• Join our community!

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

  • Ads by Google:
     




    Get email alerts Subscribe to Celiac.com's FREE weekly eNewsletter

    Ads by Google:



       Get email alertsSubscribe to Celiac.com's FREE weekly eNewsletter

  • Member Statistics

    77,466
    Total Members
    3,093
    Most Online
    3sth3rcho
    Newest Member
    3sth3rcho
    Joined
  • 0

    Researchers Use CRISPR/Cas9 to Produce Low Gluten Wheat Strains


    Jefferson Adams


    • For the first time, researchers have used CRISPR/Cas9 technology to produce low-gluten, non-transgenic wheat.


    Image Caption: For the first time, researchers have used CRISPR/Cas9 technology to produce low-gluten, non-transgenic wheat. Photo: CC--Sam Beebe

    Celiac.com 10/25/2017 - For people with celiac disease, eating gluten proteins from wheat, barley, and rye triggers an auto-immune response, and the accompanying physical symptoms.


    Ads by Google:




    ARTICLE CONTINUES BELOW ADS
    Ads by Google:



    A team of researchers recently set out to engineer low-gluten wheat strains that also have low-reactivity for people with celiac disease. To meet their goals, the team designed two sgRNAs to target a conserved region adjacent to the coding sequence for the 33-mer in the -gliadin genes. They then sought to evaluate the results.

    The research team included Susana Sánchez-León, Javier Gil-Humanes, Carmen V. Ozuna, María J. Giménez, Carolina Sousa, Daniel F. Voytas, and Francisco Barro. They are variously affiliated with the Departamento de Mejora Genética Vegetal, Instituto de Agricultura Sostenible (IAS-CSIC), Córdoba, Spain; the Department of Genetics, Cell Biology, and Development, Center for Genome Engineering at the University of Minnesota in Minneapolis, MN, USA; and with the Facultad de Farmacia, Departamento de Microbiología y Parasitología, Universidad de Sevilla, Spain.

    The gliadin gene family of wheat includes four highly reactive peptides, with the 33-mer peptide being the main culprit in celiac patients. In all, the team generated twenty-one mutant lines, all of which showed strong reduction gliadin proteins.

    Of the 45 different genes identified in wild type gliadin, the team mutated up to 35 different genes in one of the lines to achieve an 85% reduction in immunoreactivity. They then identified the transgene-free lines, and found no off-target mutations in any of the potential targets.

    So, what does this all mean in English? Well, basically the low-gluten, transgene-free wheat lines that the team describes here could be used to produce low-gluten foods, as well as serving as source material to introduce the low-gluten, low-reactivity traits into selected wheat varieties.

    Basically, the technology could be used to create low-gluten wheat varieties with low immunoreactivity. Now, most folks with celiac disease, especially those with higher gluten sensitivity, would likely need more than and 85% reduction in immunoreactivity to see any real benefit. However, this study provides an interesting glimpse at how science might help researchers to create wheat strains that are safe for people with celiac disease.

    Source:


    0


    User Feedback

    Recommended Comments

    There are no comments to display.



    Your content will need to be approved by a moderator

    Guest
    You are commenting as a guest. If you have an account, please sign in.
    Add a comment...

    ×   Pasted as rich text.   Paste as plain text instead

      Only 75 emoji are allowed.

    ×   Your link has been automatically embedded.   Display as a link instead

    ×   Your previous content has been restored.   Clear editor

    ×   You cannot paste images directly. Upload or insert images from URL.


  • Popular Contributors

  • Ads by Google:

  • Who's Online   5 Members, 1 Anonymous, 320 Guests (See full list)

  • Related Articles

    Jefferson Adams
    Celiac.com 05/09/2016 - Exciting gluten-free news from Japan, where researchers say they have successfully sequenced the entire buckwheat genome. This is a big deal, because buckwheat flour offers certain advantages over numerous other gluten-free flours, especially in noodle making.
    Those familiar with buckwheat know that, despite its name, it contains no wheat or gluten, and is, in fact actually a kind of fruit. The sequencing of the buckwheat gene is exciting because it provides information necessary to develop new kinds of gluten-free noodles and other buckwheat-based foods that may be tastier and chewier than traditional gluten-free products.
    Yasuo Yasui of Kyoto University and colleagues have sequenced the full buckwheat genome for the first time, identifying genes which could be modified for improved cultivation capabilities and taste appeal.
    Buckwheat is a central ingredient in soba noodles -- a traditional Japanese favorite -- and is also used to make other noodles from China and Korea. In Italy, buckwheat is used in a dish called pizzoccheri, a type of short tagliatelle, a flat ribbon pasta, made with 80% buckwheat flour and 20% wheat flour. Elsewhere in Europe, buckwheat is used in French gallettes, and Slovenian struklji, While in other regions of the world it appears in pancakes and other foods.
    In the study, published in DNA Research, the Japanese team found genes related to "mochi-ness", which refers to the soft, chewy texture of foods like marshmallows or fresh bagels. Until now, scientists had not succeed in getting the distinctive 'mochi' texture with buckwheat," says Yasui.
    "Since we've found the genes that could give buckwheat this texture, I think we can hope to see foods, including soba noodles and doughy European foods, with radical new sensations appearing on the market in the near future,” Yasui adds.
    Some people are allergic to buckwheat, and Yasui says that the sequencing information may help to make buckwheat safe for those individuals as well.
    So, stay tuned to learn more about the future of buckwheat in crafting new, chewier noodles, and more.
    Source:
    kyoto-u.ac.jp

    Jefferson Adams
    Celiac.com 10/18/2016 - Whole grains, including gluten-free grains, have never been more popular, but as their fortunes grow as a whole, that of wheat is diminishing.
    The whole grains category includes both gluten-free grains, such as quinoa and other ancient grains, and gluten grains, such as barley, rye and triticale, but wheat products have never been less popular, and continue their downward sales slide.
    This year, 1,282 new products have registered for the Whole Grain Stamp so far, a pace set to meet or beat last year's record of 2,122 new products; up from 1,666 in 2014 and 1,622 in 2013, according to Cynthia Harriman, director of food and nutrition strategies at the Whole Grains Council. More than half of new products with the Whole Grain Stamp had a gluten-free first ingredient last year, an increase over 33% in 2007 to 2009, according to Harriman. However, even as scientists question the claimed benefits of gluten-free foods, such as weight loss, for people without celiac disease, many consumers are eating gluten-free foods "just for the variety," Harriman said.
    Either way, the market for gluten-free foods is set to approach $5 billion by 2021, up from $2.84 billion in 2014. Going forward, more of that market will go to gluten-free grains, lees to wheat.
    Flour used to be the main way consumers bought whole grains, but now consumers and manufacturers are embracing complete, minimally processed whole grains, which can improve product textures, flavors and health benefits.
    Sprouted grains are also receiving more attention and are expected to generate product sales of $250 million by 2018. Overall, 27% of consumers say they are eating more whole grains than they did six months ago, according to a recent survey.
    Read more at Fooddive.com.

    Jefferson Adams
    Celiac.com 03/22/2017 - A new study published in the journal Food Chemistry shows that even the ancient varieties of wheat that have not been subject to hybridization, contain toxic epitopes that trigger adverse autoimmune response in celiac patients.
    What makes gluten toxic to people with celiac disease? Also, what is the relationship between various kinds of wheat and their celiac toxicity?
    To answer those questions, a team of researchers analyzed various kinds of wheat from several countries, all produced in the same agronomic year (2013-2014) at the Experimental Station at the Agronomic, Food and Biosystems School of Madrid.
    Their study focused on a specific set of proteins in gluten, called gliadins. Marta Rodríguez-Quijano, a researcher at the Technical University of Madrid and one of the writers behind the study, says that "gliadins have the greatest clinical effect against the innate and adaptive immune responses that lead to coeliac disease." However, the specific type of gliadins differ among the many varieties of wheat.
    The scientists assessed the presence of T-lymphocytes (immune cells that are related to celiac disease) in the various kinds of wheat) by using an antibody capable of recognizing toxic epitopes or antigenic determinants. Their data shows that the different varieties of wheat produce considerably different immune responses depending on the T-cells analyzed.
    Certain wheat varieties, such as the French "Pernel' T. aestivum ssp. vulgare L., have low toxic epitope content," explains Rodríguez-Quijano, which means that they are less likely to trigger a strong immune reaction in people with celiac disease.
    This study provides the scientific basis for using such epitopes to design and breed wheat products that are safe for people with celiac disease. A successful effort in this arena will help to "combat the poor nutritional and technological characteristics of gluten-free products and thereby contribute to improving patients' quality of life," says Rodríguez-Quijano.
    This researchers are not alone in their efforts to create wheat strains that are safe for people with celiac disease. A similar project is under way in Kansas, with researchers working with the University and industry support to evaluate wheat strains that may be suitable for people with celiac disease.
    Will the future mean safe wheat for people with celiac disease? Stay tuned for developments on this and related stories.

    Jefferson Adams
    Celiac.com 06/01/2017 - With low prices and slim margins, life is tough for people who trade in wheat, corn and soybeans these days. So much so that some traders are turning to obscure commodities like desert-grown tomatoes and chickpeas to turn a profit.
    Over the last several years, as farmers have produced far more of these crops than the marker can handle, margins for handling major grain crops have sunk. That has led some trading firms to seek higher margins in niche markets, such as tomatoes and organic grains, while other firms are looking to organic grains, and markets for costlier processed food ingredients or gluten-free products.
    One such company is Germany's BayWa AG. According to Jean-Francois Lambert, the founder and managing partner of consultant Lambert Commodities, "The general trading environment for agricultural commodities is rather difficult," and the challenge looks to continue, at least through next year.
    This fall in prices is a far cry from the price surge seen for much of the previous decade, when growing populations and burgeoning economies drove rising demand.
    Now, really huge firms are unlikely to see much benefit from investing in these smaller markets, no matter the margins. That's because the markets are still too small to have any major impact on their bottom line, and any gains would represent only tiny fractions of their overall portfolios.
    However, small and mid-sized traders can potentially do much better with investments in lesser-known commodities like quinoa or organic crops. For these traders, higher margins and growing demand can yield returns that improve their bottom line. One small company, Grain Services Srl, a brokerage based in Reggio Emilia, Italy, currently receives about 30 percent of its total revenue from gluten-free, organic or niche products, including quinoa, rice, amaranth and lentils, even though these make up just 7% of the firms overall business, says managing director Andrea Cagnolati.
    With prices for gluten-free grains and flours expected to surge over the next ten years, look for more investors to make big bets on that market, or to use it as a hedge against major market doldrums.
    Source:
    ESMMagazine.com

  • Recent Articles

    Jefferson Adams
    Celiac.com 06/19/2018 - Could baking soda help reduce the inflammation and damage caused by autoimmune diseases like rheumatoid arthritis, and celiac disease? Scientists at the Medical College of Georgia at Augusta University say that a daily dose of baking soda may in fact help reduce inflammation and damage caused by autoimmune diseases like rheumatoid arthritis, and celiac disease.
    Those scientists recently gathered some of the first evidence to show that cheap, over-the-counter antacids can prompt the spleen to promote an anti-inflammatory environment that could be helpful in combating inflammatory disease.
    A type of cell called mesothelial cells line our body cavities, like the digestive tract. They have little fingers, called microvilli, that sense the environment, and warn the organs they cover that there is an invader and an immune response is needed.
    The team’s data shows that when rats or healthy people drink a solution of baking soda, the stomach makes more acid, which causes mesothelial cells on the outside of the spleen to tell the spleen to go easy on the immune response.  "It's most likely a hamburger not a bacterial infection," is basically the message, says Dr. Paul O'Connor, renal physiologist in the MCG Department of Physiology at Augusta University and the study's corresponding author.
    That message, which is transmitted with help from a chemical messenger called acetylcholine, seems to encourage the gut to shift against inflammation, say the scientists.
    In patients who drank water with baking soda for two weeks, immune cells called macrophages, shifted from primarily those that promote inflammation, called M1, to those that reduce it, called M2. "The shift from inflammatory to an anti-inflammatory profile is happening everywhere," O'Connor says. "We saw it in the kidneys, we saw it in the spleen, now we see it in the peripheral blood."
    O'Connor hopes drinking baking soda can one day produce similar results for people with autoimmune disease. "You are not really turning anything off or on, you are just pushing it toward one side by giving an anti-inflammatory stimulus," he says, in this case, away from harmful inflammation. "It's potentially a really safe way to treat inflammatory disease."
    The research was funded by the National Institutes of Health.
    Read more at: Sciencedaily.com

    Jefferson Adams
    Celiac.com 06/18/2018 - Celiac disease has been mainly associated with Caucasian populations in Northern Europe, and their descendants in other countries, but new scientific evidence is beginning to challenge that view. Still, the exact global prevalence of celiac disease remains unknown.  To get better data on that issue, a team of researchers recently conducted a comprehensive review and meta-analysis to get a reasonably accurate estimate the global prevalence of celiac disease. 
    The research team included P Singh, A Arora, TA Strand, DA Leffler, C Catassi, PH Green, CP Kelly, V Ahuja, and GK Makharia. They are variously affiliated with the Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Lady Hardinge Medical College, New Delhi, India; Innlandet Hospital Trust, Lillehammer, Norway; Centre for International Health, University of Bergen, Bergen, Norway; Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Gastroenterology Research and Development, Takeda Pharmaceuticals Inc, Cambridge, MA; Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy; Department of Medicine, Columbia University Medical Center, New York, New York; USA Celiac Disease Center, Columbia University Medical Center, New York, New York; and the Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India.
    For their review, the team searched Medline, PubMed, and EMBASE for the keywords ‘celiac disease,’ ‘celiac,’ ‘tissue transglutaminase antibody,’ ‘anti-endomysium antibody,’ ‘endomysial antibody,’ and ‘prevalence’ for studies published from January 1991 through March 2016. 
    The team cross-referenced each article with the words ‘Asia,’ ‘Europe,’ ‘Africa,’ ‘South America,’ ‘North America,’ and ‘Australia.’ They defined celiac diagnosis based on European Society of Pediatric Gastroenterology, Hepatology, and Nutrition guidelines. The team used 96 articles of 3,843 articles in their final analysis.
    Overall global prevalence of celiac disease was 1.4% in 275,818 individuals, based on positive blood tests for anti-tissue transglutaminase and/or anti-endomysial antibodies. The pooled global prevalence of biopsy-confirmed celiac disease was 0.7% in 138,792 individuals. That means that numerous people with celiac disease potentially remain undiagnosed.
    Rates of celiac disease were 0.4% in South America, 0.5% in Africa and North America, 0.6% in Asia, and 0.8% in Europe and Oceania; the prevalence was 0.6% in female vs 0.4% males. Celiac disease was significantly more common in children than adults.
    This systematic review and meta-analysis showed celiac disease to be reported worldwide. Blood test data shows celiac disease rate of 1.4%, while biopsy data shows 0.7%. The prevalence of celiac disease varies with sex, age, and location. 
    This review demonstrates a need for more comprehensive population-based studies of celiac disease in numerous countries.  The 1.4% rate indicates that there are 91.2 million people worldwide with celiac disease, and 3.9 million are in the U.S.A.
    Source:
    Clin Gastroenterol Hepatol. 2018 Jun;16(6):823-836.e2. doi: 10.1016/j.cgh.2017.06.037.

    Jefferson Adams
    Celiac.com 06/16/2018 - Summer is the time for chips and salsa. This fresh salsa recipe relies on cabbage, yes, cabbage, as a secret ingredient. The cabbage brings a delicious flavor and helps the salsa hold together nicely for scooping with your favorite chips. The result is a fresh, tasty salsa that goes great with guacamole.
    Ingredients:
    3 cups ripe fresh tomatoes, diced 1 cup shredded green cabbage ½ cup diced yellow onion ¼ cup chopped fresh cilantro 1 jalapeno, seeded 1 Serrano pepper, seeded 2 tablespoons lemon juice 2 tablespoons red wine vinegar 2 garlic cloves, minced salt to taste black pepper, to taste Directions:
    Purée all ingredients together in a blender.
    Cover and refrigerate for at least 1 hour. 
    Adjust seasoning with salt and pepper, as desired. 
    Serve is a bowl with tortilla chips and guacamole.

    Dr. Ron Hoggan, Ed.D.
    Celiac.com 06/15/2018 - There seems to be widespread agreement in the published medical research reports that stuttering is driven by abnormalities in the brain. Sometimes these are the result of brain injuries resulting from a stroke. Other types of brain injuries can also result in stuttering. Patients with Parkinson’s disease who were treated with stimulation of the subthalamic nucleus, an area of the brain that regulates some motor functions, experienced a return or worsening of stuttering that improved when the stimulation was turned off (1). Similarly, stroke has also been reported in association with acquired stuttering (2). While there are some reports of psychological mechanisms underlying stuttering, a majority of reports seem to favor altered brain morphology and/or function as the root of stuttering (3). Reports of structural differences between the brain hemispheres that are absent in those who do not stutter are also common (4). About 5% of children stutter, beginning sometime around age 3, during the phase of speech acquisition. However, about 75% of these cases resolve without intervention, before reaching their teens (5). Some cases of aphasia, a loss of speech production or understanding, have been reported in association with damage or changes to one or more of the language centers of the brain (6). Stuttering may sometimes arise from changes or damage to these same language centers (7). Thus, many stutterers have abnormalities in the same regions of the brain similar to those seen in aphasia.
    So how, you may ask, is all this related to gluten? As a starting point, one report from the medical literature identifies a patient who developed aphasia after admission for severe diarrhea. By the time celiac disease was diagnosed, he had completely lost his faculty of speech. However, his speech and normal bowel function gradually returned after beginning a gluten free diet (8). This finding was so controversial at the time of publication (1988) that the authors chose to remain anonymous. Nonetheless, it is a valuable clue that suggests gluten as a factor in compromised speech production. At about the same time (late 1980’s) reports of connections between untreated celiac disease and seizures/epilepsy were emerging in the medical literature (9).
    With the advent of the Internet a whole new field of anecdotal information was emerging, connecting a variety of neurological symptoms to celiac disease. While many medical practitioners and researchers were casting aspersions on these assertions, a select few chose to explore such claims using scientific research designs and methods. While connections between stuttering and gluten consumption seem to have been overlooked by the medical research community, there is a rich literature on the Internet that cries out for more structured investigation of this connection. Conversely, perhaps a publication bias of the peer review process excludes work that explores this connection.
    Whatever the reason that stuttering has not been reported in the medical literature in association with gluten ingestion, a number of personal disclosures and comments suggesting a connection between gluten and stuttering can be found on the Internet. Abid Hussain, in an article about food allergy and stuttering said: “The most common food allergy prevalent in stutterers is that of gluten which has been found to aggravate the stutter” (10). Similarly, Craig Forsythe posted an article that includes five cases of self-reporting individuals who believe that their stuttering is or was connected to gluten, one of whom also experiences stuttering from foods containing yeast (11). The same site contains one report of a stutterer who has had no relief despite following a gluten free diet for 20 years (11). Another stutterer, Jay88, reports the complete disappearance of her/his stammer on a gluten free diet (12). Doubtless there are many more such anecdotes to be found on the Internet* but we have to question them, exercising more skepticism than we might when reading similar claims in a peer reviewed scientific or medical journal.
    There are many reports in such journals connecting brain and neurological ailments with gluten, so it is not much of a stretch, on that basis alone, to suspect that stuttering may be a symptom of the gluten syndrome. Rodney Ford has even characterized celiac disease as an ailment that may begin through gluten-induced neurological damage (13) and Marios Hadjivassiliou and his group of neurologists and neurological investigators have devoted considerable time and effort to research that reveals gluten as an important factor in a majority of neurological diseases of unknown origin (14) which, as I have pointed out previously, includes most neurological ailments.
    My own experience with stuttering is limited. I stuttered as a child when I became nervous, upset, or self-conscious. Although I have been gluten free for many years, I haven’t noticed any impact on my inclination to stutter when upset. I don’t know if they are related, but I have also had challenges with speaking when distressed and I have noticed a substantial improvement in this area since removing gluten from my diet. Nonetheless, I have long wondered if there is a connection between gluten consumption and stuttering. Having done the research for this article, I would now encourage stutterers to try a gluten free diet for six months to see if it will reduce or eliminate their stutter. Meanwhile, I hope that some investigator out there will research this matter, publish her findings, and start the ball rolling toward getting some definitive answers to this question.
    Sources:
    1. Toft M, Dietrichs E. Aggravated stuttering following subthalamic deep brain stimulation in Parkinson’s disease--two cases. BMC Neurol. 2011 Apr 8;11:44.
    2. Tani T, Sakai Y. Stuttering after right cerebellar infarction: a case study. J Fluency Disord. 2010 Jun;35(2):141-5. Epub 2010 Mar 15.
    3. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    4. Jäncke L, Hänggi J, Steinmetz H. Morphological brain differences between adult stutterers and non-stutterers. BMC Neurol. 2004 Dec 10;4(1):23.
    5. Kell CA, Neumann K, von Kriegstein K, Posenenske C, von Gudenberg AW, Euler H, Giraud AL. How the brain repairs stuttering. Brain. 2009 Oct;132(Pt 10):2747-60. Epub 2009 Aug 26.
    6. Galantucci S, Tartaglia MC, Wilson SM, Henry ML, Filippi M, Agosta F, Dronkers NF, Henry RG, Ogar JM, Miller BL, Gorno-Tempini ML. White matter damage in primary progressive aphasias: a diffusion tensor tractography study. Brain. 2011 Jun 11.
    7. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    8. [No authors listed] Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 43-1988. A 52-year-old man with persistent watery diarrhea and aphasia. N Engl J Med. 1988 Oct 27;319(17):1139-48
    9. Molteni N, Bardella MT, Baldassarri AR, Bianchi PA. Celiac disease associated with epilepsy and intracranial calcifications: report of two patients. Am J Gastroenterol. 1988 Sep;83(9):992-4.
    10. http://ezinearticles.com/?Food-Allergy-and-Stuttering-Link&id=1235725 
    11. http://www.craig.copperleife.com/health/stuttering_allergies.htm 
    12. https://www.celiac.com/forums/topic/73362-any-help-is-appreciated/
    13. Ford RP. The gluten syndrome: a neurological disease. Med Hypotheses. 2009 Sep;73(3):438-40. Epub 2009 Apr 29.
    14. Hadjivassiliou M, Gibson A, Davies-Jones GA, Lobo AJ, Stephenson TJ, Milford-Ward A. Does cryptic gluten sensitivity play a part in neurological illness? Lancet. 1996 Feb 10;347(8998):369-71.

    Jefferson Adams
    Celiac.com 06/14/2018 - Refractory celiac disease type II (RCDII) is a rare complication of celiac disease that has high death rates. To diagnose RCDII, doctors identify a clonal population of phenotypically aberrant intraepithelial lymphocytes (IELs). 
    However, researchers really don’t have much data regarding the frequency and significance of clonal T cell receptor (TCR) gene rearrangements (TCR-GRs) in small bowel (SB) biopsies of patients without RCDII. Such data could provide useful comparison information for patients with RCDII, among other things.
    To that end, a research team recently set out to try to get some information about the frequency and importance of clonal T cell receptor (TCR) gene rearrangements (TCR-GRs) in small bowel (SB) biopsies of patients without RCDII. The research team included Shafinaz Hussein, Tatyana Gindin, Stephen M Lagana, Carolina Arguelles-Grande, Suneeta Krishnareddy, Bachir Alobeid, Suzanne K Lewis, Mahesh M Mansukhani, Peter H R Green, and Govind Bhagat.
    They are variously affiliated with the Department of Pathology and Cell Biology, and the Department of Medicine at the Celiac Disease Center, New York Presbyterian Hospital/Columbia University Medical Center, New York, USA. Their team analyzed results of TCR-GR analyses performed on SB biopsies at our institution over a 3-year period, which were obtained from eight active celiac disease, 172 celiac disease on gluten-free diet, 33 RCDI, and three RCDII patients and 14 patients without celiac disease. 
    Clonal TCR-GRs are not infrequent in cases lacking features of RCDII, while PCPs are frequent in all disease phases. TCR-GR results should be assessed in conjunction with immunophenotypic, histological and clinical findings for appropriate diagnosis and classification of RCD.
    The team divided the TCR-GR patterns into clonal, polyclonal and prominent clonal peaks (PCPs), and correlated these patterns with clinical and pathological features. In all, they detected clonal TCR-GR products in biopsies from 67% of patients with RCDII, 17% of patients with RCDI and 6% of patients with gluten-free diet. They found PCPs in all disease phases, but saw no significant difference in the TCR-GR patterns between the non-RCDII disease categories (p=0.39). 
    They also noted a higher frequency of surface CD3(−) IELs in cases with clonal TCR-GR, but the PCP pattern showed no associations with any clinical or pathological feature. 
    Repeat biopsy showed that the clonal or PCP pattern persisted for up to 2 years with no evidence of RCDII. The study indicates that better understanding of clonal T cell receptor gene rearrangements may help researchers improve refractory celiac diagnosis. 
    Source:
    Journal of Clinical Pathologyhttp://dx.doi.org/10.1136/jclinpath-2018-205023