Celiac.com 12/07/2022 - What is the nutritional and health impact of a long-term gluten-free diet on people with celiac disease? A team of researchers recently set out to take a deep look at the influence of a long-term gluten-free diet on nutritional status, body composition, and associated factors in adult Saudi females with celiac diseases. 

One Year Study of Fifty-one Diagnosed Celiac Patients

For their study, the team included fifty-one diagnosed celiac patients who had followed a gluten-free diet for over one year.  They collected data on patient dietary patterns, along with a complete analysis of anthropometric parameters, levels of vitamins B12 and D, and complete blood count (CBC). 

The data show that all patients suffered from an insufficient intake of all micro and macro-nutrients, including vitamin D, folate, calcium, and iron. Otherwise, their bloodwork fell within the expected ranges. 

While one-third of patients were slim, nearly half showed decreased total body fat, more than half of the patients showed low waist/hip ratios, and more than sixty-percent showed decreased levels of visceral fat. On the whole, patients with poor nutritional status also tended to have poor educational levels and some psychosocial factors that may have influenced their results.

However, the team did find that a gluten-free diet in women with celiac disease negatively affects their nutritional intake and anthropometric indices, and leads to a deficiency in major nutrients, vitamins, and ions.

Study Conclusions

This study confirms other studies that show that gluten-free foods often have poorer nutritional quality than their non-gluten-free counterparts, and that many people with celiac disease suffer from poor nutrition or malnutrition. 

The results highlight the need for women, but also for all celiacs on a gluten-free diet, to be extra vigilant about making sure to get enough nutrition, fiber and nutrients.

Nutrients 2022, 14(10), 2090

The research team included Aeshah Ibrahim Alhosain, Ghedeir M. Alshammari, Barakat Lafi Almoteri, Mohammed A. Mohammed, Manal Abdulaziz Binobead, and Mohammed Abdo Yahya. They are variously affiliated with theDepartment of Food Science and Nutrition, College of Food and Agricultural Sciences, King Saud University in Riyadh, Saudi Arabia, and the Department of Gastroenterology, Buraidah Central Hospital, Ministry of Health in Buraydah, Saudi Arabia.

Celiac.com 11/28/2022 - First-degree relatives of people with celiac disease have much higher celiac disease rates than the general population, but there isn't much data on the clinical characteristics of the relatives as a group.

To get a better idea of the exact level of risk, a team of Canadian researchers recently carried out a retrospective review of patients who visited a pediatric celiac disease clinic. 

The researchers conducted a retrospective review of 227 patients (144 girls and 83 boys) who were diagnosed with biopsy-proven celiac disease between 1996 and 2014, with an average age of 8 years old at diagnosis. All patients were screened using tissue transglutaminase (tTG-IgA) tests with normal IgA immunoglobulin level for their age. Out of the 227 celiac patients, 49 (21.6%) were initially screened because a first-degree relative had celiac disease, and out of this group 24 (49%) were symptomatic, while 25 (51%) were asymptomatic.

The 49 first-degree relatives had equally severe Marsh biopsy scores whether they were symptomatic or asymptomatic, and compared to the 178 patients who were screened for other reasons 149 (83.7%) were symptomatic, and 29 (16.3%) were asymptomatic. Interestingly their was no significant difference between the different patient groups' biopsy Marsh scores or tTG-IgA levels at screening.

According to the researchers:

• "Although 51% of patients screened due to an affected first-degree relative were asymptomatic, their disease histology was as severe as those screened for symptoms suggestive of celiac disease. These findings support current recommendations to screen all first-degree relatives of patients with celiac disease regardless of clinical symptoms."

The findings support current recommendations to screen all first-degree relatives of patients with celiac disease, even in the absence of clinical symptoms.

If you have an unscreened first-degree relative, a mother, father, brother, sister, son or daughter, it's a good idea for them to get screened, especially if they have symptoms, but even if they don't, as "silent " celiac disease can be an issue for many of these folks.

Read more in the Journal of Pediatric Gastroenterology and Nutrition and at medscape.com.

The research team included Michelle J Gould; Jenna Dowhaniuk; Jorge Arredondo; Paul Azzopardi; Tina Hu; Heather Mileski; Andrea Carpenter; Nikhil Pai; and Herbert Brill. They are variously affiliated with the Department of Paediatrics, University of Toronto, Toronto, ON, Canada; the Division of Gastroenterology and Nutrition, Department of Paediatrics, McMaster University, Hamilton, ON, Canada; the Department of Pathology, McMaster University, Hamilton, ON, Canada; the Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada; the Department of Medicine, University of Toronto, Toronto, ON, Canada; The Hospital for Sick Children, Toronto, ON, Canada; the Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Canada; the Department of Pediatrics, William Osler Health System, Brampton, ON, Canada; and McMaster Children’s Hospital, Hamilton, ON, Canada.

Celiac.com 11/03/2022 - Fair warning, this article talks freely about poop, poop storage, and poop replacement. Basically, this article is all about poop, and the role it might plays in your future good health, so if that's an issue, now is a good time to tune out, or in if you want to learn more. 

The crucial role of the gut microbiome in maintaining human health is just beginning to be understood. Many different cultures, and more than a few scientists, talk of a gut/brain connection. And healthy poop plays a major role in a healthy gut.

We know that patients with C-diff and other gut maladies can benefit from fecal transplants from people with healthy guts. It's done via a medical procedure called fecal microbiota transplantation, or FMT.

Some research shows FMT may help treat inflammatory bowel diseases, such as Crohn’s or ulcerative colitis.

Studies in animals indicate that FMT may help treat obesity, lengthen lifespan, and reverse some effects of aging, such as age-related decline in brain function. Other clinical trials are assessing its potential for treating cancer.

Now scientists are taking a serious look at the idea that banking fecal samples when we're young, and implanting them in our colons later in life, might help reverse damage, and restore gut health. The science behind this is not robust at the moment. It is mainly anecdotal and relies, in part, on extrapolating benefits from existing fecal transplants and extending those to regular people as a way to treat potential conditions later in life.

Even so, a number of researchers are taking the lead and encouraging existing stool banks to permit regular folks to bank their poop now, so they can use it in the future when there is more science done to support the concept.

That means the researchers feel strongly that future research, data and clinical experience will back them up and confirm their bet. Believe it or not, poop banks are already a thing. Just like sperm banks or blood banks, or any number of other banks for health-related specimens, stool banks exist for treating some of the conditions we've mentioned.

So, the whole process of banking poop, would be pretty simple. You would head to your local stool bank. You would then provide a sample, which the bank would screen for diseases, wash, process, and deposit into long-term storage.

Then, later in life, your doctors could access the sample for implantation to treat inflammatory bowel disease, heart disease, or type 2 diabetes, or even to restore your gut after medical treatment that wipes out your microbiome, like antibiotics or chemotherapy.

In such cases, doctors could use medical procedure called fecal microbiota transplantation, or FMT, to implant your banked stool to revitalize your gut microbiome to its earlier, healthier state, Scott Weiss, MD, Harvard Medical School professor and a co-author of a recent paper on stool banking, told reporters. 

However, Weiss adds, it is best to use healthy samples, so ideally banking stool between the ages of 18 and 35, or before any serious medical condition impacting the gut. Although samples provided by people who are still healthy, even into their 50s, could still be helpful later.

Certainly, a world in which we can treat major diseases with a simple transplant from our personal stool banks is an intriguing and attractive one. Just how much benefit can be gained from FMT remains to be seen, but results like these are encouraging. Stay tuned for more on this and related stories.

Read more on this topic at WebMD.com
 

Celiac.com 10/24/2022 - The advisability of considering the extra-intestinal manifestations of celiac disease, even in patients without typical intestinal symptoms, is not well studied. A team of researchers recently set out to examine the literature regarding the occurrence of thrombotic events in celiac disease, and to synthesize the data from case reports and case series.

The research team included Nikola Pantic, Ivana Pantic, Dorde Jevtic, Vanajakshi Mogulla, Stevan Oluic, Momcilo Durdevic, Terri Nordin, Mladen Jecmenica, Tamara Milovanovic,Tatjana Gavrancic, and Igor Dumic.

The team performed a systematic review of medical literature by searching the Pub-Med/MEDLINE database through January 2022, to identify published cases and case series on this topic, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. 

The team included a total of 55 cases in the study.  Most patients were previously healthy people, with no comorbidities. 

In nearly one-third of the cases, a celiac disease diagnosis was made before thrombosis began. In just over one-third of the other patients, thrombosis preceded the celiac diagnosis or was made together with the celiac diagnosis. 

Most thrombosis (about 1 in 3 cases) was found in hepatic veins, while thrombosis of cerebral blood vessels, deep venous thrombosis of lower extremities, and pulmonary thromboembolism were less common. 

Nearly 4 out of 5 cases of thrombosis were restricted to one site only. Nearly 70% of thrombosis patients were treated with anticoagulants, and placed on a gluten-free diet.

This study reinforces the importance of considering extra-intestinal manifestations of celiac disease, even in patients without typical intestinal symptoms. 

The original article belongs to the Special Issue Celiac Disease and Non-celiac Gluten Sensitivity, Extraintestinal-Associated Conditions: Efficacy of a Gluten-Free Diet.

Read more at MDPI.com

The researchers are variously affiliated with the Clinic of Hematology, University Clinical Center of Serbia, Belgrade, Serbia; the Clinic of Gastroenterology and Hepatology, University Clinical Center of Serbia, Belgrade, Serbia; the Elmhurst Hospital Center, Department of Internal Medicine, Elmhurst, NY, USA; the Icahn School of Medicine at Mount Sinai, New York, NY, USA; the Mayo Clinic Alix School of Medicine, Rochester, MN, USA; the Department of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI, USA; the Department of Internal Medicine, Loyola University Medical Center, Maywood, IL, USA; the Department of Hospital Medicine, Advocate Aurora Health, Green Bay, WI, USA; the Oceana Gastroenterology Associated, Corona, CA, USA; and the Department of Hospital Medicine, Mayo Clinic, Jacksonville, FL, USA.

Celiac.com 10/06/2022 - The effects of a gluten-free diet on screen-detected celiac disease is poorly understood. A team of researchers recently set out to assess the population-based rates of undiagnosed celiac disease in adults, and to examine the effects of a gluten-free diet on screen-detected celiac disease. 

The research team included Jan-Magnus Kvamme, Sveinung Sørbye, Jon Florholmen & Trond S. Halstensen. They are variously affiliated with the Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Norway; the Department of Gastroenterology, University Hospital of North Norway, Tromsø, Norway; the Department of Pathology, University Hospital of North Norway, Tromsø, Norway; the Institute of Oral Biology, University of Oslo; and the Medical Department, Lovisenberg Diaconal Hospital, Oslo, Norway.

For their population-based health study, the team looked at results from nearly thirteen-thousand adults in Tromsø, Norway.  The team invited study participants with increased levels of anti-tissue transglutaminase-2 IgA or anti-deamidated gliadin peptide IgG to undergo gastroduodenoscopy and biopsy, the results of which received both histological and immunohistochemical assessment. 

The rate of previously diagnosed celiac disease was 0.37%, while the rate of previously undiagnosed celiac disease was 1.10%. Thus, 1.47% of the population had celiac disease, of whom 75% were undiagnosed. 

Overall, those who adopted a gluten-free diet resulted in significant improvements in overall gastrointestinal symptoms, diarrhea, and health-related quality of life, with nearly eighty-percent reporting reduced abdominal discomfort, and nearly sixty-percent reporting better energy levels. 

The vast majority of undiagnosed adult celiac disease patients on a gluten-free diet reported reduced gastrointestinal symptoms and improved health-related quality of life. 

Because most adult patients appear to consider the symptoms a part of their normal state and therefore remain untested and undiagnosed, the team recommends that clinicians to be more liberal celiac disease testing, even in patients with few or no abdominal symptoms.

Read more in Nature

Celiac.com 10/03/2022 - In addition to their usual season pitch to seniors, doctors are recommending that people with celiac disease get a pneumonia vaccine. 

People with celiac disease face a greater risk for pneumonia than non-celiacs. However, about seventy-five percent of celiac patients fail to get a pneumonia vaccine after they are diagnosed, writes a research team in the journal Alimentary Pharmacology and Therapeutics.

The recommendation stems from the team's 2016 study, in which the researchers used data on English patients collected between 1997 and 2011, including 9,803 with celiac disease and a comparison group of 101,755 people without celiac.

The study was conducted by F. Zingone, A. Abdul Sultan, C. J. Crooks, L. J. Tata, C. Ciacci, and J. West, who are variously affiliated with the Division of Epidemiology and Public Health, University of Nottingham, City Hospital, Nottingham, UK; and the Coeliac center, Department of Medicine and Surgery, University of Salerno, Salerno, Italy.

They found that, even though people with and without celiac disease had pneumonia at similar rates, people under age 65 with a celiac diagnosis, who didn’t get a pneumonia vaccine were nearly thirty-percent more likely to get pneumonia than those who were vaccinated.

The problem may be related to impaired spleen function. Celiac disease can cause spleen issues for up to a third of patients, which may put them at greater risk for infections.

Spleen function does tend to improve for celiacs on a gluten-free diet, which is another reason early diagnosis and quick adoption of a gluten-free diet is essential to a good prognosis.

Dr. Shamez Ladhani of Public Health England in London, who was not involved in the study, told reporters for Reuters that "getting a flu vaccine can also help protect against bacterial infections like pneumonia," and also recommended that patients with spleen problems should get a flu vaccine every year and the pneumonia vaccine every five years.

Read more in Alimentary Pharmacology and Therapeutics

09/12/2022 - In most cases, celiac disease is diagnosed using anti-tTG, anti-DGP, or EMA serological tests, and then confirmed via duodenal biopsy. Xerostomia or dry mouth is a common problem for people with celiac disease. Xerostomia interferes with normal salivary gland function, causing dry mouth, which can trigger oral plaque and periodontal disease.

Looking to establish a non-invasive method for diagnosing celiac disease, a team of researchers recently set out to compare salivary and serum levels of tissue transglutaminase IgA (tTG-IgA), and to assess the severity of xerostomia symptoms in people with celiac disease. The research team included Mehran Ajdani, Nazanin Mortazavi, Sima Besharat, Saeed Mohammadi, Taghi Amiriani, Ahmad Sohrabi, Alireza Norouzi, and  Ghezeljeh Edris.

For their case–control study, the team drew participants from the internal ward of Sayyad Shirazi hospital, along with a healthy control group of students at Gorgan Dental College. The team then conducted serum analysis with patient consent. They followed with a salivary test, and then compared the results of both tests.

The team used the Xerostomia Inventory questionnaire to assess the severity of xerostomia symptoms. The team looked at factors such as total protein concentration of saliva, albumin concentration, amylase level, along with levels  of pH, sodium, calcium, potassium, phosphorus, and interleukin (6, 18, and 21).

The team looked at a total of seventy-eight people, aged 15 to 68, about two-thirds of whom were female. Overall, the serum and saliva of people without celiac disease showed higher levels amylase than those with celiac disease. 

Meanwhile, people with celiac disease showed higher average levels of IL-6، IL-18 ،IL-21, and salivary and serum tTG. Additionally, celiac patients were more likely to develop xerostomia than non-celiacs.

The team's findings show that celiac disease can reduce some salivary enzymes and elements in the mouth, and increase inflammatory cytokines, salivary, and serum tTG.

The team suggests that doctors should help celiac patients to manage dry mouth to help avoid the damage associated with the condition.

Previous studies have shown that dental enamel defects are strong indicators of celiac disease. Learning about the connection between celiac disease and mouth health This new study further highlights the relationship between celiac disease conditions in the mouth and teeth.

Stay tuned for more on this and related stories.

Read more in BMC Gastroenterology

The researchers are variously affiliated with the Dental Research Center, Golestan University of Medical Sciences, Gorgan, Iran; the Department of Oral and Maxillofacial Medicine, School of Dentistry, Golestan University of Medical Sciences, Gorgan, Iran; the Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran; the Stem Cell Research Center, Golestan University of Medical Sciences, Gorgan, Iran; the Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran; and the Cancer Control Research Center, Cancer Control Foundation, Iran University of Medical Sciences, Tehran, Iran.

Celiac.com 09/05/2022 - According to studies, most people with celiac disease are exposed to gluten on a regular basis, even those who are trying to be diligent about avoiding gluten. For these people, eating gluten can trigger gastrointestinal symptoms and intestinal damage.

Anyone whose ever had that happen can testify to the unpleasant results, including the stomach pain, bloating, diarrhea, and other symptoms. Currently, there aren't too many options for celiacs who are exposed to small amounts of gluten, especially for those exposed on a regular basis. 

A team of researchers recently set out to assess changes in the ratio of villus height to crypt depth in celiac patients exposed to 2g of gluten per day for 6 weeks, as part of a study on IMGX003 (Latiglutinase). On behalf of theCeliacShield Study Group, the research team included Joseph A. Murray; Jack A. Syage; Tsung-Teh Wu; Chaitan Khosla; and Jennifer A. Sealey-Voyksner.

They are variously affiliated with the Mayo Clinic, Gastroenterology and Hepatology in Rochester, MN; the Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN; ImmunogenX, Inc., Newport Beach, CA; the Boston Biostatistics Research Foundation, Framingham, MA; Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland; and Stanford University, Stanford, CA.

The team administered the double-blind, placebo-controlled gluten-challenge as part of a Phase 2 trial to assess the safety and efficacy of a 1,200 mg dose of IMGX003 in celiac patients exposed to 2 g of gluten per day for 6 weeks. 

The team used ANCOVA to assess progress toward their main endpoint, which was a change in the ratio of villus height to crypt depth (Vh:celiac disease), along with secondary endpoints, which included densities of intraepithelial lymphocytes (IEL) and symptom severity. Tertiary endpoints included serology and gluten-immunogenic peptides (GIP) in urine.

Forty-three out of fifty randomized patients completed the challenge. Twenty one patients received IMGX003, while twenty-two received a placebo. 

The results showed that IMGX003 reduced gluten-induced intestinal mucosal damage and symptom severity in celiac patients on a six week gluten challenge of 2 grams per day. 

Drugs like IMGX003 could potentially play a role in receding symptoms and gut damage in people with celiac disease who are exposed to low amounts of gluten, especially through accidental exposure. 

Still, we've seen promising drugs come and go, each falling by the wayside when they failed to deliver in clinical trials. Stay tuned for more on this and related stories.

Read more at gastrojournal.org

Celiac.com 08/08/2022 - Celiac disease is triggered by digestion-resistant gluten peptides that carry immunogenic epitopes. Sourdough fermentation has shown promise in reducing the concentration of gluten peptides within food. However, researchers don't know much about the effect of partial sourdough fermentation on immunogenic gluten. 

A team of researchers recently set out to examine the effect of a single sourdough culture, much like those commonly consumed in commercial products, on the digestion of immunogenic gluten peptides. The research team included Olivia J. Ogilvie; Juliet A. Gerrard; Sarah Roberts; Kevin H. Sutton; Nigel Larsen; and Laura J. Domigan.

They are variously affiliated with the School of Biological Sciences, University of Canterbury, 20 Kirkwood Avenue, Upper Riccarton, Christchurch in New Zealand; the Riddet Institute, Massey University, Private Bag in Palmerston North, New Zealand; the School of Biological Sciences, University of Auckland, Private Bag in Auckland, New Zealand; The New Zealand Institute for Plant & Food Research Limited, Private Bag in Christchurch Mail Centre, Christchurch 8140, New Zealand; and the Department of Chemical and Materials Engineering, University of Auckland, Private Bag Auckland 1142, New Zealand.

The team used the INFOGEST protocol to digest sourdough bread. Across the entire the digestion process, they used quantitative and discovery mass spectrometry to model the kinetic release profile of key immunogenic peptides, and to profile novel peptides, while using ELISA to assess the allergenicity of gluten. Additionally, they performed macrostructural studies. 

As it turns out, sourdough fermentation changed the protein structure, in vitro digestibility, and immunogenic peptide release profile of certain peptides. Interestingly, sourdough fermentation did not reduce overall concentration of immunogenic peptides, but it did change the in vitro digestion profile of certain peptides. 

The team's effort shows that partial sourdough fermentation can change immunogenic gluten digestion. Theirs is the first study to assess the in vitro kinetic profile of immunogenic gluten peptides from sourdough bread.

The idea that the celiac immune reaction to immunogenic gluten peptides can be reduced using sourdough fermentation is an intriguing one. Stay tuned for more on this and related stories.

Read more in Nutrients 2021, 13(6), 1906
 

Celiac.com 05/12/2022 - Recent studies suggest that KIR+CD8+ T cells could offer a path to controlling autoimmune diseases, such as “long COVID,” which emerge after viral infections.

Ly49+CD8+ T cells are a subset of CD8+ T cells that have shown immunoregulatory activity in mice. These cells can suppress myelin oligodendrocyte glycoprotein (MOG)–specific pathogenic CD4+ T cells through their cytolytic activity and thereby ameliorate experimental autoimmune encephalomyelitis (EAE). 

However, whether a similar CD8+ regulatory T cell subset exists in humans and whether its suppressive activity extends beyond autoimmune diseases to play a more general role in peripheral tolerance remains to be determined.

A team of researchers recently shared some relevant findings regarding CD8+ T cells in humans.

The research team included Jing Li; Maxim Zaslavsky; Yapeng Su; Jing Guo; Michael J Sikora; Vincent van Unen; Asbjørn Christophersen; Shin-Heng Chiou; Liang Chen; Jiefu Li; Xuhuai Ji; Julie Wilhelmy; Alana M McSween; Brad A Palanski; Venkata Vamsee Aditya Mallajosyula; Nathan A Bracey; Gopal Krishna R Dhondalay; Kartik Bhamidipati; Joy Pai; Lucas B Kipp; Jeffrey E Dunn; Stephen L Hauser; Jorge R Oksenberg; Ansuman T Satpathy; William H Robinson; Cornelia L Dekker; Lars M Steinmetz; Chaitan Khosla; Paul J Utz; Ludvig M Sollid; Yueh-Hsiu Chien; James R Heath; Nielsen Q Fernandez-Becker; Kari C Nadeau; Naresha Saligrama; and Mark M Davis.

A recent report by Li et al., notes the existence of a similar CD8+ T cell subset in humans, which possess killer cell immunoglobulin-like receptors (KIRs). This function in humans mirrors that in the mouse Ly49 family.

These cells are able to suppress self-reactive CD4+ T cells, and are more plentiful in patients with autoimmune conditions, such as celiac disease, multiple sclerosis, and lupus, as well as in patients infected with influenza virus or severe acute respiratory syndrome coronavirus 2. 

When researchers injected viruses into mice selectively deficient in Ly49+CD8+ T cells, the mice showed normal antiviral immune responses, but they later developed symptoms of autoimmune disease. 

The team found that CD8+ T cells express inhibitory killer cell immunoglobulin-like receptors (KIRs), making them the human equivalent of Ly49+CD8+ regulatory T cells in mice.

These CD8+ T cells are abundant in the blood and inflamed tissues of patients with several different autoimmune diseases. Moreover, these CD8+ T cells easily eliminated pathogenic gliadin-specific CD4+ T cells from the leukocytes of celiac disease patients in vitro. 

Because of this, KIR+CD8+ T cells could offer a path to controlling autoimmune diseases, such as “long COVID,” which emerge after viral infections.

Tellingly, in COVID-19 patients, the team also found elevated levels of KIR+CD8+ T cells, but not CD4+ regulatory T cells, which corresponded to disease severity, and levels of vasculitis. 

Selective destruction of Ly49+CD8+ T cells in virus-infected mice reversed their infections, and restored their autoimmunity. 

These results suggest that in humans, as in mice, these regulatory CD8+ T cells act uniquely to suppress pathogenic T cells in autoimmune and infectious diseases.

Read more in Science. 2022 Apr 15;376(6590):eabi9591.

Also: PubMed.

The researchers are variously affiliated with the Institute of Immunity, Transplantation and Infection, Stanford University School of Medicine, Stanford, CA, USA; the Program in Computer Science, Stanford University, Stanford, CA, USA; the Institute for Systems Biology, Seattle, WA, USA; the Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, USA; the Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA; the KG Jebsen Coeliac Disease Research Centre, University of Oslo, Oslo, Norway; the Institute of Clinical Medicine, University of Oslo, Oslo, Norway; the Department of Immunology, University of Oslo, Oslo, Norway; The Howard Hughes Medical Institute, Stanford University School of Medicine, Stanford, CA, USA; the Human Immune Monitoring Center, Stanford University School of Medicine, Stanford, CA, USA; the Department of Chemistry, Stanford University, Stanford, CA, USA; Sean N; Parker Center for Allergy and Asthma Research, Department of Medicine, Stanford University, Stanford, CA, USA; the Program in Immunology, Stanford University School of Medicine, Stanford, CA, USA; Division of Neuroimmunology, Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA; the Department of Neurology and UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, USA; Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA; VA Palo Alto Health Care System, Palo Alto, CA, USA; the Division of Immunology and Rheumatology, Department of Medicine, Stanford University, Stanford, CA, USA; the Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA; the Stanford Genome Technology Center, Stanford University, Palo Alto, CA, USA; the European Molecular Biology Laboratory (EMBL), Genome Biology Unit, Heidelberg, Germany; the Department of Chemical Engineering, Stanford University, Stanford, CA, USA; the Stanford ChEM-H, Stanford University, Stanford, CA, USA; the Department of Immunology, Oslo University Hospital, Oslo, Norway; the Department of Bioengineering, University of Washington, Seattle, WA, USA; and the Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University, Stanford, CA, USA.

Celiac.com 05/02/2022 - Patients with chronic illnesses often suffer from sexual function. Many patients with chronic gastrointestinal and liver disorders also suffer from sexual dysfunction, but little study has been done on celiac patients, even though celiac disease is a highly common gastroenterological disorder that can cause multiple nutrient deficiencies. A team of researchers recently set out to investigate the sexual function incidence and the risk factors for sexual dysfunction in both male and female celiac disease patients.

For their cross-sectional observational study, the team anonymously included two hundred and eighty-four patients, with 170 females, and 114 males. The team evaluated female sexual function through the Female Sexual Function Index questionnaire. 

They used the International Index of Erectile Function-5 questionnaire to assess male sexual function. They also recorded clinical-demographic information for both groups. To figure out overall rates and assessment of sexual dysfunction in this group of celiac disease patients. They then compared differences in the patient-reported outcomes among the different subgroups, looking for clinical-demographic predictors of sexual dysfunction.

Half of the women's group had a total score compatible with sexual dysfunction: nearly half showed low desire, half showed inability to obtain orgasm, nearly eighty percent showed arousal disorder, two-thirds reported lubrication disorder, and a whopping 94.70%, showed sexual discomfort during intercourse. 

Meanwhile, more than sixty percent of the men's group showed scores marking erectile function, with seven percent of those showing mild erectile dysfunction, more than twenty percent mild to moderate erectile dysfunction, and just under three percent showing severe erectile dysfunction. 

In both male and female patient groups, sexual dysfunction was also associated with altered body mass index. 

Most celiac disease patients suffer from sexual dysfunction. Early age at the time of diagnosis was a major predictor of sexual dysfunction in male celiac patients. That is, the younger the patient at celiac diagnosis, the greater the likelihood that the patient will later suffer sexual dysfunction.

Because of this the research team recommends assessment of sexual function as part of initial celiac disease patient assessment, to ensure prompt diagnosis and treatment for any dysfunction.

Read more in Andrology

The research team included Lorenzo Romano, Raffaele Pellegrino, Carmine Sciorio, Biagio Barone, Antonietta Gerarda Gravina, Antonio Santonastaso, Caterina Mucherino, Silvia Astretto, Luigi Napolitano, Achille Aveta,Savio Domenico Pandolfo, Davide Loizzo, Francesco Del Giudice, Matteo Ferro, Ciro Imbimbo, Marco Romano, and Felice Crocetto. They are variously affiliated with the Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, Naples, Italy; the Hepato-Gastroenterology Unit, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy; the Urology Unit, ASST “Alessandro Manzoni” Hospital, Lecco, Italy; the Gastroenterology Unit, “Sant'Anna and San Sebastiano” Hospital, Caserta, Italy; the Division of Urology, Department of Surgery, VCU Health, Richmond, Virginia, USA; the Urology, Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari “Aldo Moro”, Bari, Italy; the Department of Maternal-Infant and Urological Sciences, Policlinico “Umberto I” Hospital, University of Rome “La Sapienza”, Rome, Italy; and the Department of Urology, Stanford Medical Center, Stanford, California, USA.

Celiac.com 04/28/2022 - Some studies have indicated that celiac disease patients may not fully respond to hepatitis B virus (HBV) vaccination, and may therefore be at greater risk of developing HBV infection. However, the data are far from conclusive. Also, there's not been much study on the risk of HBV infection in celiac disease patients.

To get a clearer picture of the issue, a team of researchers recently set out to assess the response to hepatitis B virus (HBV) vaccination and the risk of HBV infection in celiac disease patients.

The research team included Nawras Habash; Rok Seon Choung; Robert M Jacobson; Joseph A. Murray; and Imad Absah. They are variously affiliated with the Division of Pediatric Gastroenterology and Hepatology; the Division of Community Pediatric and Adolescent Medicine, Division of Pediatric Infectious Diseases; the Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.

For their cross-sectional study, the team used data from the National Health and Nutrition Examination Survey (NHANES) database, from 2009–2014, to assess the rate of HBV vaccination, immune response, and HBV infection risk in patients with and without celiac disease. 

The team calculated the rate of HBV infection via retrospective analysis of two groups of patients. The first visited the Mayo Clinic from 1998–2021, while the second was a stable longitudinally observed cohort, the Rochester Epidemiology Project (REP), from 2010–2020.

Based on the NHANES data, the rate of HBV infection in the United States was 0.33%. Of 93 patients with celiac disease, 46 (49%) were vaccinated for HBV and of the remaining 19,422 without celiac disease, 10,228 (53%) were vaccinated. 

Twenty-two (48%) vaccinated patients with celiac disease had HBV immunity, while 4,405 (43.07%) of vaccinated patients without celiac disease had HBV immunity, which was not significantly different. 

NHANES data showed no cases of HBV infection in celiac patients. 

During the study period, the team found just over 3,500 patients with celiac disease who were seen at Mayo Clinic, and nearly four thousand patients with celiac disease in the REP database. Of those patients with celiac disease, only four (0.11%) at Mayo Clinic and nine (0.23%) of the REP patients had HBV infection.

These data show that the rate of HBV vaccination and immunity was similar for individuals with and without celiac disease. Overall, they showed no greater risk of HBV infection for celiac disease patients. 

Based on these results, HBV screening and HBV revaccination to increase immunity is not required for people with celiac disease.

Read more in the Journal of Pediatric Gastroenterology and Nutrition: March 2022 - Volume 74 - Issue 3 - p 328-332