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Celiac.com 04/13/2010 - A team of clinicians recently described a case of immune modulation by non-Hodgkin lymphoma in a patient with two primary intestinal T-Cell lymphomas and long-standing celiac disease. F. MuÌˆhr-Wilkenshoff, M. Friedrich, H. D. Foss, M. Hummel, M. Zeitz, and S. Daum made up the research team. They are variously affiliated with the Medical Clinic I, Gastroenterology, Rheumatology and Infectious Diseases, and with the Department of Pathology, Charité of the Campus Benjamin Franklin of University Medicine Berlin, Germany. About 20–30% of all non-Hodgkin lymphomas (NHLs) are gastrointestinal in nature. Of these gastrointestinal lymphomas, about 20–30% occur in small intestine The clinical team recently reported the case of a 72-year-old patient who had been diagnosed with celiac disease when he was 52-years old. The man had not followed a gluten-free diet, yet showed no evidence of enteropathy or celiac-associated antibodies, but still developed a jejunal T-cell lymphoma. Doctors resected the lymphoma due to perforation and treated the patient with four courses of IMVP-16. The patient began and maintained a strict gluten-free diet. Two years later, the patient appeared with weight loss and a clonally divergent refractory sprue type II with loss of antigen (CD8; T-cell receptor-) expression in intraepithelial lymphocytes. At this time, he showed high titers of celiac-associated antibodies, although he was on a strict GFD. The research team notes that the missing enteropathy under a gluten-containing diet supports the idea of immune suppression in malignant diseases, especially non-Hodgkin lymphoma. They also note that the fact that, even while maintaining a strict gluten-free diet, the patient developed refractory sprue type II, an early form of another independent T-cell lymphoma, along with celiac-associated antibodies, suggests that clonal intraepithelial lymphocytes might be stimulating antibody production. Thus, they conclude that isolated detection of celiac-associated antibodies in patients with celiac disease does not prove that patients have deviated from their gluten-free diets. Source: Digestion 2010;81:231–234 DOI: 10.1159/000269810
Celiac.com 11/02/2009 - When it comes to health and wellness, probiotics are the new black. Their role in promoting beneficial gut bacteria and in mediating adverse gut reactions is gaining a great deal of attention and study among the nutrition and health-minded. This is also true in the field of celiac disease research, where the role of probiotic strains in positively influencing various immune reactions within the gut is drawing clinical study and a good deal of interest. A number of strains of probiotic bacteria are important in regulating certain activities in gut-associated lymphoid tissue. By better understanding exactly what factors control probiotic-driven immuno-modulation, researchers hope to improve their role in the treatment, or even prevention, of specific immune-mediated diseases. A team of Italian researchers recently set out to examine the effects of various strains of Lactobacillus spp. and Bifidobacterium lactis in transgenic mice expressing the human DQ8 heterodimer, a HLA molecule linked to celiac disease. The research team was made up of R. D'Arienzo, F. Maurano, P. Lavermicocca, E. Ricca, and M. Rossi of the Institute of Food Sciences, CNR, in Avellino, Italy. The team used live mice mucosally immunized with the gluten component gliadin. To support their efforts, the team conducted in vitro analysis on immature bone marrow-derived dendritic cells (iBMDCs). Their results revealed that all strains up-regulated surface B7-2 (CD86), indicating DC maturation, but with varying intensity. No probiotic strain triggered significant levels of IL-10 or IL-12 in iBMDCs, whereas Lactobacillus paracasei and Lactobacillus fermentum basically induced TNF-alpha expression. Notably, when probiotic bacteria were co-administered in live mice with mucosa immunized with the gluten component gliadin, each of these strains increased the antigen-specific TNF-alpha secretion. The results indicate that probiotics promote strain-specific reactions that support, rather than suppress, the innate and adaptive immune systems of live mice with gluten antigen sensitivity. Using live mice models to better understand the role of probiotic bacteria in mediating immune response to gliadin and other food proteins provides important insight into how such immune responses may be mediated in humans. Such insights will help to speed better treatments for celiac disease and possibly other food-triggered immune reactions. This study supports the notion that Lactobacillus spp. and Bifidobacterium lactis strains may be helpful in promoting better gut health for sufferers of celiac disease. However, further research in humans is needed for conclusive evidence. Source: Cytokine. September 5th, 2009.