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Ok, so I am just vain enough that I need to fancy up occasionally. I have been a Mary Kay customer for years, and they're not gluten free. So, I need all the recommendations. What products have you loved? Hated? I'm especially interested in concealers. eyeliner, mascara, lip stain, clear lip liner, eyeshadow, and face powder. Also, face and eye creams/serums. Thank you!
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Celiac.com 09/27/2023 - A team of researchers recently set out to explore duodenal villous atrophy in adults with suspected celiac disease without IgA deficiency. The research team included Prof Carolina Ciacci, MD, Prof Julio Cesar Bai, MD, Geoffrey Holmes, MD, Abdulbaqi Al-Toma, MD, Prof Federico Biagi, MD, Prof Antonio Carroccio, MD, Rachele Ciccocioppo, MD, Prof Antonio Di Sabatino, MD, Rachel Gingold-Belfer, MD, Mariana Jinga, MD, Prof Govind Makharia, MD, Sonia Niveloni, MD, Gary L Norman, PhD, Kamran Rostami, MD, Prof David S Sanders, MD, Edgardo Smecuol, MD, Vincenzo Villanacci, MD, Santiago Vivas, MD, and Fabiana Zingone, MD, on behalf of theBi.A.CeD study group. The team conducted a multi-center, prospective cohort study to assess the accuracy of serum anti-tissue transglutaminase IgA (tTG-IgA) in diagnosing celiac disease in adults. The study included adult participants aged 18 years or older, with suspected celiac disease, who were not on a gluten-free diet, and did not have IgA deficiency. The participants were enrolled from 14 tertiary referral centers across different regions from February 27, 2018, to December 24, 2020. The main objective was to determine whether serum tTG-IgA tests could reliably diagnose celiac disease based on duodenal villous atrophy. The study included 436 participants (296 women and 140 men) with complete data on serum tTG-IgA and duodenal histology. Of these, 363 participants had positive serum tTG-IgA results, and 73 had negative results. After local review, it was found that 341 of the participants with positive serum tTG-IgA had positive histology (true positives), while 22 had negative histology (false positives). Among the 73 participants with negative serum tTG-IgA, seven had positive histology (false negatives), and 66 had negative histology (true negatives) after local review. Study Findings: Positive Predictive Value of 95.9% for Celiac Disease Serum tTG-IgA The study's findings showed a positive predictive value of 93.9% and a negative predictive value of 90.4% for serum tTG-IgA in diagnosing celiac disease. The sensitivity was 98.0%, indicating the test's ability to correctly identify true positive cases, while the specificity was 75.0%. After central re-evaluation of duodenal histology in discordant cases, the positive predictive value increased to 95.9%, and specificity improved to 81.5%. The sensitivity remained high at 98.0%. The study also found that the positive predictive value of serum tTG-IgA increased as the serological threshold was defined at higher multiples of the upper limit of normal (ULN). The area under the receiver operating characteristic curve (AUC) for serum tTG-IgA was 0.87 for the categorical definition (positive vs. negative) and 0.93 for the numerical definition (multiples of the ULN) in predicting duodenal villous atrophy. Conclusion Based on the data, the study suggests that in adults with a reliable suspicion of celiac disease and high serum tTG-IgA levels, a biopsy may reasonably be avoided in the diagnostic process. This information can be valuable in improving the efficiency and accuracy of diagnosing celiac disease in certain cases, reducing the need for biopsy. Read more in The Lancet Gastroenterology and Hepatology Note: The researchers are variously affiliated with the Department of Medicine, Surgery, and Dentistry, Scuola Medica Salernitana, University of Salerno, Salerno, Italy; the Research Institutes, Universidad del Salvador, Buenos Aires, Argentina; the Small Bowel Section, Dr C Bonorino Udaondo Gastroenterology Hospital, Buenos Aires, Argentina; Department of Gastroenterology, Royal Derby Hospital, Derby, UK; the Department of Gastroenterology and Hepatology, St Antonius Hospital, Nieuwegein, Netherlands; the Department of Internal Medicine and Medical Therapy, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy; the Gastroenterology Unit of Pavia Institute, Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy; the Unit of Internal Medicine, Cervello Hospital, University of Palermo, Palermo, Italy; the Gastroenterology Division, Rabin Medical Centre, Beilinson Hospital, Petah Tikva, Israel; the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; the Gastroenterology Department, Carol Davila University of Medicine and Pharmacy, Central Military Emergency University Hospital, Bucharest, Romania; the Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India; the Research and Development, Headquarters and Technology Centre for Autoimmunity, Werfen, San Diego, CA, USA; the Gastroenterology Unit, MidCentral DHB, Palmerston North, New Zealand; the Academic Unit of Gastroenterology, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK; the Institute of Pathology, Spedali Civili University of Brescia, Brescia, Italy; the Gastroenterology Unit, University Hospital of Leon, Leon, Spain; and the Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy, on behalf of the Bi.A.CeD study group.
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Celiac.com 03/12/2021 - EpiLynx by Dr. Liia is now bundling their products in a way that will save you both time and money. Be sure to see our review of their Gluten-Free Sunrise Bundle. This Rejuvenation Night Bundle offers the following items in a single package, at a reduced price compared to the cost of buying them individually, and they even offer an additional price reduction if you set up a two month automatic subscription (follow the links read our reviews): EpiLynx by Dr. Liia Gluten-Free EpiLinkage Rejuvenation Night Cream EpiLynx by Dr. Liia Gluten-Free EpiLinkage Rejuvination Eye Cream EpiLynx by Dr. Liia Gluten-Free EpiLinkage Rejuvenation Serum EpiLynx by Dr. Liia has quickly become the premier brand of gluten-free cosmetics and skin care products because they use the best quality, gluten-free, allergen-free, vegan, cruelty-free and lectin minimized ingredients available. Each item in this bundle is appropriate for all skin types, and this kit will give your dull skin a more radiant and youthful appearance. Their Rejuvenation Night Cream, Serum and Eye Cream will deliver moisture into the deepest layers of your skin and provide long lasting positive effects. Each product delivers two key anti-aging and anti-wrinkle ingredients: hyaluronic acid and niacinamide. For anyone looking to rid their makeup cabinet from cosmetics that contain gluten and allergens, now is the time to stock up and save money with their Rejuvenation Night Bundle—and don't forget to set up a regular subscription order for maximum savings! Visit their site for more info.
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EpiLynx by Dr. Liia Anti-Oxidant Vitamin C Serum
Celiac.com Sponsor: Review posted an article in Product Reviews
Celiac.com 04/22/2021 - For those dealing with damaged skin, EpiLynx by Dr. Liia has a great solution—their Vitamin C Serum contains not just vitamin C, but also aloe vera, chamomile flower extract and hyaluronic acid, and this combination, it turns out, is great as an anti-oxidant that will rejuvenate your damaged skin, and protect it from aging. Like all of their products, their Vitamin C Serum is formulated to be gluten-free, allergen-free, and vegan. This Vitamin C Serum will also protect your skin from the sun's UV exposure, and is designed to use daily after washing your face to create a “hydrating” base. Vitamin C helps to promote collagen production in your skin, and this can help to thicken the dermis and diminish wrinkles, which will give your skin a more youthful appearance. The combination of chamomile flower extract with aloe vera and vitamin C creates strong antioxidant, anti-inflammatory, and antiseptic properties that will help prevent sun damage and diminish age spots, and the aloe vera base won't leave a greasy film on skin. Vitamin C Serum will help to eradicate skin blemishes, diminish age lines, and increase skin elasticity. EpiLynx by Dr. Liia offers a wide range of high-end gluten-free cosmetics, face creams, lotions, and makeup, and has quickly become the leader in this important area. EpiLynx by Dr. Liia also offers a steep discount on this product when you create a subscription for it on their site, which will allow it to be sent to you on a regular basis so you won't ever run out. Visit their site for more info. -
Celiac.com 04/09/2021 - For those with acne, EpiLynx by Dr. Liia now offers a new gluten-free “Acne Bundle,” which will save you money, especially if you set up a renewal subscription. The bundle includes the following two crucial acne skin care products: Kojic Acid Face Cream for Acne-Prone Skin Pore Refining Serum Both products are designed to be tough on acne, yet gentle on your skin. Using each will help curb acne breakouts by offering pore-cleaning and skin hydrating benefits, and, if you have acne, should be part on your daily morning and evening skin care routine. Kojic Acid Face Cream for Acne-Prone Skin is gluten-free, allergen-free and vegan, and contains kojic acid and niacinamide, which can help you deal with age spots, scars, and acne caused by skin bacteria. It's formulated to lighten sun damaged areas, and can have an anti-aging effect on your skin. Kojic acid can help fight the most common strains of bacteria that cause acne. Pore Refining Serum is fragrance-free, gluten-free, allergen-free and vegan, and is formulated with lactic acid and sodium lactate, both of which help to clean out your pores and shrink them. Lactic acid has been shown to increase the rate of cell renewal, and improve your skin's texture and tone. Sodium lactate helps your skin retain water and stay hydrated. The Pore Refining Serum also contains salicylic acid which penetrates your pores and helps to exfoliate your skin and decrease the build-up of dead skin cells on the surface that can clog up your pores. It also helps to remove dirt, pollution, bacteria and other irritants that can trigger acne. EpiLynx by Dr. Liia's new skin care bundles offer great savings over the cost of buying each item separately, and an even better deal if you decide to subscribe to them. Celiac.com highly recommends all EpiLynx by Dr. Liia products due to their focus on high quality, gluten-free skin care products and cosmetics. Visit their site for more info.
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Celiac.com 03/03/2021 - We just discovered that EpiLynx by Dr. Liia now offers a brand new “Sunrise Bundle,” which includes three of their most important, and popular, gluten-free creams/serums. In the past we've reviewed each of these items individually (click the links below to read our review of each product), and their new Sunrise Bundle includes: EpiLynx by Dr. Liia Gluten-Free EpiRadiance Sunrise Eye Cream EpiLynx by Dr. Liia Gluten-Free EpiRadiance Sunrise Serum EpiLynx by Dr. Liia Gluten-Free EpiRadiance Sunrise Cream The nice thing about this new bundle is that it offers all these great products together, at a reduced price, compared to the cost of buying them individually. There's also a significant price reduction when you set up a two month automatic subscription for the bundle, which will eliminate the hassle of running out, or having to reorder it. For those who are new to EpiLynx by Dr. Liia, they are the premier brand of gluten-free cosmetics and skin care products because they utilize only the highest quality, gluten-free, vegan, cruelty-free and lectin minimized ingredients. Each product in the Sunrise Bundle delivers two key anti-aging and anti-wrinkle ingredients deep into your skin: hyaluronic acid and niacinamide. The hyaluronic acid will help to restore your skin by creating a natural moisture barrier, while the niacinamide will give your skin a firmer, younger appearance by tightening saggy pores. Their Sunrise Eye Cream will increase your skin's natural moisture and collagen levels and help to eliminate wrinkles. Now you can save money and get each of their most popular gluten-free skin care products in a single bundle, and save even more when you set up a regular subscription order. Visit their site for more info.
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Celiac.com 11/22/2019 - EpiLynx by Dr. Liia EpiSilk Crystal Serum is an anti-wrinkle skin care product that contains the antimicrobial “DermaSilk,” which is like regular silk but free of sericin, which can cause irritation. It's composed of long, very smooth, natural fibers that help lock in moisture and keep your skin clear and free of irritation. This luxurious serum targets dark circles under your eyes, as well as acne and dry skin. I found that it increased my skin's brightness on the areas where it was applied, and made my skin feel silky smooth. Best of all it is gluten-free and made in the USA by and for those who are sensitive to gluten. About EpiLynx by Dr. Liia: Epilynx was founded by Dr. Liia Ramachandra, PharmD, PhD, who founded the company after her struggle with gluten sensitivity. For more info visit their site.
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Celiac.com 01/08/2020 - Researchers currently don't have much good information on the frequency of hypogammaglobulinemia (Ig deficiency) in people with multiple sclerosis. A team of researchers recently set out to assess the frequency of reduced immunoglobulin (Ig) concentrations and its association with immunotherapy and disease course in two independent multiple sclerosis study groups. The research team included Greta Zoehner, Andrei Miclea, Anke Salmen, Nicole Kamber, Lara Diem, Christoph Friedli, Maud Bagnoud, Farhad Ahmadi, Myriam Briner, Nazanin Sédille-Mostafaie, Constantinos Kilidireas, Leonidas Stefanis, Andrew Chan, Robert Hoepner, and Maria Eleftheria Evangelopoulos. The team's retrospective cross-sectional study included multiple sclerosis patients and control patients with head or neck pain from Bern University Hospital in Bern, and Eginition University Hospital in Athens. The lower limits of normal (LLN) for serum Ig concentration were IgG < 700 mg/dl, IgM < 40 mg/dl, and IgA < 70 mg/dl. The team analyzed the results using the Mann–Whitney U test, analysis of variance test, and multiple linear regression. The study shows that multiple sclerosis patients have high rates of reduced serum IgG concentrations, both with and without disease-modifying treatments. Interestingly, in patients with other autoimmune diseases, Ig deficiency is also more prevalent, and 1.7% of patients with celiac disease and 5.2% of patients with systemic lupus erythematosus also have IgA deficiency. Given that infections or interference with antibody production usually happen at much lower IgG levels, around 400 mg/dl, and below, the importance of lower IgG concentrations at the levels noted remains unknown. The team suggests using the information to monitor IgG levels, particularly with anti-B-cell therapies, and considering IgG substitution at levels below 400 mg/dl. Read more in Therapeutic Advances in Neurological Disorders The researchers are variously affiliated with the Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; the University Institute of Clinical Chemistry, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; the Center of Laboratory Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; the Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; and the Department of Neurology, Eginition University Hospital at the National and Kapodistrian University of Athens, Athens, Greece.
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Celiac.com 06/28/2017 - Tests to measure serum endomysial antibodies (EMA) and antibodies to tissue transglutaminase (tTG) were developed to screen for celiac disease in patients who are actively eating gluten. However, doctors often use them to monitor patients on a gluten-free diet. Now, making sure celiac patients are successfully following a gluten-free diet is important, as unconscious gluten ingestion can lead to complications over time. But how accurate are these tests for assessing gluten-free compliance in celiac patients? A team of researchers recently set out to assess the sensitivity and specificity of tTG IgA and EMA IgA assays in identifying patients with celiac disease who have persistent villous atrophy despite a gluten-free diet. The research team included Jocelyn A. Silvester, Satya Kurada, Andrea Szwajcer, Ciarán P. Kelly, Daniel A. Leffler, and Donald R. Duerksen. They are variously affiliated with the Farncombe Family Digestive Health Research Institute and Division of Gastroenterology, and the Department of Pathology and Molecular Medicine and Department of Medicine, McMaster University, Hamilton, Ontario. To begin their meta-analysis, the team searched PUBMED, EMBASE, BIOSIS, SCOPUS, clinicaltrials.gov, Science Citation Index, and Cochrane Library databases through November 2016. They included studies of subjects with biopsy-confirmed celiac disease, follow-up biopsies and measurement of serum antibodies on a gluten-free diet, biopsy performed on subjects regardless of symptoms or antibody test results. Their analysis excluded patients with refractory celiac disease, undergoing gluten challenge, or consuming a prescribed oats-containing gluten-free diet. They determined positive or negative findings based on manufacturer cut-off values. They defined villous atrophy a Marsh 3 lesion or villous height:crypt depth ratio below 3.0. They constructed forest plots to determine the sensitivity and specificity of detection for individual studies. For their meta-analysis, they used a bivariate random effects model to determine both sensitivity and specificity. Their search of abstracts revealed 5,408 unique citations, which yielded 442 articles for detailed review. Those reviewed articles yielded just 26 studies that met the team’s inclusion criteria (6 of tTG assays, 15 of EMA assays, and 5 of tTG and EMA assays). Inability to cross-tabulate histologic and serologic findings was the most common reason the team excluded a given study from analysis. They found that serum assays identified patients with persistent villous atrophy with high levels of specificity: 0.83 for the tTG IgA assay (95% CI, 0.79–0.87) and 0.91 for the EMA IgA assay (95% CI, 0.87–0.94). However, the tests showed low sensitivity for detecting villous atrophy: 0.50 for the tTG IgA assay (95% CI, 0.41–0.60) and 0.45 for the EMA IgA assay (95% CI, 0.34-0.57). Results were similar in both pediatric and adult patients. A meta-analysis of biopsy-confirmed celiac patients who received follow-up biopsy while on a gluten-free diet, showed that tests for serum tTG IgA and EMA IgA had low sensitivity, detecting persistent villous atrophy less than 50 percent of the time. The team supports the search for more accurate, non-invasive, markers of mucosal damage in celiac patients who follow a gluten-free diet. Source: Gastroenterology. DOI: http://dx.doi.org/10.1053/j.gastro.2017.05.015
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Celiac.com 01/26/2017 - The only currently effective therapy for celiac disease is for patients to follow a gluten-free diet. However, no serum marker for gluten intake has yet been found, so it's not always easy for doctors to tell if patients are following their diets properly. A team of researchers recently set out to evaluate the use of alkylresorcinol concentrations for detecting dietary gluten intake in humans and mice. The research team included R. S. Choung, J. A. Murray, E. V. Marietta, C. T. Van Dyke, and A. B. Ross. They are variously affiliated with the Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA, and with the Department of Biology and Biological Engineering, Chalmers University of Technology in Gothenburg, Sweden. For their study, they compared alkylresorcinol concentrations among 34 treated patients with celiac disease, 36 untreated celiac disease patients and 33 control subjects. They also evaluated seven additional celiac disease patients whose serum samples were available at diagnosis and after gluten-free diet. In mice, they compared alkylresorcinol concentrations in the serum of five mice fed a regular chow, and 10 mice fed lifelong with a gluten-free chow. In addition, They also assessed the effect of added gluten on alkylresorcinol concentrations. Their study indicates that serum alkylresorcinol concentrations could be a useful marker for dietary gluten in celiac disease. Certainly, having an easy, reliable way for doctors to spot dietary gluten will be useful in helping people with celiac disease maintain their required gluten-free diets. Source: Alimentary Pharmacology & Therapeutics. DOI: 10.1111/apt.13917
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Celiac.com 02/28/2008 - A study published in the Leukemia Research Journal (Volume 30, issue 12, Pages 1585-1586 - December 2006) looked at samples of serum from multiple myeloma patients. In 35% of the samples the myeloma monoclonal proteins had antigliadin activity, and migrated just like celiac anti-gliadin antibodies when subjected to electrophoresis. Monoclonal gammopathy (MGUS) is a precursor stage to multiple myeloma, with the same or very similar sort of monoclonal proteins as in multiple myeloma, and converts to it at the rate of about 1.5% per year. Therefore if one lives for 20 years after diagnosis with MGUS, one has a 30% chance of ending up with deadly, so far incurable, multiple myeloma, which is a cancer of the bone marrow and blood. For those diagnosed with MGUS it seems like a time bomb ticking, and each time one goes for the monitoring blood tests, there is some degree of anxiety. It was postulated by the researchers that multiple myeloma may actually be an end result of untreated celiac disease. This is why there has been a large reaction about this on the various MGUS web forums.Thirty-five percent is very high! At least one of our ChooseHope.com MGUS forum members was recently tested and found to have Celiac Disease and there are numerous other persons on the various MGUS forums alleging that they have this combination of conditions. In another publication from the database at PubMed.gov (Gut. 1976 Sep;17(9):735-9.), a study that showed that when a patient with MGUS and Celiac Disease was put on a gluten-free diet the monoclonal proteins entirely disappeared by the end of 3 years! Hence you can imagine what big news this is to all the MGUS patients, on the various online MGUS forums. Here is the suggestion that Celiacs might avoid becoming MGUS patients, that MGUS patients might perhaps avoid progression to multiple myeloma, and that multiple myeloma patients might have halted or slower progression of their disease, simply by being on a gluten-free diet! This is indeed big news! The ramifications of this are that everyone with Celiac Disease really should undergo testing for MGUS/Myeloma which can be associated with various autoimmune diseases, increased rate of osteoporosis, and neuropathy, or no symptoms at all! Likewise all MGUS patients should be tested for celiac disease, which again can be associated with various autoimmune diseases, increased rate of osteoporosis, and neuropathy, or no symptoms at all! Do you see the similarities? I am currently working on a letter to Blue Cross Blue Shield, informing them of the results of these studies and suggesting that their policy of reimbursing for celiac DNA testing of first degree relatives of known celiacs should be expanded to also include all persons having serum monoclonal proteins. This would include not just MGUS and multiple myeloma, but also Waldenstrom's macroglobulinemia. I would also like to call for intensified research on the link between celiac disease and paraproteinemia.
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Anti-tTG Serum Level Correlates to Degree of Intestinal Damage
Scott Adams posted an article in Latest Research
Journal of Clinical Gastroenterology 2003; 36(3):219-221 Celiac.com 03/28/2003 - A study by Antonio Tursi, M.D, et al, was recently conducted to evaluate the correlation between the degree of histologic intestinal damage in celiac patients and their level of positivity (serum value) to anti-tissue transglutaminase antibodies (anti-tTG). The study looked at 119 adult celiac patients who were diagnosed consecutively (47 men and 72 women; mean age, 28 years; range, 22-51 years), and were stratified for histologic damage according to Marsh classification. The final step was to compare their Marsh histologic intestinal damage classification with their anti-tTG serum values. Here are their results: Marsh I lesions were present in 13 patients (10.92%), Marsh II in 24 anti-tTG (20.16%), Marsh IIIa in 27 anti-tTG (22.68%), Marsh IIIb in 31 anti-tTG (26.05%) and Marsh IIIc in 24 anti-tTG (20.16%). Anti-tTG positivity was ranging from 1 of 13 anti-tTG (7.69%) in Marsh I lesions to 23 of 24 anti-tTG (95.83%) in Marsh IIIc lesions respectively (P The researchers conclude that the mean serum value in celiacs with severe enteropathy (Marsh IIIb-c lesions) was higher than in those with only slight enteropathy (Marsh I-IIIa). Further, serologic test results in the absence of histologic evaluation (biopsy) may "underestimate the real prevalence of celiac disease," thus delaying a proper diagnosis and putting patients at risk for a large variety of serious health problems.- 1 comment
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Serum I-FABP as Marker for Enterocyte Damage in Celiac Disease
Jefferson Adams posted an article in Latest Research
Celiac.com 03/22/2013 - Enterocyte damage is one of the common features of celiac disease, and often results in malabsorption. Presently, doctors don't know very much about the recovery of enterocyte damage and its clinical consequences. Serum intestinal fatty acid binding protein (I-FABP) is a marker that allows researchers to study enterocyte damage. A research team set out to determine the severity of enterocyte damage in adult-onset celiac disease, how it responds to a gluten-free diet, and the correlation among enterocyte damage, celiac disease autoantibodies and histological abnormalities during the course of disease. The research team included M. P. M. Adriaanse, G. J. Tack, V. Lima Passos, J. G. M. C. Damoiseaux, M. W. J. Schreurs, K. van Wijck, R. G. Riedl, A. A. M. Masclee, W. A. Buurman, C. J. J. Mulder, and A. C. E. Vreugdenhil. They are affiliated with the Department of Paediatrics & Nutrition and Toxicology Research Institute Maastricht (NUTRIM) at Maastricht University Medical Centre in Maastricht, the Netherlands. For their study, the team first determined I-FABP blood levels in 96 biopsy-proven adults with celiac disease, and in 69 patients following a gluten-free diet. They used 141 individuals with normal antitissue transglutaminase antibody (IgA-tTG) levels as a control group. They found that levels of I-FABP were related to the degree of villous atrophy (Marsh grade) and IgA-tTG. Patients with untreated celiac disease showed higher I-FABP levels (median 691 pg/mL) compared with control subjects (median 178 pg/mL, P < 0.001) and correlated with Marsh grade (r = 0.265, P < 0.05) and IgA-tTG (r = 0.403, P < 0.01). I-FABP blood levels in patients following a gluten-free diet dropped substantially, but not within the range found in control subjects, even though they showed normalization of IgA-tTG levels and Marsh grade. Celiac patients with elevated I-FABP levels who did not respond to gluten-free diet showed persistent histological abnormalities. The team's main finding was that enterocyte damage, as assessed by serum I-FABP, correlates with the severity of villous atrophy in celiac disease at the time of diagnosis. Even though enterocyte damage improves upon treatment with a gluten-free diet, the majority of patients still show substantial enterocyte damage despite the absence of villous atrophy and low IgA-tTG levels. Thus, they conclude that elevated I-FABP levels that do not respond to a gluten-free diet likely point to histological abnormalities and warrant further evaluation. Source: Aliment Pharmacol Ther. 2013 Feb;37(4):482-90. doi: 10.1111/apt.12194.- 2 comments
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Celiac.com 01/04/2013 - Currently, doctors must still use invasive techniques to distinguish between uncomplicated and complicated forms of celiac disease. In an effort to find a non-invasive approach to the issue, a research team recently set out to investigate the potential use of novel serum parameters, including IL-6, IL-8, IL-17, IL-22, sCD25, sCD27, granzyme-B, sMICA and sCTLA-4 in patients diagnosed with active celiac disease, celiac disease on a GFD, Refractory coeliac disease (RCD) type I and II, and enteropathy associated T-cell lymphoma (EATL). The research team included Greetje J. Tack, Roy L. van Wanrooij, B. Mary Von Blomberg, Hedayat Amini, Veerle M. Coupe, Petra Bonnet, Chris J. Mulder and Marco W. Schreurs. Their investigation revealed elevated levels of the pro-inflammatory IL-8, IL-17 and sCD25 in both active celiac disease and in refractory celiac disease, types I and II. They also found that RCDII patients displayed higher serum levels of soluble granzyme-B and IL-6 in comparison to active celiac disease patients. Furthermore, EATL patients showed higher levels of IL-6 as compared to all other groups. Otherwise, the team found no differences between RCDI and active celiac disease or RCDII. These novel serum parameters show distinct immunological differences in RCDII and EATL, compared with uncomplicated celiac disease and RCDI. Source: BMC Gastroenterology 2012, 12:159. doi:10.1186/1471-230X-12-159
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Celiac.com 06/24/2010 - Scientists have previously seen a nuclear fluorescence reactivity (NFR) pattern on monkey esophagus in sections which were exposed to celiac disease patients that were sera positive for anti-endomysium antibodies (EMA). Because of this prior knowledge, scientists created a new study to illustrate the NFR, to study NFR positive results in connection with gluten withdrawal, and also to assess the possible role of NFR in celiac disease follow-up's. For twelve months, scientists closely evaluated twenty untreated celiac patients, eighty-seven treated celiac patients, and fifteen healthy control subjects. Scientists incubated the sera of all 122 patients on monkey esophagus sections. The goal was to evaluate the existence of NFR by indirect immunofluorescence analysis. To asses the rate of NFR in culture supernatants, duodenal mucosa samples from treated celiac patients were challenged with gliadin peptides. Scientists evaluated the reactivity of NFR immunoglobulins (Igs) response to the nuclear extract of human intestinal cells. What they found was that serum NFR was visible in all untreated celiac patients and it persisted for up to 151 +/-37 days from gluten withdrawal. It reappeared in treated celiac patents when they did not stick to their dietary restrictions. Serum NFR was also present in two of the healthy control subjects. NFR presented itself before EMA, in culture supernatants of celiac intestinal mucosa that was challenged with gliadin peptides. The Igs responsible for NFR were labeled as, “IgA2 Subclass”. The NFR had different results than the EMA and anti-nuclear antibodies, although they reacted with two nuclear antigens of 65 and 49 kDa. Thus, a new auto-antibody named NFR, which is related to celiac disease, was depicted. In conclusion, the studies of NFR have demonstrated that NFR detection has potential to be used as a beneficial tool in monitoring compliance of a gluten-free diet, as it has the ability to diagnose slight dietary shifts pertaining to gluten. Source: Clinical and Experimental Immunology
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Elevated Serum Cytokines and Celiac Disease
Jefferson Adams posted an article in Diagnosis, Testing & Treatment
Celiac.com 11/11/2009 - Although doctors view celiac disease mainly as a gastrointestinal disease, it is now known to have widespread systemic manifestations. A team of researchers recently set out to define the nature and role of systemic cytokine levels in the pathophysiology of celiac disease. The research team was made up of John Sanil Manavalan, Lincoln Hernandez, Jayesh Girish Shah, John Konikkara, Afzal Jamal Naiyer, Anne Roland Lee, Edward Ciaccio, Maria Theresa Minaya, Peter H.R. Green, and Govind Bhagat of the Departments of Medicine and Pathology at Columbia University's College of Physicians and Surgeons. The team conducted multiplex cytokine assays on four different groups of adult patients: patients with active celiac disease; patients on a gluten-free diet with positive TTG IgA antibodies, patients on a gluten-free diet with negative antibodies; and those with refractory celiac disease. They then compared the results against the values in healthy adult controls. Patients with active celiac disease and those on gluten-free diet with positive antibodies showed substantially higher levels of pro-inflammatory cytokines, such as interferon-, interleukin (IL)–1, tumor necrosis factor–, IL-6 and IL-8, and also Th-2 cytokines such as IL-4 and IL-10, compared with normal controls and patients on a gluten-free diet without antibodies. One interesting finding was that patients following a gluten-free diet for under 1 year showed substantially higher levels of both pro-inflammatory cytokines and Th2 cytokines compared with the patients on gluten-free diet for more than 1 year. Moreover, the team noted a statistically significant association between levels of TTG IgA titers and serum levels of Th-2 cytokines IL-4 (p 0.001), IL-10 (p 0.001) and inflammatory cytokines such as IL-1 (p 0.001), IL-1 (p 0.005), and IL-8 (p 0.05). Journal of Human Immunology, 2009. j.humimm.2009.09.351- 2 comments
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Celiac.com 01/11/2007 – Researchers in Finland have determined that many patients with untreated celiac disease show the presence of intestinal endomysial autoantibodies (EmA), even in the 10-20% of cases where their serum EmA is negative. The researchers also believe that the negative serum EmA test in these cases is an indication of more advanced and long-standing celiac disease. Normally positive serum EmA is close to 100% accurate, however there is a subset of around 10-20% of patients where the test is negative even though they do have the disease. Dr. Katri Kaukinen and colleagues at the University of Tampere looked at 177 celiac disease patients and found that 22 were serum EmA-negative. A common theme among the 22 serum EmA-negative patients was that they were older and had more abdominal symptoms and other complications that indicated a more advanced stage of celiac disease than their serum EmA-positive counterparts. The research team found that even though the EmA antibodies could not be detected in the blood of these 22 patients, they could be detected in the small bowel mucosa in all of them, and none were detected in 20 control patients. Dr. Kaukinen and colleagues believe that the use of intestinal EmA antibody detection should be used in seronegative individuals who are suspected to have celiac disease. This study further supports Dr. Kenneth Fines use of IgA antigliadin antibodies in the stool to detect gluten sensitivity, and one has to wonder if the EmA antibodies, if detectable in the small bowel mucosa, would not also be detectable in the patient’s stool, and if so would that not be a much better and more cost-effective way to perform such a screening? Gut 2006;55:1746-1753.
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The following abstract was submitted to celiac.com directly by William Dickey, Ph.D., a leading celiac disease researcher and gastroenterologist who practices at Altnagelvin Hospital, Londonderry, Northern Ireland. Scandinavian Journal of Gastroenterology 2005; 40: 1240-3. Dickey W, Hughes DF, McMillan SA. Celiac.com 09/27/2005 - What does a positive endomysial antibody (EmA) test mean if the biopsy does not show villous atrophy? The authors studied 35 patients where this was the case. In the authors practice, these patients account for 10% of all EmA positives. Firstly, the lack of villous atrophy did not necessarily mean a normal biopsy: 14 patients had excess inflammatory cells (lymphocytes) consistent with a mild abnormality of gluten sensitivity. Secondly, many of these patients had typical celiac features: twelve had a family history of celiac, five had dermatitis herpetiformis and thirteen had osteopenia or osteoporosis on DEXA scan. After discussion, 27 patients opted to take a gluten-free diet from the first biopsy: 26 of these had clinical improvement. Seven of eight patients who persisted with a normal diet developed villous atrophy on follow-up biopsies. The authors conclude that a positive EmA result indicates gluten sensitivity even if biopsies do not show villous atrophy. While a biopsy remains important as a baseline reference, these patients should be offered a gluten-free diet to allow clinical improvement and prevent the development of villous atrophy. There may be no such thing as a "false positive" EmA, although the authors emphasise that the same conclusion cannot yet be applied to tissue transglutaminase antibody results.
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Eur J Gastroenterol Hepatol. 2002 Apr;14(4):425-7. Related Articles, Links Celiac.com 07/30/2004 - The following abstract of a study that was done in 2002 emphasizes the importance of vitamin supplementation in the treatment of many celiacs: Dickey W. - Department of Gastroenterology, Altnagelvin Hospital, Londonderry BT47 6SB, Northern Ireland. OBJECTIVE: Although coeliac disease is a disorder of the proximal small bowel, associated vitamin B12 deficiency has been reported. This study aimed to assess the prevalence of B12 deficiency in a large series of coeliac patients, and to exclude the possibility that it is due to associated autoimmune gastritis. DESIGN: Prospective routine measurement of serum B12 in coeliac patients, with investigations for pernicious anaemia/autoimmune gastritis in B12-deficient patients. SETTING: Gastroenterology department of a large district general hospital. INTERVENTIONS: If they were not taking vitamin B12 supplements already, patients had serum B12 measured before starting dietary gluten exclusion. Those with low levels also had gastric biopsies taken and plasma gastrin and serum gastric parietal cell and intrinsic factor antibodies measured. MAIN OUTCOME MEASURES: Prevalence of low serum B12, and presence or absence of indicators of pernicious anaemia/autoimmune gastritis in patients with low serum B12. RESULTS: Of 159 patients, 13 had low serum B12 at diagnosis. A further six had been receiving B12 replacement therapy for 3-37 years before diagnosis, giving an overall prevalence of 12% (19 patients). Only 2/19 patients had gastric corpus atrophy, one with intrinsic factor antibodies and the other with hypergastrinaemia. There was no relationship between low B12 and clinical characteristics. CONCLUSIONS: Low B12 is common in coeliac disease without concurrent pernicious anaemia, and may be a presenting manifestation. B12 status should be known before folic acid replacement is started.
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