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Iodine testing for DH: This is an old procedure used to create DH blisters. By applying a 30 percent solution of iodine as a patch, a DH outbreak can be created. This may be applicable in some patients when a biopsy is needed and no blisters are available. Immunofluorescence: The indirect immunofluorescence test shows that the serum of a patient contains specific antibodies that bind to different areas of the epithelium. The direct immunofluorescence tests by a skin biopsy shows a specific diagnosis pattern of DH. Traditionally this biopsy is obtained from the buttocks. If no outbreaks are observed in this area, the biopsy is recommended for another area where the itching is observed. DH Drugs: The common drugs used to initially control the blisters are: Dapsone, Sulfoxone, and Sulfapyridine. Each one has different advantages/disadvantages or availability in the treatment of DH. Dapsone changes the life span of red blood cells from an average of 120 days to 30 days. Dapsone is known for possible hematologic changes as a common side effect.
Celiac.com 06/08/2012 - In a new study, researchers at Brigham and Women's Hospital (BWH) addressed whether the genetic risk of the most common medical conditions, including celiac disease, stems from many rare mutations that each confer a high degree of risk in various people, or from common differences throughout the genome that modestly influence risk. They used data and new analysis tools to assess new methods to better understand gene mutations for celiac and three other diseases, rheumatoid arthritis, coronary artery disease and myocardial infarction (heart attack); and type 2 diabetes. The researchers developed a new statistical method that used what is called "polygenic risk score analysis," to estimate the heritable genetic markers of these diseases that is explained by common differences across the genome. The method makes use of data from earlier genome-wide association studies, or GWAS, an approach used to scan DNA samples for common genetic markers seen throughout the population—called SNPs (single nucleotide polymorphisms). For rheumatoid arthritis, the team used computer simulations to show that the underlying genetic risk is largely due to many common alleles rather than rare mutations. They observed similar results for celiac disease (43 percent), myocardial infarction (48 percent) and type 2 diabetes (49 percent). "What is remarkable," says senior author Robert Plenge, MD, PhD, BWH director of Genetics and Genomics in the Division of Rheumatology, Immunology and Allergy, "is that our statistical model was broadly applicable to several common diseases, not just rheumatoid arthritis...Our study provides a clear strategy for discovering additional risk alleles for these and likely many other common diseases." According to the researchers, these methods can be applied to other genome-wide datasets (e.g., GWAS or whole genome sequencing) to estimate the degree to which there is a genetic component. Source: Nature Genetics 44, 483–489 (2012) doi:10.1038/ng.2232
Troncone R, Greco L, Mayer M, Mazzarella G, et. al. Gastroenterology, 1996; 111: 318-324 The final paragraph says: In conclusion, our data show that approximately half of the siblings of patients with celiac disease show signs of sensitization to gluten as they mount an inflammatory local response to rectal gluten challenge. The genetic background and the clinical meaning of such gluten sensitivity need to be established. Further studies, particularly at the jejunal level, are necessary before deciding if any action is to be taken in this subset of first-degree relatives.