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Hello, I'm looking for a Gastro Psychiatrist or GI doctor who works with mental illness and would appreciate any recommendations. I've also thought about looking for immunologist who work with the gut microbiome. I live in Nebraska so a doctor in the Midwest would be ideal, but I would appreciate any recomendations! I struggle with anxiety, depression, and multiple food allergies. I've been gluten free about 6 months so I don't think I can be tested for celiac. I've been thinking about doing a gluten challenge to be tested, but out of all my food allergies gluten seems to make anxiety the worst. So, I'm not sure if its worth testing or just keep avoiding. While I've seen improvement in digestive and mental health symptoms since eliminating food allergies, I'm still struggling. I highly suspect I have immune related issues from dysbiosis as I was regularly put on antibiotics for sinus infections growing up. I have a lot of symptoms that point to Candida, histamine intolerance, or SIBO. It would be great to investigate some of these causes under the care of a physician. Any advice is appreciated! <3 Elizabeth
Celiac.com 08/08/2016 - Celiac-associated duodenal dysbiosis has not yet been clearly defined, and the mechanisms by which celiac-associated dysbiosis could concur to celiac disease development or exacerbation are unknown. To clarify the situation, a research team recently analyzed the duodenal microbiome of celiac patients. The research team included V D'Argenio, G Casaburi, V Precone, C Pagliuca, R Colicchio, D Sarnataro, V Discepolo, SM Kim, I Russo, G Del Vecchio Blanco, DS Horner, M Chiara, G Pesole, P Salvatore, G Monteleone, C Ciacci, GJ Caporaso, B Jabrì, F Salvatore, and L Sacchetti. They are variously affiliated with CEINGE-Biotecnologie Avanzate, Naples, Italy, the Department of Molecular Medicine and Medical Biotechnologies and the Department of Medical Translational Sciences and European Laboratory for the Investigation of Food Induced Diseases at the University of Naples Federico II, Naples, Italy, the Department of Medicine and the University of Chicago Celiac Disease Center, University of Chicago, Chicago, Illinois, USA, the Department of Medicine and Surgery, University of Salerno, Salerno, Italy, the Department of System Medicine, University of Rome Tor Vergata, Rome, Italy, the Department of Biosciences, University of Milan, Milan, Italy, the Institute of Biomembranes and Bioenergetics, National Research Council, Bari, Italy, the Department of Biochemistry and Molecular Biology, University of Bari A. Moro, Bari, Italy, the Northern Arizona University, Flagstaff, Arizona, USA, the IRCCS-Fondazione SDN, Naples, Italy. The team used DNA sequencing of 16S ribosomal RNA libraries to assess duodenal biopsy samples from 20 adult patients with active celiac disease, 6 celiac disease patients on a gluten-free diet, and 15 control subjects. They cultured, isolated and identified bacterial species by mass spectrometry. Isolated bacterial species were used to infect CaCo-2 cells, and to stimulate normal duodenal explants and cultured human and murine dendritic cells (DCs). They used immunofluorescence and ELISA to assess inflammatory markers and cytokines. Their findings showed that proteobacteria was the most abundant, and Firmicutes and Actinobacteria the least abundant, phyla in patients with active celiac disease. In patients with active celiac disease, bacteria of the Neisseria genus (Betaproteobacteria class) were substantially more abundant than it was in either of the other groups (P=0.03), with Neisseria flavescens being most prominent Neisseria species. Whole-genome sequencing of celiac disease-associated Neisseria flavescens and control-Nf showed genetic diversity of the iron acquisition systems, and of some hemoglobin-related genes. Neisseria flavescens was able to escape the lysosomal compartment in CaCo-2 cells and to induce an inflammatory response in DCs and in ex-vivo mucosal explants. Marked dysbiosis and the pronounced presence of a peculiar strain characterize the duodenal microbiome in active celiac disease patients. This suggests that celiac-associated Neisseria flavescens could contribute to the many inflammatory signals in celiac disease. Source: Am J Gastroenterol. 2016 Jun;111(6):879-90. doi: 10.1038/ajg.2016.95. Epub 2016 Apr 5.
Celiac.com 03/19/2010 - Celiac disease is a chronic inflammatory disorder of the gut triggered by an adverse immune response to dietary gluten proteins in genetically susceptible individuals. One of the first ways the body responds to offending proteins in an adverse celiac disease response is by producing mucous via IgA secretion in an effort to neutralize offending antigens and pathogens. A team of researchers recently sought to better document the relationships between immunoglobulin-coated bacteria and bacterial composition in feces of celiac disease patients, untreated and treated with a gluten-free diet (GFD) and healthy controls. The research team included Giada De Palma, Inmaculada Nadal, Marcela Medina, Ester Donat, Carmen Ribes-Koninckx, Miguel Calabuig, and Yolanda Sanz. They observed that intestinal dysbiosis and reduced immunoglobulin-coated bacteria are associated with celiac disease in children. Both untreated and treated celiac disease patients showed markedly lower levels of IgA, IgG and IgM-coated fecal bacteria compared to healthy controls. Celiac disease patients showed substantially reduced ratio of Gram-positive to Gram-negative bacteria compared to control subjects. Untreated celiac disease patients showed less abundant group proportions (P<0.050) of Bifidobacterium, Clostridium histolyticum, C. lituseburense and Faecalibacterium prausnitzii than did healthy controls. Untreated celiac disease patients showed more abundant group proportions (P<0.050) of Bacteroides-Prevotella than in control subjects. Both untreated and treated celiac disease patients showed significantly impoverished (P<0.050) levels of IgA coating the Bacteroides-Prevotella compared with healthy controls. From these results, the research team concluded that intestinal dysbiosis plays a role in reduced IgA-coating bacteria in celiac disease patients. This offers a fresh perspective into the possible relationships between the gut microbiota and the host defenses in celiac disease patients. Source: BMC Microbiology 2010, 24 February