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Found 1,857 results

  1. Celiac.com 10/16/2018 - Apparently, local St. Louis radio station Z1077 hosts a show called “Dirty Little Secret.” Recently, a woman caller to the show drew ire from listeners after she claimed that she worked at a local bakery, and that she routinely lied to customers about the gluten-free status of baked goods. The woman said she often told customers that there was no gluten in baked goods that were not gluten-free, according to local tv station KTVI. Apparently the woman thought this was funny. However, for people who cannot eat gluten because they have celiac disease, telling people that food is gluten-free when it is not is about as funny as telling a diabetic that food is sugar-free when it is not. Now, of course, eating gluten is not as immediately dangerous for most celiacs as sugar is for diabetics, but the basic analogy holds. That’s because many people with celiac disease suffer horrible symptoms when they accidentally eat gluten, including extreme intestinal pain, bloating, diarrhea, and other problems. Some people experience more extreme reactions that leave them in emergency rooms. As part of a story on the “joke” segment, KTVI interviewed celiac sufferer Dana Smith, who found the punchline to be less than funny. “It’s absolutely dangerous, somebody could get very sick,” said Smith. KTVI also interviewed at least one doctor, Dr. Reuben Aymerich of SSM St. Clare Hospital, who pointed out that, while celiac disease is “not like diabetes where you can reduce the amount of sugar intake and make up for it later, it’s thought you need to be 100 percent compliant if you can.” For her part, Smith sought to use the incident as a teaching moment. She alerted the folks at Z1077 and tried to point out how serious being gluten-free is for many people. Mary Michaels, owner of Gluten Free at Last Bakery in Maryville, Illinois, says it’s time people became more respectful. “I wouldn’t make fun of you if you had diabetes or a heart condition it’s kind of like that,” Michals said. We will likely never know if the radio station caller was telling the truth, or just putting listeners on. The Z1077 morning team did post a follow-up comment, which stated that they take celiac disease seriously, and that they did not intend to offend anyone. One host said his mom has celiac disease. It’s good to see a positive response from the radio station. Their prank was short-sighted, and the caller deserved to be called out on her poor behavior. Hopefully, they have learned their lesson and will avoid such foolishness in the future. Let us know your thoughts below.
  2. Celiac.com 10/15/2018 - If you’re on a gluten-free diet for medical reasons, then you’re probably already cautious about eating out. A new study tells us exactly why people with celiac disease and other gluten-sensitive conditions have reason to be very careful about eating out. According to the latest research, one in three foods sold as "gluten-free" in U.S. restaurants actually contain trace levels of gluten. This is partly due to the fact that the gluten-free diet has become popular with many non-celiacs and others who have no medical need for the diet. That has led many restaurants to offer gluten-free foods to their customers, says study author Dr. Benjamin Lebwohl, of Columbia University's Celiac Disease Center. But, if this research is any indication, too many restaurants don’t do a good job with gluten-free. For the study, more than 800 investigators set out to assess the true gluten content of dishes listed as "gluten-free" on menus. Armed with portable gluten sensors, they tested for gluten levels that met or exceeded 20 parts per million, the standard cutoff for any gluten-free claim. Based on more than 5,600 gluten tests over 18 months, the investigators determined that 27 percent of gluten-free breakfast meals actually contained gluten. At dinner time, this figure hit 34 percent. The rise could reflect a steady increase in gluten contamination risk as the day unfolds, the researchers said. Off course, the risk is not all equal. Some restaurants are riskier than others. Unsurprisingly, the biggest culprit seems to be restaurants that offer gluten-free pastas and pizzas. Nearly half of the pizza and pasta dishes from those establishments contained gluten, according to the study. Why is that? Well, as most folks with celiac disease know all too well, kitchens aren’t really set up to segregate gluten, and "sharing an oven with gluten-containing pizza is a prime setting for cross-contamination," says Lebwohl. Also, too many restaurants use the same water to cook gluten-free pasta as they do for regular pasta, which contaminates the gluten-free pasta and defeats the purpose. Moreover, although the U.S. Food and Drug Administration regulates gluten-free labels on packaged food products, there is currently no federal oversight of gluten-free claims in restaurants. The results of the study will be presented today at a meeting of the American College of Gastroenterology, in Philadelphia. Research presented at meetings is usually considered preliminary until published in a peer-reviewed medical journal. In the absence of federal enforcement at the restaurant level, the burden for making sure food is gluten-free falls to the person doing the ordering. So, gluten-free eaters beware! These results are probably not surprising to many of you. Do you have celiac disease? Do you eat in restaurants? Do you avoid restaurants? Do you have special tactics? Feel free to share your thoughts below. Read more at UPI.com
  3. Celiac.com 06/13/2012 - In general, doctors and researchers know a good deal about how celiac disease works, and they are finding out more all the time. However, they know very little about non-celiac gluten sensitivity (NCGS). In an effort to learn more about non-celiac gluten sensitivity, a team of researchers recently carried out a study to measure the presence of somatization, personality traits, anxiety, depression, and health-related quality of life in NCGS individuals, and to compare the results with celiac disease patients and healthy control subjects. They also compared the response to gluten challenge between patients with non-celiac gluten sensitivity and those with celiac disease. The research team included M. Brottveit, P.O. Vandvik, S. Wojniusz, A. Løvik, K.E. Lundin, and B. Boye, of the Department of Gastroenterology at Oslo University Hospital, Ullevål in Oslo, Norway. In all, the team looked at 22 patients with celiac disease and 31 HLA-DQ2+ NCGS patients without celiac disease. All patients were following a gluten-free diet. Over a three day period, the team challenged 17 of the celiac disease patients with orally ingested gluten. They then recorded the symptoms reported by those patients. They did the same with a group of 40 healthy control subjects. The team then had both patients and healthy control subjects complete questionnaires regarding anxiety, depression, neuroticism and lie, hostility and aggression, alexithymia and health locus of control, physical complaints, and health-related quality of life. Interestingly, patients with non-celiac gluten sensitivity reported more abdominal (p = 0.01) and non-abdominal (p < 0.01) symptoms after the gluten challenge than patients with celiac disease. The increase in symptoms in non-celiac gluten sensitivity patients was not related to personality. However, the two groups both reported similar responses regarding personality traits, level of somatization, quality of life, anxiety, and depressive symptoms. Responses for both groups were about the same as for healthy controls. The results showed that patients with non-celiac gluten sensitivity did not show any tendencies toward general somatization, as both celiac disease patients and those with non-celiac gluten sensitivity showed low somatization levels. Source: Scand J Gastroenterol. 2012 Apr 23.
  4. Celiac.com 10/19/2018 - Work to develop a vaccine for celiac disease could soon lead to a vaccine for diabetes. After successful phase 1 studies of Nexvax2, their peptide-based therapeutic vaccine for celiac disease, ImmusanT has seen a significant investment from venture philanthropy organization JDRF T1D. ImmusanT's peptide therapy program for celiac disease may provide lessons for a similar therapeutic treatment for Type 1 diabetes. The investment will support ImmusanT as it attempts to develop a vaccine to prevent Type 1 diabetes, based on the early success of its peptide immunotherapy program for celiac disease, the two entities announced in a press release. ImmusanT’s celiac peptide therapy program works by identifying antigens that trigger an inflammatory responses in people with autoimmune diseases. Once identified, the peptide therapy is used to neutralize the autoimmune response. This celiac disease program goes back to 1998, when Anderson first began his efforts to find and identify the peptides. The findings were published in 2010, and the company was founded shortly afterward by Leslie Williams, BS, RN, MBA, director, president and CEO of ImmusanT. From there, ImmusanT conducted five phase 1 trials for its celiac therapy. Those trials have proven very promising, and the latest investment into a similar drug for diabetes is proof of that promise. In the case of celiac disease, the drug works by “targeting T cells in patients. Those T cells that are engaged as peptides are distributed throughout the body after the injection, and we see evidence that the T cells are being activated about 2 hours later,” Robert Anderson, BMedSc, MB, ChB, PhD, FRACP, chief scientific officer for ImmusanT, told Endocrine Today. “We found that if we gradually increase the dose in patients building up to a maintenance dose level, they become non-reactive to those peptides.” With much of the early research targeted towards demonstrating the drug’s safety, and getting the right dose and dose regimen, the development of a version targeted at diabetes, says Anderson, “should be more streamlined due to the lessons learned during the celiac disease program. That’s partly because the team knows “a lot more going into Type 1 diabetes about how peptide therapy works and how to optimize it than we did when we started celiac disease, where it was a blank slate.” This is really exciting news. A vaccine for celiac disease is exciting, to be sure, but a viable vaccine for diabetes would be a major development in disease prevention. Stay tuned for more news as the story develops. Read more at Healio.com
  5. Celiac.com 10/10/2018 - The Technical University in Vienna has announced a new remedy for celiac disease symptoms that they say can “alleviate or even completely eliminate the symptoms of celiac disease.” It should be available commercially in only a few years. Because most current efforts to treat celiac disease affect the immune system, possible side effects must therefore be fully assessed. This means years of study, and a long approval process. However, the TU Wien research team worked in collaboration with the industrial partner Sciotech Diagnostic Technologies GmbH to create a different approach. Their team based its approach for a celiac disease treatment on using only the part of the antibody that binds to gluten, which allowed them to create a product that works extremely well, but does not rely on triggering an immune response. Instead of a drug that works on the immune system, TU Wien created a simple medical product that directly attacks the gluten molecules to render them harmless. This makes the approval process much simpler, meaning that the product should be available in ordinary pharmacies as early as 2021. According to Professor Oliver Spadiut, head of the Integrated Bioprocess Development Research Group at TU Wien, “bodies produce antibodies that fit intruding antigens precisely, like a key to a lock. This immune response makes these antigens harmless.” He goes on to say that “If a new antibody fragment is found and produced that docks to and blocks the invading gluten molecule without triggering the immune system, the symptoms of celiac disease can be suppressed." The goal of their research project was to produce a complex of two such antibody fragments that envelop the gluten molecule at a molecular level, so that it can no longer have any further effects in the intestines. The result is a groundbreaking treatment for celiac disease and gluten intolerance. The process is complicated, and requires the team to re-program certain bacteria so that they produce exactly the desired antibody fragment. The full process took a while to iron out, but, says Spadiut, it “can be easily reproduced, can be scaled up to industrial application and delivers a very good yield of the desired product." This is very exciting news. Aside from efforts toward an outright vaccine, this is the first news of a potential treatment that can negate the effects of gluten without affecting the immune system itself. If all goes well, Spadiut says, the product “will be available in ordinary pharmacies in a few years.” Stay tuned for news about ongoing developments of this interesting treatment for celiac disease. Read: Additional scientific information Source: TUWien.ac.at
  6. Celiac.com 10/03/2018 - Gluten-related disorders include the full spectrum of adverse clinical symptoms and conditions triggered by eating gluten. A team of researchers recently set out to review the available medical literature concerning MDs and gluten sensitivity with and without enteropathy. The research team included A Vinagre-Aragón, P Zis, RA Grunewald, and M Hadjivassiliou, with the Academic Department of Neurosciences, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, South Yorkshire, UK. Celiac disease or gluten sensitive enteropathy is the most common manifestation, but clinicians have reported a number of extra-intestinal manifestations, which may occur without enteropathy. Gluten sensitivity is another term that has been used to include all gluten-related disorders, including those where blood tests show antibodies to gluten in the absence of any enteropathy. Gluten ataxia is the most common extra-intestinal neurological manifestation, and has been well documented. Clinicians have reported movement disorders related to gluten sensitivity. To assess the current medical literature on movement disorders and gluten sensitivity, both with and without enteropathy, the team conducted a systematic search on the PubMed database, and included 48 articles that met the inclusion criteria into the present review. This review demonstrates that the range of gluten related movement disorders goes beyond gluten ataxia, and shows that the majority of patients with gluten-related disorders benefit from a gluten-free diet. Read the full review at: Nutrients. 2018 Aug 8;10(8). pii: E1034. doi: 10.3390/nu10081034.
  7. 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
  8. Celiac.com 10/05/2018 - This short quiz includes basic celiac facts, recent celiac and gluten-free news and other information that appeared in the last few months on Celiac.com. The answers are in the section below the quiz, so don't peek! True or False? A tainted gluten-free meal nearly killed an Australian woman. Bifidobacterium infantis NLS super strain reduces a-Defensin-5 expression in celiac disease patients. Vitamin A and D deficiency common in kids with newly diagnosed celiac disease. New UK fund promotes celiac research and gluten-free food improvement. Easy to spot tooth wear and enamel defects point to celiac disease. Undiagnosed celiac disease more common in women and girls. Research indicates 1.4% of humans have celiac disease. A new urine test can spot gluten in the blood of people with celiac disease. Women's diet during pregnancy has little impact on celiac disease risk in their infants. Gluten-Free condoms are available for people concerned about topical exposure to gluten. A Phoenix realtor recently advertised a house as 'gluten-free.’ Current screening methods miss significant cases of celiac disease. A new vaccine makes it safe for people with celiac disease to safely consume gluten. A long-distance conversation with a guru can help treat your celiac disease. Food made with gluten-free ingredients is safe for people with celiac disease. Celiac disease is a food allergy. Celiac disease rarely affects people of non-European ancestry. Celiac disease is a children’s condition. Celiac disease can be painful, but isn't life-threatening. A little gluten is okay for people with celiac disease and gluten-intolerance to eat. ANSWERS Here are the answers for our short quiz above on basic celiac facts, recent celiac news and other information. True or False? A tainted gluten-free meal nearly killed an Australian woman. TRUE Bifidobacterium infantis NLS super strain reduces a-Defensin-5 expression in celiac disease patients. TRUE Vitamin A and D deficiency common in kids with newly diagnosed celiac disease. TRUE New UK fund promotes celiac research and gluten-free food improvement. TRUE Easy to spot tooth wear and enamel defects point to celiac disease. TRUE Undiagnosed celiac disease more common in women and girls. TRUE Research indicates 1.4% of humans have celiac disease. TRUE A new urine test can spot gluten in the blood of people with celiac disease. TRUE Does Diet During Pregnancy Have Any Impact on Celiac Disease Risk in Infants? TRUE Gluten-Free condoms are available for people concerned about topical exposure to gluten. TRUE A Phoenix realtor recently advertised a house as 'gluten-free.’ TRUE. Phoenix realtor Mike D’Elena recently advertised a house as 'gluten-free’. Current screening methods miss significant cases of celiac disease. TRUE A new vaccine makes it safe for people with celiac disease to safely consume gluten. FALSE. While several such vaccines are under development, with some even undergoing clinical and human trials, no such drug has been proven to work and approved by the FDA. Hopefully the clinical tests will work and this will one day be an alternative for some people. A long-distance conversation with a guru can help treat your celiac disease. FALSE Food made with gluten-free ingredients is safe for people with celiac disease. FALSE. Just because food is made with gluten-free ingredients does not necessarily make it safe for people with celiac disease. Case in point, Domino’s Pizza recently introduced gluten-free pizza crusts. However, these pizzas are prepared in the same areas and ovens as Domino’s regular pizzas, and may be contaminated with gluten from wheat flour. These pizzas are not considered safe for people with celiac disease. There are many similar cases in the restaurant world. Contamination is a serious issue for some celiacs, so buyers be aware and be wary. Celiac disease is a food allergy. FALSE. Celiac disease is not a food allergy or an intolerance, it is an autoimmune disease. People with celiac disease suffer damage to the lining of the small intestine when they eat wheat, rye or barley. They also face higher risks for many other auto-immune conditions. Celiac disease rarely affects people of non-European ancestry. FALSE. Celiac disease is more common in people of northern European ancestry, but it affects all ethnic groups and is found in southern Asia, the Middle East, North Africa and South America. Celiac disease is a children’s condition. FALSE. Celiac disease can develop at any age. In fact, celiac disease is most commonly diagnosed in people aged 40-60 years old. Celiac disease can be painful, but isn't life-threatening. FALSE. It’s true that classic celiac disease symptoms, like stomach pain, bone pain, fatigue, headaches, skin rash, and digestive issues, won’t kill patients outright. However, undiagnosed or untreated, celiac disease can trigger other autoimmune disorders, and leave patients at much greater risk of developing certain types of deadly cancer. A little gluten is okay for people with celiac disease and gluten-intolerance to eat. FALSE. Gluten levels above 20 parts per million can cause adverse immune reactions and chronic damage in people with celiac disease. Read more about celiac disease, gluten, gluten-free and gluten intolerance facts at Celiac.com.
  9. Celiac.com 03/27/2017 - A number of researchers are looking to provide alternative or adjunct treatments to the gluten-free diet in celiac disease. Meanwhile, a number of companies are currently developing a wide variety of such options, ranging from various kinds of enzyme therapies, to treatments that eliminate celiac disease reactions, even to vaccines to inoculate celiac sufferers against their condition, perhaps allowing for full recovery and a return to non-gluten-free eating habits, as desired. At least, that's one dream. More likely will be the development of enzymes or other treatments that offer celiacs varying degrees of protection from gluten ingestion. Most likely, such treatments would be designed to augment an existing gluten-free diet, and to provide protection against moderate gluten-contamination when eating out. One particular enzyme that shows strong potential in breaking down toxic peptides in A-gliadin, the main culprit in celiac reactions, is caricain. A recent paper discusses the scientific principles behind the use of caricain for enzyme therapy. The paper is based on a recent study, in which a team of researchers set out to review the structures of the toxic peptides in A-gliadin for key sequences of amino acids or motifs related to toxicity, especially with respect to digestive difficulties, or immunogenicity. The research team included Hugh J. Cornell and Teodor Stelmasiak. They are affiliated with the RMIT University, School of Applied Sciences, Melbourne, Australia, and with Glutagen Pty Ltd, Maribyrnong, Victoria, Australia. For their study, they first evaluated structures of synthetic A-gliadin peptides shown to be toxic in the fetal chick assay, both before and after digestion with duodenal mucosa from patients in long remission. They also measured synthetic peptides corresponding to the undigested residues, and compared the key amino acid sequences, to see if they might be related to direct toxicity and immunogenicity of the peptides. They found that the smallest toxic peptides from celiac mucosal digestion were octa-peptides, which they found in greater amounts than similar products from normal digestion. One of those peptides corresponded to residues 12-19 of A-gliadin and contained the key motifs PSQQ and QQQP of De Ritis et al., while the other corresponded to residues 72-79, and contained the key motif PYPQ (extending to PYPQPQ). These key motifs have been noted by other workers, especially those investigating immunological activity over the past two decades. They are present in undigested residues from celiac mucosal digestion These motifs, along with the greater prevalence of these residues, as compared with residues from normal digestion, supports the basic notions underpinning enzyme therapy for celiac disease. This study also supports the basic scientific merits of research and development of the enzyme caricain to break down gliadin peptides with two different types of toxicity, and thus to potentially benefit people with celiac disease. Source: International Journal of Celiac Disease. Vol. 4, No. 4, 2016, pp 113-120. doi: 10.12691/ijcd-4-4-2 Previous study: NCBI
  10. Celiac.com 09/25/2018 - In a patent application that could have a huge impact on the gluten-free industry, General Mills, Inc. has described its method and system for removing foreign, gluten-containing grains to establish gluten-free oats. Current FDA guidelines require all products labeled gluten-free to have a maximum gluten content of 20 parts per million (ppm). Published August 23rd, patent application No. US 20180236453 A1 details a method for producing oat grains with gluten levels below 20 ppm and, more preferably, below 10 ppm. Natural oats generally do not contain gluten, but after harvest, transport and storage, large batches of raw oats may contain small amounts of gluten-containing grains, such as wheat, barley, rye and triticale. These can sometimes occur at levels exceeding 20 ppm. The General Mills patent application describes a method of arranging mechanical oat sorting operations in series, or in both series and parallel operations. The multi-step process best includes width grading, multiple length grading steps, along with a potential de-bearding step. The resulting oats will be gluten-free to under 20 ppm, and possibly to under 10 ppm, and are suitable for the production of gluten-free oat food products, including cereals and granolas. To receive a patent, General Mills will have to prove that their process does what they say it does. A successful patent for General Mills could have a huge effect on the gluten-free oat foods industry. For one, it may allow General Mills to become a major supplier of gluten-free oats for other manufacturers. The benefits of larger scale, more economical gluten-free oat production could include more, and more readily available, gluten-free oat products, along with lower prices for both manufacturers and consumers. Stay tuned for more developments on this and related stories. Read more at Justicia.com
  11. I am a adolescent female and I have celiac disease. I get all the typical celiac symptoms but over the last couple of days I have developed strange symptoms I have never had before. I feel Extremely. Thirsty all the time even if I drink water, I am urinating constantly but it dosent hurt. I have a new pain in my upper,upper abdomen and I feel faint occaisonally and I am getting leg cramps but I have no idea whether the cramps are related to diabetes or not. We went to the doctor and the doctor did a urine sample on me to test for sugar in my urine but she said she couldnt detect any. Anyway she booked me in for a blood test to make sure. What I am wondering is if anyone was diagnosed with diabetes type 1 but had a negative urine test? Or if they have heard of anyone like this?. I have also posted a question similair on a diabetes forum but I wanted to see if anyone knew about it from a celiac point of view because I was wondering if something to do with celiac caused the urine test to be negative though I havent researched it yet .Please can you help? Thanks in advance
  12. Celiac.com 10/01/2018 - A team of researchers recently set out to establish the rates of epilepsy in patients with celiac disease or gluten sensitivity and vice versa and to characterize aspects of the epileptic syndromes presented by these patients. The research team included Thomas Julian, Marios Hadjivassiliou, and Panagiotis Zis. They are variously affiliated with the Sheffield Institute for Translational Neuroscience University of Sheffield in Sheffield, UK; and the Academic Department of Neurosciences Sheffield Teaching Hospitals NHS Trust Sheffield, UK. The team conducted a systematic computer-based literature search on the PubMed database, and gathered information on rates, demographics and epilepsy phenomenology. Patients with celiac disease are nearly twice as likely to have epilepsy as the general population. Celiac disease is twice as common in epilepsy patients as in the general population. Researchers still need to do more studies to assess rates of gluten sensitivity in epilepsy patients. The data indicate that the prevalence of celiac disease or gluten sensitivity is higher for certain epilepsy scenarios, including childhood partial epilepsy with occipital paroxysms, adult patients with fixation off sensitivity (FOS) and those with temporal lobe epilepsy (TLE) with hippocampal sclerosis. Epilepsy in the context of gluten-related disorders is a syndrome of celiac disease, epilepsy and cerebral calcification (CEC syndrome), which is frequently described in the literature. The good news is that gluten-free diet helps to control epilepsy in 53% of cases, either reducing seizure frequency, enabling reduced doses or even termination of anti-epileptic drugs. Patients with epilepsy of unknown cause should receive blood tests for markers of gluten sensitivity, and may benefit from a gluten-free diet. Read more at: Springer.com
  13. Celiac.com 09/27/2018 - Microscopic colitis is a frequent culprit in cases of chronic watery diarrhea among elderly patients. Although patients with microscopic colitis seem to have higher rates of celiac disease, researchers haven’t done much research on the relationship between dietary gluten consumption, and risk of microscopic colitis in people who do not have celiac disease. A team of researchers recently prepared a prospective study of US women without celiac disease. The research team included Po-Hong Liu MD, MPH; Benjamin Lebwohl MD, MS; Kristin E. Burke MD; Kerry L. Ivey PhD; Ashwin N. Ananthakrishnan MBBS, MPH; Paul Lochhead MBChB, PhD; Ola Olen MD, PhD; Jonas F. Ludvigsson MD, PhD; James M. Richter MD; Andrew T. Chan MD, MPH; & Hamed Khalili MD, MPH. The research team studied 160,744 US women without celiac disease who were enrolled in the Nurses’ Health Study (NHS) and the NHSII. They then estimated dietary gluten intake using validated food frequency questionnaires at four year intervals. They confirmed cases of microscopic colitis through a review of medical records. The team used Cox proportional hazard modeling to estimate the multivariable-adjusted hazard ratio (HR) and 95% confidence interval (CI). The researchers found 219 cases of microscopic colitis over more than 20 years of follow-up covering 3,716,718 person-years, for a crude incidence rate of 5.9 cases per 100,000 person-years, in NHS and NHSII. Most significantly, they found that dietary gluten intake did not influence the risk of developing microscopic colitis. Compared to individuals in the lowest quintile of energy-adjusted gluten intake, the adjusted HR of microscopic colitis was 1.18 for the middle quintile and 1.03 for the highest quintile. Even adjusting the figures to account for primary gluten sources, including refined and whole grains, made no substantial difference in the effect estimates. Further, there was no difference in association rates according to lymphocytic or collagenous subtypes; nor were the rates changed by age, smoking status, or body mass index. The good news from this study is that gluten intake plays no role in promoting microscopic colitis in adult women without celiac disease. Read more at: The American Journal of Gastroenterology (2018)
  14. Celiac.com 09/26/2018 - Non-celiac gluten sensitivity (NCGS) is a clinical syndrome marked by both intestinal and extra-intestinal symptoms that respond to the elimination of gluten-containing food and the adoption of a gluten-free diet. A team of researchers recently set out to review the diagnostic challenges surrounding non-celiac gluten sensitivity, and to summarize recent advances in research and provide a brief overview of the history of the condition for the benefit of professionals working in gastroenterology. The research team included Giovanni Casella, Vincenzo Villanacci, Camillo Di Bella, Gabrio Bassotti, Justine Bold, and Kamran Rostami. They are variously affiliated with General Practioner National Health Italy; the Institute of Pathology Spedali Civili Brescia Italy; the Pathology Department, Carate Brianza Hospital, ASST-Vimercate (Monza Brianza), Italy; the Gastroenterology and Hepatology Section of the Department of Medicine at the University of Perugia School of Medicine in Perugia, Italy; the Department of Gastroenterology Milton Keynes University Hospital, Milton Keynes, UK; and with Allied Health and Social Sciences, University of Worcester, UK. The researchers searched academic databases such as PubMed and Google Scholar using key words like ”non-celiac gluten sensitivity,” “gluten related disorders,” and the studies outlined in reference page were selected and analyzed. Clinical opinion generally holds that NCGS is best diagnosed by ruling out celiac disease and wheat allergy. Currently there is no blood test that can pinpoint NCGS. The underlying causes of symptoms in NCGS patients is poorly understood. However, there have been a few recent insights. Professional estimates of NCGS rates currently vary between 0.6 and 6%. Gastrointestinal symptoms of NCGS overlap slightly with those of irritable bowel syndrome. Researchers are currently investigating the histologic characteristics of NCGS, which range from normal histology to slightly elevated rates of T lymphocytes in the superficial epithelium of villi. Positive response to gluten free diet for up to 6 weeks, followed by a recurrence of symptoms after a gluten challenge, is still the best confirmation of NCGS. The Salerno expert criteria may help to accurately diagnose NCGS, especially in research settings, but isn’t particularly useful for diagnosis in clinical practice. Source: Gastroenterol Hepatol Bed Bench 2018;11(3):197-202).
  15. Celiac.com 12/03/2014 - It is important for pregnant women seeking medical consultation to get good, evidence-based information. This is especially true for pregnant women with celiac disease, who might wonder whether they face an increased risk of adverse birth outcomes and pregnancy complications as a result of their disease. So, does celiac disease increase a woman’s risk for pregnancy complications and adverse birth outcomes? Until now, there hasn’t been much good, solid data to give women a clear answer. With that in mind, a research team in England recently conducted a population-based study on pregnancy outcomes and adverse birth conditions in women with celiac disease. The research team included Alyshah Abdul Sultan PhD, Laila J Tata PhD, Kate M. Fleming PhD, Colin J. Crooks PhD, Jonas F. Ludvigsson PhD, Nafeesa N. Dhalwani PhD, Lu Ban PhD, and Joe West PhD. They are variously affiliated with the Division of Epidemiology and Public Health, City Hospital Campus at the University of Nottingham, Nottingham, UK; the Department of Medical Epidemiology and Biostatistics at the Karolinska Institute in Stockholm, Sweden; and with the Department of Paediatrics at Örebro University Hospital in Örebro, Sweden. The team used linked primary care data from the Clinical Practice Research Datalink and secondary care Hospital Episode Statistics data to assess all singleton pregnancies between 1997 and 2012. They used logistic/multinomial regression to compare pregnancies of women with and without celiac disease for risks of pregnancy complications (antepartum and postpartum hemorrhage, pre-eclampsia, and mode of delivery), and for adverse birth outcomes (preterm birth, stillbirth, and low birth weight). They stratified risk levels based on whether women were diagnosed or undiagnosed before delivery. They found 363,930 pregnancies resulting in a live birth or stillbirth, 892 (0.25%) of which were among women with celiac disease. Women with diagnosed celiac disease showed no increased risk of pregnancy complications or adverse birth outcomes compared with women without celiac disease. However, pregnant women with diagnosed celiac disease did show a higher risk of postpartum hemorrhage and assisted delivery, with an adjusted odds ratio (aOR) of 1.34. Importantly, the team found no increased risk of any pregnancy complication among those with undiagnosed celiac disease. In all, they found just a 1% absolute excess risk of preterm birth and low birth weight among mothers with undiagnosed celiac disease, which corresponds to aOR=1.24 (95% confidence interval (CI)=0.82–1.87) and aOR=1.36 (95% CI=0.83–2.24), respectively. Overall, the results of this study offer some good news to pregnant women with celiac disease. Whether diagnosed or undiagnosed during pregnancy, celiac disease is not associated with a significantly higher risk of pregnancy complications and adverse birth outcomes. Source: Am J Gastroenterol. 2014;109:1653-1661.
  16. Celiac.com 09/24/2018 - A team of researchers recently set out to investigate the degradation of gluten in rye sourdough products by means of a proline-specific peptidase. The research team included Theresa Walter, Herbert Wieser, and Peter Koehler, with the Deutsche Forschungsanstalt für Lebensmittelchemie, Leibniz Institut in Freising, Germany. Their team monitored gluten content of rye sourdough during fermentation using competitive ELISA based on the R5 antibody. The team noted a decrease in gluten over time, but found that even prolonged fermentation did not bring gluten levels below 20 ppm requirement for gluten-free foods. Interestingly, they did find that Aspergillus niger prolyl endopeptidase (AN-PEP) extensively degraded gluten concentrations of up to 80,000 mg/kg in rye flour, rye sourdough, and sourdough starter under specific temperatures and pH values. Nor did the enzyme inactivate the microorganisms in the sourdough starter. Gluten-free rye flour alone or in combination with sourdough starter was used to produce gluten-free bread, which the team then assessed for its sensory characteristics. Whereas gluten-free sourdough bread lacked any of the favorable qualities of conventional rye bread, the replacement of sourdough by egg proteins yielded gluten-free bread comparable to the conventional rye, and with better qualities than bread made with naturally gluten-free ingredients. This study demonstrates the feasibility of using ANPEP treatment to produce high-quality gluten-free sourdough bread from originally gluten-containing cereals, such as rye. Rye products rendered gluten-free in this manner have the potential to increase the choice of high-quality foods for celiac patients. Source: European Food Research and TechnologyMarch 2015, Volume 240, Issue 3, pp 517–524
  17. 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
  18. Celiac.com 09/17/2018 - Her name is Hawkeye, she’s a black lab, and her mission is to detect gluten for a young man named Toby, who gets terribly sick if he eats food that contains gluten. Hawkeye is up to 98% accurate at detecting gluten with just a few sniffs. Hawkeye was also expensive, costing a princely $16,000, not including food, and vet bills. That may sound expensive, but, says Toby’s mom, Amy "when you think about it trainers are often training only one to two dogs at a time and our trainer, she only trained one dog at a time and it took a year.” In Toby’s case, the community rallied to raise the money to buy Hawkeye, who is a registered service dog, and so can accompany Toby nearly everywhere. Everyone loves Hawkeye and her role in Toby’s life. Amy calls Hawkeye a “life-giver, and says that Amy continued “she's breathed life and confidence into Toby that we haven't seen in a really long time." She adds that the family has “really seen just growth and development in him because he's not getting sick as often and he's now able to learn more. So he can now say his alphabet, learn his numbers and colors, things that just a year ago he wasn't doing." Gluten-sniffing dogs are rare, but their numbers are growing. 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. The website 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.” Love the idea of a gluten sniffing dog, but maybe daunted by the price, logistics or commitment? There are portable gluten sensors currently on the market, with greater accuracy than Hawkeye, for a few hundred dollars. Disclosure: Nima Labs is a paid advertiser for Celiac.com
  19. 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)
  20. Celiac.com 10/30/2013 - Rates of celiac disease and the use of drugs to inhibit the secretion of stomach acid have both increased in recent decades. A research team recently set out to explore the association between anti-secretory medication exposure and subsequent development of celiac disease. The research team included Benjamin Lebwohl, Stuart J. Spechler, Timothy C. Wang, Peter H.R. Green, and Jonas F. Ludvigsson. They are affiliated with the Celiac Disease Center at the Department of Medicine at Columbia University College of Physicians and Surgeons in New York, NY. For their population-based case control study, the research team looked at data for celiac disease patients diagnosed at any of the pathology departments in Sweden from July 2005 through February 2008. They matched each patient by age and gender with up to 5 control subjects. They found prior prescriptions for proton pump inhibitors and histamine-2 receptor antagonists in all subjects. Using conditional logistic regression to measure the association between these prescriptions and the subsequent diagnosis of celiac disease, they also found that patients with proton pump inhibitor prescriptions were much more likely to have celiac disease (OR 4.79; 95% CI 4.17–5.51). Patients prescribed both proton pump inhibitors and histamine-2 receptor antagonists had an even higher risk for celiac disease (OR 5.96; 95% CI 3.58–9.91) than those who received proton pump inhibitors alone (OR 4.91; 95% CI 4.26–5.66) or histamine-2 receptor antagonists alone (OR 4.16; 95% CI 2.89–5.99). The data clearly show that patients who use anti-secretory medications are at much greater risk for developing celiac disease following the use of these medicines. The fact that this connection persisted even after the team excluded prescriptions for anti-secretory medicines in the year preceding the celiac disease diagnosis suggests a causal relationship. Source: Digestive and Liver Disease
  21. 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
  22. 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.
  23. 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
  24. Hello. My youngest daughter (8 y/o) was recently diagnosed with Celiac Disease, thorough labs and biopsies. It was suggested that our who family be tested and so I immediately began that process. My middle daughter (15 y/o) labs came in with a positive IGA of 13 but the transgluten was negative. What could this mean? My middle daughter is being referred to the pros GI specialist that my youngest goes to but her pediatric doctor is running a great deal more labs to look into other autoimmune disorders as well. I am being told, regardless of the negative portion that she does have Celiacs and obviously they'll need to confirm with biopsies, but both the labs and the pediatrician say its celiac...Can anyone clarify this more for me because I can't seem to find the correct search online to find the answers that I am looking for and my anxiety is through the roof right now! TIA
  25. Celiac.com 09/01/2018 - Celiac disease is a common disease triggered by gliadin exposure in genetically sensitive individuals. It has long been known that untreated celiac disease is associated with intestinal malabsorption, but it is also associated with ongoing inflammation. This inflammation may have adverse effects on the uptake of important nutrients. This is probably the underlying reason for the increased risk of osteoporosis demonstrated in patients with celiac disease. Malabsorption and ongoing inflammation in untreated celiac disease could also potentially have a negative effect on fetal development. Several reports have indicated an adverse effect of untreated celiac disease on pregnancy outcome. We set out to use the national registers of Sweden to: Evaluate the association of untreated celiac disease and birth weight, pregnancy duration and intrauterine growth. Evaluate the same association in treated celiac disease. Compare the risk of the above two groups with a reference group of 2.8 million births to mothers who never had a diagnosis of celiac disease. A fourth objective was to evaluate placental weight to see if lower placental weight was more frequent in women with celiac disease. We found that untreated celiac disease (women diagnosed after pregnancy, but most likely having untreated celiac disease at time of pregnancy) was associated with a two-fold risk of low birth weight, pre-term birth, intrauterine growth retardation and cesarean section. The low birth weight and intrauterine growth retardation may have been mediated through malabsorption, since placental weight was lowest in women with untreated celiac disease. This study was published in Gastroenterology Aug 2005. A link to this paper can be found here: gastrojournal.org After that we set out to evaluate the association between adverse pregnancy outcome in males with untreated and treated celiac disease. In a previous paper, we had found an increased risk of adverse pregnancy outcome when the father had celiac disease (Ludvigsson et al, Gut, 2001). Now, taking advantage of the large Swedish national registers (all births since 1973 and onwards are recorded), we found no increased risk of low birth weight, pre-term birth or cesarean section in infants to fathers with untreated or treated celiac disease. This study was published in the Scandinavian Journal of Gastroenterology in Feb 2006.
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