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Celiac.com 02/19/2024 - A recent study presented at the 2023 annual meeting of the American College of Gastroenterology has raised concerns about the increasing incidence of enteropathy-associated T-cell lymphoma (EATL) – a rare and aggressive form of T-cell, non-Hodgkin lymphoma. This alarming trend has prompted researchers to explore the possible connection between EATL and celiac disease, shedding light on the risks faced by individuals with this autoimmune condition. Lead investigator Dr. Isabel Hujoel, Clinic Director of the Celiac Disease Center at UW Medical Center, Seattle, highlighted the strong association between EATL and celiac disease. While EATL is rare, most cases are observed in patients with celiac disease, suggesting a potential link between the two conditions. The study, utilizing data from the Surveillance, Epidemiology, and End Results (SEER) program database, identified 463 cases of EATL between 2000 and 2020, with an age-adjusted incidence rate of 0.014 per 100,000 people. Alarmingly, the incidence of EATL increased by 2.58% annually over this 20-year period. Despite advancements in medical treatment, the prognosis for EATL remains poor, with a median survival of approximately six months. Findings from the study revealed that most cases were treated with a combination of surgery and chemotherapy. However, survival outcomes did not improve over the study period, underscoring the urgent need for more effective treatment strategies. Dr. Sophia Dar, a gastroenterology fellow at Southern Illinois University School of Medicine, emphasized the importance of early detection and treatment. While chemotherapy showed promising results, the overall mortality rate remained high, highlighting the challenges in managing this aggressive cancer. Researchers emphasized the need for further investigation into the factors contributing to the high mortality rate associated with EATL. Understanding these factors could pave the way for more efficient treatment plans and improved outcomes for patients. Debra Silberg, MD, PhD, Chief Scientific Officer of the nonprofit Beyond Celiac, emphasized the rarity of EATL and the need for targeted screening. Screening for EATL should be considered in cases of refractory celiac disease or when there is suspicion of complications related to celiac disease. The rise in cases of EATL serves as a sobering reminder of the potential complications associated with celiac disease. Heightened awareness, early detection, and improved treatment options are crucial in addressing this rare but deadly cancer among individuals with celiac disease. Read more at gastroendonews.com

Celiac.com 05/10/2021 - A top physician in Turkey recently warned that rates of autoimmune diseases like Type 1 diabetes and celiac will likely rise in the wake of the coronavirus pandemic. Autoimmune diseases, including thyroid issues, happen when the body attacks its own tissues. The coronavirus causes the body's immune system to produce “attacking” antibodies. Because "[v]iruses serve as a mechanism that pull the trigger for autoimmune diseases,” an increase in rates of autoimmune diseases was unavoidable after a year of pandemic," says Professor Tufan Tükek, head of the Faculty of Medicine at Istanbul University. Lingering COVID-19 symptoms Impede Autoimmune Disease Management Ongoing coronavirus symptoms have been a problem for numerous recovered patients, and can impair the management of autoimmune diseases. For example, in diabetes patients, studies show that the symptoms influence blood sugar levels, and impede its management by causing fatigue and memory issues. In March 2020, Istanbul University became one of the first institutions in the country to establish an observation center for recovered coronavirus patients. Since then, they have monitored nearly 4,000 patients. Professor Tükek says that, in the early days of the pandemic, diarrhea was the main "long COVID-19" symptom, and then, after a second COVID-19 wave last summer, their team began seeing more memory issues and hair loss. Lately, Tükek said, they are seeing more cases of blood clots. COVID-19 Symptoms Can Linger for Months Dr. Huzeyfe Arıcı, a physician working at the observation center, said that COVID-19 symptoms can linger for up to eight weeks, in many cases. “We have patients suffering from back pain that long, something that cannot be cured by painkillers. We also see an increasing number of cases with memory lapses,” he stressed. With COVID-19 survivors numbering in the millions, it is an open question as to how many will be affected by lingering symptoms, for how long, and what can be done to help them. The idea that coronavirus could increase rates of diabetes, celiac or other autoimmune conditions is bit alarming. Quantifying and describing the problems and then creating a way to address them is crucial. Look for more information as other observation centers share their observations on COVID-19 survivors. Read more in Dailysabah.com

Celiac.com 03/25/2021 - Sometimes, studies can surface that create the appearance of a monumental revelation, but in reality, there isn't much to support their claims. The latest example is an article based on a recent study that appears in Foods magazine. Wheat farmers are using increasing amounts of nitrogen on their fields, which may be stoking the global increase in cases of celiac disease, according to a study published in the Foods magazine, and led by Josep Peñuelas, a researcher at CREAF and the CSIC. The study makes some sweeping conclusions that will likely raise some eyebrows. But at the end of the day, it's long on generalizations and thin on data, and facts. Beginning with little perspective on historical versus modern usage levels, or actual physical impacts, Peñuelas points out that wheat farmers today use ten times more nitrogen to fertilize wheat crops than in the 1960s. Peñuelas points out that celiac rates in the US went from 0.2 to 1% over the last 25 years. However, there are likely many reasons for this, and ascribing the cause to increased nitrogen use seems far fetched. Even ascribing the cause to increased wheat consumption seems a stretch. Because celiac disease testing and awareness have increased substantially over the last couple of decades, it's difficult to get a handle on exactly how widespread the problem is, though evidence points to new rates outpacing increases from testing alone. He then makes some sweeping conclusions. "Nitrogen fertilization translates into a possible direct global health problem," says Peñuelas, although he is cautious about drawing conclusions and admits that very little study has been done in this area. Peñuelas admits that his team did not "carry out the medical study, but we warn of a new consequence. The relationship that we have identified does not imply the existence of a single direct cause: there may be other factors, although this is important." He adds that "the nitrogen fertilization that we ecologists study has very relevant effects on microorganisms and the functioning of the earth, and we add that it also has an effect on human health." This may be true, but the fact is that the actual chemical, biological and environmental triggers that cause the development of celiac disease in genetically susceptible people remain largely unknown. As do the causes of the genetic propensity for celiac disease. Moreover, the level of genetic susceptibility in the general population remains largely unknown, especially relative to previous eras. Overall, the study, while perhaps well intended, seems thin on detail and long on generalizations and claims that are not based on data and solid science. Peñuelas makes a lot of general claims about nitrogen use on wheat fields, increased planting and consumption of wheat, and rises in celiac disease to make some equally general claim that rising nitrogen use has something to do with it all, and possibly other problems. He states: "Everything suggests that we have another risk factor caused by a world richer in nitrogen through the increase of gliadins in wheat, an important risk factor that may explain, at least in part, the increase in the prevalence of celiac disease." "Everything" suggests? Really? Surely if "everything" points to wheat as "another risk factor caused by a world richer in nitrogen through the increase of gliadins in wheat," then surely there's good data to support that claim? But the study offers none. How about let's see some data from an actual scientific study that does more than make some blanket associations about wheat and nitrogen and celiac disease? With all respect to Peñuelas and Foods magazine, these types of claims are unsupported by any hard data, and questionable in their conclusions. Here are some questions that go unanswered: Are wheat farmers dumping more fertilizer on their crops than ever before, or has wheat cultivation expanded ten times in the last 50 years or so? Is there any hard evidence that elevated nitrogen use impacts the physical qualities of wheat, especially the gliadins that trigger celiac reactions? Are there other plausible explanations for a rise in celiac disease rates, such as NSAID use, or dietary shifts? The data so far discounts the idea that wheat, even hybridized varieties common today, are really that much different, or more likely to trigger celiac disease or gluten intolerance than in the past. The reason it's important to clarify such studies is because they can promote misinformation about topics that really matter. Modern wheat is not more toxic than historical varieties This claim is similar to claims that modern wheat is more "toxic" to people with celiac disease than historical varieties, or more likely to trigger the development of celiac disease, neither of which have been shown to be true. In fact, a recent study suggests no connection between celiac antigenicity and modern wheat strains. In fact, both ancient and modern wheat strains trigger reactions in people with celiac disease, and may contribute to its development. Rain levels change gliadin levels more than hybridization Sometimes actual data can yield surprising results. Not too long ago, anew study on old and new wheat varieties shows no evidence for higher immunoreactivity in hybridized wheat strains. In fact, they found that rain changes immunoreactivity of wheat proteins even more than breeding. Think about that: Rain levels change gliadin levels much more than selective breeding. In general, be skeptical of simple answers to complex problems, especially without good detail in the form of data. Demanding good science, solid data, and supportable conclusions will help people avoid reaching the wrong conclusions about important issues.

Celiac.com 08/18/2020 - In the last decade or so, cases of celiac disease have been on the rise globally. Is the disease itself becoming more common, or are more people being diagnosed? A recent podcast by The People's Perspective on Medicine explores the potential surge of celiac disease with guests, Dr. Joseph Murray, MD, and Leonardo Trasande, MD, MPP. The episode also covers Covid-19, and its risks and effects in those with celiac disease, Show 1221 is called: What Explains the Recent Increase in Celiac Disease? The program explores the dramatic increase in celiac disease in the last decades, and the rise may be explained by the fact that many more people are now aware of the condition and eating gluten-free, or other facts. Dr. Murray is with the Division of Gastroenterology and Hepatology at the Mayo Clinic in Rochester, Minnesota. Dr. Murray directs a celiac disease research and clinical program focused on epidemiology, complications and mouse models of gluten sensitivity. Dr. Trasande is a professor in pediatrics, environmental medicine, and population health at New York University. He serves as Director of the Division of Environmental Pediatrics and Vice Chair for Research in the Department of Pediatrics at NYU School of Medicine. The podcast covers the topic from numerous angles, including: What Is Celiac Disease?; Diagnosing Celiac Disease; Who Gets Celiac Disease?, and Environmental Pollutants and the Increase in Celiac Disease. COVID-19 and Possible Risks Associated with Celiac Disease At about the 30 minute mark Dr. Murray discusses how COVID-19 infection can present as GI symptoms, such as diarrhea, abdominal pain, bloating, and loss of appetite. Those with celiac disease should not assume that their GI symptoms are from gluten exposure, and should consider getting tested for COVID-19. It has been shown that those with celiac disease patients have an immune system that is less responsive to vaccines, which also creates a concern about whether this will also be an issue when a COVID-19 vaccine becomes available. According to Dr. Murray, celiac disease patients also have a higher risk of pneumonia, which is of concern if it develops as a complication of COVID-19, and they also have a higher risk of shingles (herpes zoster), which might be triggered by a COVID-19 infection. Because of the additional COVID-19 risk factors mentioned, those with celiac disease should be more careful than others. Celiac disease is not considered as high a risk factor as diabetes, hypertension, and being over age 65, but those with it should consider themselves at somewhat high risk and take additional precautions, for example: Wear a mask in indoor public places at all times; Don't make unnecessary trips outside your home; Don't go into crowded shopping areas if you don't have to; Minimize your contact with people outside your household. The initial broadcast took place on July 25, 2020. The show can now be streamed online, or downloaded for free. To listed to the show: Show 1221: What Explains the Recent Increase in Celiac Disease? Join our Forum discussion on this podcast.