Search the Community

Celiac.com 05/10/2024 - Celiac disease is an autoimmune condition triggered by gluten consumption, that can manifest in people across a wide spectrum of body weights, including obesity. Despite the common perception that celiac disease is associated with weight loss, recent studies suggest otherwise, revealing a complex interplay between this condition and obesity. Here's a rundown of the basics. Understanding Celiac Disease Celiac disease, also known as sprue or gluten-sensitive enteropathy, occurs when the body mounts an abnormal immune response to gluten, a protein found in wheat, barley, and rye. When individuals with celiac disease ingest gluten, it damages the lining of the small intestine, leading to various symptoms such as diarrhea, bloating, fatigue, and weight loss. However, some individuals, including those with obesity, may exhibit different symptoms or even gain weight after starting a gluten-free diet. Triggers of Celiac Disease Celiac disease can emerge at any stage of life, with triggers ranging from physiological events like pregnancy and surgery to emotional stress and infections. Although the exact mechanisms underlying the onset of celiac disease later in life remain unclear, factors affecting the immune system may play a role in triggering the condition. Obesity and Celiac Disease: Risk Factors While the exact relationship between obesity and celiac disease remains under-explored, emerging research suggests that obesity can coexist with celiac disease, with some studies reporting obesity rates of up to 44% among individuals with celiac disease. Moreover, individuals with celiac disease may develop obesity, particularly if they consume a gluten-free diet high in processed foods and low in whole foods. However, it's challenging to determine whether obesity increases the risk of celiac disease or vice versa. Celiac disease can often go undiagnosed, complicating efforts to understand the temporal relationship between these conditions. Nonetheless, both celiac disease and obesity independently pose risks for various health complications, including metabolic syndrome, fatty liver disease, high blood pressure, diabetes, and heart disease. The relationship between celiac disease and obesity is multifaceted and warrants further investigation. While individuals with celiac disease may present with a range of body weights, including obesity, understanding the mechanisms underlying this association is crucial for improving diagnosis, management, and treatment strategies for both conditions. As research in this field continues to evolve, healthcare providers can offer more tailored interventions to individuals affected by celiac disease and obesity alike. Read more at healthline.com

Celiac.com 02/08/2024 - Living with celiac disease often means navigating a complex landscape of symptoms, dietary restrictions, and the quest for an optimal quality of life. Understanding Patterns Behind Persistent Celiac Symptoms Celiac disease is not a one-size-fits-all condition. A subgroup of adults experiences persistent symptoms, both gastrointestinal and extraintestinal, the origins of which are often elusive. A team of researchers recently conducted an observational study to uncover patterns within this diverse symptom landscape and explore their connections to gluten-free diet adherence, mental health, and quality of life. The research team included Cara Dochat, Niloofar Afari, Rose-Marie Satherley, Shayna Coburn & Julia F. McBeth. They are variously affiliated with San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA; the VA San Diego Healthcare System, San Diego, CA, USA; the University of California San Diego, La Jolla, CA, USA; the Department of Psychological Interventions, University of Surrey, Guildford, UK; the Children’s National Health System, Washington, DC, USA; the George Washington University School of Medicine & Health Sciences, Washington, DC, USA; and the Celiac Disease Foundation, Woodland Hills, CA, USA. The Study in Focus Their study included 523 U.S. adults with self-reported, biopsy-confirmed celiac disease. Participants voluntarily completed a set of questionnaires addressing various aspects of their condition: Celiac Symptoms Index (CSI): Capturing physical symptoms and subjective health. Celiac Dietary Adherence Test: Assessing adherence to a gluten-free diet. PROMIS-29, SF-36, and Celiac Disease Quality of Life Survey: Exploring psychiatric symptoms and quality of life. Latent profile analysis identified four distinct symptom profiles: Little to No Symptoms (37%): Individuals in this profile reported excellent subjective health and minimal symptoms. Infrequent Symptoms (33%): Experience relatively moderate symptoms with a focus on extraintestinal symptoms. Occasional Symptoms (24%): Moderate symptoms, particularly gastrointestinal, physical pain, and fair to poor subjective health. Frequent to Constant Symptoms (6%): Enduring significant symptoms and fair to poor subjective health. Beyond Symptoms: The Mental Health and Quality of Life Equation Interestingly, profiles did not significantly differ in terms of clinical characteristics, gluten-free diet adherence, or overall quality of life. However, distinctions emerged in mental health dimensions. Profiles 2 and 3 reported moderate symptomology, with Profile 2 leaning toward more extraintestinal symptoms and Profile 3 showing a dominance of gastrointestinal symptoms, physical pain, and lower subjective health. Profile 3, despite its moderate symptom burden, surprisingly reported the lowest psychiatric symptoms and the highest quality of life on standardized measures. Implications and Future Directions The study’s findings underscore the complexity of celiac disease, emphasizing that a one-size-fits-all approach may not be effective. Notably, even lower symptom burden did not always correlate with better mental health and quality of life, suggesting a need for nuanced behavioral interventions. The lack of profile differences in gluten-free diet adherence implies the necessity for additional dietary or medical assessments and interventions. As we navigate the intricate terrain of celiac disease, personalized and comprehensive care emerges as a key consideration, addressing not only symptoms but also the broader aspects of mental health and overall well-being. Read more in BMC Gastroenterology volume 24, Article number: 9 (2024)

Celiac.com 07/10/2023 - Previous observational studies have suggested links between migraine, inflammatory bowel disease (IBD), and celiac disease. However, it remained unclear whether these associations were due to shared genetic factors or if there was a causal relationship. Understanding these connections could have implications for treatment and symptom management. A research team recently aimed to investigate the possible genetic and causal connections between migraine, inflammatory bowel disease, and celiac disease. To do this, they conducted a Mendelian randomization study using data from various genome-wide association studies. The Research Team The research team included Nike Zoe Welander MSc, Gull Rukh PhD, Mathias Rask-Andersen PhD, Aster V. E. Harder MSc, MD, The International Headache Genetics Consortium, Arn M. J. M. van den Maagdenberg PhD, Helgi Birgir Schiöth PhD, and Jessica Mwinyi MD, PhD. They are variously affiliated with theDepartment of Surgical Sciences, Uppsala University, Uppsala, Sweden; the Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden; the Department of Human Genetics, Leiden University Medical Center, Leiden, the Netherlands; and the Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands. The Study - Statistical Analyses to Assess Genetic Correlation and Causality Their study analyzed data from over 60,000 migraine cases, 25,000 inflammatory bowel disease cases, and 12,000 celiac disease cases, along with their respective control groups. Different subtypes of migraine and inflammatory bowel disease were also considered separately. The researchers used specific statistical analyses to assess genetic correlation and causality. The Findings - No Genetic Correlation The findings showed no genetic correlation between migraine and inflammatory bowel disease or celiac disease when all participants with migraine were analyzed together. There was also no evidence of inflammatory bowel disease or celiac disease causing migraine, or migraine causing inflammatory bowel disease or celiac disease. Causal Associations Between Celiac Disease and Migraine However, the study did indicate some potential causal associations between celiac disease and migraine with or without aura, as well as between migraine without aura and ulcerative colitis. It is important to note that these associations did not reach statistical significance after adjusting for multiple testing. In conclusion, this study did not find evidence of a shared genetic basis or a causal relationship between migraine and either inflammatory bowel disease or celiac disease. Although there were indications of potential causal associations with specific subtypes of migraine, further research is needed to confirm these findings and explore the underlying mechanisms. Read more in headachejournal.onlinelibrary.wiley.com

Celiac.com 06/12/2023 - Celiac disease is an autoimmune disorder characterized by gastrointestinal symptoms and nutrient deficiencies. While genetic factors, particularly HLA association, play a significant role in its development, the exact environmental triggers remain unclear. Recent studies have proposed infections as potential contributing factors. With the Covid-19 pandemic causing a systemic inflammatory response and affecting the gastrointestinal tract, researchers in southern Sweden set out to investigate whether Covid-19 infection could increase the risk of developing celiac disease. The research team included Jesper Lexner, Ylva Lindroth and Klas Sjöberg. They are variously affiliated with the Department of Gastroenterology and Nutrition, Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmö, Sweden; and the Division of Medical Microbiology, Department of Laboratory Medicine, Skåne University Hospital, Lund University, Lund, Sweden. The Covid-19 and Celiac Disease Connection To explore the potential association between Covid-19 infection and celiac disease, the researchers identified all patients, including children and adults, in the county of Skåne with newly diagnosed biopsy- or serology-verified celiac disease or positive tissue transglutaminase antibody tests (tTG-ab) from 2016 to 2021. They also identified individuals who tested positive for Covid-19 using PCR or antigen tests in 2020 and 2021. The Findings During the period from March 2020 to December 2021, there were 201,050 cases of Covid-19 in Skåne, and among them, 568 patients were diagnosed with celiac disease or had positive tTG-ab tests. Interestingly, only 35 of these patients had previously been infected with Covid-19. Contrary to initial expectations, the incidence of verified celiac disease and tTG-ab positivity was lower during the Covid-19 pandemic compared to before. The incidence rates of celiac disease were 21.1 and 22.4 cases per 100,000 person-years for patients with and without prior Covid-19 infection, respectively. Implications of the Study The findings of this study suggest that Covid-19 infection is not a significant risk factor for the development of celiac disease. While previous research has indicated that gastrointestinal infections may play a role in the pathogenesis of celiac disease, respiratory infections, such as those caused by the SARS-CoV-2 virus, appear to have less relevance in this regard. Study Limitations It is important to note that this study focused on a specific region in southern Sweden and the findings may not be generalizable to other populations or geographic areas. Further research involving larger and more diverse populations is warranted to validate these findings. Additionally, the study did not explore potential mechanisms underlying the connection between gastrointestinal infections and celiac disease pathogenesis, highlighting the need for future investigations in this area. Understanding the environmental triggers and risk factors associated with celiac disease is crucial for improving diagnosis, treatment, and prevention strategies. While the Covid-19 pandemic has posed significant challenges worldwide, this study suggests that Covid-19 infection does not increase the risk of developing celiac disease. Read more in BMC Gastroenterology volume 23, Article number: 174 (2023)

Celiac.com 01/09/2023 - Psoriasis is one of several skin conditions long associated with celiac disease. Several studies have found connections between psoriasis and celiac disease, but so far no study has shown a causal connection between these two autoimmune conditions. A new study shows that celiac disease patients face a higher risk of psoriasis, but not vice versa. Here's what they found. Genetic Study A team of researchers recently set out to explore the causal link between psoriasis and celiac disease with bidirectional 2-sample Mendelian Randomization (MR) study. The research team included Lin Li, Lixin Fu, Liwen Zhang & Yanyan Feng. They are affiliated with theDepartment of Dermatology, Chengdu Second People’s Hospital, Chengdu, Sichuan, China. The Psoriasis-Celiac Disease Connection The team set out to extract eligible instrument variables with genome-wide significance. To do so, the team used data from the published genome-wide association studies (GWAS) of the European population. They then performed sensitivity, post-MR, and inverse variance weighted (IVW) analyses. The MR analyses showed that genetically doubling the odds of celiac disease would increase the risk for psoriasis. Subsequent sensitivity analyses reinforced those results. Higher Psoriasis Risk for Celiac Patients However, the team's data showed that genetically determined psoriasis was not connected with the risk for celiac disease. This study offers new genetic evidence that celiac patients face an increased risk of psoriasis, while psoriasis patients face no higher celiac risk. For this reason, the team advises clinicians to be aware of the connections, and to closely watch for any psoriasis-associated skin symptoms in celiac patients, or in patients with celiac symptoms. This study offers another valuable insight into the many connections between celiac disease and the risk of other auto-immune conditions, and perhaps supports the idea that all non-genetically determined psoriasis patients should be screened for celiac disease. Read more at Scientific Reports volume 12, Article number: 21508 (2022)

Celiac.com 12/12/2022 - Atopic dermatitis is associated with immune dysregulation, but epidemiological data on the pattern of autoimmune comorbidity in people with atopic dermatitis are limited. A team of researchers recently set out to determine the risk of autoimmune conditions in people newly diagnosed with atopic dermatitis. The research team included Simon de Lusignan, MD; Helen Alexander, BSc, MBBS; Conor Broderick, MB, BCh, BAO, MSc; Andrew McGovern, MD; Claire Feeney, PhD; Carsten Flohr, PhD. They are variously affiliated with theNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom; the Royal College of General Practitioners Research and Surveillance Centre, London, United Kingdom; the Unit for Population-Based Dermatology Research, St John’s Institute of Dermatology, Guy’s & St Thomas’ NHS Foundation Trust and King’s College London, London, United Kingdom; the Momentum Data, Pendragon House, St Albans, United Kingdom; and with Pfizer Ltd, Tadworth, United Kingdom. A Retrospective Cohort Analysis The team used the the UK-based Oxford–Royal College of General Practitioners Research and Surveillance Centre primary care database to conduct a retrospective cohort analysis that covered the period from January 2009 to December 2018. They compared baseline rates and incidents after diagnosis of autoimmune conditions in nearly 175,000 children and adults with new-onset atopic dermatitis, and nearly 700,000 control subjects, matched for age, sex, and general practitioner practice. Outcomes were a composite of any autoimmune condition, including Crohn disease, ulcerative colitis, celiac disease, pernicious anemia, type 1 diabetes, autoimmune hypothyroidism, Graves disease, psoriatic arthritis, rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematosus, Sjögren syndrome, vitiligo, alopecia areata, and multiple sclerosis, and each individual autoimmune condition. Their Findings The team found that people diagnosed with atopic dermatitis were more likely to have an existing autoimmune condition, compared to control subjects. Once the team eliminated patients with preexisting autoimmune disease, they found a connection between atopic dermatitis and cases of new-onset autoimmune disease. Patients with more severe atopic dermatitis faced a greater risk than those with moderate or mild atopic dermatitis. People with atopic dermatitis also faced a significantly higher risk for psoriatic arthritis, Sjögren syndrome, Crohn disease, vitiligo, alopecia areata, pernicious anemia, ulcerative colitis, rheumatoid arthritis, and hypothyroidism, but not for other autoimmune conditions. Conclusions From their results, the team concludes that people with atopic dermatitis, especially those with severe atopic dermatitis, face significantly higher risk for developing numerous other autoimmune conditions. Stay tuned for more on this and related stories. Read more in: Allergy and Clinical Immunology

Celiac.com 11/14/2022 - Some studies have linked coronary artery disease with celiac disease, but hard evidence is scant. To date, there has been no solid medical literature on common risk factors linking celiac disease and coronary artery disease. Risk factors for coronary artery disease include hypertension, hyperlipidemia, type 2 diabetes, obesity, and tobacco use. However, common risk factors connecting celiac disease and coronary artery disease are poorly documented. A team of researchers recently set out with three goals. First, to assess potential demographic differences between celiac patients with coronary artery disease and without coronary artery disease. Secondly, to examine the risk factors of coronary artery disease in celiac patients. Lastly, to compare celiac-coronary artery disease patients and matched non-celiac coronary artery disease to see if there are more coronary artery disease risks for people with celiac disease. The research team included Maryam B. Haider, Paul Naylor, Avijit Das, Syed M. Haider, and Murray N. Ehrinpreis. They are variously affiliated with the Department of Gastroenterology Gastroenterology at Wayne State University in Detroit, MI; the DMC/Wayne State University - Sinai Grace Hospital in Detroit, MI; the Wayne State University School of Medicine in Detroit, MI; and Binghamton University in Binghamton, NY. For their nationwide retrospective case-control study, the team used the National Inpatient Sample (NIS) database to identify patients admitted between 2016 and 2018 with a principal or secondary diagnosis of celiac disease. They then assessed sociodemographic and clinical risk factors for coronary artery disease in celiacs, and compared the celiac-coronary artery disease patients with the matched non-celiac coronary artery disease group. Of nearly 24,000 hospitalizations with celiac disease from 2016 to 2018, nearly 20%, were found to have coronary artery disease. Established coronary artery disease risk factors for celiac patients included hypertension, hyperlipidemia, type 2 diabetes, and a family history of coronary artery disease. Interestingly, tobacco use is not a coronary artery disease risk factor in celiac patients. Odds of coronary artery disease were 55% less likely for female celiac patients, compared to male patients. The odds of coronary artery disease were 20% greater in patients with essential hypertension, double in patients with type 2 diabetes, and five times higher in celiac patients with hyperlipidemia. Patients with coronary artery disease had higher rates of iron deficiency anemia, which were nearly 10% for celiac-coronary artery disease patients, compared with just under 8.3% for non-coronary artery disease celiac patients, and just over 7.3% for people with non-celiac coronary artery disease. The team's findings confirm that, as with non-celiac individuals, males and individuals of Caucasian race with celiac disease face a higher risk of coronary artery disease. They also confirmed that celiac-coronary artery disease patients have a higher rates of hyperlipidemia than non-celiac coronary artery disease patients, while celiacs with type 1 diabetes have an early diagnosis of coronary artery disease, compared to celiacs with type 2 diabetes. Lastly, they found that iron deficiency anemia is an important risk factor for coronary artery disease in those with celiac disease. Teasing out the common links and risk factors for celiac disease and coronary artery disease is important work, and this study helps to advance that cause. Clearly further, and larger, study will be helpful in our ongoing journey to understand the puzzle that makes up the links celiac, coronary artery disease, and other diseases. Read more in Cureus 14(6): e26151

Celiac.com 10/17/2022 - Headache is one of the main clinical symptoms and complaints of people with celiac disease, and often it manifests as migraine. The roots and origins of migraine as it relates to celiac disease are complex, and still poorly understood. The term 'dysbiosis' refers to a disruption of the microbiome that triggers an imbalance in the gut microbiota, which leads to changes in their functional composition and metabolic activities, or changes to their distribution within the gut microbiome. A team of researchers recently set out to give a narrative summary of the literature on celiac disease's neurological symptoms, particularly migraines, and to assess potential connections with dysbiosis. The research team included Hodan Qasim, Mohamed Nasr, Amad Mohammad, Mosab Hor, and Ahmed M. Baradeiya. They are variously affiliated with theDepartment of Internal Medicine, Alfaisal University, Riyadh, SAU; the Ophthalmology, Palestinian Medical Council, Ramallah, PSE; the Department of Ophthalmology, Children Retina Institute, Los Angeles, USA; the department of General Internal Medicine, Mansoura general hospital in Mansoura, Egypt; and the Research center, Fresno clinical research center, Fresno, USA. In an effort to explain the connection, researchers have proposed various mechanisms involving the gut-brain axis, including: the interaction of chronic inflammation with inflammatory and vasoactive mediators; the modulation of the intestinal immune environment of the microbiota; and a malfunction of the autonomic nervous system. The research article refers to a known gut-brain pathway that can influence neurological illnesses such as migraines. Some data suggests that gut microbiota can influence the brain-gut axis, and may impact nociceptive behavior and brain function A layer of columnar intestinal epithelial cells separates the 100 trillion bacteria present on the gut surface from the host. The key pathophysiological processes connected to migraine are thought to work partly due to the gut microbiota composition, which also plays a significant role in the gut-brain axis. Potential pathways include neurotransmitters, hormones, and inflammatory chemicals originating from the microbiome. However, further research is required to fully understand the basic specific factors which influence the process. The team's review aims to give a narrative summary of the literature on celiac disease's neurological symptoms, particularly migraines, and to assess any potential associations to dysbiosis, an imbalance in the microbiome that may be related to celiac disease. Read more at Cureus.com

Celiac.com 07/25/2022 - Celiac disease and inflammatory bowel disease share a number of factors, including some co-occurrence, independent of temporal sequence, which suggests a shared etiology. To better understand the picture, a team of researchers recently set out to determine the risk of inflammatory bowel disease (IBD) in patients with celiac disease (and vice versa) compared to matched subjects from the general-population. The research team included Karl Mårild MD PhD; Jonas Söderling PhD; Lebwohl, Benjamin MD; Green, Peter HR MD; Pinto-Sanchez, Maria Ines MD MSc; Halfvarson, Jonas MD PhD; Bjorn Roelstraete PhD; Ola Olén MD PhD; and Jonas F. Ludvigsson MD PhD. The researchers used the Swedish histopathology and healthcare register data to identify nearly 50,000 patients with celiac disease, along with nearly 85,000 with IBD diagnosed in 1969-2016. The team compared each patient to age- and 336 sex-matched general-population subjects with celiac disease, and 503 with IBD. They used Cox regression to estimated hazard ratios (HRs) for IBD in celiac patients and vice versa. To reduce potential surveillance bias, the team limited their main analyses to events beyond the first year of follow-up. Nearly eight-hundred patients were diagnosed with IBD during follow-up, compared to 1015 in the matched group. Te HR for IBD was 3.91 in celiac patients, which is similar to HRs for Crohn’s disease and ulcerative colitis. During follow-up, 644 IBD patients and nearly six-hundred in the matched group were diagnosed with celiac disease. The HR for celiac disease in IBD patients was 5.49, with the highest risk estimates seen in ulcerative colitis, the HR for Crohn’s disease was 3.31. Even though most patients with celiac disease and IBD are diagnosed in under a year, many experienced HRs of 3-4 even ten years later. Over a twenty year follow-up period, 2.5% of celiac patients developed IBD, while 1.3% of IBD patients developed celiac disease. The team is advising physicians to keep in mind the two-way connection between celiac diagnosis and IBD in the initial assessment and follow-up of both conditions. Because of their common co-occurrence, which is independent of the order in which the diseases are contracted, the researchers suggest the potential for a shared etiology between the two conditions. Read more in the American Journal of Gastroenterology The researchers are variously affiliated with the Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden; the Department of Pediatric Gastroenterology, Queen Silvia Children's Hospital, Gothenburg, Sweden; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden; the Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; the Celiac Disease Center Department of Medicine Columbia University College of Physicians and Surgeons New York NY USA; the Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada; the Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; the Sachs' Children and Youth Hospital, Stockholm South General Hospital, Stockholm, Sweden; the Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; and the Department of Pediatrics, Orebro University Hospital, Orebro, Sweden.

Celiac.com 06/22/2020 - Since 2004 data collected prospectively by The Environmental Determinants of Diabetes in the Young (TEDDY) study group has helped researchers to better understand T1D, and associated autoimmune conditions, like celiac disease. TEDDY is funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Celiac disease and T1D share a number of genetic factors. Seeking to explain why some children with high-risk genes develop T1D or celiac disease, while most do not, the TEDDY team monitors study subjects for both T1D and celiac disease. TEDDY research has already shown that genetically predisposed children who eat gluten at, or above, certain levels in early childhood, had higher rates of celiac disease. "An interesting finding from TEDDY has been how early the autoimmune destruction of insulin-producing cells begins–often in the initial two years of life," said study TEDDY co-chair Marian Rewers, MD, PhD, a professor of pediatrics and medicine and executive director of the Barbara Davis Center for Diabetes at the University of Colorado School of Medicine. The TEDDY study follows infants with high T1D risk factors for 15 years to look for certain beta-cell autoantibodies and diabetes. TEDDY has also looked at biomarkers that indicate faster or slower progression to diabetes after autoimmune destruction begins. "While T1D and celiac disease share a lot of genetic characteristics, there are intriguing differences in the ways these diseases develop and progress," says Dr. Rewers, adding that "TEDDY research and discovery will help drive the "design of future trials to prevent both T1D and celiac disease." TEDDY is looking to uncover viruses and nutritional factors that work with genes to initiate destruction of the beta cells by the immune system, which is signaled by the appearance of islet autoantibodies. Ultimately, TEDDY investigators are looking to uncover a way to prevent both diabetes and celiac disease in children. The latest information from TEDDY highlights potential "triggers" for the autoimmune process that generates type 1 diabetes (T1D), and how those triggers engage in children with with genetic risk factors for T1D. That information is highlighted in the "Update from the TEDDY Study" symposium today at the American Diabetes Association's (ADA's) 80th Virtual Scientific Sessions. Among TEDDY's latest findings are two new papers, Longitudinal Metabolome-Wide Signals Prior to the Appearance of a First Islet Autoantibody in Children Participating in the TEDDY Study; and Distinct Growth Phases in Early Life Associated With the Risk of Type 1 Diabetes. Read the original press release at PRNewswire.com. Stay tuned for more on TEDDY and related stories.

Celiac.com 11/02/2017 - What is the link between the autoimmune diseases Sjögren's syndrome and celiac disease? In a study, 14.7% of Sjögren's syndrome patients were found to have celiac disease and 11.8% of non-celiac Sjögren's syndrome patients were found to have inflamed mucosa in the small intestine. With this knowledge, people who suffer from Sjögren's syndrome may be able to find relief for their symptoms with the gluten-free diet. Four million Americans are suffering from a disease they don't even know they have and their doctors don't even know to test for. Sound familiar? If you're familiar with my work as a gluten-free advocate, you have probably guessed that what I'm describing is celiac disease, an autoimmune reaction triggered by gluten, a protein component in wheat, barley, and rye. If that was your guess, you would actually be wrong: there is another underdiagnosed and common autoimmune disease that we and our doctors need to be aware of—Sjögren's syndrome, which affects the exocrine, or moisture-producing, glands. Unlike celiac disease, Sjögren's syndrome doesn't have a standardized effective treatment, but fortunately, research is demonstrating a link between these two autoimmune diseases, bringing good news for Sjögren's patients who may see relief of their symptoms by eliminating gluten from their diet. Chances are, many haven't heard of Sjögren's syndrome. This relatively unknown and underdiagnosed disease is an autoimmune disease in which the immune system attacks the tear and saliva glands of the body, reducing their production and resulting in dry mouth and eyes and other symptoms. Complications of Sjögren's include tooth decay, corneal ulcers, and non-Hodgkin's lymphoma. In women, vaginal dryness can also be a symptom. According to the UK's National Health Service, 9 out of 10 people who suffer from this condition are women, and the average age onset is between the ages of 40 and 60 years old. In a study by the Institute of Medical Technology, University of Tampere, Finland, 34 Sjögren's syndrome patients and a control group of 28 people were given a small bowel biopsy; five (14.7%) of the Sjögren's patients tested positive for celiac disease and four (11.8%) of the non-celiac patients were found to have inflammation in the mucous membrane of the small intestine. According to the study's conclusions, "The findings show a close association between Sjögren's syndrome and celiac disease." Currently, there are two classifications of Sjögren's syndrome as either primary, meaning that it has developed on its own, or secondary, which means that it has developed as the result of another autoimmune disease, such as rheumatoid arthritis or lupus. There is no "cure" for Sjögren's; researchers have identified a combination of factors—environmental, genetic, and hormonal, according to the National Health Service. There are a variety of treatments which can vary in effectiveness, including saliva-stimulating medication and eye drops. The good news is that Sjögren's patients who are found to be celiac may see the relief of their symptoms through a gluten-free diet, currently the effective and only treatment used for celiac disease. Just as with celiac disease, Sjögren's syndrome is under diagnosed relative to its frequency. As a diagnosed celiac American, I consider myself very lucky that I've been correctly diagnosed with celiac disease. With the help of advocate groups all over the country, gluten-free awareness and celiac diagnosis is on the rise. By spreading the word about the association between Sjögren's syndrome and celiac disease, we can help those with Sjögren's achieve better health and quality of life. Resources: National Health Service (UK): Sjögren's syndrome http://www.nhs.uk/conditions/Sjogrens-syndrome/Pages/Introduction.aspx National Institutes of Health: Celiac disease and markers of celiac disease latency in patients with primary Sjögren's syndrome http://www.ncbi.nlm.nih.gov/pubmed/10201480 Nutritional Healing: Articles. Sjögren's World: Links http://www.sjogrensworld.org/links.htm

Celiac.com 04/06/2017 - A new study showing connections between anorexia nervosa and celiac disease, both before and after celiac diagnosis, is raising eyebrows and inviting questions. Results of the study appear in the April 3 issue of Pediatrics. Because the two conditions share a number of symptoms, including abdominal pain, bloating, diarrhea, and underweight, doctors can have some difficulty telling them apart. Until now, previous data linking anorexia with celiac disease came mostly from individual case reports. To get a better picture, Karl Mårild, MD, PhD, from the Barbara Davis Center, University of Colorado, Aurora, and colleagues conducted a cohort and case-control investigation examining the connection between celiac disease and timing of diagnosis for anorexia nervosa. To do this, the research team reviewed records from Sweden's 28 pathology departments. They looked at 17,959 cases of small intestinal biopsy-verified celiac disease in women from 1969 through 2008, and compared them with 89,379 sex- and age-matched population-based controls. The team confirmed cases of anorexia nervosa through inpatient and hospital-based outpatient records. They also looked at individuals undergoing biopsy who showed small intestinal inflammation or normal mucosa, but tested positive for celiac-related autoantibodies. They recorded educational level, socioeconomic status, and type 1 diabetes status. Their results showed that the hazard ratio for developing anorexia nervosa after a celiac diagnosis was 1.46, which fell to 1.31 beyond the first year after celiac diagnosis (with a 95% confidence interval for both). The odds ratio for association of previous anorexia nervosa diagnosis among people with a diagnosis of celiac disease was 2.18, with a 95% CI. The findings remain the same, even after the team adjusted for type 1 diabetes status and socioeconomic levels. Women who had positive celiac serology, but with no signs of villous atrophy, were also more likely to be diagnosed with anorexia nervosa, both before and after celiac diagnosis. The researchers propose three explanations for these findings: First, celiac disease may have been misdiagnosed earlier as anorexia nervosa, or vice versa. Second, it's possible that closer scrutiny of patients diagnosed with one condition may have prompted a bias in detecting the second condition. Third, it's possible that people with a shared genetic susceptibility may face a higher risk of developing both conditions. Whatever the reason behind the association, the study indicates that the connections between the two conditions are likely complex, and definitely invites further study. In the meantime, the researchers write that the "bidirectional association between diagnosis of anorexia nervosa and celiac disease warrants attention in both the initial assessment, and in the follow-up of women with these illnesses." As a result of this study, the team encourages "physicians to closely monitor these patients and calls for heightened understanding of factors that contribute to their co-occurrence." Source: Pediatrics. Published online April 3, 2017