Jump to content
  • Sign Up
  • Join Our Community!

    Do you have questions about celiac disease or the gluten-free diet?

  • Alcat: Medical Researchers Find a Biomarker for Non-Celiac Gluten Sensitivity

      The Alcat test was every bit as accurate at predicting a sensitivity to gluten challenge or placebo, in their study population consisting of 25 subjects, as was the double-blind placebo-controlled oral challenge.

    Caption: Image: CC--Cell Science Systems

    Celiac.com 03/01/2019 - Although only an estimated 1% of the US population has celiac disease, millions more, 11% of US households, eat gluten free. Celiac is an autoimmune disease whereby the immune cells attack the lining of the small intestine, resulting in malabsorption and greater risk of diabetes and other autoimmune disorders. Strict avoidance of gluten is mandatory for people with celiac disease.

    But, millions of people believe they suffer from gluten sensitivity, also known as Non-celiac gluten sensitivity; or NCGS. Until recently, the diagnostic criterion for NCGS was if you felt better avoiding gluten then you had NCGS. Physicians and scientists working in the field became concerned that this simple criterion was prone to subjective evaluation and conditioning; i.e., the placebo effect, and could cause many people to unnecessarily avoid an otherwise nutritious food staple.

    Thus, they established the double-blinded placebo-controlled oral challenge, as the standard diagnostic criterion for NCGS; or, DBPCOC, for short. If you think the name is formidable, try following the procedure itself. Although reliable, the procedure is too cumbersome and time consuming to be used in routine clinical practice.

    Hence, clinicians were eager to find a simple test that would correlate with the oral challenge. Today, researchers at the San Mateo Hospital at the University of Pavia (Italy) led by Dr. Michele Di Stefano, report in the December issue of Clinical Nutrition ESPEN, they have found such a marker. The title of their paper is, Non-Celiac Gluten Sensitivity in patients with severe abdominal pain and bloating: The accuracy of ALCAT 5. The name connotes use of the ALCAT test® developed by Cell Science Systems, in Deerfield Beach, FL; used in this study to measure the immune cell response, in vitro, to challenge with 5 gluten containing grains.

    The question was, Does an immune cell reaction that occurs in the test well, in response to gluten exposure, such as it does in the Alcat test, reflect an immune cell response that occurs in the body? The answer, according to the Pavia researchers, is, yes. The Alcat test was every bit as accurate at predicting a sensitivity to gluten challenge or placebo, in their study population consisting of 25 subjects, as was the double-blind placebo-controlled oral challenge. According to the authors the DBPCOC is a lengthy and cumbersome procedure with lower patient compliance, whilst the Alcat test is simple to perform and results are rapidly obtained. Hence, since the results are similar, the Alcat test might represent a better and less costly alternative.

    The Alcat 5 Test can be ordered here.

    About Cell Science Systems, Corp.
    CSS is a CLIA licensed lab and an FDA registered Medical Device establishment, that has developed the Alcat test for food and chemical sensitivities, as well as GI function assays, Telomere length assessments, molecular diagnostics, and, in January of 2019 will also be launching cellular tests for the assessment of functional micro-nutrient deficiencies and anti-oxidant status. CSS received the company of the year award in 2016 for Food Intolerance Testing, North America, by Frost & Sullivan. The Alcat test has been clinically validated in clinical research at the Yale School of Medicine where mechanistic studies were also conducted which have led to new discoveries regarding the pathogenic mechanisms underlying food sensitivities. CSS will continue to participate in industry grant-funded, cross border, translational research that focuses on the role of food induced release of DNA and its role in pathology. CSS is located in Deerfield Beach, FL and Potsdam, Germany.



    User Feedback

    Recommended Comments

    There are no comments to display.



    Guest
    This is now closed for further comments

  • About Me

    This article is a paid advertising spot for this Web site. For more information about our advertising programs, including how you can see your ad on this site, please visit our advertising page.

  • Related Articles

    Jefferson Adams
    Celiac.com 11/14/2013 - Until now, rates of non-celiac gluten sensitivity were largely a matter of clinical speculation, basically, educated guesswork among doctors.
    Some thought that rates of non-celiac gluten-sensitivity might by much higher than rates of celiac disease in the USA. But there was just no actual clinical data supporting these claims.
    A team of researchers recently set out to get some good clinical data that would tell them how common non-celiac gluten sensitivity actually is.
    The research team included Daniel V. DiGiacomo, Christina A. Tennyson, Peter H. Green, and Ryan T. Demmer. They are variously affiliated with the Department of Medicine, Celiac Disease Center at Columbia University, and the Department of Epidemiology at the Mailman School of Public Health at Columbia University in New York.
    The authors used the Continuous National Health and Nutrition Examination Survey (NHANES) 2009–2010 to enroll 7762 people from the civilian, non-institutionalized, US population free of celiac disease.
    They then analyzed the data to estimate rates of adherence to a gluten-free diet among participants without celiac disease as a surrogate marker for non-celiac gluten sensitivity in the US.
    They also used the data to characterize the demographics and general health status of the study participants.
    Overall, forty-nine participants reported adherence to a gluten-free diet. With a weighted national prevalence of 0.548%, this represents 1.3 million individuals between 6 and 80 years old in the US.
    The prevalence of a gluten-free diet was higher in females (0.58%) than males (0.37%), although this was not statistically significant (p = 0.34).
    Participants reporting a gluten-free diet were older (46.6 vs. 40.5 years, p = 0.005), had higher high-density lipoprotein, lower iron and lower body mass index.
    These numbers put the estimated national prevalence of non-celiac gluten sensitivity at 0.548%, about half the rate of celiac disease.
    However, the team calls for further studies in order to better understand the population burden of non-celiac gluten sensitivity.
    Source:
    Rev Esp Enferm Dig. 2013 Apr;105(4):187-193. doi:10.3109/00365521.2013.809598

    Jefferson Adams
    Celiac.com 06/04/2015 - Some researchers feel that people who self report non-celiac gluten sensitivity (SR-NCGS) and also follow a gluten-free diet might actually fall within the spectrum of irritable bowel (IBS). Interestingly, recent reports suggest that large numbers of people with inflammatory bowel disease (IBD) also follow a gluten-free diet.
    A research team recently assessed the relationship between IBD and self-reported non-celiac gluten sensitivity (SR-NCGS). The team included I.Aziz, F. Branchi, K. Pearson, J. Priest, and D.S. Sanders. They are variously affiliated with the Department of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals, Sheffield, United Kingdom; and the Gastroenterology and Endoscopy Unit in the Department of Pathophysiology and Transplantation at the Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Department of Pathophysiology and Transplant, Università degli Studi di Milano in Milan, Italy.
    To screen for SR-NCGS and the use of a GFD, they used a cross-sectional questionnaire in 4 groups: ulcerative colitis (n = 75), Crohn's disease (n = 70), IBS (n = 59), and dyspeptic controls (n = 109). They also looked at diagnostic outcomes for IBD in 200 patients presenting with SR-NCGS.
    A total of 25 out of 59 patients with IBS (42.4%), and 40 out of 145 patients (27.6%) with IBD reported SR-NCGS. That number was just 19 of 109 for dyspeptic control subjects (17.4%). As far a gluten-free diet, currently, 11.9% of patients with IBS, and 6.2% of those with IBD are following a gluten-free diet, as compared with just 0.9% for dyspeptic controls; P = 0.02.
    For the purposes of of this study, the team made no differences between ulcerative colitis and Crohn's disease. However, 40.9% of Crohn's disease patients with SR-NCGS suffered from stricturing disease, compared with 18.9% for Chrohn's patients without SR-NCGS; (P = 0.046). Crohn's disease patients with SR-NCGS showed higher overall scores on the Crohn's Disease Activity Index (228.1 versus 133.3, P = 0.002) than those without SR-NCGS.
    The team analyzed 200 cases presenting with SR-NCGS, and found that 197 of them, or 98.5% were most likely diet-related IBS. However, 3 of the SR-NCGS patients (1.5%) actually had IBD, with all of the associated alarm symptoms, and/or abnormal blood parameters.
    The results show that SR-NCGS is not exclusive to IBS, but is also seen in some patients with IBD, which is a more severe, more debilitating condition.
    The team is calling for randomized studies to further delineate the nature of this relationship and clarify whether a gluten-free is appropriate for certain IBD patients.

    Source:
    Inflamm Bowel Dis. 2015 Apr;21(4):847-53. doi: 10.1097/MIB.0000000000000335.

    Jefferson Adams
    Celiac.com 11/25/2015 - People with Non-Celiac Gluten Sensitivity (NCGS) suffer intestinal and non-intestinal symptoms when they consume gluten-containing food, but they do not have either celiac disease or wheat allergy.
    Because there is currently no known NCGS biomarker, it is important to develop reliable standard procedures to confirm NCGS diagnosis. A recent scientific paper examines expert recommendations on how the diagnostic protocol should be performed for the confirmation of NCGS.
    The researchers contributing to the paper include Carlo Catassi, Luca Elli, Bruno Bonaz, Gerd Bouma, Antonio Carroccio, Gemma Castillejo, Christophe Cellier, Fernanda Cristofori, Laura de Magistris, Jernej Dolinsek, Walburga Dieterich, Ruggiero Francavilla, Marios Hadjivassiliou, Wolfgang Holtmeier, Ute Körner, Dan A. Leffler, Knut E. A. Lundin, Giuseppe Mazzarella, Chris J. Mulder, Nicoletta Pellegrini, Kamran Rostami, David Sanders, Gry Irene Skodje, Detlef Schuppan, Reiner Ullrich, Umberto Volta, Marianne Williams, Victor F. Zevallos, Yurdagül Zopf, and Alessio Fasano. They are variously affiliated with 26 research institutions worldwide.
    They have come up with a series of recommendations known as the Salerno Experts' Criteria.
    Under that criteria, a comprehensive diagnosis should measure the patient's clinical response to the gluten-free diet (GFD) and assess the effect of a gluten challenge after a period of treatment with the GFD. Such an evaluation uses a self-administered instrument that relies on a modified version of the Gastrointestinal Symptom Rating Scale.
    In this way, the patient identifies one to three main symptoms that are quantified on a rating scale ranging from 1 to 10.
    Patients then follow a double-blind placebo-controlled gluten challenge by ingesting 8 grams of gluten per day for a one-week challenge followed by a one-week washout of strict GFD, and then moving to the second one-week challenge.
    The gluten-challenge should contain cooked, homogeneously distributed gluten. A variation of at least 30% of one to three main symptoms between the gluten and the placebo challenge should be seen to differentiate between a positive and a negative result.
    These guidelines are designed to help the clinician to reach a firm and positive diagnosis of NCGS and facilitate the comparisons of different studies.
    Source:
    Am J Gastroenterol. 2015 Sep 29. doi: 10.1038/ajg.2015.296.

    Jefferson Adams
    Celiac.com 05/15/2017 - For all the talk of studies touting evidence for non-celiac gluten sensitivity, the actual data don't stack up very well, according to an recent assessment by two researchers, whose results appear in Clinical Gastroenterology and Hepatology.
    In an effort to determine the accuracy of using a double-blind, placebo-controlled study to confirm diagnosis of non-celiac gluten sensitivity in patients who respond to a gluten-free diet, researchers Javier Molina-Infante, and Antonio Carroccio recently set out to assess data on a series of such studies. Both researchers are affiliated with the Department of Gastroenterology, Hospital Universitario San Pedro de Alcantara in Caceres, Spain.
    For their study, the pair analyzed data from 10 separate double-blind, placebo-controlled, gluten-challenge trials on a total of 1312 adults. The available studies varied significantly in many ways. The duration of the gluten challenge, for example, varied from 1 day to 6 weeks. The daily doses for those gluten challenges varied from 2 grams to 52 grams, with 3 studies administering 8 grams or less each day. The composition of the gluten-free placebo also varied considerably between tests; including variation by gluten-free product type, and levels of xylose, whey protein, rice, or corn starch containing fermentable carbohydrates.
    Most of the studies did find gluten challenge to significantly increase symptom scores compared with placebo. However, out of 231 NCGS patients, only 38 patients (16%) showed gluten-specific symptoms. Moreover, nearly half (40%) of these patients showed similar or increased symptoms in response to placebo; something researchers term a 'nocebo' effect. That leaves just 6 or 7 patients out of 231 showing gluten-specific symptoms.
    The researchers also point to heterogeneity and to potential methodology flaws in gluten challenge studies. They also present powerful questions about gluten as the trigger for symptoms in most patients with presumptive NCGS. Lastly, they highlight the importance of the nocebo effect in these types of studies.
    These results certainly invite more careful, rigorous studies on the matter, and challenge researchers to provide solid data from well-crafted double-blind placebo controlled studies.
    Basically, what little evidence we thought we had to support the existence of non-celiac gluten sensitivity has been shown to be thin at best. Until solid evidence arrives, the status of non-celiac gluten sensitivity will remain open to question and doubt by both researchers and potential sufferers.
    Source:
    Clin Gastroenterol Hepatol. 2017;15(3):339-348.

  • Popular Contributors

  • Forum Discussions

    Doritos does make a few gluten-free versions.     
    Just wanted to chime in. During my 2 plus years of healing I had joint pain and muscle pain with some of the nightshade mainly peppers and tomato. I stopped them. I can now eat them again. My theory is when my gut gets cc my holey gut dumps some of my food in my blood stream and my already ticked off immune system let's me know what is allowed. Apparently for a time nightshades  of potato, tomatos, and peppers were an issue. I was able to gradually introduce potatoes first and then tomatos, then
×
×
  • Create New...