Search the Community
Showing results for tags 'proves'.
Found 3 results
Jefferson Adams posted an article in Celiac Disease & Gluten Intolerance ResearchCeliac.com 08/02/2013 - A great deal of effort goes into determining the best procedures for screening for celiac disease. Ideally it would be great to test everyone, but that is currently too expensive on such a large scale. So, one of the things researchers study is how to get the best results with limited resources. To better understand the cost-effectiveness of universal screening for celiac disease versus screening only patients who are at risk for or showing symptoms of celiac disease, a team of researchers looked specifically at the high risk, and associated costs, of non-traumatic hip and vertebral fractures if celiac disease is untreated or undiagnosed. Their results appear in Clinical Gastroenterology and Hepatology. The team found that the current standard practice of screening adolescents who are either symptomatic or at high-risk for celiac disease proves to be more cost-effective than universal screening. They also found that screening helps to prevent decreased bone mineral density, which can affect up to 70 percent of untreated celiac patients, and often leads to osteoporosis and non-traumatic hip and vertebral fractures. Overall, blanket screening and selective screening both had similar lifetime costs and quality of life ratings, but screening only those at risk or with actual symptoms proved to be more cost effective in preventing bone loss and fractures among patients with undiagnosed or subclinical celiac disease. They noted that additional analyses looking at risk and cost of other potential consequences of undiagnosed and untreated celiac disease, such as anemia, infertility and malignancy, might change the cost-effectiveness balance more in favor of universal screening for celiac disease. Source: American Gastroenterological Association
Jefferson Adams posted an article in Celiac Disease & Gluten Intolerance ResearchCeliac.com 04/13/2009 - A team of Spanish researchers recently set out to determine rates and clinical status of gluten sensitive enteropathy (GSE) detected by mass blood screens. The researchers also sought to determine sensitivity of anti-transglutaminase (tTGA) and anti-endomysium antibodies (EmA) in diagnosis, and compliance with a gluten-free diet (GFD) and follow-up. The research team was made up of doctors Meritxell Mariné, Fernando Fernández-Bañares, Montserrat Alsina, Carme Farré, Montserrat Cortijo, Rebeca Santaolalla, Antonio Salas, Margarita Tomàs, Elias Abugattas, Carme Loras, Ingrid Ordás, Josep M Viver, and Maria Esteve. Researchers recruited one thousand, eight hundred and sixty eight subjects, who were the screened for tTGA and EmA. Positive screens were referred for duodenal biopsy, DQ2/DQ8 genotyping, clinical feature charting, blood tests, and densitometry. More than 98% of subjects showed tTGA levels below 2 U/mL, so researchers designated this as the baseline level for normality, and deemed results positive at or above this level if confirmed twice in a single sample. Researchers also charted adherence to a GFD and follow-up results. A total of 26 subjects (1.39%) showed positive tTGA and/or EmA results, Of those, 21 underwent biopsy, with results showing six Marsh â…¢ (one â…¢a, four â…¢b, one â…¢c), nine Marsh â… and six Marsh 0, with a GSE rate of 1:125. EmA sensitivity for GSE was 46.6% (11.1% for Marsh â… , 100% for Marsh â…¢), while tTGA, sensitivity was 93.3% (88.8% for Marsh â… , 100% for Marsh â…¢). All 15 patients with abnormal blood tests showed clinical manifestations related to GSE. Marsh â… and â…¢ subjects showed more abdominal pain than Marsh 0 (P = 0.029), and also showed more distention and diarrhea. The team saw no differences in the rates of osteopenia between Marsh â… and â…¢ (P = 0.608). They found that 66.7% of the 15 GSE patients complied with a gluten-free diet, and that 80% responded positively to the diet. 69.2% participated in follow-up study. This study showed positive blood screens in nearly 1.4% of those tested. The study showed frequent and clinically relevant rates of GSE among the general population. This confirms that celiac disease and related conditions are at least as common as the 1% figure commonly quoted, and indicate that when criteria are expanded to include less severe cases, they may be even higher. The study confirmed tTGA as the marker of choice, and showed that mass screening programs such as this one are helpful in spotting celiac disease early, and in referring people for treatment and follow-up before the disease develops into more costly and debilitating conditions often associated with untreated celiac disease. World J Gastroenterol. 2009 March 21; 15(11): 1331–1338.
Phenotyping of Intraepithelial Lymphocytes (IELs) Proves to be a Useful Test in Intestinal Pathology
Jefferson Adams posted an article in Celiac Disease & Gluten Intolerance ResearchCeliac.com 08/29/2007 - A study that appeared in the August issue of Journal of Clinical Gastroenterology, found that celiac disease and small intestinal bacterial growth both show increased levels of intraepithelial lymphocytes (IELs), especially gammadelta+ IELs. A sharp increase in gammadelta+ IELs has been noted in people with celiac disease, but little is known about the role of this particular class of IELs in other intestinal pathologies. A team of researchers led by J.M. Remes-Troche set out to assess the levels of IEls, especially of gammadelta+, in the duodenal mucosa biopsies from individuals w/ celiac disease and to compare them with those of patients with small intestinal bacterial overgrowth (SIBO), and irritable bowel syndrome (IBS). The study team looked at 12 individuals with untreated celiac disease, 8 patients with SIBO, and 10 patients with diarrhea-predominant IBS. All patients were given an upper-endoscopy for mucosal biopsy and jejunal aspirate. Intraepithelial cells were isolated from 2 small bowel biopsies, and labeled with monoclonal antibodies CD103-PE (phycoerythrin), CD3-FITC (fluoresecein isothio-cynate), celiac disease-7R-PE, CD45RO-APC (allophycocyanin), and TcR gammadelta-FITC. Researchers conducted flow cytometry analysis using a standard FACScan. Total IEL levels and subsequent levels were catalogued as percentages as follows: 16.7 +/- 6% for IBS patients; 25.7 +/- 17% for SIBO patients; and 26 +/- +/- 13% in celiac patients (P=0.2). Patients with SIBO & celiac disease showed significantly higher percentages of gammadelta+ IELs (14.6 +/- 8% and 15.7 +/- 13%) compared to IBS patients (4.1 +/- 2.5%, P<0.05). The results of the study indicate that gammadelta+ IELs might play a crucial role against intestinal bacterial infections. Journal of Clinical Gastroenterology. 2007 Aug;41(7):671-676 health writer who lives in San Francisco and is a frequent author of articles for Celiac.com.