
    INTERVENTION: Gluten-free diet (explained during a single physician visit). MAIN OUTCOME
    MEASURES: Gastrointestinal Symptoms Rating Scale (GSRS), in which scores range from 0 to 6 (higher scores represent worse symptoms); and quality of life measured with the Psychological General Well-Being Questionnaire (PGWB). Scores range from 22 to 132 (higher scores mean greater well-being).
    RESULTS: At baseline, patients with symptom-detected celiac disease had poorer quality of life and more gastrointestinal symptoms than those with screen-detected celiac disease. Reported compliance with the gluten-free diet was good. All mucosal lesions of the small bowel had resolved at the follow-up biopsy. After 1 year of following the diet, quality of life for patients with screen-detected disease significantly improved (mean PGWB score increased from 108 to 114; P
    CONCLUSIONS: Gluten-free diet was associated with improved quality of life for patients with symptom-detected celiac disease and patients with screen-detected celiac disease. Concerns about the burden of a gluten-free diet, at least over the short term, may be unfounded.
    PMID: 12088289


    Jefferson Adams

    Patients Diagnosed in Childhood Might Evolve toward Latency on a Normal Diet
    Celiac.com 05/23/2007 - The results of a study recently published in the journal Gut indicate that some people who suffer from celiac disease might not need to remain on a gluten free diet for their entire lives, and that some celiac patients might be able to safely introduce gluten containing foods without suffering a relapse.
    Previous Studies Showing Positive Response to Wheat Introduction in Patients with Celiac Disease are Promising, But Incomplete
    Several studies have shown that some patients diagnosed with celiac disease in childhood were able to remain on a gluten-containing diet after gluten challenge without suffering a relapse. However, most of these studies included a small number of patients, or followed the patients for only a short period after gluten was reintroduced into their diets.
    These previous studies also limited their evaluation largely to assessment of celiac disease serology and histology of duodenal biopsies, and did not attempt to identify what factors might predict the development of tolerance to gluten.
    Determining Long-term Response to Gluten Consumption in Celiac Disease Patients
    A research team made up of doctors Tamara Matysiak-Budnik (1), Georgia Malamut (1,2), Natacha Patey-Mariaud de Serre (3), Etienne Grosdidier (2), Sylvie Seguier (3), Nicole Brousse (3), Sophie Caillat-Zucman (4), Nadine Cerf-bensussan (1), Jacques Schmitz (5) and Christophe Cellier (1,2), set out to determine whether children diagnosed with celiac disease must follow a gluten free diet for life.
    To determine the effects of reintroducing gluten into the diets of celiac patients, the research team set out to monitor the clinical and physical progress of adult celiac patients who had been diagnosed as children, who underwent a gluten challenge, and who were asymptomatic.
    The study focused on a specific group of patients, all but two of whom were diagnosed as children and followed until adulthood in the Department of Pediatric Gastroenterology in Necker Hospital and thereafter at the Georges Pompidou European Hospital in Paris; after which, they were entered into a local register of adult celiac patients and were recruited for the study based on two criteria: celiac disease diagnosed in childhood; and adherence to a normal diet.
    The patients in the study were from 18 to 65 years old, and had been diagnosed with celiac disease in childhood. The research team recorded data in the following categories: biological parameters of malabsorption; bone mineral density; clinical celiac status; gluten intake; HLA genotype; serological markers of celiac disease; as well as histological and immuno-histochemical parameters in duodenal biopsies.

    Results Show 20% Long-term Latency in Celiac Patients who Eat Normal Diet
    Of those studied, 61 patients had returned to a normal diet, and were asymptomatic. 48 showed various degrees of villous atrophy (silent celiac disease), and 13 had no detectable atrophy (latent celiac disease) on duodenal biopsies. Compared to those with silent celiac disease, patients with latent celiac disease showed markedly less osteopenia/osteoporosis [1/9 (11%) versus 23/33 (70%), p<0.001)], and lower TcR- + intraepithelial T cell counts (38±20 vs. 55±15, p<0.01).
    Patients with latent celiac disease had a lower mean age at the time of their first gluten free diet compared to patients with silent celiac disease (14.4±5 vs 40.1±47 months, p<0.05).
    Compared to the seven control patients on a long-term gluten free diet, the latent patients did not differ significantly, except for a higher frequency of celiac disease-specific serum antibodies. However, a follow-up found that two of the patients with latent celiac disease had suffered a clinical and histological relapse.
    Results showed that of those patients who remained asymptomatic after the reintroduction of gluten, 20% showed long-term latency.
    The study concludes that some patients with celiac disease may not need to remain on a life-long gluten free diet, and that some may indeed be able to safely reintroduce gluten into their diets with no adverse effects. However, the latency patients may experience may be transient, and therefore a regular follow-up is necessary. Also, patients with silent celiac disease should remain on a gluten free diet.
    Participating hospitals:
    (1) INSERM, U793, Faculté de Médecine René Descartes, IFR94, Paris, France.
    (2) AP-HP, H&OCIRC;pital Européen Georges Pompidou, Department of Hepato-Gastroenterology,
    Paris, France.
    (3) AP-HP, H&OCIRC;pital Necker-Enfants Malades, Department of Pathology, Paris, France.
    (4) INSERM, Equipe Avenir, Faculté de Médecine René Descartes, Paris, France.
    (5) AP-HP, H&OCIRC;pital Necker-Enfants Malades, Department of Pediatric Gastroenterology, Paris, France.
    Gut 2006;13(10).
    Comments on this Study by Ron Hoggan
    This is dressed up like a new finding, but it isn't. There are a number of studies that show similar findings. Part of that problem lies in the interpretation of the biopsies, and part of the problem arises out of failing to recognize the variable nature of the disease. It has long been known to wax and wane for reasons beyond our ken. Samuel Gee (1888) and Gibbons (1889) both reported the cyclic nature of their patients symptoms. They cited a study to support the idea of a two year rule saying that relapse would usually occur within two years, yet Kuitunen P, Savilahti E, Verkasalo M., in Late mucosal relapse in a boy with coeliac disease and cows milk allergy. Acta Paediatr Scand. 1986 Mar;75(2):340-2. reported one patient who at 4.3 years on a normal diet showed normal villous architecture. It was not until a follow-up biopsy at more than 8 years of eating a gluten-containing diet that he showed villous atrophy. These findings, along with all the other studies that have shown long delays in some patients before relapsing, argue strongly for Michael N. Marsh's position that we should concentrate on treating any immune system that is sensitized to gluten with a gluten-free diet. His rectal challenge is an excellent tool for identifying such sensitized immune systems. Dr. Fines fecal antibody test probably fits into the same category. The underlying assumption is that the biopsy will identify all cases of intestinal lesion regardless of the possibility of patchy lesions that are well documented in the literature. They deal with increased IEL counts as if they were a feature of latent celiac disease when that is not the case. There are several other points on which this study falters. They admit that the latency can be transient. Unfortunately, they have not exchanged emails with people where they have returned to eating gluten and have developed an abdominal cancer. I exchanged emails with such a young man who blamed himself for having killed himself with his carelessness about his diet. How awful that was for him! Yet these authors seem to think it is quite acceptable for patients to indulge during their latency periods and only consider a diet if there is a relapse of intestinal lesion.
     

    Destiny Stone
    Celiac.com 07/08/2010 - Acute abdominal pain is the most common symptom leading to emergency surgery; accounting for up to 50% of emergency surgical admissions and nonspecific abdominal pain (NSAP) likely accounts for 40% of the cases. While abdominal pain can often be a symptom of celiac disease, up until this point there have been no official studies to determine the  the association of celiac disease and abdominal pain.
    A group of researchers in the UK attempted to uncover the connection between celiac disease and abdominal pain. Using a case-controlled study of 300 consecutive, new, and unselected patients exhibiting acute abdominal pain, and a healthy control group not presenting any abdominal pain, were matched by age and gender and then assessed accordingly.
    Initially, the research team under Dr. David S. Sanders of the Gastroenterology and Liver Unit, Royal Hallamshire Hospital, Sheffield, UK,  used immunoglobulins, IgA/IgG anti-gliadin (ADA), and endomysial antibodies (EMA) to evaluate the test subjects for celiac disease. Any of the test subjects that tested with a positive IgA,  AGA, EMA or IgG AGA accompanied by IgA deficiency was provided with the opportunity to receive a small bowel biopsy to confirm a celiac diagnosis; only 1 person declined.
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    Researchers matched case controls and then determined the antibody status of the control group and the abdominal pain group. While there were no corresponding  pairs, the statistical chance of having celiac disease when demonstrating acute abdominal pain has an odds ratio of 4.6. Although when NSAP was solely taken into consideration, the prevalence of celiac disease exhibited profound significance with a rate of 10.5%. 
    Of the test subjects that maintained the gluten-free diet for the recommended time period of 12 -18 months, all of them exhibited an improvement of their symptoms, and their antibody profiles were negative. 
    From this study, researchers concluded that targeting patients with NSAP or those that exhibit  other high risk celiac symptoms, will likely improve  the diagnostic yield of celiac disease, specifically among those exhibiting  typical celiac symptoms. Additionally, the ideal situation would be if more doctors were to recognize NSAP symptoms as  having the potential to be connected with celiac disease and screen for celiac accordingly; as delayed or undiagnosed celiac disease can eventually lead to a myriad of other long-term and permanent health issues including, osteoporosis, infertility, and an increased risk of cancer.
    Source:

    Ann Surg. 2005 Aug;242(2):201-7.

    Jefferson Adams
    Celiac.com 02/04/2013 - Ever wonder what happens to all those celiac disease patients who volunteer to do a gluten-challenge in the name of science? Well, the short answer is that they likely suffer, and may incur gut damage, at least in the short term.
    A team of researchers looking for ways to reduce or eliminate that problem recently conducted a study using larazotide acetate, a first-in-class oral peptide that prevents tight junction opening, and may reduce gluten uptake and associated problems.
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    Source: 
    Aliment Pharmacol Ther. 2013;37(2):252-262.

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    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

    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.
    Now, to be honest, some of those animals in question do perform a genuine service for those who need emotional support dogs, like veterans with PTSD.
    However, many of these animals are not service animals at all. Many of these animals perform no actual service to their owners, and are nothing more than thinly disguised pets. Many lack proper training, and some have caused serious problems for the airlines and for other passengers.
    Now the major airlines are taking note and introducing stringent requirements for service animals.
    Delta was the first to strike. As reported by the New York Times on January 19: “Effective March 1, Delta, the second largest US airline by passenger traffic, said it will require passengers seeking to fly with pets to present additional documents outlining the passenger’s need for the animal and proof of its training and vaccinations, 48 hours prior to the flight.… This comes in response to what the carrier said was a 150 percent increase in service and support animals — pets, often dogs, that accompany people with disabilities — carried onboard since 2015.… Delta said that it flies some 700 service animals a day. Among them, customers have attempted to fly with comfort turkeys, gliding possums, snakes, spiders, and other unusual pets.”
    Fresh from an unsavory incident with an “emotional support” peacock incident, United Airlines has followed Delta’s lead and set stricter rules for emotional support animals. United’s rules also took effect March 1, 2018.
    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