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Jefferson Adams posted an article in Celiac Disease & Gluten Intolerance ResearchCeliac.com 03/07/2016 - Even though doctors know a lot more about celiac disease than they did just a few years ago, and even though they are learning more all the time, there are still very few detailed clinical descriptions of large groups of celiac patients. Recently, a team of researchers reviewed a large Dutch cohort of celiac patients to create an overview that focused on symptom presentation, co-occurrence of immune mediated diseases and malignancies. The research team included M Spijkerman, IL Tan, JJ Kolkman, S Withoff, C Wijmenga, MC Visschedijk, and RK Weersma. They are variously associated with the Department of Gastroenterology and Hepatology, University of Groningen and University Medical Center Groningen, Groningen; the Department of Genetics, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands, and with the Department of Gastroenterology and Hepatology, Medisch Spectrum Twente, Enschede, The Netherlands. To create their overview, the team performed a retrospective study in a Dutch university and a non-university medical hospital that included only patients with biopsy proven (≥Marsh type 2 classification) celiac disease. The team selected 412 patients from 9,468 small-bowel biopsy pathology reports and financial codes. About a third of the group showed classical celiac symptoms, including diarrhea (37.4%), fatigue (35.0%), weight loss (31.6%), abdominal pain (33.3%). Around 10% showed atypical symptoms, including constipation (10.4%) and reflux (12.4%), while nearly 12% were diagnosed without any reported symptoms. About one in four patients also had immune-mediated diseases, most commonly type 1 diabetes mellitus (4.9%), microscopic colitis (4.9%), and immune mediated-thyroid disease (4.1%). Celiac patients who also had immune-mediated diseases were significantly older at the time of diagnosis, compared to those without (P=0.002). A total of 53 patients (12.9%) had malignancies, eight of whom suffered from Enteropathy Associated T-cell Lymphomas. This is the first Dutch study to describe a group of celiac patients in such detail. The study highlights the wide range of clinical variables in celiac disease, as well as the importance of screening for celiac patients for concomitant diseases. Source: Dig Liver Dis. 2016 Jan 18. pii: S1590-8658(15)30028-1. doi: 10.1016/j.dld.2016.01.006. [Epub ahead of print]
In a good year, Spring means fresh, wild salmon, and 2011 looks to be a good year for this king among fish. One of my favorite breakfast dishes is this variation on Eggs Benedict that some call Dutch Benedict. If you're thinking about whipping up some Hollandaise sauce for your Mother's Day Benedict, consider this savory variation that uses smoked wild salmon in lieu of ham or canadian bacon. Ingredients: 4 gluten-free English muffins 8 eggs, poached 8 ounces smoked wild Salmon 1 teaspoon cider vinegar 1 tablespoon chives as garnish 1 teaspoon paprika (garnish) Hollandaise sauce (see below) Butter (optional) Directions: Prepare the Super Easy Hollandaise as below and set aside, keeping warm. Brown the bacon in a medium skillet over medium-high heat. Split and toast English muffins, and top with butter (optional). Place on warm plates. Top each muffin with a slice of smoked salmon and a hot poached egg. Drizzle with Hollandaise sauce; garnish with paprika and chopped chives. Super Easy Hollandaise Sauce: 3 egg yolks 1/4 teaspoon Dijon mustard 1 tablespoon lemon juice 1 dash red hot pepper sauce, such as Tabasco or Trappey's 1/2 cup butter Directions: In the container of a blender, combine the egg yolks, mustard, lemon juice and hot pepper sauce. Cover, and blend for about 5 seconds. Place the butter in a glass measuring cup. Heat butter in the microwave for about 1 minute, or until completely melted and hot. Set the blender on high speed, and pour the butter into the egg yolk mixture in a thin stream. It should thicken almost immediately. Keep the sauce warm until serving by placing the blender container in a pan of hot tap water.
Scott Adams posted an article in Gluten-Free Grains and FloursGastroenterology, Oct 2003, Vol 125, No 4, p1105-13 Celiac.com 10/30/2003 – It has long been known that celiac disease is caused by T-cell responses to wheat gluten-derived peptides, but the toxicity of other widely consumed grains has not been well studied. The researchers who conducted this study were aimed at determining the toxic T-cell stimulatory properties of barley hordeins, rye secalins, and oat avenins. Except for one instance, they found that there were no identical T-cell stimulatory gluten peptide matches in these grains. There were, however, similar responses found in "11 homologous sequences in hordeins, secalins, and avenins located in regions similar to those in the original gluten proteins," and seven of the 11 peptides were recognized by gluten-specific T-cell lines and/or clones from patients with celiac disease. The team discovered that key amino acids can be substituted, which will either partially or totally stop the T-cell stimulation by the gluten peptides, and that "single nucleotide substitutions in gluten genes will suffice to induce these effects." The researchers conclude: "These results show that the disease-inducing properties of barley and rye can in part be explained by T-cell cross-reactivity against gluten-, secalin-, and hordein-derived peptides. Moreover, the results provide a first step toward a rational strategy for gluten detoxification via targeted mutagenesis at the genetic level."
Scott Adams posted an article in Celiac Disease & Gluten Intolerance ResearchGastroenterology, Oct 2003, Vol 125, No 4, p1032-41 Celiac.com 10/30/2003 – A Dutch research team has identified the specific regions of chromosome 19 that contribute to celiac disease. Despite its well-known association with human leukocyte antigen (HLA)-DQ2 and DQ8, the pathogenesis of celiac disease has remained largely unknown. The team studied 82 Dutch families who met strict diagnostic criteria which included biopsies that presented Marsh III lesions. The 216 independent celiac disease patients were compared to 216 age and sex-matched controls. As expected the study found significant linkage to the suspected HLA region, but more importantly found additional, previously unknown and significant linkages at 19p13.1 (with a peak at marker D19S899), and at 6q21-22, which is ~70 cm downstream from the HLA region in question. The researchers conclude: "Significant linkage of celiac disease to chromosome region 19p13.1 was detected in our genome-wide screen. These results were confirmed by the association of D19S899 to celiac disease in an independent case-control cohort. Furthermore, we identified a possible second celiac disease locus on chromosome region 6q21-22." The study was dedicated to the memory of Lodewijk Sandkuijl (1953-2002), who died shortly after its completion. He was an inspiration to the researchers and was a world expert on biostatistics.