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Is Reflux Involved in Esophageal Mucosal Changes in Active Celiac Disease Patients?

Celiac.com 04/20/2016 - People with celiac disease very often have reflux symptoms. A team of researchers recently set out to evaluate mucosal integrity and motility of the lower esophagus as possible contributors to reflux symptoms in patients with celiac disease.

Photo: CC--Jacinta Illuch ValeroThe research team included María Inés Pinto-Sánchez, Fabio D. Nachman, Claudia Fuxman, Guido Iantorno, Hui Jer Hwang, Andrés Ditaranto, Florencia Costa, Gabriela Longarini, Xuan Yu Wang, Xianxi Huang, Horacio Vázquez, María L. Moreno, Sonia Niveloni, Premysl Bercik, Edgardo Smecuol, Roberto Mazure, Claudio Bilder, Eduardo C. Mauriño, Elena F. Verdu, and Julio C. Bai.

They are variously affiliated with the Farncombe Family Digestive Health Research Institute at McMaster University, in Hamilton, Ontario, Canada, the Department of Medicine, "Dr. Carlos Bonorino Udaondo" Gastroenterology Hospital in Buenos Aires, Argentina, Favaloro University Hospital in Buenos Aires, Argentina, Consejo de Investigación en Salud, MSAL, Gobierno de la Ciudad Autónoma de Buenos Aires, Argentina, and with the Gastroenterology Chair, Universidad del Salvador in Buenos Aires, Argentina.

For their study, they enrolled newly diagnosed celiac disease patients with and without reflux symptoms, non-celiac patients with classical reflux disease (GERD), and control subjects, who had no reflux symptoms.

Using both light microscopy and electron microscopy, they assessed endoscopic biopsies from the distal esophagus for dilated intercellular space (DIS). They used qRT-PC to determine tight junction (TJ) mRNA proteins expression for zonula occludens-1 (ZO-1) and claudin-2 and claudin-3 (CLDN-2; CLDN-3).

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Overall, patients with active celiac disease showed higher DIS scores than controls, and similar to GERD patients. They found altered DIS even in celiac disease patients without reflux symptoms, who had normalized after one year of a gluten-free diet.

Celiac disease patients with and without reflux symptoms had lower expression of ZO-1 than controls. Celiac disease and GERD patients showed similar expression of CLDN-2 and CLDN-3.

This study shows that patients with active celiac disease have altered esophageal mucosal integrity, independent of any reflux symptoms.

Loss of TJ integrity in the esophageal mucosa may result from altered expression of ZO-1, which may contribute to the development of reflux symptoms.

Source:

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6 Responses:

 
bryan
Rating: ratingfullratingfullratingemptyratingemptyratingempty Unrated
said this on
25 Apr 2016 3:34:32 PM PDT
These articles might be beneficial if a layman could actually understand what is being said.....

 
jack
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said this on
27 Apr 2016 2:17:30 PM PDT
I agree. Even being a nurse, I was challenged to understand what was being said.

 
Mark
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said this on
25 Apr 2016 6:39:32 PM PDT
Excellent!!!!
Perhaps all celiacs could pass this on to their on to their gastro!
THANK YOU!

 
Shirley
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said this on
26 Apr 2016 11:44:07 AM PDT
I agree with Bryan. It would be great if a layperson such as myself could understand these reports.

 
Dawna
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said this on
26 Apr 2016 1:00:43 PM PDT
I figured as much.

 
Christie
Rating: ratingfullratingfullratingfullratingemptyratingempty Unrated
said this on
03 May 2016 7:44:24 AM PDT
If you could understand all that was being said it would be great! However it seems as if the GERD I currently have is due to my celiac , also I know now that the Nexiym I've been taking is also causing malabsorption issued as well..... My BIG question would be , OK , now they have figured this out ...WHAT can we do about it ???




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The only symptom I know of that is celiac for certain is dh, which must be diagnosed by a dermatologist.

I have both eoe and celiac and now that I have been gluten free for 18 months, my anemia is gone. It is good to get off the iron supliments because mine may have been the cause of my ulcers. It feels good to recover and heal! I may work my way down to fewer supliments and lots of feel great da...

Your daughter does not have a strong positive. I suspect that the GI might do as RMJ suggested which would be to load her up on gluten for six months and retest. On the other hand, with a diagnosed sibling and a very mild positive, your GI might recommend the endoscopy or run the test again to ...

I was diagnosed with celiac last year on an endoscopy looking for the cause of my anemia. At the time, my GI doc tested m for EoE and it was negative. Fast forward 11 months, I developed sudden heart burn, dysphagia out of the blue. My doc thinks it's EoE. Biopsy was last week and I am still wait...

No, the control test is to verify that she will react to that particular type of test. If she didn't, then certain of the bloods would not be applicable to her. They would be false negatives. As far as tests being weak positives, that's like being a little pregnant. A positive is a positive....