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    Jefferson Adams earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in biology, anatomy, medicine, science, and advanced research, and scientific methods. He previously served as Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

  • Related Articles

    Destiny Stone
    Is Intestinal Biopsy Avoidable in Diagnosing Celiac Disease?
    Celiac.com 07/14/2010 - Intestinal biopsy is considered the the gold standard for celiac disease testing. However, biopsy is an  invasive procedure and most people would be happy to avoid biopsy all together. Based solely on serology, a new diagnostic standard  has been proposed that would no longer require intestinal biopsy for celiac disease diagnosis in some patients.
    Researchers performed duodenal biopsy and serology in six-hundred and seventy-nine adults who were at high risk and low risk for celiac disease. They tested blood samples  to detect antibodies to tissue transglutaminase (tTG) and deamidated gliadin peptide (DGP). The goal of researchers was to establish the diagnostic performance of various serological tests for diagnosing celiac disease in patients with varying pretest results. In this study, they hope to find potential serological algorithms to decrease the requirement for biopsy.
    One-hundred and sixty-one consecutive adults with undiagnosed, but suspected intestinal disorders were selected as the high-risk group to be evaluated for celiac disease. Five-hundred and eighteen patients who had been referred for routine upper gastrointestinal endoscopy due to non-specific symptoms such as indigestion, were randomly selected for the low-risk group.
    Prevalence of celiac disease was found in 39.1% of the high-risk group, and 3.3% of the low-risk group. Of the  high-risk patients, all individual assays demonstrated a high diagnostic efficacy, while the low-risk group demonstrated a lower diagnostic efficacy.
    The serological findings of this study demonstrated that the algorithm used for individual assays allows patients to avoid biopsy with a negative serology; and positive serology results would require a patient to undergo biopsy. The DGF/tTG Screen assay  may very well be recognized as the best preliminary test for celiac disease. The combination of two tests which include a DGP/tTG screening, may have the ability to  identify celiac disease correctly in various clinical situations, which would allow biopsy to be avoided in the vast majority of cases.
    Although the findings were significant for this study, small bowel histology is still deemed the gold standard for accurate celiac disease diagnosis. Further validation of the algorithms is necessary to confirm the findings of this study before new diagnostic guidelines can be considered.

    Source:
    World J Gastroenterol. 2010 Jul 7;16(25):3144-52.
     



    Destiny Stone
    Celiac.com 08/11/2010 - New studies from the United States, Europe and other Countries around the world indicate that the commonness of celiac disease has dramatically increased  in the last decade, possibly as much as four-times the amount seen in the 1950's. Most current studies show that celiac disease is prevalent in at least 1% of the general population.
    To determine when the prevalence of celiac disease started to increase, researchers at the Mayo Clinic analyzed blood samples stored from Air Force recruits taken in the early 1950's, and compared them with blood samples from this decade. Expecting to see at least 1% of the samples come up positive for gluten antibodies, they were surprised to find the numbers were much smaller than anticipated. The results of these studies suggest that until the 1950's, celiac disease was extremely rare. From these findings, researchers determined that celiac disease is about 4 times more prevalent now, than it was in the 1950's, suggesting an environmental change to the grains happened in the 1950's.
    While there are many documented statistics on diagnosed celiacs, there is new research revolving around “latent celiac disease”, or gluten sensitivity.  According to a study by Dr. Ludvigsson's team and as outlined in the Journal of the American Medical Association, latent celiac disease is defined by someone who has a "normal small intestinal mucosa but positive celiac disease serology," and is estimated to be prevalent in at least 1 in 1,000 people worldwide.
    According to Dr. Ludvigsson's team mortality rates are higher for those with celiac disease and latent celiac disease than it is in the general population. Ten out of 1,000 people with celiac disease will die in a years time, compared to  approximately 7 in 1,000 people without the disease. Although, Dr. Ludvigsson emphasizes that while mortality and increased risk for other disorders are raised for those with celiac and latent celiac disease, "the absolute risk increase is very small."
    Unfortunately,  celiac disease often goes undetected. In most countries at least 2/3 of people with celiac disease are undiagnosed. The reason for the high number of undiagnosed celiac's is because celiac symptoms vary widely from each other and can present in several ways. They can be asymptomatic (without symptoms), or classic symptomatic celiac (diarrhea, weight loss, failure to thrive, malabsorbtion, etc.), or non-traditional (osteoporosis, malignancy, depression etc.), making it difficult to accurately diagnose celiac disease. Many autoimmune disorders, specifically, autoimmune liver disease, thyroid disease, type 1 diabetes, and Addison's disease can be an indicator of celiac disease, and according to Dr. Ludvigsson, doctors should be evaluating patients for celiac disease for a variety of symptoms and disorders. 
    There are alternative treatment strategies for gluten sensitivities currently underway, but to date a gluten-free diet is the only effective treatment for celiac disease. As such, Dr. Ludvigsson urges health practitioners to emphasize to their patients the importance of strict adherence to the gluten-free diet. Dr. Ludvigsson also stresses the significance of medical follow-up for celiac patients.
    Source:

    MedScape Today

    Diana Gitig Ph.D.
    ImmusanT's Celiac Vaccine Passed Phase I Clinical Trials
    Celiac.com 05/23/2011 - ImmusanT, Inc., a biotechnology start up based in Cambridge, Massachusetts, is testing a vaccine to desensitize celiac patients to gluten. It is called Nexvax2, and it has already passed Phase I clinical trials, which means that it is safe and tolerable to humans. Nexvax2 is slated to begin Phase II trials, which address efficacy, within the next year.
    Nexvax2 was developed by Nexpep Pty, Ltd., a company in Melbourne, Australia. It is based on their findings that only three peptides are responsible for eliciting the majority of the T cell response that goes on to destroy the intestines of celiac patients. HLA molecules function to present these toxic peptides to T cells; this presentation is what activates the T cells, instigating the inflammatory response. Thus, this vaccine relies on the HLA type. It is specific for celiacs with the HLA-DQ2 haplotype, accounting for about 90% of celiac patients. Nexvax2 encompasses these three proprietary peptides, presenting them to T cells in the absence of a second, T-cell stimulatory signal. T cell recognition of the HLA-DQ2 bound toxic peptides thus occurs in a non-inflammatory environment, establishing tolerance to dietary gluten. This peptide based approach has been successful in generating tolerance in people with cat-sensitive asthma, and has not been used more broadly because it has been difficult to identify the correct toxic epitopes. Similar efforts are underway to discover and develop peptide-based therapeutic vaccines for other autoimmune diseases, including multiple sclerosis, Type-1 diabetes, and rheumatoid arthritis, but celiac disease is an ideal target for the technology because the HLA types that activate the inflammatory T cells in celiac disease are so well defined.
    The vaccine consists of a weekly or monthly injection, and would allow those with celiac disease to resume eating "normal" levels of gluten without suffering adverse effects. Other therapies that have proposed to treat celiac disease, such as those promoted by the companies Alva, Alba, and Chemocentryx, did not aim to replace the gluten free diet; they allowed only small, intermittent exposure to gluten. During the Phase I trial of Nexvax2, some people who got the injections containing the highest doses of the toxic peptides suffered gastrointestinal distress; they thus inadvertently acted as a positive control, indicating that the peptides administered are in fact the correct ones.
    ImmusanT is also partnering with INOVA Diagnostics to use reactivity to these peptides as a diagnostic test both for celiac disease and for those celiac patients who might be good candidates for the Nexvax2 vaccine - i.e. those 90% who are HLA-DQ2 rather than those who are HLA-DQ8.
    Source:

    http://www.sciencedaily.com/releases/2011/05/110509091559.htm

    Tina Turbin
    Celiac Disease Prevalence is on the Rise
    Celiac.com 10/12/2011 - According to recent estimates, three million Americans suffer from celiac disease—approximately 1% of the population, and only three percent of them have to this writing been correctly diagnosed. As startling as that sounds to us all, according to a news article on Medscape Today, the incidence of celiac disease has increased markedly over the last three decades, perhaps even as fourfold, and studies are suggesting the incidence may actually be higher than 1% of the population.
    What is the reason for this? According to Dr. Jonas Ludvigsson, MD, from the Department of Medicine, Epidemiology Unit at the Karolinska Institute and Orebro University Hospital in Sweden, and a renowned celiac expert, there may be many factors explaining this, but there probably is an actual increase underlying these.
    The Medscape article went on to report that the Mayo Clinic has confirmed increase in celiac disease incidence, reported in Discovery's Edge, the Mayo Clinic's research magazine. Dr. Joseph Murray, MD, and colleagues analyzed stored blood samples from Air Force recruits in the early 1950s for gluten antibodies. It was assumed that 1% would be positive, given today's estimates, but the number of positive results was far smaller. Dr. Murray and his colleagues compared their results with two more recently collected sets with the conclusion that celiac disease is about four times more common today than it was in the 1950s.
    Additionally, Dr. Ludviggon's research team in Sweden has found that those living with celiac disease and latent celiac disease have higher mortality than those who don't have these conditions. Latent celiac disease is also known as "gluten sensitivity," a term to describe those who have "normal small intestinal mucosa but positive celiac disease serology," estimated to affect 1 in 1000 people. According to Dr. Ludvigsson's research team, in 1 year, 10 of 1000 individuals with celiac disease will die, as compared with 7 in 1000 individuals without the disease. The mortality rate is increased among those who also have latent celiac disease as well. The increased risk, however, is quite small.
    As alarming as the statistics are regarding the increasing rate of celiac disease, Dr. Ludvigsson shares some good news with Medscape—the methods of diagnosing celiac disease are actually improving. According to some other estimates, the rate of celiac diagnosis rate is increasing. For those who are testing positive for the celiac disease, the only method of treatment currently available is eliminating gluten from the diet. Yes, this is a simple treatment, although it can require some challenging lifestyle adjustments for the gluten-free community, something which I address in my work as an author, researcher, and gluten-free advocate. In the future, we may see other treatments such as gluten-digesting enzymes (which are on the rise) or even the genetic modification of the structure of gluten in wheat so that it will not cause an autoimmune reaction in celiac patients. Even with celiac diagnosis incidence on the rise, with raised awareness and effective diagnosis, we can help change the lives of millions of celiac Americans for the better. This is an important endeavor.


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    Im the same, I never know what to eat, some food does better than others for me, I went on to make my own soup and Im glad I did, I should do it more often and at least then J know what's going in to it, it wasn't the best first try but I enjoyed it haha
    Thank you for the advice, in the end I went and made my own soup, not great for my first try but it was better than potentially making myself worse, I enjoyed it, I got some vitamains too to take, I was able to find a liquid Vitamain B Complex, the store I went to was helpfull enough to show me what was Gluten Free.   I fealt awful around then, Im feeling like I have more energy now I can actually do things and focus more, Ill keep on like I have been, Im not 100% and still have some B
    Not to mention the fact that (for those using the Nima) the Nima sensor has been known to give false positives. https://www.theverge.com/2019/4/1/18080666/nima-sensor-testing-fda-food-allergy-gluten-peanut-transparency-data https://www.celiac.ca/cca-statement-nima-gluten-sensor/ https://www.allergy-insight.com/nima-is-it-really-96-9-accurate/ https://www.glutenfreewatchdog.org/news/troubling-gluten-testing-data-released-by-nima-but-hold-the-phone/ https://www.glutenfreew
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