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Celiac.com 05/15/2018 - There is a good amount of anecdotal evidence that people with non-celiac gluten sensitivity can tolerate sourdough bread, but there is no good science to support such claims. To determine if sourdough bread help conquer wheat sensitivity, the Alberta Wheat Commission (AWC) is funding a team of researchers to see if the sourdough fermentation process can reduce or eliminate wheat components that trigger wheat sensitivity. The project will study the way the sourdough bread fermentation process breaks down proteins and carbohydrates in wheat flour. Chair of the AWC Research Committee, Terry Young, said new research suggests that wheat protein may not be the cause of gluten sensitivity in people without celiac disease. Longer fermentation, aka sourdough fermentation, is more common in Europe. Young says that reports indicate that “incidents of non-celiac sensitivity…are actually lower in Europe." He adds the current research will focus on the fermentation, but the future may include the development of wheat varieties for gluten sensitive individuals. The research will be led by food microbiologist at the University of Alberta, Dr. Michael Gänzle, who said the use of sourdough bread in industrial baking reduces ingredient costs and can improve the quality of bread as well. Dr. Gänzle wants to assess anecdotal claims that people with non-celiac wheat or gluten intolerance can tolerate sourdough bread. His team wants to “determine whether fermentation reduces or eliminates individual wheat components that are known or suspected to cause adverse effects.” The team readily admits that their project will not create products that are safe for people with celiac disease. They may, however, create products that are useful for people without celiac disease, but who are gluten sensitivity. The AWC is collaboratively funding the project with the Saskatchewan Wheat Development Commission, and the Minnesota Wheat Research Promotion Council, which will contribute $57,250, and $20,000, respectively. The research team will issue a report of its findings after the project is completed in 2021. Studies like this are important to shed light on the differences between celiac and non-celiac gluten sensitivity. Stay tuned for more developments in this exciting area of research. Source: highriveronline.com

Celiac.com 01/31/2022 - As intestinal permeability and innate immune system activation emerge as possible pathophysiological mechanisms in non-celiac gluten sensitivity (NCGS), a number of researchers have become interested in markers for gut integrity and inflammation. The idea being that thesis markers might help to reveal pathological changes that occur with non-celiac gluten sensitivity. A team of researchers recently set out to assess relevant biomarkers in non-celiac gluten sensitivity by analyzing serum levels of gut integrity and permeability markers, pro-inflammatory cytokines and antigliadin IgG in patients with suspected non-celiac gluten sensitivity on a gluten-free diet, and compare them to serum levels in patients with irritable bowel syndrome (IBS) and healthy controls (HC). The research team included Hanna Fjeldheim Dale, Julianne CH Johannessen, Ingeborg Brønstad, and Gülen Arslan Lied. They are variously affiliated with the Centre for Nutrition, Department of Clinical Medicine, University of Bergen, Bergen, Norway; the Division of Gastroenterology, Department of Medicine, Haukeland University Hospital, Bergen, Norway; and the National Centre of Functional Gastrointestinal Disorders, Haukeland University Hospital, Bergen, Norway. Their team analyzed serum samples collected from twenty patients with suspected non-celiac gluten sensitivity patients on a gluten-free diet, twenty with IBS, and twenty healthy sex and age matched control subjects. The team used IBS severity scoring system (IBS-SSS) to assess gastrointestinal symptom severity. Compared to heathy control subjects, suspected non-celiac gluten sensitivity and IBS patients had higher IBS-SSS scores. Their analysis showed no significant differences in serum levels of any of the gut integrity and permeability markers, cytokines or antigliadin IgG antibodies between the three groups. However, they did see positive correlations between claudin-1 and i-FABP, and between claudin-1 and antigliadin IgG antibodies. The team's assessment showed no differences in serum levels of gut integrity and permeability markers, pro-inflammatory cytokines or antigliadin IgG antibodies among patients with suspected non-celiac gluten sensitivity patients on a gluten-free diet, IBS and healthy control subjects. The findings suggest that these biomarkers do not offer a way to spot possible pathophysiological mechanisms in non-celiac gluten sensitivity. Stay tuned for more on this and related stories. Read more at DovePress.com.

Celiac.com 01/27/2020 - Celiac disease is a common autoimmune disease triggered by gluten in wheat, barley and rye in people with a genetic predisposition. We've reported before about the connection between celiac disease and apthous stomatitis (canker sores). The case of celiac patient with severe canker sores who experienced remission and major improvement with etanercept treatment merits attention. A team of physicians recently reported the case of a celiac patient who suffered from severe aphthous stomatitis (canker sores) that caused difficulty swallowing, chewing and speaking. The problem triggered weight loss, social and psychological problems, and interfered with her ability to do her job. Worse yet, nothing seemed to work. Various topical and systemic medications either did nothing or provided only limited relief. Doctors were stumped. Finally, they got the patient to agree to treatment with etanercept, which led to complete remission of aphthous stomatitis, decrease in arthralgia and fatigue, along with major improvement in patient quality of life. The treatment team notes that new treatments, like etanercept, for some of the more severe expressions of celiac disease could offer major symptom and quality of life improvements for many patients. However, these drugs are not well studied for such cases, so the team is calling for more study to assess the long-term efficacy and safety of these drugs, along with the mucosal and/or systemic complications of celiac disease. For up to date information on aphthous ulcers, aka canker sores, and celiac disease, check out the this site's Forum. Source: Clin Mol Allergy. 2013; 11: 6. The research team included Adey Hasan, Hiren Patel, Hana Saleh, George Youngberg, John Litchfield, and Guha Krishnaswamy. They are variously affiliated with the Department of Internal Medicine, East Tennessee State University, Johnson City, TN, USA; the Division of Allergy, Asthma and Immunology, East Tennessee State University, PO Box 70622, Johnson City, TN, USA; the James H. Quillen VA Medical Center, East Tennessee State University, Johnson City, TN, USA; the Department of Pathology, Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA; and with the Department of Medicine, Quillen College of Medicine, Johnson City, TN 37614-0622, USA.

Celiac.com 11/14/2013 - Until now, rates of non-celiac gluten sensitivity were largely a matter of clinical speculation, basically, educated guesswork among doctors. Some thought that rates of non-celiac gluten-sensitivity might by much higher than rates of celiac disease in the USA. But there was just no actual clinical data supporting these claims. A team of researchers recently set out to get some good clinical data that would tell them how common non-celiac gluten sensitivity actually is. The research team included Daniel V. DiGiacomo, Christina A. Tennyson, Peter H. Green, and Ryan T. Demmer. They are variously affiliated with the Department of Medicine, Celiac Disease Center at Columbia University, and the Department of Epidemiology at the Mailman School of Public Health at Columbia University in New York. The authors used the Continuous National Health and Nutrition Examination Survey (NHANES) 2009–2010 to enroll 7762 people from the civilian, non-institutionalized, US population free of celiac disease. They then analyzed the data to estimate rates of adherence to a gluten-free diet among participants without celiac disease as a surrogate marker for non-celiac gluten sensitivity in the US. They also used the data to characterize the demographics and general health status of the study participants. Overall, forty-nine participants reported adherence to a gluten-free diet. With a weighted national prevalence of 0.548%, this represents 1.3 million individuals between 6 and 80 years old in the US. The prevalence of a gluten-free diet was higher in females (0.58%) than males (0.37%), although this was not statistically significant (p = 0.34). Participants reporting a gluten-free diet were older (46.6 vs. 40.5 years, p = 0.005), had higher high-density lipoprotein, lower iron and lower body mass index. These numbers put the estimated national prevalence of non-celiac gluten sensitivity at 0.548%, about half the rate of celiac disease. However, the team calls for further studies in order to better understand the population burden of non-celiac gluten sensitivity. Source: Rev Esp Enferm Dig. 2013 Apr;105(4):187-193. doi:10.3109/00365521.2013.809598

Celiac.com 05/30/2018 - One of the key aspects of non-celiac gluten sensitivity (NCGS) is that patients are diagnosed partly by the absence of celiac disease. That is, patients with NCGS, whatever their symptoms, do not have celiac disease. But could those patients still have some kind of gut damage, or permeability issues? Do people with non-celiac gluten sensitivity have distinct duodenal histological features? Researchers are seeking a better understanding of this still undefined condition. Some researchers have suggested that histology may play a key role in NCGS, but there is still no consensus. A recent review by Bardella et al. revealed that histology is not always reported in NCGS studies, and exclusion of celiac disease is generally done by showing negative serology and/or genetic typing. In June 2015, researchers published what is now called the Salerno Experts’ criteria, which proposes a double (or single)-blind, placebo-controlled, (DBPC), crossover gluten challenge as the gold standard to NCGS diagnosis In order to investigate histological findings of people with suspicion of NCGS, we retrospectively evaluated duodenal biopsies of a cohort of patients undergoing clinical diagnostic algorithm for NCGS as proposed by the Salerno consensus. The research team included B Zanini, V Villanacci, M Marullo, M Cadei, F Lanzarotto, A Bozzola, and C Ricci. They are variously affiliated with the Gastroenterology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123, Brescia, Italy; and with the Institute of Pathology Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia, Italy. Their team’s main goal was to underline that the peculiar IEL distribution and the increased eosinophil count may represent a valid warning that help to identify patients with NCGS, given the absence of serological markers for NCGS. The team also performed a CD3 immunohistochemical evaluation of T lymphocytes confirming that the IEL numbers were normal, but their distribution is peculiar, as noted by the clusters of T lymphocytes in the superficial epithelium and linear disposition of T lymphocytes in the deeper part of the mucosa above the muscularis mucosae. They also note that their failure to fully match study subjects with placebo challenge is a limitation of this study, but stress the current uncertainty of the actual clinical diagnostic algorithm as supported by recent reviews of the literature. The team’s observations led them to note that histology may play a similar role in NCGS diagnosis as it does in celiac diagnosis. Researchers do know that, unlike with celiac disease, there is an absence of damage or change to intestinal mucosa in patients with NCGS, especially an absence of villous atrophy. In addition, the morphological exclusion of celiac disease is a crucial assessment, because some patients classified as NCGS show increased duodenal IEL count (> 25 IELs/100 enterocytes), corresponding to Marsh I, or grade A lesions of celiac histological classification. To properly diagnose NCGS, the team says it’s very important to confirm these features, to rule out any type of organic malabsorption diseases, and to definitively rule out celiac disease, via a negative celiac disease serology. Taken as a whole, the team’s results provide evidence that both intraepithelial lymphocytes and eosinophils play a role in the physiopathology behind NCGS. They are calling for more studies to confirm their findings and to determine whether the results they observed were specific to NCGS. Source: Virchows Arch. 2018 Apr 4. doi: 10.1007/s00428-018-2346-9

Celiac.com 10/13/2010 - Until now Catholics with gluten-sensitivity have found it difficult to participate fully in Mass by consuming the communion wafers, which traditionally contain gluten. To address that situation, the Benedictine Sisters of Perpetual Adoration in Clyde, Mo., have developed a Communion host that is extremely low in gluten – allowing Catholics with gluten sensitivity an alternative to taking only the cup during communion. Low-gluten communion wafers mean that more Catholics with gluten-sensitivity will be able to consume both the body and the blood of the host, both the communion wafer and the wine, in their celebration of Mass. Canon law and tradition require that communion wafers contain a percentage of wheat for a valid celebration of Eucharist, said Timothy Johnston, Director of Liturgy of the Catholic Diocese of Salt Lake City. However, the host made by the Benedictine Sisters of Perpetual Adoration contains gelatinized wheat starch. The sisters report the hosts test to a level of 0.01 percent gluten. The Secretariat for the Liturgy of the United States Conference of Catholic Bishops has stated that these hosts meet the requirements of the Code of Canon Law (924 §2) and may be used at the celebration of the Eucharist with permission of the person’s pastor. “They are the only group of sisters (or Catholic group at that) that make valid low-gluten hosts. Any other company or group is not approved for use during the liturgy,” Johnston said. He encourages Catholics with gluten-sensitivity who wish to learn more to begin a discussion with their pastor so that each may understand the church doctrine and teaching regarding low-gluten hosts, as well as the practical steps necessary for Holy Communion. Johnston also advises Catholics who wish to receive the low-gluten wafer to discuss the matter in advance with the celebrant and Extraordinary Ministers of Holy Communion so that everyone is comfortable with the procedure. “There are several parishes that use low-gluten hosts,” Johnston said, including St. Andrew, the Cathedral of the Madeleine and Saint Thomas More. Responding in a letter to expressions of gratitude from many Catholics with gluten-sensitivity, the Sisters of Perpetual Adoration write that they are “inspired by the deep desire of those suffering from gluten intolerance to receive Holy Communion…[and] humbled by the many letters, emails, and phone calls we have received thanking us for our efforts to produce low gluten altar bread.” The letter adds that the Sisters “blessed to have the opportunity to allow God to work through our hands…[and] honored and privileged to provide for you and your parish the bread that becomes the Body of Christ.” Obviously, since the new wafers are not completely gluten-free, questions of individual sensitivity will need to be addressed. However, this is a huge step toward allowing people with gluten sensitivity to take both the body and the blood when taking communion. Source: Intermountain Catholic News

Celiac.com 07/24/2013 - Gastrointestinal symptoms are a common feature in children with autism, drawing attention to a potential association with celiac disease or gluten sensitivity. So far, studies of the immune response to gluten in autistic individuals, along with its association with celiac disease have produced inconsistent data. A team of researchers recently set out to assess immune reactivity to gluten in children diagnosed with autism according to strict criteria, and to evaluate the potential link between autism and celiac disease. The research team included Nga M. Lau, Peter H. R. Green, Annette K. Taylor, Dan Hellberg, Mary Ajamian, Caroline Z. Tan, Barry E. Kosofsky, Joseph J. Higgins, Anjali M. Rajadhyaksha, and Armin Alaedini. For their study, the team assessed 37 children (with or without gastrointestinal symptoms) diagnosed with autism according to both the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview, Revised (ADI-R), 27 unaffected siblings, and 76 age-matched healthy controls. They then tested blood specimens for antibodies to native gliadin, deamidated gliadin, and transglutaminase 2 (TG2). They then genotyped all children with positive antibody tests for celiac disease associated HLA-DQ2 and -DQ8 alleles. The team found that children with autism had substantially higher levels of IgG antibodies compared with unrelated healthy controls (p<0.01). The IgG levels were also higher compared to the unaffected siblings, but were not statistically significant. Autistic children with gastrointestinal symptoms showed significantly greater IgG anti-gliadin antibody response, compared to those without them (p<0.01). All groups showed similar IgA response to gliadin across groups. Both study subjects and control subjects ahd similar levels of celiac disease-specific serologic markers, i.e., antibodies to deamidated gliadin and TG2. The researchers found no association between increased anti-gliadin antibody and presence of HLA-DQ2 and/or -DQ8. Some children with autism do show a type of increased immune reactivity to gluten which appears to be different from celiac disease. The increased anti-gliadin antibody response and its association with GI symptoms suggests that these children may suffer from immunologic and/or intestinal permeability abnormalities. Source: PLOS Online