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Hey there, I'm new! I've spent quite some time on this site reading up and thought I'd ask the experts. In end of November I started experiencing symptoms (toilet and gas focus) which in January really started escalating enough to send me to the doctor. I explained my symptoms and got a blood test and results about 10 days ago. My 'Deamidated Gliadin IgA was high at 31 U/mL (normal being <15) while the other results were all normal. Doc told me to go to GI for endoscopy, although stated this isn't a 'huge' increase. Meanwhile my symptoms started escalating to the occasional vomit, massive fatigue and feeling like I would collapse while walking to work. I'm reading a lot about this now (though still don't feel knowledgeable at all), and I'm wondering 1) does this number give any indication of celiac as a stand alone? No family history. 2) Is it possible that if it could be celiac, that it can happen so quickly? It just seems to be so sudden so I'm quite confused. I'm seeing the GI next week for next steps. It's just been a tough couple of weeks and I don't seem to get much help from the GP. Any tips would be appreciated!
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Celiac.com 04/11/2022 - Researchers and clinicians are just beginning to understand the many connections between celiac disease and diabetes. We've done a number of articles on links between celiac disease and diabetes. We've talked about how a gluten-free diet might help lower diabetes risk. We've looked at the potential role of gluten in Type 1 Diabetes. We've even asked if having type 1 diabetes mellitus and celiac disease automatically mean worse health and quality of life? We know that rates of diabetes are much higher in celiacs than in the general population, and vice versa. We also know that non-diabetic patients often show celiac-specific humoral immunoreactivity at the time of their celiac disease diagnosis. What about diabetic patients? Do they show type 1 diabetes celiac-specific humoral immunoreactivity? To find out, a research team recently looked at celiac-associated humoral autoimmunity in child, adolescent, and adult patients at the onset of type 1 diabetes (DM1) to see if those patients exhibit DM1 celiac-specific humoral immunoreactivity, as do non-diabetic celiac patients at first diagnosis. The research team included Claudio Tiberti Aceliac disease, Francesca Panimolle BS, Margherita Bonamico MD, Blegina Shashaj MD, Tiziana Filardi MD, Federica Lucantoni BS, Raffaella Nenna MD, Francesco Costantino MD, Andrea Lenzi MD, and Susanna Morano MD. They are variously affiliated with the Department of Internal Medicine, University of Rome “Sapienza,” Rome, Italy; the Department of Pediatrics, University of Rome “Sapienza,” Rome, Italy; and the Department of Physiopathology, University of Rome “Sapienza,” Rome, Italy. The team found IgA anti-transglutaminase autoantibodies (IgA-tTGAb) in more than 650 new-onset DM1 serum samples. They then analyzed IgA-tTGAb-positive DM1 samples for IgG-tTG, deamidated gliadin (DGP), and actin antibodies, and compared the results against those from more than 80 screen-detected non-diabetic patients at the time of their celiac diagnosis. In all, nearly thirteen percent of DM1 samples were positive for IgA-tTGAb, with patients 18 years or over showing lower autoantibody frequency, that's about 2.2 times more than in adult patients. Meanwhile, compared with non-diabetic celiacs, IgA-tTGAb+ DM1 patients showed substantially lower IgA-tTGAb titers, IgG-tTGAb, and DGPAb frequency/titers, along with sharply lower average number of celiac-autoantibody positive results per patient. These results show that the age of diabetes onset is negatively associated with risk of celiac disease, that is, the lower age of DM1 onset, the higher the risk of developing celiac disease. Compared with the activity of non-diabetic patients at the time of celiac diagnosis, celiac-specific humoral immunoreactivity is sharply lower at the onset of DM1. The team suggests that a general lower celiac-specific humoral immune response reflects a slower process of celiac disease development in DM1 patients, which is marked by nearly imperceptible gastrointestinal symptoms. This hypothesis is supported by an autoimmune diabetes study that shows a direct correlation between intensity of the humoral immune response and more prominent characteristics of insulin deficiency.* Stay tuned for more stories on connections between celiac disease and diabetes. Read more in Diabetes Care. 2012 Oct; 35(10): 2083–2085 *Buzzetti R, Di Pietro S, Giaccari A, et al. Non Insulin Requiring Autoimmune Diabetes Study Group High titer of autoantibodies to GAD identifies a specific phenotype of adult-onset autoimmune diabetes. Diabetes Care 2007;30:932–938
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Does Vitamin D Play a Role in Celiac Disease Onset?
Scott Adams posted an article in Latest Research
Celiac.com 07/06/2020 - Although researchers are just beginning to learn about the role of vitamin D on the immune system and on infection, recent studies point to vitamin D as an immune system regulator and signaling component. Over 900 genes are reportedly regulated by vitamin D. Researchers are investigating numerous potential influences of Vitamin D on chronic diseases such as diabetes, celiac disease and cardiovascular, neurological, and autoimmune diseases. A team of researchers recently set out to define the possible role of vitamin D in celiac disease development, taking into account potential links among vitamin D, the immune system and celiac disease. The research team included Giorgia Vici, Dalia Camilletti, and Valeria Polzonetti. They are variously affiliated with the School of Biosciences and Veterinary Medicine, University of Camerino in Camerino, Italy. Beside supporting and protecting the skeletal system by assisting in calcium production, researchers have described additional potential roles for vitamin D. Studies have shown that vitamin D may be a key player in inflammation and immunity, and in controlling the intestinal mucosa barrier. Researchers suspect that vitamin D influences numerous conditions, such as immune-mediated diseases, and due to its involvement in immune modulation it could be a major factor in the onset of celiac disease. Celiac disease is a chronic auto-immune condition that often results in damage to the small intestine when those with it consume gluten proteins. Researchers have begun to understand that other factors also play a role in the development of celiac disease, and recent vitamin D research has shown that tissues and cells that have nothing to do with mineral and bone metabolism present a vitamin D receptor (VDR) and vitamin D-activating enzymes. Researchers have noted that the VDR expresses itself as antigen-presenting cells and lymphocytes, which indicates that vitamin D is a key modulator of immune and inflammation mechanisms, and suggests that VDR gene polymorphisms function as markers of either resistance or susceptibility to autoimmune diseases. For these reasons, the researchers call for clarifying the role of vitamin D in the onset of celiac disease. They are calling for international studies to assess the variables that can influence celiac onset, such as vitamin D levels of pregnant women, vitamin D supplementation and/or UV exposure. Better understanding of the role played by vitamin D in celiac disease could lead the way to new strategies for preventing celiac disease. Stay tuned for more on the role of vitamin D in celiac disease onset, treatment, and prevention. Read more in Nutrients. 2020 Apr; 12(4): 1051.doi: 10.3390/nu12041051- 13 comments
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Can Probiotics Delay Gluten Intolerance in Children?
Jefferson Adams posted an article in Latest Research
Celiac.com 10/09/2017 - New trial data suggests that the probiotic strains Lactobacillus plantarum Heal 9 and Lactobacillus paracasei 8700:2 may provide support for the immune system and delay the onset of gluten intolerance in children. The findings, recently presented at the International Celiac Disease Symposium in New Delhi, suggest that Probi's patented probiotic strains have a 'surprisingly consistent' effect on suppressing coeliac autoimmunity and may delay the onset of the disease in children who are genetically pre-disposed to the condition. "To our knowledge this is the first time a probiotic study has been performed on this specific population and the results show immune-supporting properties of these probiotics as well as a potential preventive effect on the development of celiac disease," said Dr Daniel Agardh of Lund University. Agardh and colleagues identified and recruited 78 children with a genetic pre-disposition to coeliac disease. The children were as a subpopulation in a multinational and multiyear autoimmunity study with thousands of children. The randomized, double-blind, placebo-controlled trial lasted six months and found that disease-related antibodies were significantly reduced in the probiotic group and significantly increased in the placebo group during the course of the study. Results show that the probiotic strains had a suppressing effect on celiac autoimmunity and may delay the onset of the disease – with tissue transglutaminase autoantibodies (tTGA) decreased in the treatment group, but increased in the placebo group. In addition, several significant differences were observed between the groups on a cellular level indicating that the probiotic may counteract coeliac disease-associated ongoing immunological and inflammatory response. "This is an excellent example of a well working collaboration between academia and the industry" commented Probi CEO Peter Nählstedt. "We see a growing interest in children's probiotics and these results enable Probi to build a product platform for children." Read more at: Nutraingredients.com- 2 comments
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Mast Cells Tied to Onset and Progression of Celiac Disease
Jefferson Adams posted an article in Latest Research
Celiac.com 05/18/2017 - Researchers understand pretty well that celiac disease is driven in part by an accumulation of immune cells in the duodenal mucosa as a consequence of both adaptive and innate immune responses to undigested gliadin peptides. Mast cells are innate immune cells that produce a majority of co-stimulatory signals and inflammatory mediators in the intestinal mucosa. A team of researchers recently set out to evaluate the role of mast cells in the development of celiac disease. The research team included Barbara Frossi, PhD, Claudio Tripodo, MD, Carla Guarnotta, PhD, Antonio Carroccio, MD, Marco De Carli, MD, Stefano De Carli, MD, Marco Marino, MD, Antonino Calabrò, MD, and Carlo E. Pucillo, MD. They are variously affiliated with the Department of Gastroenterology and Digestive Endoscopy at the University Hospital of Udine in Udine, Italy; the Department of Medical and Biological Sciences, University of Udine, Udine, Italy; the Second Unit of Internal Medicine, University of Udine, Udine, Italy; the Department of Experimental and Clinical Biomedical Sciences “Mario Serio,” University Hospital of Florence, Florence, Italy; the Tuscany Referral Center for Adult Coeliac Disease, AOU Careggi, Florence, Italy; the Department of Health Science, University Hospital of Palermo in Palermo, Italy; and the Department of Internal Medicine and Specialist at the University Hospital of Palermo in Palermo, Italy. For their study, the research team scored intestinal biopsy results from celiac patients according to Marsh classification, and characterized those results for leukocyte infiltration and MC distribution. They also characterized mast cell reactivity to gliadin and its peptides via in vitro assays. The team found that infiltrating mast cells reflected the severity of mucosal damage, and their numbers were increased in patients with higher Marsh scores. They noted that mast cells responded directly to non-immunodominant gliadin fragments by releasing pro-inflammatory mediators. Their immunohistochemical analysis of infiltrating mast cells, along with the effects of gliadin peptides on intestinal mast cells, indicates that patients in with advanced celiac disease face an increase in pro-inflammatory mast cell function. This result was also tied to increased neutrophil accumulation, the prevalence of M1 macrophages, and the severity of tissue damage. This study clearly describes the progressive stages of celiac disease, and shows that mast cells are a prominent feature of the inflammatory process. These results show that mast cells are associated with the onset and progression of celiac disease, and that the view of celiac disease should be revised to account for the contribution of mast cells in the onset and progression of the disease; and in the development any new celiac treatments. Source: Journal of Allergy, & Clinical Immunology. DOI: http://dx.doi.org/10.1016/j.jaci.2016.08.011- 2 comments
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New Study Sheds Light on Elderly Onset Celiac Disease
Jefferson Adams posted an article in Latest Research
Celiac.com 09/28/2016 - Celiac disease occurs most often in children and young adults. However, people can develop celiac disease at any age, and rates are rising even among older people. Because older people often show clinically atypical symptoms, they can sometimes experience a delay in diagnosis. Also, serological tests have a lower sensitivity and specificity in the older patients. This means that doctors only begin to suspect celiac disease in the presence of other, often vaguely associated complications, such as autoimmune disorders, fractures, and finally, malignancy, and that diagnosis must be aided by endoscopic and imaging tools. A team of researchers recently set out to assess the incidence and prevalence of celiac disease in the elderly, the patterns of clinical presentation, diagnosis, and the most frequent complications, with the aim of increasing awareness and reducing the diagnostic delay of celiac disease even in the elderly population. The research team included Maria Cappello, Gaetano C. Morreale, and Anna Licata of the Gastroenterology and Hepatology Section, DIBIMIS, University of Palermo School of Medicine, Palermo, Italy. The team's recent article highlights their findings regarding celiac rates and incidence in older patients, along with patterns of clinical presentation, diagnosis, and most frequent complications. The researchers conclude: "Despite a paucity of symptoms, such as diarrhea and weight loss, celiac disease has been increasingly recognized in the elderly. Other presentations in the elderly age group include iron deficiency anemia (often refractory to oral iron), autoimmune disorders, bone disease due to osteopenia, including fractures, malignant intestinal disease, especially lymphoma, and finally idiopathic dilated cardiomyopathy. Diagnosis may be delayed due to limited symptoms, a low index of clinical suspicion, or diagnostic difficulties related to important cognitive impairment that often affects elderly people. Although for these patients, the GFD is the key of clinical management, elderly patients sometimes are scarcely adherent to diet. Patients should be referred to specialists to ensure the better management of the disease and related complications. Micronutrients, such as iron, calcium, vitamin D supplementation, and vitamins, should be part of a modified GFD for the elderly patients. All other therapeutical interventions that limit malabsorption and avoid complications should be considered part of a management strategy." Source: Clin Med Insights Gastroenterol. 2016; 9: 41–49. doi: 10.4137/CGast.S38454 PMCID: PMC4965017- 2 comments
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Lancet. 2003 Jun 21;361(9375):2152-4. Celiac.com 08/25/2003 – This interesting study compares a specific amino acid sequence found in Candida cell wall protein to a the gliadin amino acid sequence that triggers the immune response in celiac disease. The researchers found that the sequences are "identical or highly homologous to known coeliac disease-related alpha-gliadin and gamma-gliadin T-cell epitopes," and propose that Candida is the trigger for the onset of celiac disease. Below is the abstract for this study. Is Candida albicans a trigger in the onset of coeliac disease? Nieuwenhuizen WF, Pieters RH, Knippels LM, Jansen MC, Koppelman SJ. Coeliac disease is a T-cell-mediated autoimmune disease of the small intestine that is induced by ingestion of gluten proteins from wheat, barley, or rye. We postulate that Candida albicans is a trigger in the onset of coeliac disease. The virulence factor of C albicans-hyphal wall protein 1 (HWP1)-contains amino acid sequences that are identical or highly homologous to known coeliac disease-related alpha-gliadin and gamma-gliadin T-cell epitopes. HWP1 is a transglutaminase substrate, and is used by C albicans to adhere to the intestinal epithelium. Furthermore, tissue transglutaminase and endomysium components could become covalently linked to the yeast. Subsequently, C albicans might function as an adjuvant that stimulates antibody formation against HWP1 and gluten, and formation of autoreactive antibodies against tissue transglutaminase and endomysium.
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Diabetes Care 2004;27:1294-1298. Celiac.com 11/29/2004 - In an effort to determine the prevalence of biopsy-confirmed celiac disease in Italian children and adolescents with type 1 diabetes, and to determine whether age at onset of diabetes is independently associated with the diagnosis of celiac disease, Dr. Franco Cerutti and colleagues at the Universita di Torino, Italy looked at 4,322 children and adolescents (4-11 years old) who had type 1 diabetes. Yearly celiac disease screening was performed on them by using IgA/IgG anti-gliadin and IgA anti-endomysium antibodies, and those with positive antibody results were given a biopsy for confirmation. Out of 4,322 children screened 292 or 6.8% had celiac disease. In 89% of cases diabetes was diagnosed before celiac disease. Using logistic regression analyses the researchers determined that those diagnosed with diabetes at a younger age, those who are female, and those with a thyroid disorder are independently associated with the risk of having both diabetes and celiac disease. The researchers conclude: "We have provided evidence that 1) the prevalence of biopsy-confirmed celiac disease in children and adolescents with type 1 diabetes is high (6.8%); 2) the risk of having both diseases is threefold higher in children diagnosed with type 1 diabetes at age 9 years; and 3) girls have a higher risk of having both diseases than boys."
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Celiac.com 06/25/2003 - The following is an abstract of a recent study published in the June edition of the Journal of Association of Physicians of India by Dr. Y.A. Gokhale and colleagues from the Lokmanya Tilak Medical College and General Hospital, Mumbai (Bombay). The researchers conclude that symptomatic osteoporotic patients, especially those with associated anemia, who are younger than 55 years of age should be screened for celiac disease. Here is the abstract: Celiac Disease in Osteoporotic Indians YA Gokhale, PD Sawant, CM Chodankar, ND Desai, MV Patil, S Maroli, MN Patil, NK Hase J Assoc Physicians India June 2003;51:579-584 Abstract: Objective: The aim of the study was to identify the atypical celiac disease (celiac disease) in a cohort of symptomatic osteoporotic patients, younger than 55 years of age and 2) To study associated clinical and laboratory features and outcome with gluten-free diet. Material and Methods: We studied 33 patients (F:M =28:5),mean age 29 years (range 15-52 years) with osteoporosis (WHO diagnostic criteria, T-score less than -2.5 on DEXA scan) from January 2000-June 2002. Serological screening for celiac disease was done by detecting circulating IgA antibodies to tissue transglutaminase by ELISA. Patients with presence of antibodies to transglutaminase were subjected to biopsy from the 2nd part of the duodenum by upper GI endoscopy. The biopsies were reported independently by two pathologists who were blinded for the serology report. Measurement of mucosal thickness, crypts and villi were done with an ocular micrometer. Other parameters like complete hemogram, serum iron, total iron binding capacity (TIBC),calcium profile,25-OH-D, parathyroid hormone (PTH) were evaluated. Assessment of clinical and laboratory parameters was performed within 4-12 weeks of starting gluten-free diet (GFD). Results: Thirteen patients had circulating IgA antibodies to transglutaminase. Intestinal biopsies were performed on 11 patients and were consistent with the diagnosis of celiac disease (total villous atrophy -two, subtotal villous atrophy with crypt hyperplasia -nine). Patients with celiac disease had significant anemia when compared with non-celiac disease osteoporotic patients. Other important observations in these 11 patients were low serum calcium and phosphorus, low 25-OH-D, high PTH. Significant improvement in clinical and laboratory parameters was noted in all patients within 6-12 weeks of starting GFD. Conclusion: Symptomatic osteoporotic patients (younger than 55 years of age) especially with associated anemia should be investigated for celiac disease. Simple measures like omission of wheat from diet (GFD) lead to significant improvement in symptoms within weeks.
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