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What Role Do Infectious Mediators and Gut Microbes Play in Celiac Disease?

Celiac.com 04/13/2015 - Celiac disease is associated complications in the small bowel, but also with problems outside the GI tract. Celiac disease affects small bowel mucosal immunity via exposure to infectious agents; therefore, it is likely that patients with untreated celiac disease are more susceptible to infectious diseases. It is possible that sensitivity to gluten increases in patients with infectious diseases, and that infection may consequently trigger celiac disease in susceptible individuals.

Photo: CC--Tim GreenA team of researchers recently conducted a review of medical literature to determine if infectious mediators may stimulate an immune reaction and act as a trigger factor for celiac disease in susceptible individuals. The research team included Mohammad Rostami-Nejad PhD, Sauid Ishaq FRCP, David Al Dulaimi MD, Mohammad Reza Zali MD FACG AGAF, and Kamran Rostami MD PhD.

For their study, they searched PubMed, Medline, Google scholar, SID, and Magiran for full text articles published between 1999 and 2014 in Persian and English. Using associated keywords, they searched for and selected papers which described the impact of infectious agents on celiac disease.

Various studies show that the intestinal microbiota of celiac disease patients show variations in the diversity and abundance of different cultivable bacterial species, which might be a result of celiac disease pathogenesis.

Celiac disease results from the interplay of environmental factors, such as gluten intake, infectious agents, and intestinal microbiota, and immunologic factors. Among environmental factors, infectious agents and intestinal microbiota have been implicated; however, the main factors underlying this connection are not well understood.

The following reasons may account for this: 1) Intraepithelial migration of infectious agents are associated with their motility and virulence, 2) adhesion interaction between human intercellular adhesion molecule 1 (ICAM-1) and the parasite MIC2, and therefore immune precipitation, could be accrued, 3) pathogenic microbiota may attack the intestinal epithelial cells and affect epithelial binding proteins (tight-junctions), as a result of which the permeability of the intestinal wall of the host will be increased.

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Understanding the correlation between infectious agents and autoimmune disorders may provide insight into the disease mechanism. In addition, it may enable the development of potential therapeutic targets to combat this common genetic disorder.

Differences in the bacterial communities in children and adults with celiac patients have been reported in some studies (Table 2).44–53 Also, the population of bacteria in treated and untreated celiac disease patients is different according to the diagnosis in adults. Some studies suggest that the microbial communities of treated celiac patients might be similar to the known microbial communities of healthy adults.

According to these studies, more investigations are required to assess the importance of some of these bacteria for celiac disease patients, such as the unknown bacterium not detected in treated and untreated celiac disease patients, and the role of the microbiota in healthy individuals. Also, infectious mediators may stimulate an immune reaction and act as a trigger factor for celiac disease in susceptible individuals.

Stay tuned for further revelations concerning the impact of celiac disease on gut microbiota, including news on how a gluten-free diet impacts the gut flora of people with celiac disease.

Source:

  • Rostami-Nejad M, Ishaq S, Al Dulaimi D, Zali MR, Rostami K. The Role of Infectious Mediators and Gut Microbiome in the Pathogenesis of
    Celiac Disease. Arch Iran Med. 2015; 18(4): 244 – 249.

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I believe the talk around this forum is that cheerios are not gluten free enough for people with celiac at this time. I don't know if anything has changed on that and when their lawyer calls me I'll quickly delete this. haha

Could be we generally say get off of dairy for a few months when going gluten free. The part of the intestines that produce the enzymes, and help break down dairy are associated with the tips of the villi, which are the most damaged if not gone in celiacs. THIS is why most of us end up with a lactose intolerance early on. And most can introduce it later after healing. As to her symptoms with it there was a bunch of research about dairy permeated the gut and causing neurological issues in a autism study I was looking at years ago. And there have been other studies about damaged intestines and how the hormones in milk can easier effect ones body. Personally I also have a huge grudge against dairy on a personal level as it is not natural to suck on a cows tits and drink the stuff, nor your dogs, nor a rabbits......I mean come on even Human Breast milk you would find odd to drink as an adult right? Back in the past dairy was a great way to get calories and fats when there was famine, etc around I mean it is meant to make a calf grow into a 500+lb cow. But on a genetic and hormonal level it is not really for human consumption and now days the whole corporate BS propaganda push and dairy farms shove that oh its healthy stuff down your throat. There are plenty of dairy free options for everything feel free to message me if you need help finding anything I have been dairy free for over a decade.

The full celiac panel checks TTG IGA and IGG, DGP IGA and IGG, IGA, EMA as Jmg stated above. Your test included TTG IGA and IGA. If your IGA was low, a low on TTG IGA would be inconclusive. But your IGA is fine. A high on any one test is a positive for celiac and should lead to an endoscopy for confirmation. So I'd get tested for TTG IGG, DGP IGA and IGG and EMA since there are symptoms. Warning I'm not a doc.

I did a gluten challenge for my endoscopy and requested a second blood test after my follow up with the consultant. I never did see those results but my GP said no celiac was indicated: Which left me gluten free for life, that wasn't an option after the challenge, but with a less satisfactory diagnosis, one by omission rather than the definitive 'you're celiac' one I was expecting. Yes! I have been 'properly' glutened on a couple of occasions but on several more I've detected a change or a reaction based on what could only have been trace amounts. NCGS is as yet poorly understood but patients tend to have more neuro symptoms than digestive. That's definitely been my experience, although it was only after going gluten free that I realised quite how many digestive symptoms I had just been living with as 'normal'. Close friends and family get the full explanation. 'I have an auto immune disease similar to 'coeliac etc.' If they stay awake long enough I'll tell them about the less than perfect testing process I went through or the Columbia Med research and the possibility of a blood test soon. They can see the difference between me on gluten and off it so they understand its not all in my head* If I'm ordering food in a restauarant or asking questions about food prep etc I will often just self declare as coeliac - people are aware of that and understand those requests are medical rather than fad diet based. I don't have any problem doing this, I'm not going to claim that and then cheat on dessert for instance and to be honest I expect once the research is complete the two conditions may wind up alongside others as different faces of the same coin. In the meantime I safeguard my health and avoid getting into a detailed conversation about genuine gluten sensitivity versus faux hipster posturing! *apart from the bits which are in my head

I originally had it on my face and scalp. (22 years ago) First biopsy with dermatologist came back as folliculitis. Then when I had a new outbreak on my upper back, she was able to remove a nice clean blister and we got the diagnosis of DH. She started me on Dapsone (100mg/day) and gluten free diet. Now I take 25-50 mg/day. My understanding at the time was that DH was the skin version of Celiac. Did a lot of research on my own. I met Dr. Peter Green at a Gluten free Vendors Fair and he said that a diagnosis of DH IS a diagnosis of Celiac, even if no other symptoms. So I stay gluten-free