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Found 1,259 results

  1. Celiac.com 09/19/2017 - Hookworms. Intestinal parasites. They sound gross. The thought of having one's gut infected with a parasitic worm generally makes people's skin crawl. Indeed, intestinal worms, like hookworm, have a bad reputation among health experts, and have been the subject of fierce public health campaigns seeking their eradication. However, researchers have also documented the gut healing abilities of parasites like hookworm. In fact, part of how hookworms seem to work in nature is to promote an optimal gut environment in which they can thrive. In nature, the guts of people infected with hookworm are generally healthy. Could hookworms and other intestinal parasites prove key to treating and possibly eliminating diseases like celiac, and asthma? A number of clinicians and researchers feel that if they can just get the right strain of hookworm, at the right levels, they can basically eradicate celiac disease, and possibly asthma and other inflammatory diseases. When hookworms are introduced into the gut of people with celiac disease in the right amount, and kept at therapeutic levels, patients see their celiac symptoms disappear and their guts return to a healthy, normal condition. In fact, hookworms do not reproduce once inside the human gut, so if doctors put , say, 10 hookworms into a gut to treat celiac disease, there will be 10 there later, not more. In nature, the way humans build up dangerous levels of hookworm is via unsanitary environmental conditions and repeated exposure to more hookworms. Done clinically, the hookworm would present little or no danger to the human who was hosting it. While still very much in the experimental phase, researchers hope to investigate a number of strains to determine the best therapeutic levels for such disease treatments. For that, they will need FDA approval. Remember, the fecal transplant was first described in the 1950s, but took decades to catch on as a conventional treatment for gut disorders, such as c-dif bacteria, partly because it was seen as crude and somehow objectionable. But it proved to work. Really well. So much so that it's now a fairly conventional treatment. Could the hookworm follow a similar path from crude and weird to cool and effective? Could hookworms be used to cure celiac disease? Only close study will tell us for sure, and that's why the move to get FDA approval is an important one. For that, special strains of hookworm must be approved. "One of the big roadblocks is having the parasites that the FDA will allow you to infect people with," says John Hawdon, vice president of the American Society of Parasitologists and a researcher at the George Washington University. He and his colleagues are applying for permission to grow hookworm larvae to standards fit for testing in humans, which is not currently permitted in the United States. Hawdon says he anticipates a lengthy application process. Stay tuned for news on efforts to develop hookworm as a potential cure to celiac disease, asthma, and more. Sources: popsci.com iflscience.com
  2. Celiac.com 09/18/2017 - Many researchers feel that the rising number of celiac disease cases supports the idea that common infections prior to the onset of autoimmune diseases could play a role in triggering the immune response. Do more respiratory infections in childhood mean a greater likelihood of celiac disease later in life? To answer that question, a team of researchers recently set out to explore the relationship between early clinical events and the development of celiac disease in genetically predisposed infants. The research team included Renata Auricchio, Donatella Cielo, Renato de Falco, Martina Galatola, Valentina Bruno, Basilio Malamisura, Maria Giovanna Limongelli, Riccardo Troncone, Luigi Greco. They are variously affiliated with the Department of Translational Medical Science, and the European Laboratory for the Investigation of Food Induced Diseases, University of Naples Federico II, Naples, Italy; the Department of Pediatrics, University Hospital of Salerno, Salerno, Italy; and Azienda Ospedaliera Gaetano Rummo Via dell'Angelo, Benevento, Italy. The team studied 373 newborns from families with at least 1 relative with celiac disease. They tested participants for human leukocyte antigen DQ2- or DQ8- and followed-up positive infants with clinical and serological assessments. They used cross tabulation and odds ratios to explore the risk associated with single variables, and logistic regression analysis was performed to determine the variables that contributed to the risk of developing celiac disease. They also used stepwise discriminant analysis to determine which variables could distinguish case patients from controls before diagnosis. The overall rate of celiac disease in this group was 6% at 3 years and 13.5% at 5 years of age, while a total of 34 children, developed celiac disease before the sixth year of life, a rate of 14%. According to analysis of adverse events, people with celiac disease shoed a higher frequency of respiratory tract infections in their first 24 months of life. In a stepwise discriminant analysis, which included sex and human leukocyte antigen risk class, only respiratory infections in the second and first years of life significantly contributed to discrimination of case patients versus controls. The team's analysis showed that the frequency of respiratory infections in the first 2 years of life can be used to identify children who later developed celiac disease. Kids with more infections were much more likely to develop celiac disease later on. Clinicians may use this information during diagnosis to help zero in on patients likely to have celiac disease. Source: Pediatrics, September 2017
  3. Celiac.com 09/12/2017 - Are we at the beginning of the end for celiac disease? The last few years have seen numerous advances in celiac diagnosis and treatment. People diagnosed recently and in the future face a very different world than that faced by celiacs just five or ten years ago. In the old days, the process of properly diagnosing involved blood tests, endoscopies, and biopsies. In the near future, a simple blood test may do the trick. In the old days, the only treatment was a life-long gluten-free diet. That is still true, but the writing of change is on the wall. Here are five advances that will change the way celiac disease is diagnosed and treated in the future. These advances may well signal the beginning of the end of celiac disease as we know it. Blood Test Diagnosis (Without Biopsy) Researchers are getting better at identifying likely celiac cases using blood tests alone, without biopsy. As these techniques are refined and integrated into medicine, chances are pretty good that in the near future, large numbers of people will be diagnosed for celiac disease without the need for biopsy confirmation. Can Antibodies Spot Celiac Disease in Kids Without a Biopsy? Kids Can Get Accurate Celiac Diagnosis Without Biopsy Celiac Diagnosis Without Biopsy Can Be Useful in Some Cases Portable Gluten Detectors Imagine a future where you can take a bit of food you're not sure about, and pop it in a portable tester that will tell you if the food is gluten-free. A few years ago, that might have been the future of science fiction. With several companies looking to introduce just such kits, that future looks a lot more certain. Innovative Device Eliminates Gluten-Free Guesswork This Device Can Help Tell You If Your Food Is Actually Gluten-Free nimasensor.com Enzymes Enzymes that break down gluten might help people with celiac disease to enjoy a more normal life by protecting them from minor gluten contamination, and allowing them a bit more confidence when eating away from home. A number of manufacturers are currently working on enzyme treatments that are specifically designed to break down gluten for people with celiac disease. AN-PEP Shows Promise in Breaking Down Gluten in Stomach Enzyme Shows Promise In Dissolving Gliadin Peptides in Celiac Patients Could Carnivorous Plant Enzymes Act Like Beano for Gluten? Could Enzymes from Oral Bacteria Treat Celiac Disease Bio-Therapeutics—Hookworms They sound gross. The thought of having their guts infected with a parasitic worm makes people's skin crawl. However, researchers have documented the gut healing abilities of parasites like hookworm. When hookworms are introduced into the gut of people with celiac disease in the right amount, and kept at therapeutic levels, patients see their celiac symptoms disappear and their guts return to a healthy, normal condition. While still very much in the experimental phase, researchers are keen to investigate various strains and to determine the best therapeutic levels for these treatments. If all goes well, treatments based on parasitic worms will likely become more viable and more common in the future. Celiac Patients Tolerate Wheat Spaghetti After Hookworm Treatment Have Celiac Disease? Try a Little Hookworm with that Pasta! Can Bloodsucking Parasites Help Treat Asthma and Celiac Disease? Controversial Pig Parasite May Soon Be Sold In Germany To Treat Disease Bio-Therapeutics—Fecal Transplant Could fecal transplants be used to cure or to treat celiac disease? Much like hookworms, once you get past the 'yuck' factor, fecal transplants are proving to be cheap, easy, reliable way to treat gut conditions like C-Diff and, possibly celiac disease. The idea is to get some healthy poop in your gut to inoculate it with beneficial microbes. The effects are nothing short of astonishing. As they are studied, developed and refined, look for bio-therapeutic approaches like fecal transplant to play a role in treating gut contains like celiac disease. A Case of Refractory Celiac Disease Cured By Fecal Microbiota Transfer Vaccine A vaccine against celiac disease would be a holy grail of sorts. Receive a dose, or maybe multiple doses over time and become immune to the adverse effects of gluten. Several companies are working on a vaccine that would basically eliminate celiac disease. Many of these have moved through the early trial phases and several have shown enough promise to move to trials in humans. This is a very exciting area of research that may pay huge dividends in the near future. Celiac Disease Vaccine Set to Begin Full Human Trials Would You Try a Vaccine for Celiac Disease? Celiac Vaccine Clears First Big Clinical Trial This Vaccine Could Be a Game-Changer for People with Celiac Disease The main takeaway from these developments is that we are now living in an age where the diagnosis and treatment of celiac disease is the focus of tremendous research and development on numerous fronts. Many of these will likely result in products, tests, or treatments for celiac disease that were unimaginable just 5 or 10 years ago.
  4. Celiac.com 09/11/2017 - The FDA has granted clearance for Immco Diagnostics' ELISA for celiac disease, and for Roche's Benchtop Analyzer. What does that mean? Immco's test is conducted as a solid phase immunoassay and is intended for the qualitative or semiquantitative detection of IgA or IgG antigliadin antibodies in human blood, and thus to aid in diagnosing patients with celiac disease or dermatitis herpetiformis in conjunction with other laboratory and clinical findings. In other important diagnostic news, a benchtop analyzer from Roche Diagnostics and an immunoassay system from Shenzhen New Industries Biomedical was among the instruments and tests cleared by the US Food and Drug Administration in July, according to the agency. The FDA granted 510(k) clearance to Roche's Cobas b 101 instrument platform, as well as the Cobas HbA1c test. The fully automated and self-contained Cobas b 101 uses a single-use reagent disc to measure HbA1c from capillary and/or venous whole-blood samples, according to a document filed with the FDA. The Cobas HbA1c is an in vitro diagnostic test for detecting the presence of glycate hemoglobin, which develops when hemoglobin joins with glucose in the blood, becoming 'glycated'. By measuring glycated hemoglobin (HbA1c), clinicians are able to get an overall picture of what our average blood sugar levels have been over a period of weeks/months. For people with diabetes this is important as the higher the HbA1c, the greater the risk of developing diabetes-related complications. The HbA1c assay is designed for use with the Cobas b 101 platform, which is not a portable home test, but is intended for a clinical laboratory or point-of-care setting. Other instruments receiving FDA clearance in July include a new flow cytometer from Becton Dickinson; an expanded version of Bruker's MALDI Biotyper; and expanded indications for BioMérieux's Vitek MS MALDI-TOF Mass Spectrometery System. The FDA recently cleared the Maglumi 2000 automated immunoassay analyzer from Shenzhen New Industries Biomedical, which uses chemiluminescent technology for running IVD tests on clinical serum samples. The firm's Maglumi 2000 TSH assay for the quantitative determination of thyroid-stimulating hormone in human serum also received 510(k) clearance. The assay is for diagnosing thyroid disorders. These are just a few of many new tests and analysis devices that are changing the way doctors diagnose and manage celiac disease, diabetes, and other diseases. Look for tests like this to have a profound influence on the way diseases are diagnosed and managed in the future. Read more: 360dx.com
  5. Celiac.com 10/12/2015 - There's been a good deal of attention devoted to gluten sensitivity in people without celiac disease, but researchers still don't know much about potential risks associated with the condition. A research team recently looked at the prevalence of autoimmune diseases among patients with non-celiac wheat sensitivity (NCWS), and investigated whether they carry antinuclear antibodies (ANA). The research team included A. Carroccio, A. D'Alcamo, F. Cavataio, M. Soresi, A. Seidita, C. Sciumè, G. Geraci, G. Iacono, and P. Mansueto. They are variously affiliated with the DiBiMIS University of Palermo, Palermo, Italy; the department of Internal Medicine at Giovanni Paolo II Hospital in Sciacca, Italy; the DiBiMIS University of Palermo, in Palermo, Italy; the department of Pediatric Gastroenterology in ARNAS Di Cristina Hospital, Palermo, Italy; and the Surgery Department at the University of Palermo in Palermo, Italy. The research team conducted a retrospective study of 131 patients diagnosed with NCWS, 121 of whom were female. The average patient age was 29.1 years, and the study was conducted at 2 hospitals in Italy from January 2001 through June 2011. The team also collected data from 151 patients with celiac disease or irritable bowel syndrome, who served as control subjects. They reviewed patient medical records to identify those with autoimmune diseases. They then conducted a prospective study of 42 patients, 38 of whom were female, with an average age of 34 years, who had been diagnosed with NCWS from July 2011 through March 2014 at 3 hospitals in Italy. For the prospective study, one hundred age- and sex-matched subjects with celiac disease or IBS served as control subjects. The team collected serum samples from all subjects and measured ANA levels using immunofluorescence analysis. Participants completed a questionnaire and the team reviewed patient medical records to identify those with autoimmune diseases. In the retrospective analysis, about 30% of patients with either NCWS or celiac disease developed autoimmune diseases; mainly Hashimoto's thyroiditis, of which there were 29 cases. Compare this with about 4% of IBS who developed an autoimmune disease (P < .001). In the prospective study, 24% of patients with NCWS, 20% of patients with celiac disease, and 2% of patients with IBS developed autoimmune diseases (P < .001). In the retrospective study, serum samples tested positive for ANA in 46% of subjects with NCWS (median titer, 1:80), 24% of subjects with celiac disease (P < .001), and just 2% of subjects IBS (P < .001). In the prospective study, serum samples were positive for ANA in 28% of subjects with NCWS, 7.5% of subjects with celiac disease (P = .02), and 6% of subjects with IBS (P = .005 vs patients with NCWS). From these results, they conclude that positive ANA results are associated with the presence of the HLA DQ2/DQ8 haplotypes (P < .001). Source: Gastroenterology. 2015 Sep;149(3):596-603.e1. doi: 10.1053/j.gastro.2015.05.040.
  6. Celiac.com 08/31/2017 - A possible mechanism behind the cause of refractory celiac disease and why fecal transplantation (fecal microbiota transfer) may provide a cure was presented in "Synthetic Stool May Advance Fecal Transplant Therapy for Celiac Disease" 02/13/2013.[1] In September 2016, the article "Serendipity in Refractory Celiac Disease: Full Recovery of Duodenal Villi and Clinical Symptoms after Fecal Microbiota Transfer" was published in the Journal of Gastrointestinal and Liver Disease[2] describing the first known case of refractory celiac disease cured by a fecal transplant. The patient in that case was being treated for a recurrent Clostridium difficile infection. This very important milestone article somehow missed the light of the news media at that time. The 68-year old woman patient was a 10-year diagnosed victim of refractory celiac disease on a gluten-free diet. On admission for treatment of severe diarrhea, the patient exhibited Marsh IIIA villous atrophy. The patient was already receiving on-going treatment for refractory celiac disease with drugs. Additional drugs and antibiotics were given to treat the diarrhea. Eventually, the patient tested positive for C. difficile. Antibiotics were ineffective to treat the recurrent C. difficile infection. A fecal microbiota transfer was then performed. The C. difficile infection and diarrhea resolved, and, 6 months after the fecal transplant, villous atrophy resolved and went to Marsh 0. All symptoms of refractory celiac disease were eliminated. The patient remains symptom free on a continuing gluten-free diet. The case clearly demonstrates the need to fully investigate the use of fecal microbiota transfers to treat celiac disease. As suggested in my earlier reference[1], a standardized synthetic stool should be developed to enable full scale clinical trials. Also a full scale research effort into completely healing and restoring the intestinal mucosa with the novel protein R-spondin1 needs to be funded and restarted. Sources: 1. Synthetic Stool May Advance Fecal Transplant Therapy for Celiac Disease. Roy S. Jamron. Celiac.com 2013 Feb 13. 2. Serendipity in Refractory Celiac Disease: Full Recovery of Duodenal Villi and Clinical Symptoms after Fecal Microbiota Transfer. van Beurden YH, van Gils T, van Gils NA, Kassam Z, Mulder CJ, Aparicio-Pages N J Gastrointestin Liver Dis. 2016 Sep;25(3):385-8.
  7. Celiac.com 08/21/2017 - Can a tiny Virginia start-up change the world with a cheap, reliable devise to test food for gluten on the fly? With their startup called Altede, Ed and Anna Champion, together with business partner Briana Petruzzi, hope to build quick, cheap tests for all sorts of food allergens. Their first target is gluten. Altede is looking to develop a test that is reliable, sensitive to FDA levels of 20ppm gluten, costs less than $5 and could be performed within a couple of minutes while sitting at a restaurant table. The Altede team doesn't expect anyone to test everything they eat. But those with severe gluten intolerance might find peace of mind in a pinch. "We really want to keep the cost low. We think that's going to be critical," says Ed Champion. "You know, $15 and you're not going to do it. It's going to be too painful. But $3 or $5…what's your afternoon worth?" Altede has developed an antibody that they grow inside of and later extract from mice, a technique also used by pregnancy test manufacturers. The antibody is specially engineered to latch onto protein molecules inside gluten. A user like Anna Champion would carry the kit, which is about the size of a pack of M&M's. When she comes across a food she wants to eat but suspects may make her sick, she puts a pea-sized sample into a liquid container that comes inside the pouch. She would shake it up and then dip the test strip. The liquid would creep along the paper, passing a stripe of the antibodies Altede designed. If gluten is present, the antibodies will latch on to the proteins, accumulate on the paper and produce a visible pink line. So far, their prototype device can detect small amounts of gluten. The prototype looks and operates just like a pregnancy test. But the test currently takes hours, instead of minutes. Ed Champion says that tweaks to the chemistry will provide quicker results, though there are still a number of technical challenges to overcome. But after two years of development, Champion says the team is getting close. To help the, prepare their portable gluten tester for a product launch, Altede recently enrolled in the first cohort of RAMP, Roanoke's business accelerator, and received a $50,000 grant from the state's Commonwealth Research Commercialization Fund. Once the company can quickly and reliably test for gluten, it will use the same technology to build tests for a number of different food allergens. Champion has invested more than $30,000 in the venture to date. He supplies the business knowledge for the company, while Anna Champion, a Virginia Tech researcher, and Petruzzi, a Ph.D. student, are the scientific brains behind the operation. Stay tuned for updates on Altede and their efforts to build a better gluten test.
  8. Celiac.com 08/28/2017 - After 14-day gluten challenge, an HLA-DQ-gluten tetramer blood test provides better detection of celiac disease than biopsy. Can that lead to new disease detection methods in patients who are already on a gluten-free diet? Doctors attempting to diagnose celiac disease are often confronted by patients who have already given up gluten. For such patients, diagnostic guidelines currently call for a gluten challenge of at least 14 days, followed by duodenal biopsy. There isn't much good data on how many false-positive results are generated by this method. To get a better picture, a team of researchers recently studied responses to 14-day gluten challenge in subjects with treated celiac disease. The research team included Vikas K Sarna, Gry I Skodje, Henrik M Reims, Louise F Risnes, Shiva Dahal-Koirala, Ludvig M Sollid, and Knut E A Lundin. They are variously affiliated with the Department of Immunology and Transfusion Medicine, Oslo University Hospital, Norway; K. G. Jebsen Coeliac Disease Research Centre, University of Oslo, Norway; Department of Clinical Service, Oslo University Hospital, Norway; Department of Pathology, Oslo University Hospital, Norway; Centre for Immune Regulation, University of Oslo and Oslo University Hospital, Norway; and the Department of Gastroenterology, Oslo University Hospital, Norway. The research team took a group of 20 patients with biopsy-verified celiac disease, all in confirmed mucosal remission, and presented them with a dietary gluten challenge of 5.7 grams per oral gluten per day for 14 days, then conducted duodenal biopsies. They analyzed blood by multiplex assay for cytokine detection, and by flow cytometry using HLA-DQ:gluten tetramers. Nineteen of the twenty participants completed the challenge. Biopsy results showed villous blunting in 5 of those 19 patients. Villous height to crypt depth ratio reduced with at least 0.4 concomitantly with an increase in intraepithelial lymphocyte count of at least 50% in 9 of the 19 patients. Interleukin-8 plasma concentration increased by more than 100% after 4 hours in 7 of 19 subjects. Frequency of blood CD4+effector-memory gut-homing HLA-DQ:gluten tetramer-binding T cells increased by more than 100% on day 6 in 12 of 15 evaluated participants. For most celiac patients, a 14-day gluten challenge did not result in sufficient mucosal architectural changes for clear diagnosis (sensitivity ≈25%–50%). The team found that an increase in CD4+ effector-memory gut-homing HLA-DQ:gluten tetramer-binding T cells in blood 6 days after gluten challenge is a more sensitive and less invasive biomarker for celiac disease. The team is calling for further study. Being able to diagnose celiac disease without biopsy could really help to improve the entire diagnostic process, and could easily lead to an increase in diagnosis. Source: Gut
  9. Celiac.com 08/25/2017 - Japanese drug maker Daiichi Sankyo will pay $300 million to settle thousands of federal and state court lawsuits over its top-selling blood pressure drugs, Benicar, Benicar HCT, Azor and Tribenzor, according to the lead Plaintiffs' lawyers. The settlement was reached in the federal multi-district litigation (MDL) case titled In re: Benicar (Olmesartan) Products Liability Litigation, MDL 2606, pending in the U.S. District Court for the District of New Jersey, Camden Division. Overseeing the federal MDL litigation are the Honorable Judge Robert Kugler and the Honorable Magistrate Judge Joel Schneider, who handled the settlement negotiations. The agreement covers about 2,500 claims by individuals who claim severe and sometimes life-threatening gastrointestinal injuries after using medications containing the active ingredient olmesartan medoxomil (Benicar, Benicar HCT, Azor and Tribenzor). Numerous reports have tied Olmesartan to sprue-like enteropathy and changes in the intestinal tract that mimic those seen in celiac disease, and inhibit a person's ability to absorb nutrients. The parties reached the resolution as they maneuvered ahead of pre-trial hearings, and an expected trial in federal court. Christopher L. Coffin and Adam M. Slater, Co-Lead Counsel for the Plaintiffs, praised the settlement as an excellent outcome for the Plaintiffs. In a statement, Coffin said that they were "very pleased with the outcome of this hard-fought litigation. This is a gratifying resolution for thousands of patients who suffered severe gastrointestinal injuries while using these blood pressure medications." Under the settlement, former olmesartan users who have claims, and who meet certain criteria will be eligible for compensation. For more information go to OlmesartanProductLitigationSettlement.com.
  10. PEDIATRICS Vol. 108 No. 2 August 2001, p. e21 Kieslich M, Errazuriz G, Posselt HG, Moeller-Hartmann W, Zanella F, Boehles H. Departments of Pediatrics, Johann Wolfgang Goethe University, Frankfurt/Main, Germany. Celiac.com 08/24/2001 - It is well known that celiac disease causes destruction of the villi in the small intestine that results in malabsorption of nutrients in affected individuals. There is solid evidence that additional neurological complications can result, such as epilepsy, possibly associated with occipital calcifications or folate deficiency and cerebellar ataxia. An increase in brain white-matter lesions has been reported in patients with Crohn disease and ulcerative colitis, but until now, not in patients with celiac disease. A recent study published in the August 2, 2001 issue of Pediatrics has now demonstrated a similar increase of these lesions in patients with celiac disease. The study was carried out by Dr. Kieslich and colleagues of the Departments of Pediatrics, Johann Wolfgang Goethe University, Frankfurt/Main, Germany, on 75 biopsy-proven celiac disease patients who were on a gluten-free diet. Most of the patients in the study were between 2.8 and 24.2 years old, and the mean age was 11.6 years. All of the patients underwent prospectively clinical neurological examinations, laboratory investigations, electroencephalography, computed tomography, and magnetic resonance imaging. According to the study the mean period of gluten exposure was 2.4 years, although it was likely longer as recent studies have shown that many celiacs are asymptomatic for many years before damage occurs that is severe enough to cause obvious symptoms. The researchers found that ten of the patients had neurological manifestations such as febrile seizures, single generalized seizures, mild ataxia, and muscular hypotonia with retarded motor development, although no folate deficiencies were found. Further, the hippocampal regions appeared normal, and no cerebral calcifications were found, however, the MRI results showed unilateral and bilateral T2-hyperintensive white-matter lesions in 15 patients (20%). According to the research, there does not appear to be a relationship between these lesions and dietary compliance or neurological or electroencephalographic abnormalities. The researchers conclude that focal white-matter lesions in the brain may represent an extra-intestinal manifestation of celiac disease. They theorize that the lesions may be the result of a decreased blood supply caused by the constriction or obstruction of blood vessels due to inflammation, or caused by the destruction of the nerve fiber due to inflammation. Further, children with white-matter lesions, even if they do not have intestinal symptoms, should be tested for celiac disease. Last, more research needs to be done on people celiac disease of all ages to develop a proper predictive value, and to discover the exact cause of the lesions.
  11. Celiac.com 08/15/2017 - Some evidence indicates that rates of celiac disease in the general population are increasing over time. Prior to the discovery of gluten's role in celiac disease, the prognosis for celiac sufferers was bleak. Did higher betas of death keep celiac disease rates correspondingly lower? To provide an answer, a team of researchers set out to examine a possible relationship between mortality rates for children under five, and prevalence rates of celiac disease. The research team included Federico Biagi; Alberto Raiteri; Annalisa Schiepatti; Catherine Klersy; and Gino R. Corazza. Their team conducted a review of literature, and found 27 studies done in 17 different countries between 1995 and 2011 describing rates of celiac disease in schoolchildren. Four of the studies were conducted in Italy. Their meta-analysis compared prevalence rates between specific-country under-five mortality groups, publication year and age. In recent decades, mortality rates for under-five year olds have been decreasing all over the world. This reduction is paralleled by rising rates of celiac disease. The Spearman correlation coefficient for these terms was -63%, 95%CI -82% to -33% (p < 0.001). So, the higher the mortality rate, the lower the prevalence of celiac disease. This finding is confirmed by the meta-analysis of the 4 studies conducted in Italy over time. The mortality rate for under five-year-olds seems to influence the rate of celiac disease in the general population. They predict a rise, in the near future, of the number of celiac disease patients, due to better survival rates of celiac children. Source: Journal of Pediatric Gastroenterology & Nutrition: Post Acceptance: July 27, 2017. doi: 10.1097/MPG.0000000000001696
  12. Celiac.com 08/05/2017 - I was told that I had irritable bowel disease about thirty years before being diagnosed with celiac disease. I avoided hard to digest foods such as corn, broccoli, beef and other foods difficult to digest, and instead I would, for instance, eat the bun of a hamburger, avoid steaks but eat the buttered buns and the gravy with a main meal and wondered why I was still having the gut and bowel reactions! Did you know that even in the absence of fully developed celiac disease, gluten can induce symptoms similar to FBD (Functional Bowel Disorder)? Doctors such as Elena F. Verdu, David Armstrong and Joseph Murray describe celiac disease and irritable bowel syndrome (IBS) as the "no man's land of gluten sensitivity.” Celiac disease is a condition traditionally characterized by chronic inflammation of the proximal small intestine resulting in villus atrophy and malabsorption. Irritable bowel disease is a clinical syndrome defined in the most recent Rome III consensus by the presence of abdominal pain or discomfort, at least three days per month in the last three months, and two or more other symptom features: 1) Improvement in defecation, 2) Association with a change in stool frequency, and 3) Association with a change in stool form or appearance. Other GI symptoms, such as bloating and distension are also considered to be consistent with a diagnosis of FBD (Functional Bowel Disorder) such as IBS. Did you know IBS has a prevalence of about 10% and is the most common GI disorder in our society, imposing a very high economic burden in North America? Did you know that there is an overlap between IBS and celiac disease? It has been reported that testing for celiac disease in patients with diarrhea-predominant IBS is cost effective if the prevalence of celiac disease is above 1%. Not only do the symptoms of IBS and celiac disease overlap, but epidemiological studies also suggest a greater than by chance association (4 - 5 fold increased risk). By convention, a patient with confirmed celiac disease is no longer considered to have IBS. It has never been determined whether celiac disease and IBS cannot co-exist, and there is no reason to think that a diagnosis of celiac disease necessarily precludes a diagnosis of IBS. Dr. Fasano has concluded that about 3% of patients with a "clinical" presentation of IBS were subsequently diagnosed with celiac disease. I would wager that many of you with confirmed celiac disease may also have the symptoms of irritable bowel disease. I cannot be alone in this! I can check off the symptoms of IBS on many occasions and yet I have diagnosed celiac disease and dermatitis herpetiformis. In Dr. Fasano's report: "they have concluded that gluten induced Patho-physiology may constitute an underlying factor in symptom generation in a proportion of patients with IBS like symptoms." A lot of this wording may seem like Greek or a "little over ones head" so to speak, but I believe what they are saying is though we define gluten sensitivity as a condition of some morphological, immunological, or functional disorder that responds to gluten exclusion and NOT a true disease. Gluten sensitivity changes that occur with IBS because of exposure to gluten are eventually going to show up positive for celiac disease. Why would a person who has been diagnosed and KNOWS that they have irritable bowel disease continue to ingest gluten when Fasano et. al., have concluded that about 3% of patients with a "clinical" presentation of IBS were subsequently diagnosed with celiac disease? Did you know that in July of 2016 teams of researchers at Columbia University published a study confirming that wheat exposure response is, in fact triggering a systemic immune reaction and accompanying intestinal cell damage. "It is estimated that the impacted population is equal to or even exceeds the number of individuals with celiac disease, the vast majority of whom remain undiagnosed" Dr. Armin Alaedin confirmed. Finally they are reporting that a person with irritable bowel disease may have gotten that way from ingesting gluten. Celiac Disease and Dermatitis Herpetiformis – Did You Know? 15 - 25% of individuals with celiac disease experience dermatitis herpetiformis? Dermatitis herpetiformis is a skin manifestation of celiac disease and is part of the abnormal immune response to gluten; Affects more men than women? Dermatitis herpetiformis generally starts in adulthood. It is not common to see dermatitis herpetiformis in children, but it can occur; Only about 20 percent of people with dermatitis herpetiformis have intestinal symptoms of celiac disease, however, biopsies show that 80 percent have some degree of damage to the small intestine, especially if a high gluten diet is maintained; If you suspect dermatitis herpetiformis you may have celiac disease; Iodine is something that a person with dermatitis herpetiformis should definitely avoid; One of the oldest checks for dermatitis herpetiformis was putting some iodine on ones thigh; Dermatitis herpetiformis sores tend to run in a line, or stay in a cluster; Dermatitis herpetiformis treatment consists of a gluten-free diet for life, just like in celiac disease? The skin's response to the gluten-free diet is much slower compared to the healing of the intestines in those with celiac disease. It may take about six months to achieve improvement, though with my own dermatitis herpetiformis spots daily dapsone was miraculous. It did take up to a year for the sores in my scalp to heal. Dr. John Zone, M.D. Professor and Dermatology Chair at the University of Utah and CDF Medical Advisory Board member states "There is little question that ingestion of large amounts of iodine dramatically worsens dermatitis herpetiformis," he continues, "iodine does not cause dermatitis herpetiformis. It worsens dermatitis herpetiformis. Gluten causes dermatitis herpetiformis." Dr. Zone explains that through seeing hundreds of celiac disease patients over the years, he has found that some react to highly concentrated solutions of iodine in cough medicines, shellfish, and kelp, which is often found in Sushi. He also cautions that dietary supplements may contain large amounts of kelp or iodine (usually in the form of potassium iodide or sodium iodide) which can worsen dermatitis herpetiformis. I can share with you that I was incorrectly told over 25 years ago by an internist that I could take up to five dapsone, going 5- 4 - 3- 2 -1, and if the spots had not totally disappeared I could repeat the process. Taking too much cased a blood disorder called Methemaglobinemia, a rare but dangerous response to taking too much dapsone. It is a blood disorder in which an abnormal amount of methemoglobin is produced. Hemoglobin is the protein in red blood cells (RBCH's) that carries and distributes oxygen to the body. Methemoglobin is a form of hemoglobin, with it the hemoglobin can carry oxygen, but is not able to release it effectively to body tissues. It can either be passed down through families (inherited or congenital) or be caused by exposure to certain drugs, chemicals, or foods (acquired). My nephew was on dapsone, which is, according to the Head of Dermatology at the University of British Columbia, the true test of dermatitis herpetiformis. By taking Dapsone for three or four days the lesions (itchy/sore blisters that beg to be itched, and when you do you break open a lesion that appears to contain liquid...they burn, then they crust, and if you continue to pick off that crust they scar your skin.) almost disappear like magic. My nephew thought it was permissible to cheat once in a while and thought that he could get away with it. He used to eat hamburgers every time the craving for a "Big Mac" overcame him! He ate one, or maybe two, until he found out he had dermatitis herpetiformis sores on the soles of his feet and was limping from the pain. Who knows what damage he was doing to the villi in his bowel! It is a vast no man's land out there, but if you are a celiac and have dermatitis herpetiformis or are gluten sensitive you need to step into that “land” and learn more about the diseases and what is going on in your body!
  13. Celiac.com 08/11/2017 - We are very pleased to provide an exciting update on our progress on bringing our therapeutic drug "latiglutenase" and our diagnostic disease management tool "CypCel" to market for patients suffering with celiac disease. ImmunogenX is a clinical-stage company founded by dedicated scientists committed to bettering the lives of celiac disease patients. We are focused on celiac disease therapy, disease management and food safety. We acquired the assets of Alvine Pharmaceuticals in 2016 and are marching ahead with great confidence and enthusiasm and plan to start our final Phase 2 trial for latiglutenase later this year. Latiglutenase is a natural product, a mixture of two gluten-specific enzymes that break down gluten in the stomach. A patient would take the therapy orally while maintaining a strict gluten-free diet. The intent of the therapy is to combat low levels of gluten that persist in the food chain, as well as in situations where ingestion of gluten is unavoidable due to cross contamination, such as at restaurants. The recent latiglutenase Phase 2b trial (CeliAction) conducted by Alvine and AbbVie unfortunately did not meet their primary goal of demonstrating clinically significant intestinal healing. The secondary goal of symptom reduction did show evidence of success in a subclass of celiac disease patients. ImmunogenX, following the acquisition of the Alvine assets, completed a post hoc data analysis from this trial. Statistically and clinically significant symptom improvement was shown for abdominal pain, bloating, tiredness, and constipation for patients who had persistent positive readings in key antibody levels (i.e., seropositive). These exciting results were highlighted at the Digestive Disease Week meeting in May 2017 and are now published in Digestive Diseases and Sciences. We will travel to India in September to present our research at ICDS 2017 (International Celiac Disease Symposium). If the primary endpoint of the CeliAction trial had been focused on reducing symptoms of gluten exposure, then that trial could rightfully have been called a success. Therefore, as a next step, ImmunogenX will be to go back into the clinic and reconfirm these positive results, demonstrating symptom improvement, in our next phase 2 trial. This will enable the company to transition to a pivotal trial for FDA registration. We attended another FDA Type C meeting in May 2017, which reinforced the continuing positive support from the agency regarding our symptom label, our Phase 2/3 trial strategy and our celiac disease symptom diary (CDSD) patient reported outcome (PRO) instrument. It is very gratifying to have such documented support from the FDA for our mission. Please visit our website www.immunogenx.com for updates on our progress and feel free to contact us with any questions (info@immunogenx.com).
  14. Celiac.com 06/12/2014 - Here are five things people with celiac disease need regular folks to know about celiac disease: We are NOT on a Fad Diet—Celiac disease is not some vague, make-believe condition. Celiac disease is a potentially serious immune disorder that, if left untreated, can lead to a very deadly types of stomach, intestinal, and other cancers. Just because a bunch of people seem to think that gluten is the new high fructose corn syrup, doesn’t mean that I’m one of them. Remember, for people with celiac disease, gluten is no joke, and avoiding gluten is the only way to stay healthy. We Won’t Be Getting Over It—Currently, there is no cure for celiac disease, and the only treatment is a gluten-free diet. That’s the only way to avoid the gut damage, lower risks for other types of auto-immune conditions, and minimize the risk of various types of cancer associated with celiac disease. Celiac Disease is a Serious Condition—Since the effects of untreated celiac disease unfold slowly over time, it’s tempting for some people to look at celiac disease as a minor inconvenience. However, it’s important to understand that celiac disease is a potentially serious autoimmune disorder that, if left untreated, can leave people susceptible to other autoimmune conditions, and to deadly types of stomach, intestinal, and other cancers. A ‘Little Gluten’ Might Hurt Me—There’s no such thing as ‘a little gluten’ to people with celiac disease. Gut damage happens with as little as 20 parts of gluten per million. That is a microscopic amount. A 'gluten-free' diet means no gluten. Period. When in Doubt, Ask—If you’re not sure if I can safely eat a certain ingredient, or a certain food, just ask. Figuring out what is or is not gluten-free can be tricky, even for me. So, it's best to ask if you're not positive. Can you think of others?
  15. Celiac.com 08/03/2017 - Some evidence indicates that feeding in the first months of life might have an impact on the risk of later celiac disease. Numerous patients with celiac disease or type 1 diabetes show high levels of antibodies against cow milk proteins. For infants with genetic susceptibility for type 1 diabetes, avoiding of cow’s milk-based formula can lower the levels of diabetes-associated autoantibodies. Could the same be true for celiac disease? To find out if weaning to an extensively hydrolyzed formula lowered the risk of celiac disease of celiac disease autoimmunity, a research team performed a randomized controlled trial. The research team included Mila Hyytinen, Erkki Savilahti, Suvi M. Virtanen, Taina Härkönen, Jorma Ilonen, Kristiina Luopajärvi, Raivo Uibo, Outi Vaarala, Hans K. Åkerblom, and Mikael Knip for the Finnish TRIGR Pilot Study Group. For their double-blind controlled trial, they enrolled 230 infants with HLA-defined predisposition to type 1 diabetes and at least 1 family member with type 1 diabetes. The infants were randomly assigned to groups, with 113 fed a casein hydrolysate formula, and 117 receiving a conventional formula whenever breastmilk was not available during the first 6–8 months of life. The team collected serum samples over an average of 10 years, and screened for antibodies to tissue transglutaminase (anti-TG2A) using a radiobinding assay, to endomysium using an immunofluorescence assay, and antibodies to a deamidated gliadine peptide using an immunofluorometry assay. In patients with anti-TG2A levels over 20 relative units, the team conducted duodenal biopsy. They measured cow’s milk antibodies during the first 2 years of life. Their results showed that about 13% of the 189 participants they analyzed for antiTG2A 25 tested positive. Just ten of the 230 study participants were diagnosed with celiac disease. The team found no significant differences in total cases of anti-TG2A positivity (hazard ratio, 1.14; 95 % CI, 0.51–2.54) or celiac disease (hazard ratio, 4.13; 95% CI, 0.81–21.02) between the casein hydrolysate and cow's milk group. Interestingly, children who developed celiac disease did show higher levels of cow's milk antibodies before the appearance of anti-TG2A or celiac disease. This study of infants with genetic risk factors for celiac disease showed evidence that weaning to a diet of extensively hydrolyzed formula compared with cow’s milk-based formula would lower the risk for celiac disease later in life. Elevated levels of cow's milk antibody before anti-TG2A and celiac disease indicates that many people may experience increased intestinal permeability before they develop celiac disease. Source: GASTROENTEROLOGY
  16. Celiac.com 05/25/2017 - No parent likes to see their child ill. This is most especially true of a newborn. The baby feels sick, perhaps has a fever, and often all they do is cry, look miserable and no one gets any sleep. So while we can all agree that it's no fun, could keeping your baby healthy actually prevent a lifetime of celiac disease? The answer is quite possibly 'yes' based on a recent study published in BioMed Central Pediatrics. The title of the study is: "Early infections are associated with increased risk for celiac disease: an incident case-referent study". [A case referent study is simply one where people with the disease to be studied are identified and compared to people in a control group who do not have that disease but are similar in other respects.] Specifically, the authors concentrated on the 'epidemic' of celiac disease present in Swedish children under two. Their goal was to discover any potential risk or protectant factors that could influence the expression of celiac disease. Nine hundred and forty five children participated in this study, 373 of whom had celiac disease, with the remainder making up the control group. All of those with the disease were diagnosed with it prior to their second birthday. The scientists discovered that if a child had 3 or more infections, regardless of type, during the first 6 months of life, their risk for contracting celiac disease was significantly increased. This risk remained stable after adjusting for variances in infants' feeding and socioeconomic status. Additionally, the risk of celiac disease was further increased if, in addition to the infections, the infants were introduced to gluten in large amounts, compared to small or medium amounts, after breastfeeding was discontinued. The authors concluded that there was actually a synergistic effect between early infections and daily gluten intake. That effect was more pronounced when the infants who were ingesting gluten, did so after breastfeeding was discontinued. So what is our take-away from this study? As a parent of a newborn, one certainly can control whether the infant is breastfed, and the benefits of doing so compared to any available formula seem irrefutable. Therefore, even if a mother is having some trouble nursing or with her milk production, it is well worth the effort to overcome whatever obstacles are present so her infant receives the benefits of nursing for at least 6 months. Personally I encourage a year, but 6 months would be the absolute minimum. Controlling whether or not your child becomes ill is certainly more difficult than ensuring he or she is breastfed, but I would like to share an interesting correlation that we see here at the clinic. Breastfed babies seem, on the whole, to be much healthier than formula fed babies. There is certainly considerable support in the research to support our clinical experience. You may have more control than you would imagine, simply by ensuring that your infant is nursed for as long as possible. The only further dietary recommendation I would suggest is that the infant's mother get checked for gluten intolerance during pregnancy or as soon as possible, and if she has any genetic markers for either celiac disease or gluten sensitivity, she should avoid all gluten (and dairy products) during the nursing months – both have been shown to lower the immune system. Finally, from a lifestyle viewpoint, it would perhaps be prudent to make the first 6 months or so of life as stress-free as possible. I know that some infants gain a passport and international travel experience well before their first birthday due to relatives in foreign lands or from out of state. While all families are excited to greet a new infant into the family, consider having the infant stay at home while others make the journey to meet him or her. This might very well prove to have long-term benefits for the child's health. I hope that you found this helpful. Unfortunately, celiac disease, much like so many other autoimmune diseases we are trying to avoid, continues to increase in frequency. Anything we can do to reduce the numbers of people suffering is well worth it. If you have any questions, comments, or would like to improve your health. Please contact me – call 408-733-0400. We are here to help! Reference: BioMed Central Pediatrics. 2012 Dec 19;12(1):194. Early infections are associated with increased risk for celiac disease: an incident case-referent study. Myléus A, et al.
  17. Celiac.com 07/13/2017 - Until recently, duodenal biopsy was considered the gold standard for diagnosing celiac disease, but that is changing. A number of studies have shown that celiac disease can be diagnosed using serological tests alone, but many clinicians have yet to embrace this approach. In both retrospective and prospective studies, one research team showed that certain IgA-tissue transglutaminase antibodies levels can predict celiac disease in adults 100% of the time. After making some adjustments to the analytical method for measuring the antibody, a team of researchers recently set out to to determine whether such serum tests can reliably diagnose celiac disease in large numbers adult patients without the need for small bowel biopsy. The research team included GKT Holmes, JM Forsyth, S Knowles, H Seddon, PG Hill, and AS Austin. They are variously associated with the Royal Derby Hospital, the Department of Pathology, and the Derby Digestive Diseases Centre at the Royal Derby Hospital in Derby, UK. For their study, the team conducted a retrospective analysis in an unselected series of 270 adult patients who underwent small bowel biopsies and the measurement of serum IgA-tissue transglutaminase antibody levels from 2009 to 2014. At an IgA-tissue transglutaminase antibody cut-off greater than 45 U/ml (>8×upper limit of normal+2SDs) the positive predictive value for celiac disease in this cohort was 100%; 40% of cases were above this cut-off. The team found that they could use IgA-tissue transglutaminase antibody levels to reliably diagnose celiac disease in a high proportion of these adult patients. This study adds to the growing body of evidence that supports the diagnosis of celiac disease without a mandatory small bowel biopsy. As a realist of these findings, the study team has changed the diagnostic guidelines for their center, and will now make celiac diagnosis based on cut-off levels of IgA-tissue transglutaminase. This is exciting news. For many, many years, the biopsy was considered the gold standard for diagnosing celiac disease. By eliminating biopsies in favor of IgA-tissue transglutaminase levels, diagnosing celiac disease could become much easier and even cheaper. Do you have celiac disease? Did you receive a biopsy for diagnosis? How do you feel about celiac diagnosis without biopsy? Share your thoughts below. Source: Eur J Gastroenterol Hepatol. 2017 Jun;29(6):640-645. doi: 10.1097/MEG.0000000000000841.
  18. Celiac.com 08/01/2017 - Although autoimmune disorders are not widely associated with Parkinson disease, there is increasing evidence for a link between immunity and neurodegenerative disorders. Indeed, both innate and adaptive immunity have been implicated in neurodegenerative disorders. A team of researchers recently set out to examine the connection between immunity and neurodegenerative disorders. The research team included Nikolaus R. McFarland, MD, PhD; Karen N. McFarland, PhD; and Todd E. Golde, MD, PhD. They are variously associated with the Center for Movement Disorders and Neurorestoration, Department of Neurology, College of Medicine, University of Florida, Gainesville, the Center for Translational Research in Neurodegenerative Disease, College of Medicine, University of Florida, Gainesville, the McKnight Brain Institute, University of Florida, Gainesville, and the Department of Neuroscience, College of Medicine, University of Florida, Gainesville. One of the more interesting examples the researchers examined is TREM2, a member of the immunoglobulin receptor superfamily that expresses itself in microglia and tissue macrophages, and which has gene variants associated increased Alzheimer ’s risk. They also took a look at other TREM2 variants that are linked to the development of polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy, a dementia associated with bone cystic lesions. Another example with less clear biological significance is the reproducible genetic association between a single-nucleotide polymorphism (SNP) in the locus and type 1 diabetes. We are at the very beginning of a research effort to better understand the connection between immunity and neurodegenerative disorders. It may take a while, but the results of these efforts will likely help researchers design better diagnostic and treatment regimes. Source: JAMA Neurol. Published online June 5, 2017. doi:10.1001/jamaneurol.2017.0843
  19. Celiac.com 07/12/2017 - Humans rely on powerful canine noses to do so many things, including sniffing for drugs, bombs and even cancer. Now, some dogs are being trained to serve their masters by sniffing out gluten. Trained to help some of the 3 million Americans who have celiac disease, gluten sniffing dogs can be a tremendous boon to their owners, especially those who are highly sensitive. One such person is Evelyn Lapadat, a 13-year-old Indiana girl with celiac disease that leaves her with joint pain, stiffness and fatigue when she eats even tiny amounts of gluten. Now, thanks to Zeus, her Australian shepherd, Evelyn rarely has an issue with gluten. That's because Zeus has been trained to sniff out even tiny amounts of gluten in food. Zeus stays by Evelyn's side throughout the day at school, checking her hands and sniffing her food. Zeus has learned to raise his paw if he smells gluten. If the food is safe, then Zeus turns his head. “I haven't gotten sick in a really long time and it's like a really big relief,” Evelyn said. Maybe one day dogs like Zeus will be much more common. See more at NBCNews.com
  20. Celiac.com 07/19/2017 - Ever wondered what life is like in the celiac disease capital of the world? In Finland, an estimated 2.4 percent of adults from 30 to 64 years old, and one in 99 children are diagnosed with celiac disease. The country also holds the record for the most overall cases of the celiac disease in the world. If ever there was a world headquarters for celiac disease, it would be Finland. One of the best things about Finland is that awareness of keliaka (celiac disease) is common, and gluten-free food is readily available. Throughout the country, most folks you run into know some friend, colleague or family member with the condition. Everyone seems to be aware that celiac disease results from an adverse gut reaction gluten, a protein in wheat, barley and rye products. Meanwhile, supermarkets, high-end restaurants, convenience stores, fast-food joints, gas stations, and even international fast food chains like McDonald’s offer gluten-free options. As a nation, Finland places a heavy emphasis on research, diagnostics or government support for celiac disease. The nation embraces people who follow what the Finns call gluteeniton, or a ‘gluten-free’ diet. So if you’re looking for the closest thing to a gluten-free paradise on earth, consider a visit to Finland. Read more at AllergicLiving.com
  21. Celiac.com 07/21/2017 - In previous studies, a team of scientists led by Professor Anette-Gabriele Ziegler had already shown an association between infections in early childhood and the development of type 1 diabetes. In that study, the researchers saw the highest risk for type 1 diabetes in children who experienced repeated respiratory infections in the first six months of life. Recently, Zeigler and another team of colleagues from the Institute for Diabetes Research at Helmholtz Zentrum München, a partner in the German Center for Diabetes Research (DZD), set out to determine whether infections during infancy are associated with increased risk for celiac disease later on. Their current study shows that the risk of developing celiac disease is particularly high when gastrointestinal tract infections occur during the first year of life. To a lesser extent, an increased disease risk was also seen in connection with early respiratory tract infections. The risk seems to be particularly high for people who experience repeated gastrointestinal infections in the first year of life. Whether the connections with early infections and later celiac risk are causal or are based on changes in the microbiome or specific immune responses is not clear from the data, said first author Dr. Andreas Beyerlein. "However," Beyerlein added, "it seems that the increased risk of celiac disease is associated with a permanent inflammation of the gastrointestinal tract in early childhood and is not caused by a specific viral or bacterial pathogen." The team reached their conclusion after analyzing fully anonymized data provided by the Bavarian Association of Statutory Health Insurance Physicians (Kassenärztliche Vereinigung Bayern) of 295,420 children who were born between 2005 and 2007. Medically attended infections from birth until a median age of 8.5 years were considered in the analysis. A total of 853 children developed gluten intolerance, equivalent to 0.3 percent. Their results appear in the American Journal of Epidemiology. Source: Helmholtz Zentrum München - German Research Center for Environmental Health
  22. Celiac.com 07/20/2017 - It is common for school teachers in the United States not to know what student has celiac disease, or allergies of any sort. Most schools don't have formal systems so that the principal, school nurse, teacher, or cafeteria workers know when a child has celiac disease or food allergies. An informal game of roulette is played, where everyone assumes that everything is fine – that is, until a child has a heath reaction. In Montreal, Canada, the Lester B Pearson School Board has taken a different approach to dealing with food allergies and conditions such as celiac disease that their students might have. They regard these health conditions to be so important that how to handle them is present in their official Policy on Safe and Caring Schools. To summarize what they do, at the beginning of each school year parents are sent a form requesting them to inform the principal, homeroom teacher, and other relevant school personnel about health conditions and allergies. This includes children who have celiac disease and gluten issues. If a child changes schools, or if a student in an existing school gets a new health diagnosis or has newly identified health needs, this information should be made known to school personnel. A photograph of the student is taken and put on a card with the health condition so that others in charge may know that a particular child has gluten issues. In the cafeteria, workers have the photos of the children posted in the kitchen where they can see them so that they can know that brown-haired Lucinda in fifth-grade has celiac disease and should be served only foods that are safe for her. Children may not know what foods have gluten in them and which do not, so they may not always be the best informants for identifying which foods being served are safe for them and which are not. Given that additives may vary according who is doing the cooking or what ingredients are used, a food like macaroni and cheese may be made with wheat pasta, making it unsafe, or corn, rice or quinoa pasta, rendering it acceptable. Both may look identical to the naked eye, but they aren't so it is a food service worker's obligation to know whether Lucinda can have the dish or not. Likewise, teachers may be given the photograph and health card so that they remember when Billy brings in cupcakes for his birthday celebration, that there are gluten-free ones available (hopefully!) in the cafeteria freezer that can be pulled out and given to Lucinda so she is not left out. The photograph technique is especially helpful when there are new cafeteria workers or substitute teachers or other personnel who may not know a child's food allergy situation like someone who interacts with the child every day might. The Lester B Pearson schools' Food and Nutrition Policy is based in Canada's Food Guide and Policy on Health Eating and Active Living. All schools in Canada are to adhere to the same set of standards. This means that a celiac child living in Vancouver should be just as safe eating at school as one in Ottawa or one in Halifax. Having national standards that are uniformly enforced helps to make all children safe. Making sure that children's food consumption is safe for all of them, especially in public institutions like schools, is part of their human rights according to the Convention on the Rights of the Child. It is the responsibility of adults who are in local parent organizations to be in charge of the oversight and safety of all children and to think through food risk and safety policies.
  23. ok today is officially one week i've been gluten free and i haven't made any noticeable differences in feeling better. my first question is: how long should i wait to expect changes to occur? am i not giving it enough time? prior to going gluten free one of my issues was constipstion, as well as other health issues usually involving an upset stomach, nausea or an uneasy feeling in my stomach. but since going gluten free i have had a bowel movement different from usual. and today it was more loose and diarrhea like and it is very rarely like that. oh and about half way through the week i got a random rash pop up on one ankle???? advice or suggestions??
  24. Celiac.com 07/14/2017 - Dietary phosphorus occurs naturally in foods like dairy products, animal meats and legumes. The institute of Medicine recommended dietary allowance (RDA) is 700 mg/day while the NHANES data indicates that the typical American consumes more than twice that every day. Phosphorus is considered an essential nutrient but it is increasingly being added to processed foods via additives (anti-caking agents to preserve moisture and color) or as a stabilizer, leavening agent or acidifier. Since it is not required to be listed on the label, it is difficult to know how much is being added and consumed. High levels of phosphorus is now being considered an independent predictive factor in mortality and morbidity from cardiovascular, kidney, and osteoporosis disorders. People with celiac disease need to be considering how many processed foods they are consuming as food manufacturers continue to offer increasing numbers of gluten-free processed foods. According to Packaged Facts 2012, breads, cereals and grains comprise 53% gluten-free purchases; snack foods 44%; sweet baked goods (cookies) 30%; frozen/refrigerated meals and entrees 27%; baking mixes 26% and packaged dinner/side dishes 24%. Phosphates in the form of food additives contribute to the increasing health implications when not consuming a fresh foods diet. Avoiding carbonated beverages is the best way to reduce phosphorus levels in the diet. Aside from that, the person with celiac disease must pay attention to ingredient statements that may include these declarations: tricalcium phosphate, trimagnesium phosphate, disodium phosphate, dipotassium phosphate. According to current regulations, these ingredients are safe when used in good manufacturing processes but the more one consumes prepared foods, the more elevated the blood phosphorus levels can rise. The Institute of Food Technology in its December 2012 journal states," It has been difficult for consumers to find gluten-free alternatives that taste good and have desirable texture properties. Consequently, manufacturers are looking for different ingredient solutions that will address these problems". Phosphate additives have provided that solution without consumers being aware of the health implications. Yes, the food world offers a wider array of gluten-free foods than ever before but just because it states "gluten-free" on the label does not mean it is a healthy food for everyday consumption. Remember: Fresh is Best! Here is a guide I use to help those choosing processed foods to be wiser consumers: Baked Goods: cake mixes, donuts, refrigerated dough = pyrophosphates for leavening and dough "improver". Beverages: phosphoric acid in colas for acidulant, pyrophosphate in chocolate milk to suspend cocoa, pyrophosphate in buttermilk for protein dispersion, tricalcium phosphate in orange juice for fortification, tetrasodium phospahte in strawberry flavored milk to bind iron to pink color. Cereals: phosphate in dry cereals to aid flow through extruder and fortification. Cheese: phosphoric acid in cottage cheese to set acidification, phosphate in dips, sauces, cheese slices and baked chips for emulsifying action and surface agent. Imitation Dairy Products (non-dairy products): phosphate as buffer for smooth mixing into coffee and as anti-caking agent for dry powders. Egg Products: phosphate for stability and color/foam improvement. Ice Cream: pyrophosphate to prevent gritty texture. Meat Products: tripolyphosphate for injections into ham, corned beef, sausage, franks, bologna, roast beef for moisture and color development. Nutrition Bars & Meal Replacement Drinks: phosphates for fortification and microbiological stability. Potatoes: phosphate in baked potato chips to create bubbles on surface, and pyrophosphate in French fries, hash browns, potato flakes to inhibit iron induced blackening. Poultry: tripolyphosphate for moisture and removal of Salmonella and Campylobacter bacterial pathogens. Puddings & Cheesecakes: phosphate to develop thickened texture. Seafood: tripolyphosphate in shrimp for mechanical peeling, pyrophosphate in canned tuna and crab to stabilize color and crystals, surimi ("crab/sea sticks") triphosphate and pyrophosphate as cryoprotectant to protein. For those not having food composition tables available, here is a comparison of common snack foods to show how phosphorus levels quickly can add up. Many food companies do not provide analysis information on phosphorus because it is not required for the nutrition label. Hershey Bar with Almonds - 116 mg Cola Beverage (12 oz) - 44 mg M&M Peanuts (1.74 oz pkg) - 93 mg Yogurt (1 cup) - 300 mg Total Cereal (1 cup) General Mills - 200 mg Peanuts (1 oz) - 150 mg Apple, raw (1 med) - 10 mg
  25. Celiac.com 06/30/2017 - Dear attending physician: If you are reading this it is because your patient either expects you to refuse or you have refused to test them for celiac disease. You may believe, in keeping with prior training, that this patient does not display the signs or symptoms associated with celiac disease. However, the symptom complex of celiac disease has recently undergone dramatic changes, beginning with the understanding that celiac disease is a systemic, rather than an intestinal ailment. World renowned researchers have weighed in on this issue, with peer reviewed reports that repeatedly establish the protean manifestations of celiac disease. They defy prior algorithms for symptom assessment toward diagnosing celiac disease. In the past, undiagnosed celiac patients were often identified as asymptomatic because their symptoms were simply not diarrhea, abdominal bloating, and muscle wasting. However, the Celiac Disease Center at the University of Chicago lists more than 300 presenting symptoms of celiac disease (1). The same group also offers a list of symptoms that demonstrate the wide range of apparently unrelated symptoms that can indicate celiac disease, only the first two of which represent these classical symptoms (2). Recurring abdominal bloating and pain Chronic or recurrent diarrhea Constipation Nausea or emesis Liver and biliary tract disorders (increased serum transaminases, primary sclerosing cholangitis) Weight loss Pale, foul-smelling stool Iron-deficiency anemia unresponsive to iron therapy Fatigue Failure to thrive or short stature Delayed puberty Arthralgia Tingling numbness in the legs Pale sores inside the mouth Dermatitis herpetiformis Abnormal dentition (tooth discoloration, loss of enamel) Unexplained infertility or recurrent miscarriage Osteopenia or osteoporosis Peripheral neuropathy Psychiatric disorders (anxiety or depression) Please remember that any one or more of the above symptoms and/or ailments may indicate untreated celiac disease, so testing for celiac disease is an important, inexpensive step toward assisting a patient to resolve these troubling, sometimes debilitating, symptoms. Overweight and obesity may also indicate underlying celiac disease. Today's affluence and accompanying food surpluses permit people who are not absorbing nutrients efficiently to eat enough to more than compensate for otherwise calorically deficient diets. Thus, only a minority of celiac disease cases present with classical symptoms in most of the first world. In fact, some reports indicate that overweight patients with celiac disease are as common as those who are underweight ( 3, 4, 5). This is why researchers have long employed the iceberg metaphor to describe the mass of people with celiac disease. The vast majority these people with celiac disease remain undiagnosed (6). Until sensitive and specific serological screening tools became available, very few cases were diagnosed and celiac disease was erroneously considered rare. In addition to alleviating quite a lot of human suffering, early detection offers some rather large economies for the health care system, as many of the more serious ailments that often befall those with untreated celiac disease may be averted through these inexpensive serological tests and subsequent prescription of a strict gluten free diet. Prior to the therapeutic use of a gluten free diet, mortality was reported at 36% among 73 children with celiac disease (7). Admittedly, it is likely that these were the more serious cases and perhaps some cases of misdiagnosis. However, even as recently as 1989, adult celiac patients experienced almost double the early mortality rate seen in the general population (8), so an early diagnosis and treatment of celiac disease is not just helpful in mitigating current symptoms, it is a powerful form of preventive medicine that is coincidental to the appropriate diagnosis and treatment of celiac disease. Let me expand on that last comment a little further. Chronic depression (9), ADHD (10), neurological (11) and neuromuscular disorders(12) treatment-resistant iron deficiency (13, 14), impaired lung function (15, 16) a variety of lymphomas including B cell and T cell (17, 18, 19) and adenocarcinomas (20, 21) dental enamel defects (22, 23) autoimmune thyroid disease (24, 25 ) autoimmunity in general (26) type 1 diabetes (27, 28) kidney disease (29) liver disease (30, 31) skin disease (32, 33) seizure disorders (34) gait disorders (35) obesity (36) fatigue (37) anxiety (38) infertility (39) osteoporosis (40) learning disorders (41, 42) aphasia (43) and many more such sequels to untreated celiac disease (44) impose an enormous economic burden on our health system and education system. This burden weighs on most levels of government, private insurance companies, families, and individuals. Much of this unnecessary cost is ultimately passed along to taxpayers and/or are incorporated into insurance premiums. We all pay. And the human costs are even greater. Attention deficits and learning disabilities impose life-long inhibitions on success and are corrosive to self esteem. Depression robs us of individual, economic and social achievements, as well as denying us the day-to-day pleasures of life. Similarly, anxiety and infertility are socially isolating and heartbreaking, each in their own ways. Neurological and seizure disorders, including gait disorders, can inhibit our mobility and/or our safe function in this increasingly complex and fast-paced society. Impaired lung function can prohibit or interfere with normal, desirable activities ranging from pleasant walks, sports, and even having sex. Lymphomas and adenocarcinomas can have rapidly fatal consequences. The individual and familial consequences are often devastating. Type 1 diabetes tethers us to insulin injections and requires that we maintain a careful balance between carbohydrate intake and insulin injections. The challenges of this diet dwarfs the inconvenience of a gluten free diet, and a late celiac diagnosis may require that some people comply with both sets of dietary constraints. Skin disease can also exact an enormous social toll, and this is ignores the discomfort and embarrassment of constant itching and scratching, as well as the pain associated with the most common skin diseases connected to celiac disease. Similarly, obesity is not only socially excluding, it poses its own sets of health hazards and life shortening penalties. As osteoporosis becomes more and more common, we can see that society's increasing nutritional dependence on gluten grains may well have set the stage for this degenerative condition, often requiring painful and expensive joint replacement surgeries as our bones gradually crumble and shrink. The dramatic loss of our ability to produce intelligible speech, called aphasia, is by no means the least of this list. The horrific nightmare of being unable to speak to others and have them understand us has been the lived experience of at least one individual. His speech slowly returned after his celiac diagnosis and some time on a gluten free diet. Too many of us are not so lucky. Many of us see ourselves, and our symptoms, in the many posts, blog comments, listservs and websites that discuss celiac disease. Yet outdated medial training can create barriers to patients seeking testing. However, given the above, peer reviewed data and expert opinions, it is difficult to imagine any reasonable argument for refusing to test a patient who requests serological testing for celiac disease. The cost is minimal and the potential benefits to those who are diagnosed, and our society, are enormous. Current data suggest a prevalence of celiac disease in the general population at somewhere around 1%, based on serological testing for selective antibodies. However, newly emerging data suggest that a portion of the population that is at least six or seven times the size of the group with celiac disease mounts an innate immune response to gluten grains. The careful characterization of one pathway for activating intestinal inflammation by non-gluten components of these grains, leaves open the possibility of "gliadin-dependent signaling pathways that still remain to be characterized" (45). Other forms of non-celiac gluten sensitivity, as signaled by IgG class antibodies against gliadin, are seen in 10% to 12% of the general population. Whether these segments of the population with non-celiac gluten sensitivity overlap or are distinct has yet to be determined, so it remains unclear whether they form 10% of our population, or as much as 19% of our culture. Finally, based on a new book by the world renowned pediatric gastroenterologist and allergist, Dr. Rodney Ford, titled Gluten: Zero Global, there is considerable evidence to suggest that, with their many other anti-nutrient, addictive, allergenic, and blood-glucose altering features, gluten grains are a questionable macronutrient food source for humans (46). Thus, testing for non-celiac gluten sensitivity, may offer many of the benefits that testing for celiac disease offers. Your patient and I are asking that you heed the above data from your professional literature and the first dictum of your profession, by 'first doing no harm', and ordering testing for celiac disease and non-celiac gluten sensitivity. Sincerely, Dr. Ron Hoggan, Ed. D. Sources: 1. http://www.cureceliacdisease.org/wp-content/uploads/2011/09/CDCFactSheets10_SymptomList.pdf 2. http://www.cureceliacdisease.org/medical-professionals/guide/symptoms 3. Dickey W, Kearney N. Overweight in celiac disease: prevalence, clinical characteristics, and effect of a gluten-free diet. Am J Gastroenterol. 2006 Oct;101(10):2356-9 4. Tucker E, Rostami K, Prabhakaran S, Al Dulaimi D. Patients with coeliac disease are increasingly overweight or obese on presentation. J Gastrointestin Liver Dis. 2012 Mar;21(1):11-5 5. Cheng J, Brar PS, Lee AR, Green PH. Body mass index in celiac disease: beneficial effect of a gluten-free diet. J Clin Gastroenterol. 2010 Apr;44(4):267-71. 6. Katz KD, Rashtak S, Lahr BD, Melton LJ 3rd, Krause PK, Maggi K, Talley NJ, Murray JA. Screening for celiac disease in a North American population: sequential serology and gastrointestinal symptoms. Am J Gastroenterol. 2011 Jul;106(7):1333-9. doi: 10.1038/ajg.2011.21. Epub 2011 Mar 1. 7. Hardwick C. 1989, as described in Holmes GKT. Non-malignant complications of coeliac disease. Acta Paediatr Suppl. 412: 68-75. 1996. 8. Logan RF, Rifkind EA, Turner ID, Ferguson A. Mortality in celiac disease. Gastroenterology. 1989 Aug;97(2):265-71. 9. Zipser RD, Farid M, Baisch D, Patel B, Patel D. Physician awareness of celiac disease: a need for further education. J Gen Intern Med. 2005 Jul;20(7):644-6. 10. ADHD (10),Niederhofer H. Association of attention-deficit/hyperactivity disorder and celiac disease: a brief report. Prim Care Companion CNS Disord. 2011;13(3). 11. neurological and neuromuscular disorders (11, 12,) Currie S, Hadjivassiliou M, Clark MJ, Sanders DS, 12. Wilkinson ID, Griffiths PD, Hoggard N. Should we be 'nervous' about coeliac disease? Brain abnormalities in patients with coeliac disease referred for neurological opinion. J Neurol Neurosurg Psychiatry. 2012 Dec;83(12):1216-1221. 13. Hadjivassiliou M, Chattopadhyay AK, Davies-Jones GA, Gibson A, Grünewald RA, Lobo AJ. Neuromuscular disorder as a presenting feature of coeliac disease. J Neurol Neurosurg Psychiatry. 1997 Dec;63(6):770-5. 14. Fayed SB, Aref MI, Fathy HM, Abd El Dayem SM, Emara NA, Maklof A, Shafik A. Prevalence of celiac disease, Helicobacter pylori and gastroesophageal reflux in patients with refractory iron deficiency anemia. J Trop Pediatr. 2008 Feb;54(1):43-53. 15. Cekın AH, Cekın Y, Sezer C. Celiac disease prevalence in patients with iron deficiency anemia. Turk J Gastroenterol. 2012 Oct;23(5):490-5. 16. Robertson DA, Taylor N, Sidhu H, Britten A, Smith CL, Holdstock G. Pulmonary permeability in coeliac disease and inflammatory bowel disease. Digestion. 1989;42(2):98-103. 17. Edwards C, Williams A, Asquith P. Bronchopulmonary disease in coeliac patients. J Clin Pathol. 1985 Apr;38(4):361-7. 18. Bautista-Quach MA, Ake celiac disease, Chen M, Wang J. Gastrointestinal lymphomas: Morphology, immunophenotype and molecular features. J Gastrointest Oncol. 2012 Sep;3(3):209-25. 19. Leslie LA, Lebwohl B, Neugut AI, Gregory Mears J, Bhagat G, Green PH. Incidence of lymphoproliferative disorders in patients with celiac disease. Am J Hematol. 2012 Aug;87(8):754-9. 20. Elfström P, Granath F, Ekström Smedby K, Montgomery SM, Askling J, Ekbom A, Ludvigsson JF. Risk of lymphoproliferative malignancy in relation to small intestinal histopathology among patients with celiac disease. J Natl Cancer Inst.2011 Mar 2;103(5):436-44. 21. Benhammane H, El M'rabet FZ, Idrissi Serhouchni K, El Yousfi M, Charif I, Toughray I, Mellas N, Riffi Amarti A, Maazaz K, Ibrahimi SA, El Mesbahi O. Small bowel adenocarcinoma complicating coeliac disease: a report of three cases and the literature review. Case Rep Oncol Med. 2012;2012:935183. 22. Vecchio R, Marchese S, Gangemi P, Alongi G, Ferla F, Spataro C, Intagliata E. Laparoscopic treatment of mucinous adenocarcinoma of jejunum associated with celiac disease. Case report. G Chir. 2012 Apr;33(4):126-8. 23. El-Hodhod MA, El-Agouza IA, Abdel-Al H, Kabil NS, Bayomi KA. Screening for celiac disease in children with dental enamel defects. ISRN Pediatr. 2012;2012:763783. 24. Erriu M, Sanna S, Nucaro A, Orrù G, Garau V, Montaldo C. HLA-DQB1 Haplotypes and their Relation to Oral Signs Linked to Celiac Disease Diagnosis. Open Dent J. 2011;5:174-8. 25. Cats EA, Bertens AS, Veldink JH, van den Berg LH, van der Pol WL. Associated autoimmune diseases in patients with multifocal motor neuropathy and their family members. J Neurol. 2012 Jun;259(6):1137-41. 26. Bardella MT, Elli L, De Matteis S, Floriani I, Torri V, Piodi L. Autoimmune disorders in patients affected by celiac sprue and inflammatory bowel disease. Ann Med. 2009;41(2):139-43 27. Nass FR, Kotze LM, Nisihara RM, de Messias-Reason IT, Utiyama SR. Autoantibodies in relatives of celiac disease patients: a follow-up of 6-10 years. Arq Gastroenterol. 2012 Jul-Sep;49(3):199-203. 28. Saadah OI, Al-Agha AE, Al Nahdi HM, Bokhary RY, Bin Talib YY, Al-Mughales JA, Al Bokhari SM. 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