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  1. Celiac.com 09/20/2018 - Some people with celiac disease experience extreme symptoms when they eat gluten. These folks adopt various strategies for navigating the world. One of those strategies involves getting a gluten-sniffing service dog. We’ve done a few stories on gluten-sniffing dogs over the years. Dogs like Zeus and Hawkeye are famous for helping their owners sniff out gluten before they can eat it. Can Gluten-Sniffing Dogs Help People with Celiac Disease? The stories are always popular. People love the stories, and people love the dogs. After all, pretty much anyone with celiac disease who has ever read about gluten-sniffing dogs would love to have one. Who could say no to a warm, fuzzy dog that can take a sniff of your food and signal you when it contains gluten? The stories almost always generate plenty of feedback and more than a few questions. To answer some of those questions, we’ve decided to do an article that provides some facts about gluten-sniffing dogs. Here are a few factors to keep in mind about gluten-sniffing service dogs: Gluten-free Dog Status: One thing to remember is that proper gluten-sniffing dogs are professionally trained service animals, much like seeing-eye dogs or hearing-ear dogs. As professional service animals, the dogs must be trained and certified as service animals. The dogs may then accompany their master pretty much anywhere they go, and are available to assess all food and snacks. Gluten-free Dog Training: Proper training takes time, which equals money. Professional trainers might only train one or two dogs, and the training can take about a year. There are very few trainers for gluten-sniffing dogs, and there are also currently no official guidelines or certification. Gluten-free Dog Cost: In our recent story on the gluten-sniffing black Lab, Hawkeye, we noted that the dog cost $16,000, not including food, and vet bills. Gluten-free Dog Reliability: Nimasensor.com notes that “[g]luten-sniffing dogs may detect gluten in amounts as small as .0025 parts per million with 95 percent to 98 percent accuracy.” The Mercola.com website says that Willow, a gluten-sniffing German shorthaired pointer in Michigan, can detect gluten with 95 percent to 98 percent accuracy. Read more on gluten-sniffing dogs: Gluten-Sniffing Dogs Are Game Changers for People With Celiac Disease Gluten-sniffing dogs help people with celiac disease What to Know About Gluten-Sniffing Dogs Gluten-Sniffing Assistance Dog Helps Celiac Sufferer Lead Normal Life
  2. Celiac.com 09/19/2018 - Great news for gluten-free cookies lovers! Girl Scouts has announced the debut of a new gluten-free cookie to its enormously popular cookie brand. The new Caramel Chocolate Chip is a chewy cookie that contains caramel, semi-sweet chocolate chips, and a hint of sea salt. also happens to be gluten-free. The new gluten-free treat will be available in select areas during the 2019 cookie-selling season; which typically runs from February to April each year. The gluten-free Caramel Chocolate Chip joins the Girl Scouts’ two other gluten-free offerings: Toffee-tastic, a buttery cookie with sweet and crunchy golden toffee bits, and Trios, a peanut butter oatmeal cookie with chocolate chips. The Girl Scouts of America has been around for over 100 years and now hosts more than 1.8 million girl members. Every year, about 100 million scouts between the ages of five and 18 sell approximately 200 million boxes of cookies nationwide. According to the Girl Scouts website, that money stays local to develop local leadership training activities, summer camps, and more activities. According to a 2016 study conducted by the Girl Scout Research Institute, approximately 85% of Girl Scouts surveyed said that Girl Scout Cookie Program helped them learn how to set goals and meet deadlines, while 88% said it helped them become effective decision-makers. Another 88% said they learned how to manage money, while 94% said the program helped them to learn business ethics. The Girl Scouts have also added online sales and iOS and Android apps that allow people to find cookies or order from their phones.
  3. Celiac.com 09/18/2018 - With a number of major tennis stars singing the praises of a gluten-free diet, including top players like Novak Djokovic, Swiss great Roger Federer weighed in on the topic. The 20-time Grand Slam winner says that he’s never tried the gluten-free diet, and that he doesn’t not “even know what that all means…I eat healthy, and I think that's what people should do, too, if they have the options. It's sure important the right diet for an athlete.” Djokovic, the 2018 US Open winner has been gluten-free since 2011, and calls the diet his biggest key to his success. For Federer, diet is helpful, but not the whole story. “[Diet] can help you, you know. I mean, I think every athlete should be in good shape. I don't think we should have any fat athletes, to be honest. We do too much sports and we should be too professional to let that happen to ourselves. If it happens, well, we should wake up. You don't have the right entourage. They're not telling you that you're a bit fat. Players try different things, and whatever works for them. I do my thing. It's been very easy and natural and healthy, and it's worked.” So, while Novak Djokovic, and a number of other athletes, have gone gluten-free and continue to tout the benefits, look for Federer to remain faithful to his generally nutritious non-gluten-free diet. Read more at: TennisWorldUSA.org
  4. Celiac.com 09/14/2018 - Celiac.com was all set to do a story on the latest peer-reviewed data on the Nima gluten testing device, when along comes Gluten-Free Watchdog with another of their famous non-recommendations. Gluten-Free Watchdog says they cannot recommend the Nima gluten test kit because of alleged flaws. But what does the science say? The latest Nima article and Gluten-Free Watchdog’s complaint both focus on the science, so let’s start there. Nima makes two different food sensors: one detects gluten, the other detects peanuts. Each sensor comprises a small, handheld electronic device and a cartridge. To test food, consumers place a pea sized amount into the cartridge, place the cartridge inside the sensor, and run the device. They then receive a smiley face or wheat symbol with "gluten found," depending on whether or not the Nima device detected the allergen. Nima reported their original data in a peer-reviewed scientific journal. Among the conclusions: “Compared with reference R5, Nima antibodies (13F6 and 14G11) had 35- and 6.6-fold higher gliadin affinities, respectively. Nima demonstrated device performance using a comprehensive list of foods, assessing detection sensitivity, reproducibility, and cross-reactivity. Nima presented a 99.0% true positive rate, with a 95% confidence interval of 97.8%–100%.” Gluten Free Watchdog says that: “Based on third party testing data, the Nima Sensor fails to detect gluten at the 20 ppm level over 20 percent of the time. It isn’t until a sample contains a level of gluten at the 40 ppm level, that a gluten found result is received close to 100% of the time.” Gluten Free Watchdog suggests that this is a problem, because: “At a level of gluten in a sample from less than 2 ppm up to a level of gluten between 30 ppm and 40 ppm, the result displayed on the Nima Sensor may be either smiley face or gluten found. If a sample is tested with a Nima Sensor and the result is a smiley face, there is no practical way for a consumer to know if the level of gluten in the sample is less than or more than 20 ppm. If a sample is tested with a Nima Sensor and the result is gluten found, there is no practical way for a consumer to know if the level of gluten in the sample is less than or more than 20 ppm. As a result, the data point received from the Nima Sensor for gluten presents major interpretation problems.” Gluten Free Watchdog charges that Nima uses “NOT the scientifically validated Ridascreen Gliadin R5 ELISA Mendez Method from R-Biopharm used by Gluten Free Watchdog.” The fact is that R5 Elisa remains the industry standard for most testing applications. Gluten Free Watchdog closes its warning with a word from their independent expert: According to Adrian Rogers, Senior Research Scientist at Romer Labs, “It could be argued that the device is not fit for purpose as the company states that there is a clear differentiation between safe and unsafe products based on a 20 ppm level which the validation data does not corroborate.” It’s worth noting that for all his accomplishments, Rogers is neither a doctor, nor a PhD. Rogers' LinkdIn page lists his education as: Bsc (Hons), Microbiology, University of Wales, Aberystwyth. A Bachelor of Science degree may not necessarily make an expert in this subject, yet he is presented as one. Rogers also seems to have a potential conflict of interest that was omitted in Thompson’s press release. Directly from Rogers’ LinkdIn site: “Romer Labs®, Inc. developed an immunochromatographic lateral flow assay for the qualitative detection of gluten in raw ingredients, processed foods, finished food products, and environmental surfaces, using the G12 antibody developed by Belén Morón. The G12 antibody targets a 33-mer peptide which is resistant to enzymatic digestion and heat denaturation, as well as being the fragment of the gliadin protein to which celiac disease sufferers react, making it a reliable analytical marker.” The company Rogers works for, Romer Labs, makes its own gluten testing kits. It seems a bit disingenuous for Gluten Free Watchdog to use a spokesperson from a potentially competing company to try to counteract a peer-reviewed scientific publication for a device which is made by a potential competitor. Nima’s Scientific Advisory Board includes some of the most highly respected celiac disease researchers and scientists in the world. They include: Peter HR Green, MD Phyllis and Ivan Seidenberg Professor of Medicine. Director, Celiac Disease Center at Columbia University; Jody Puglisi, PhD Stanford University Professor of Structural Biology; Lucille Beseler, MS, RDN, LDN, CDE, FAND Family Nutrition Center of South Florida; Benjamin Lebwohl, MD, MS Director of Clinical Research Celiac Disease Center at Columbia University; John Garber, MD Gastroenterology, Mass General; and Thanai Pongdee, MD Consultant, Division of Allergic Diseases, Mayo Clinic. Nima says that Gluten Free Watchdog’s view of their recently published validation is incomplete and misleading. Nima wrote: “All the studies show Nima is highly sensitive across a range of both low and high levels of gluten." "The Nima third party data accurately reported gluten found at 20 ppm and above between 93.3% for food as prepared (a food item that is spiked with an intended quantity of gluten) and 97.2% for food as quantified by an ELISA lab kit (used to determine the exact ppm of gluten in the food)." "The Nima peer reviewed study published in the Food Chemistry Journal reported gluten found at 20 ppm and above at 96.9% accuracy." The statement that: “'Nima will fail to detect gluten at 20 ppm 20% of the time' is almost entirely driven by 1 specific food out of 13 tested. That sample, when quantified, was actually below 20 ppm." "In real life, people get glutened at many different ppm levels, not just 20 ppm. Nima has been shown to detect gluten at levels below, at and above 20 ppm across a variety of foods in a number of studies.” Reading the peer reviewed data provided by Nima, and reading Gluten Free Watchdog’s complaints, it becomes clear that Gluten Free Watchdog’s complaints sound serious and authoritative, but ring a bit hollow. Consider the Following Analogy Imagine a gluten-sniffing dog that performed as well as Nima in scientific trials; same performance, same exact data. You can give this dog a sniff, or a small bite of food, and he can signal you if the food’s got gluten in it with 97% accuracy at 20ppm or below. Nearly 100% accuracy at 40ppm or above (as stated by Gluten Free Watchdog). People would think that the dog was not only cute and fluffy, but wonderfully helpful and everyone would love it, and everyone with celiac disease would want one. And it would be a great big gushing warm and fuzzy feel-good story. Pretty much no one would be arguing that the dog was potentially dangerous, or somehow unfit for people with celiac disease. Such dogs would also be far more expensive to own and maintain than the Nima device. Apparently such dogs can cost upwards of $16,000, not including the cost of food, vet bills, etc. So, what’s the accuracy rate of a gluten-sniffing dog, anyway? From Mercola.com: Willow, a German shorthaired pointer, is another gluten-sniffing dog, in this case living in Michigan. Her owner, Dawn Scheu, says she can detect gluten with 95 percent to 98 percent accuracy. She worked with a trainer (the same one who trained Zeus) to teach her own dog to detect gluten, with excellent results. Gluten-sniffing dogs may detect gluten in amounts as small as .0025 parts per million with 95 percent to 98 percent accuracy. So, will Gluten Free Watchdog be warning against gluten-sniffing dogs anytime soon? Somehow, because Nima is a mechanical device made by a company, it's not so warm and fuzzy, not so feel-good. Maybe Nima needs to shape their device like a cute little doggy, or a Pez candy dispenser? But the data remains, as does the fact, whatever its drawbacks, anything that detects gluten like Nima does, as well as it does, is potentially very helpful for celiac disease in numerous situations. And it is extremely unlikely to do them any harm. Nima seems very much committed to transparency, scientific excellence, and continual product improvement. These are noble goals and generally a win for people with celiac disease. Think of it, just ten years ago, a portable gluten-sensor with the kind of accuracy Nima is reliably achieving would have been the stuff of fantasy. Yet here it is. More accurate than any gluten-sniffing dog, and for a couple hundred bucks. People with celiac disease are living in a very different world than just a few years ago. Nima did not have to publish its data, but it chose to do so, and in a reputable, peer-reviewed scientific journal. Nima conducted its research using solid scientific standards, and reported those results publicly. They explained their methodology and results, they acknowledged product limitations and expressed a commitment to improvement. How is this remotely controversial? The celiac disease community is fortunate to have companies committed to investing time and money into products and devices that help to improve the lives of people with celiac disease. We feel strongly that the perfect should not be the enemy of the good. Devices like the Nima gluten sensor can be helpful for numerous people with celiac disease. Disclosure: Nima is a paid advertiser on Celiac.com. Celiac.com's advertisers do not influence our editorial content. Read Nima’s full report on test data at: Food Chemistry.com Read Gluten Free Watchdog’s Statement on the Nima device at: Glutenfreewatchdog.org Read Nima’s Reply to Gluten Free Watchdog at: Nimasensor.com
  5. Celiac.com 09/13/2018 - Bob’s Red Mill finds itself under fire by two women who claim the company knowingly hides the presence of an allegedly cancer-causing weed killer in its steel cut oat and rolled oat products, and falsely advertises those products as healthy. Tamara Frankel and Natasha Paracha filed a federal class action in San Francisco, alleging that parent company Bob’s Red Mill Natural Foods knows that its oat products contain or likely contain glyphosate, but fails to disclose it on the label. The women cite a recent report by the Environmental Working Group, an environmental research and advocacy group, which claimed to find traces of controversial herbicide glyphosate in Cheerios, Quaker Oats and other oat-based breakfast foods. The women contend that Bob’s uses labels such as “gluten free,” “wheat free” and “purity tested,” which lead consumers to falsely believe them to be healthy. Both U.S. and European regulators have concluded that glyphosate is safe, while that World Health Organization’s International Agency for Research on Cancer classifies it as a probable human carcinogen. Bayer subsidiary Monsanto, maker of the glyphosate-based herbicide Roundup has faced numerous lawsuits over its product. A San Francisco jury recently found that exposure to Roundup caused the cancer of a school groundskeeper, and awarded him $289 million in damages. Shortly after that verdict, the Environmental Working Group released a report claiming that 31 of 45 oat-based food samples tested positive for glyphosate, and that levels exceeded safety limits of 160 parts per billion. EWG applies a more stringent standard than the 2 mg/kg/day of glyphosate standard used by the U.S. Environmental Protection Agency, and the 1.1 mg per day standard used by the State of California. Frankel and Paracha are represented by Patricia Syverson of the San Diego law firm Bonnett, Fairbourn, Friedman & Balint. Stay tuned for more developments on this and related stories.
  6. Celiac.com 09/12/2018 - Many people with celiac disease develop peripheral neuropathy, also known as gluten neuropathy. A team of researchers recently set out to determine rates of neuropathic pain in patients with seemingly idiopathic peripheral neuropathy and gluten sensitivity, and to make note of any contributing factors. They included patients with positive antigliadin, endomysial, and/or transglutaminase antibodies, with or without enteropathy. The research team included P Zis, PG Sarrigiannis, DG Rao, and M Hadjivassiliou. They are affiliated with the Academic Department of Neurosciences, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Glossop Rd, Sheffield, South Yorkshire, UK. They invited all consecutive patients with gluten neuropathy attending a specialist gluten/neurology clinic to participate in the study. They used the DN4 questionnaire and the visual analog scale to assess pain levels. They used the Overall Neuropathy Limitations Scale to assess the severity of neuropathy, along with the Mental Health Index (MHI-5) to assess patients' general mental health status. A total of 33 out of 60 patients with gluten neuropathy showed neuropathic pain. The team found no significant differences between the painful, and the non-painful groups in terms of age, gender, neuropathy severity and neuropathy type. Over half of patients with painless gluten neuropathy followed a strict gluten-free diet, compared with just 21.2% of those with painful neuropathy. Patients with painful gluten neuropathy also showed significantly worse MHI-5 scores. After adjusting for age, gender and MHI-5 scores, multivariate analysis showed that, strict gluten-free diet lowered the odds of peripheral neuropathic pain by nearly 90%. Most patients with gluten neuropathy commonly have neuropathic pain, which is associated with poorer mental health status. A strict gluten-free diet might substantially reduce rates of peripheral neuropathic pain in patients with gluten neuropathy. Read more at: J Neurol. 2018 Jul 21. doi: 10.1007/s00415-018-8978-5.PMID: 30032386
  7. Celiac.com 09/11/2018 - Gluten sensitivity is the most common sign of celiac disease. Clinical celiac diagnosis usually involves a positive blood test followed by biopsy confirmation of a typical enteropathy. The body’s immune response to celiac disease involves both adaptive and innate immunity, and is marked by anti-gliadin (AGA) and anti-transglutaminase 2 antibodies (tTGA), lymphocytic infiltration in the intestinal epithelial membrane, and expression of multiple cytokines. Researchers know that long pentraxin 3 (PTX3), an acute-phase inflammatory molecule, plays an important role in innate immunity. A pair of researchers recently set out to assess the relationship between Pentraxin 3 and biopsy status in celiac patients. Roberto Assandri and Alessandro Montanelli of the Department of Clinical Pathology, Clinical Chemistry Laboratory ASST Ospedale Maggiore di Crema, Italy, and the Clinical Chemistry Laboratory, Spedali Civili di Brescia, Italy, set out to explore a possible relationship between PTX3 and celiac disease. They used Marsh Histological grade following Marsh criteria classification to dividing 108 celiac disease patients into three groups: Group 1: Marsh 0, patients with a known history of celiac disease under gluten free diet, complete remission; Group 2: Marsh 1 and Marsh 2; Group 3: Marsh 3. As a control group, they used 30 healthy age-matched individuals with no known history of celiac disease or gastrointestinal symptoms. They used sandwich ELISA on an automated platform to measure PTX3 serum levels. They found that PTX3 serum levels were substantially higher in group 3 and group 2 compared with the healthy control group. They found no statistically significant differences between group 1 and the healthy control group. They noted a strong linear correlation between PTX3 serum levels and AGA levels in group 2, and group 3, but no such correlations between PTX3 serum levels and tTGA levels. Blood tests showed that PTX3 correlated with major gastrointestinal damage in celiac patients. PTX3 is a part of the innate immune system’s humoral branch. Data from this study show that PTX3 serum levels are high in active disease patients with pathological levels of AGA. They also show that patients with normal AGA IgA levels had PTX3 serum levels compared to healthy control subjects. The team proposes that PTX3 can modulate the innate response to gliadin in celiac disease, and may also regulate the adaptive immune response. Read more at: Gastroenterology and Hepatology
  8. Celiac.com 09/10/2018 - Anyone diagnosed with celiac disease needs to eat a gluten-free diet if they hope to see their condition improve, and not lead to worse outcomes. So, how much gluten exposure do celiacs get on a gluten-free diet? William F. Balistreri, MD, Director Emeritus, Pediatric Liver Care Center; Medical Director Emeritus, Liver Transplantation at Cincinnati Children's Hospital in Cincinnati, Ohio presented data at this year's Digestive Disease Week that focused on the challenges celiac patients face in trying to follow a gluten-free diet. Gluten-free standards and labels help improve awareness, but even so, eating gluten-free can be a challenge. Anyone with celiac disease can tell you that the chances of accidental gluten contamination are many, and that consent vigilance is required. Even ”gluten-free foods" are not always free from variable amounts of gluten, whether by imprecise food production, processing, packaging, or preparation. Accidental gluten exposure can also come via non-foods, such as lipstick, shampoo, toothpaste and the like. Regular, low-level gluten exposure can cause many celiac patients to have mucosal inflammation despite maintaining a gluten-free diet. Product by product, gluten levels are generally well-known, but not much is known about how much gluten exposure levels in people with celiac disease who are following a gluten-free diet. Such information could be quite helpful in designing disease management and patient follow-up strategies. Gluten immunogenic peptide (GIP) analysis provides direct and quantitative measurement of gluten exposure, has proven useful in diagnosis and clinical management of non-responsive or refractory celiac patients. To figure out the amounts of gluten ingested by highly motivated, educated celiac patients following a gluten-free diet, the research team measured levels of GIPs in food, urine, and stool. They noted the connections between gluten exposure and persistent villous atrophy or related conditions. The study also analyzed food samples from restaurant “doggie bags" saved by the study subjects. The team detected gluten in at least one food sample from nearly 90% of patients consuming a gluten-free diet. That indicates that nearly nine out of ten people with celiac disease, who are trying hard to follow a gluten-free diet, as being exposed to gluten when they eat out. Overall, approximately 33% of food samples tested positive for GIPs above 20 ppm, and the estimated GIPs ingested ranged from 0.23 mg to > 40 mg per exposure. This new information confirms what many people with celiac disease have long suspected. Namely, that avoiding gluten is really hard to do, even for who are highly aware of gluten-related celiac disease issues, and who work hard to avoid gluten. Read more at: Medscape.com
  9. Celiac.com 09/07/2018 - For the first time in one place, here are Celiac.com’s most popular recipes for gluten-free dinner entrees. These recipes have been enjoyed by hundreds of thousands of readers and have anchored more than a few gluten-free dinner tables. They are sure to please even the most hungry gluten-free eaters. Celiac.com’s Twenty Most Popular Gluten-Free Dinner Recipes are: Really Good Gluten-free Beef Stew Recipe Really Good Gluten-Free Chinese-style Fried Rice Recipe Easy Gluten-free Meatloaf Recipe Gluten-free Lobster Mac and Cheese with Truffle Oil Recipe Basic Gluten-Free Cheese Risotto Recipe Easy Gluten-Free Slow Cook Pot Roast Recipe Really Good Gluten-free Shepherd's Pie Recipe Really Good Gluten-Free Chicken Marsala Recipe Really Good Gluten-free Lasagna Recipe Gluten-free Italian-style Meatballs Recipe Gluten-Free Potato Salad Recipe Easy Gluten-Free Ground Beef Tacos Recipe Classic Gluten-Free Mexican-Style Rice Recipe Gluten-Free Chinese-style Lemon Chicken Recipe Celiac.com's Best Ever Gluten-free Thanksgiving Recipe Gluten-Free Corned Beef Recipe Gluten-Free Irish Soda Bread Recipe Easy Gluten-Free Bacon and Cheese Cornbread Recipe Gluten-Free Chicken Vegetable Curry Recipe Easy Gluten-Free Oven-baked Salmon Recipe
  10. Celiac.com 09/06/2018 - What are the most common foods that can trigger allergic reactions in people? First, and it's important to be clear about this, a food allergy is not to be confused with a food sensitivity. Food sensitivities are common and usually harmless, if sometimes uncomfortable. Food sensitivity can cause symptoms like gas, bloating, stomach upset, indigestion, and the like when some people eat certain foods. A food allergy, on the other hand, is an immune reaction that happens when the body mistakes harmless food, a peanut for example, for something that could make you sick. When you eat a food you're allergic to, your immune system thinks you’re body is being harmed, and reacts to protect you from that harm. This reaction can be as mild as a light skin rash or red, itchy eyes, or it could be serious enough to cause difficulty breathing, swelling, pain, shock and even death. An allergic reaction can happen very soon after eating an allergenic food, or it can happen many hours later. Either way, food allergies are potentially serious, and should be treated as such. According to WebMD, these nine foods account for about 90% of all food allergies: Peanuts Tree nuts, such as walnuts, almonds, pine nuts, brazil nuts, and pecans Soy Milk Eggs Wheat, barley, and rye—Celiac disease Oats Fish Shellfish Mild symptoms of a food allergy reaction include: Red, swollen, dry, or itchy skin and rash (hives or eczema) Runny or stuffy nose, sneezing, or a slight, dry cough Itchy, watery, red eyes Itchy mouth or inside your ear Funny taste in your mouth Upset stomach, cramps, vomiting, or diarrhea Though any of these foods can cause an allergic reaction, peanuts, nuts, fish, and shellfish are well known for causing severe allergic reactions. Symptoms of a sever allergic reaction to food include: Trouble breathing or swallowing Swollen lips, tongue, or throat Feeling weak, confused, or light-headed, or passing out Chest pain or a weak, uneven heartbeat If you suspect that you or someone you know is having an allergic reaction to food, especially a severe reaction, definitely seek medical attention immediately.
  11. Celiac.com 09/05/2018 - About one out of every twenty celiac patients fails to respond to a gluten-free diet, and goes on to develop refractory celiac disease (RCD). RCD is a serious condition marked by appearance of intraepithelial T lymphocytes. Depending on the phenotype of the lymphocytes, people develop either RCD I or RCD II. Patients with RCD type II (RCDII) show clonal expansions of intraepithelial T lymphocytes, and face an especially poor prognosis. Just over half of these patients will die within five years of onset due to aggressive enteropathy-associated T-cell lymphoma. At this time, researchers don’t know whether genetic variations might play a role in the severe progression from celiac disease to RCDII. A team of researchers recently set out to try to get some answers. The team began by conducting the first genome-wide association study to identify the causal genes for RCDII, along with the molecular pathways at play in cases of RCDII. For their genome-wide association study, the team used 38 Dutch patients with RCDII, and replicated the 15 independent top-associated single nucleotide polymorphism (SNP) variants (P<5×10) in 56 independent French and Dutch patients with RCDII. The team found that, after replication, SNP rs2041570 on chromosome 7 was significantly associated with progression to RCDII (P=2.37×10, odds ratio=2.36), but not to celiac disease susceptibility. They also found that SNP rs2041570 risk allele A was associated with lower levels of FAM188B expression in blood and small intestinal biopsies. Stratifying RCDII biopsies by rs2041570 genotype revealed differential expression of innate immune and antibacterial genes that are expressed in Paneth cells. The team’s efforts resulted in the identification of a new SNP associated with the severe progression of celiac disease to RCDII. Their data suggest that genetic susceptibility to celiac disease might be unrelated to celiac progression to RCDII, and suggests that Paneth cells might play a role in RCDII progression. Source: Eur J Gastroenterol Hepatol. 2018 Aug;30(8):828-837. The research team included B Hrdlickova, CJ Mulder, G Malamut, B Meresse, M Platteel, Y Kamatani, I Ricaño-Ponce, RLJ van Wanrooij, MM Zorro, M Jan Bonder, J Gutierrez-Achury, C Cellier, A Zhernakova, P Nijeboer, P Galan, S Withoff, M Lathrop, G Bouma, RJ Xavier, B Jabri, NC Bensussan, C Wijmenga, and V Kumar. They are variously affiliated with the Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, the Department of Gastroenterology, VUMC, Amsterdam, The Netherlands, INSERM U1163, Imagine Institute and Paris Descartes University, the Department of Gastroeneterology, Georges Pompidou European Hospital, the Paris 13 University Sorbonne Paris Cité, UREN, Inserm (U557), Inra (U1125), Cnam, Bobigny, France, the scientific director of McGill University and Génome Québec Innovation Centre, Montréal, Québec, Canada, the Gastrointestinal Unit and Center for the Study of Inflammatory Bowel Disease, Massachusetts General Hospital and Harvard Medical School, Boston, The Broad Institute of MIT and Harvard, Cambridge, Massachusetts, the Department of Medicine, University of Chicago, Chicago, Illinois, USA., and the K.G. Jebsen Coeliac Disease Research Centre, Department of Immunology, University of Oslo, Norway.
  12. Celiac.com 09/04/2018 - Want a tasty, simple, reasonably quick gluten-free dinner that is sure to satisfy? This recipe for salted cod and smashed potatoes is just the ticket. Add some arugula with a delightful vinaigrette, and you're home free. This recipe pairs smashed potatoes with slated cod, milk, garlic, and herbs for a big, gluten-free suppertime hit. Ingredients: 4 cod fillets, 4-6 ounces each 1½ cups whole milk 2 shallots, sliced 1½ teaspoons salt 1 teaspoon dried thyme 2 bay leaves 3 cloves garlic, crushed 1 pound red baby potatoes 2 tablespoons salted butter ¼ cup chives 1 ounce arugula pinch of salt pinch of cracked black pepper 2 teaspoons extra virgin olive oil Tomato and thyme vinaigrette: 5 ounces plum tomatoes ½ teaspoon thyme 1½ cups tomato juice 1 tablespoon sherry vinegar 2 pinches of salt 1 pinch of cracked black pepper Directions: For the vinaigrette, add all the ingredients in a blender and puree until smooth. Strain, and season to taste, and put aside. Rub the cod fillets with salt and set aside for 25 minutes. Place the potatoes in a pot, bring to a simmer and cook until tender. When potatoes are done, drain away the water, and place potatoes in a bowl. While still warm, crush the potatoes in the bowl, add the melted butter, salt, and the chopped chives. Run cod under cold water to rinse all the salt off. Place cod in a large saucepan with the cold milk, thyme, crushed garlic, sliced shallots and bay leaves. Bring to a simmer, cook for four minutes, remove and place on plate for serving. Place the potato just off the middle of the plate, place the cod on top and spoon over the dressing. Dress the rocket with the olive oil, salt and pepper, and add place beside the cod.
  13. Celiac.com 09/03/2018 - Can an office-based point of care test (POCT) improve celiac disease detection and diagnosis? A team of researchers recently set out to measure the diagnostic performance of an IgA/IgG-deamidated gliadin peptide (DGP)-based POCT for celiac disease detection, patient acceptability, and inter-observer variability of the POCT results. The research team included Michelle S. Lau MBChB, Peter D. Mooney MD, William L. White MBChB, Michael A. Rees BMedSci, Simon H. Wong MBChB, Marios Hadjivassiliou FRCP, Peter H. R. Green MD, Benjamin Lebwohl MD & David S. Sanders FRCP. They are variously affiliated with the Academic Department of Gastroenterology, the Academic Department of Neurosciences and University of Sheffield, Royal Hallamshire Hospital, Sheffield Teaching Hospitals, Sheffield, UK, and with the Celiac Disease Centre at Columbia University Medical Centre in New York, NY, USA. Beginning in 2013, and running through 2017, the team recruited patients who had been referred for secondary care with gastrointestinal symptoms, anemia and/or weight loss (group 1), along with a group of patients with self-reported gluten sensitivity, but unknown celiac disease status (group 2). Every patient in the study received a POCT, tests for IgA-tissue transglutaminase (IgA-TTG), IgA-endomysial antibodies (IgA-EMA), total IgA levels, and a duodenal biopsy. A total of 500 patients completed acceptability questionnaires, and the team compared inter-observer variability of the POCT results among five clinical staff for 400 cases. Group 1 included 1,000 patients. The team saw forty-one patients (4.1%) diagnosed with celiac disease. The sensitivities of the POCT, IgA-TTG, and IgA-EMA were 82.9, 78.1, and 70.7%; the specificities were 85.4, 96.3, and 99.8%. Group 2 included 61 patients. The POCT showed 100% sensitivity, but negative predictive value in detecting celiac disease in group 2. A majority of patients preferred the POCT to a blood draw (90.4% to 2.8%). A Fleiss Kappa coefficient of 0.895 reflected good inter-observer agreement on the POCT results. The POCT had comparable sensitivity to a blood test, and accurately spotted all celiac disease cases in a gluten sensitive group. But, because its low specificity may could cause further unnecessary tests, it’s not good enough to take the place of blood testing. It turns out that spotting celiac disease is only part of the battle. Making sure to rule out people who don’t have celiac disease is equally important. That’s why it’s important that any diagnostic test be both sensitive, to spot celiac disease, and specific, to rule out celiac disease in those who don’t have it. Until we get a PCOT with high enough sensitivity and specificity to make accurate celiac diagnosis and accurate elimination of those without celiac disease, the current blood testing regime will continue. Read more at: The American Journal of Gastroenterology; volume 113, pages1238–1246 (2018)
  14. Celiac.com 08/31/2018 - We've had more than a few requests to make our most popular gluten-free recipes available with a single click. So, for the first time in one place, here are Celiac.com’s most popular recipes for gluten-free desserts. These recipes have been enjoyed by hundreds of thousands of readers and have anchored more than a few gluten-free tables. They are sure to please even the picky gluten-free eaters. Here are Celiac.com’s most popular gluten-free dessert recipes: Cheesecake with Gluten-free Almond Crust This cheesecake recipe is not only one of our most popular recipes, it is one of our most widely read and shared features of all time. Gluten-Free Chocolate Pudding with Fresh Vanilla Whipped Cream This gluten-free chocolate pudding with fresh vanilla whipping cream will have you doing your little chocolate dance and singing your happy tummy song. Quick Gluten-Free Cranberry Coconut Cookies These gluten-free cranberry coconut cookies are fun to eat, and a snap to make. Soft and Chewy Gluten-free Ginger Snaps Break out the milk, because this recipe for soft, chewy, gluten-free gingers snaps will have hungry, happy snackers begging for more. Tasty Gluten-Free Apple Crisp This recipe for super-tasty apple crisp is gluten-free and easy as pie to make. Gluten-free Apple Pie and 20 More Recipes for Festive Gluten-free Holiday Treats This recipe for a delicious gluten-free apple pie, plus 20 more gluten-free recipes to make your holiday season a homemade gluten-free hit.
  15. Celiac.com 08/29/2018 - Up to one in twelve patients with gluten sensitivity develops neurological symptoms such as ataxia, dementia, seizures or peripheral neuropathy, though the reasons for this are still poorly understood. As a means of better understanding the immunological mechanisms behind this reality, a team of researchers recently reported the case of a 68‐year‐old male patient suffering from progressive ataxia and dementia associated with chronic diarrhea, and both elevated IgG and IgA antigliadin‐antibodies. The research team included Michel Mittelbronn, Jens Schittenhelm, Gellert Bakos, Rob A. De Vos, Manfred Wehrmann, Richard Meyermann, and Katrin Bürk. They are variously affiliated with the Institute of Brain Research at the University of Tübingen, and the Institute for Cell Biology, Department of Immunology at the University of Tübingen, Tübingen, Germany, the Neurological Institute/Edinger Institute, Goethe University Medical School, Frankfurt, the Department of Pathology, St. Georg Hospital, Leipzig, Germany, and with the Laboratory for Pathology, Enschede, the Netherlands. Autopsy indicated that frequent argyrophilic glial and neuronal inclusions within the basal nucleus of Meynert were the structural markers of the cognitive decline. The patient showed substantial neuronal loss in the cerebellar cortex and the inferior olives, along with infiltrating CD8+/perforin+/granzyme B+ cells, and reactive astrogliosis and microglial activation. In patients with gluten sensitivity and neurological disease, it is likely that CD8+ cytotoxic T and NK cells function as effector cells that trigger neuronal cell death, and thus might play some role in triggering cerebellar symptoms in gluten ataxia cases. The team concludes by noting that an absence of B‐ or plasma cells, along with multiple CD8+, granzyme B and perforin expressing cells in ataxia‐associated brain areas, indicates pronounced cytotoxic effects in neuro-pathogenesis of gluten sensitivity. This is one of the first reports to indicate that CD8+, perforin+, and granzyme B+ effector cells infiltrate the cerebellum and inferior olives in cases of gluten ataxia. Read more in: Neuropathology
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