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Celiac.com 06/12/2018 - A life-long gluten-free diet is the only proven treatment for celiac disease. However, current methods for assessing gluten-free diet compliance are lack the sensitivity to detect occasional dietary transgressions that may cause gut mucosal damage. So, basically, there’s currently no good way to tell if celiac patients are suffering gut damage from low-level gluten contamination. A team of researchers recently set out to develop a method to determine gluten intake and monitor gluten-free dietary compliance in patients with celiac disease, and to determine its correlation with mucosal damage. The research team included ML Moreno, Á Cebolla, A Muñoz-Suano, C Carrillo-Carrion, I Comino, Á Pizarro, F León, A Rodríguez-Herrera, and C Sousa. They are variously affiliated with Facultad de Farmacia, Departamento de Microbiología y Parasitología, Universidad de Sevilla, Sevilla, Spain; Biomedal S.L., Sevilla, Spain; Unidad Clínica de Aparato Digestivo, Hospital Universitario Virgen del Rocío, Sevilla, Spain; Celimmune, Bethesda, Maryland, USA; and the Unidad de Gastroenterología y Nutrición, Instituto Hispalense de Pediatría, Sevilla, Spain. For their study, the team collected urine samples from 76 healthy subjects and 58 patients with celiac disease subjected to different gluten dietary conditions. To quantify gluten immunogenic peptides in solid-phase extracted urines, the team used a lateral flow test (LFT) with the highly sensitive and specific G12 monoclonal antibody for the most dominant GIPs and an LFT reader. They detected GIPs in concentrated urines from healthy individuals previously subjected to gluten-free diet as early as 4-6 h after single gluten intake, and for 1-2 days afterward. The urine test showed gluten ingestion in about 50% of patients. Biopsy analysis showed that nearly 9 out of 10 celiac patients with no villous atrophy had no detectable GIP in urine, while all patients with quantifiable GIP in urine showed signs of gut damage. The ability to use GIP in urine to reveal gluten consumption will likely help lead to new and non-invasive methods for monitoring gluten-free diet compliance. The test is sensitive, specific and simple enough for clinical monitoring of celiac patients, as well as for basic and clinical research applications including drug development. Source: Gut. 2017 Feb;66(2):250-257. doi: 10.1136/gutjnl-2015-310148.
squirmingitch posted a topic in Celiac Disease - Post Diagnosis, Recovery/Treatment(s)It looks like it won't be too long before we have a new method of testing for dietary compliance and it appears it's going to be more accurate/sensitive than the present serum tests. At this link, there is an interview with Ivor D. Hill, MD, MB ChB; Alessio Fasano, MD. http://www.medscape.com/viewarticle/870809#vp_4 I would point you to page 4 of that. Some of you may not be able to access the linked page. You can sign up for Medscape, it's free and that's what I did, then you can access all of their articles. The following is part of what both Dr. Hill said and what Dr. Fasano said: Dr. Hill: A very interesting paper has just come out in the American Journal of Gastroenterology,in which a group from Spain looked at gluten immunogenic peptides in the stool and documented that you can actually identify these in the stool. People think that, based on dietary review, they are completely gluten free. That may be something in the future that will give us a very good test, and I am excited about the possibility that we will actually be able to detect gluten immunogenic peptides in the stool and know that the patient is still being exposed, as opposed to relying on dietary review, symptoms, and TTG testing. Dr Fasano: To echo what Ivor has said, we do have a concern. The same Spanish group presented a follow-up of evidence of the robust performance of this test for immunogenic peptides in stool at the World Congress in Montreal. I am as impressed as Ivor that this might be a very objective, strong way to monitor for inadvertent exposure to gluten. Here are links to the studies they are referring to and the results: http://www.medscape.com/medline/abstract/27644734 http://www.medscape.com/viewarticle/869914 http://www.nature.com/ajg/journal/v111/n10/full/ajg2016439a.html