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Showing results for tags 'study'.
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The Gluten Contamination Study We've Been Waiting For
Jefferson Adams posted an article in Additional Concerns
Celiac.com 10/14/2019 - One of the big debates among people with celiac disease concerns how vigilant celiacs need to be to make sure they avoid gluten. What does science say about gluten contamination in three common scenarios? How careful do you need to be about gluten contamination? For example, how likely are you to get gluten over 20ppm if you share a toaster, pasta water, or slice a cupcake with the same knife used to cut a non-gluten-free cupcake? A team of researchers recently set out to assess three common scenarios where people with celiac disease might reasonably fear gluten contamination. How did the actual risk for each situation measure up? Scenario 1: Water used to cook regular pasta is reused to cook gluten-free penne and fusilli. The gluten-free pasta is then rinsed and served. Scenario 2: Toasting Gluten-Free Bread in an Uncleaned Shared Toaster Gluten-containing bread is toasted in a toaster. Immediately afterward, gluten-free bread is toasted in the same toaster. Scenario 3: Slicing a Gluten-Free and Regular Cupcake with Same Knife The research team included Vanessa M. Weisbrod, BA; Jocelyn A. Silvester, MD PhD; Catherine Raber, MA; Joyana McMahon, MS; Shayna S. Coburn, PhD; and Benny Kerzner, MD. They are variously affiliated with the Celiac Disease Program, Children’s National Health System, Washington, DC, USA; and the Harvard Celiac Disease Program, Boston Children’s Hospital, Boston, MA. Their paper titled, Preparation of Gluten-Free Foods Alongside Gluten-Containing Food May Not Always Be as Risky for Celiac Patients as Diet Guides Suggest, appears in Gasterojournal.org. Control samples of gluten-free pasta, bread, and cupcakes all tested below the limit of detection. Samples were individually packaged in plastic bags with randomized sample numbers. To avoid “hot spots” and ensure even analysis, all items were homogenized for analysis. Gluten content was measured with R5 sandwich ELISA (R7001, R-Biopharm, Darmstadt, Germany) which has a limit of detection of 5 ppm gluten by Bia Diagnostics (Colchester, Vermont). All control samples were similarly tested. The team then quantified gluten samples as under 5ppm, 5-10ppm, 10-20ppm, or over 20ppm, and based their confidence intervals upon binomial distribution. Boiling Gluten-Free Pasta in Regular Pasta Water In the first scenario, the team boiled sixteen-ounce packages of gluten-containing Barilla brand penne and fusilli separately in stainless steel pots in fresh tap water for 12 minutes, then removed with strainers. The water was reused to cook Dr. Schar gluten-free penne and fusilli. The team also tested the effect of rinsing some samples of the cooked and contaminated pasta under cold tap water for 30 seconds. The team found that Gluten was detected in all pasta samples cooked in water used for gluten-containing pasta, ranging from 33.9ppm to 115.7ppm. The rinsed gluten-free pasta samples tested at 5.1 ppm and 17.5 ppm detectable gluten. Interestingly, rinsing pots with water alone after cooking gluten-containing pasta was as effective as scrubbing with soap and water to prevent detectable gluten transfer. Toasting Gluten-Free Bread After Non-Gluten-Free Bread In the second scenario, the team toasted regular gluten-containing bread in two rolling toasters in a busy hospital cafeteria at 20-minute intervals, or in one of three shared pop-up toasters. Immediately after toasting the gluten-containing bread, they toasted Dr. Schar Artisan White Bread. Gluten-containing crumbs were visible in all toasters. They team did not clean the toasters. The team found that toasting in a shared toaster was not associated with gluten transfer above 20ppm; the four samples with detectable gluten had levels ranging only from 5.1 ppm to 8.3 ppm gluten. Slicing a Gluten-Free Cupcake with Knife Used on Gluten Cupcake In the third scenario, the team used a knife to slice frosted gluten-containing cupcakes. The knife was then reused to slice a frosted gluten-free Vanilla Cupcake from Whole Foods Gluten-Free Bake House. The knife was then washed in soap and water, rinsed in running water, or cleaned with an antibacterial hand wipe (Wet Ones) and a new gluten-free cupcake was sliced. Both gluten-free cupcakes were analyzed for gluten content. Although 28/30 cupcake samples had detectable gluten transfer, only 2/28 tested over 20ppm. The team found that cutting cupcakes with a knife used to cut frosted gluten-containing cupcakes was associated with low-level gluten transfer even when crumbs were visible on the icing adhered to the knife. All three knife washing methods tested were effective in removing gluten. The team acknowledges the limitations of their study, including small sample size, etc. They are calling for further study to assess best kitchen practices for people with celiac disease who are trying to avoid gluten contamination in shared kitchens. Main Takeaways 1) Some kitchen activities may pose less of a risk of cross-contact with gluten than is commonly believed. 2) Standard washing effectively removes gluten from shared utensils. 3) Cooking gluten-free pasta in the same water as regular gluten-containing pasta is likely okay, as long as the pasta gets rinsed well. 4) Sharing a toaster is unlikely to result in gluten contamination. Read more in Gastrojournal.org Conflict of Interest Declaration: JAS has served on an advisory board of Takeda Pharmaceuticals and received research support from Cour Pharma, Glutenostics, and the Celiac Disease Foundation. The other authors have no conflicts of interest to disclose. Funding Source: Supported by philanthropic gifts from the Celiac Disease Foundation, Dr. SCHAR USA, and Bia Diagnostics. JAS is supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under Award Number K23DK119584.- 70 comments
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Celiac.com 06/22/2024 - Celiac disease is an autoimmune disorder where gluten ingestion damages the small intestine. Traditionally, diagnosis involves blood tests for specific antibodies and a confirmatory biopsy, an invasive procedure with associated risks. Research is exploring less invasive methods, including the use of tissue transglutaminase immunoglobulin A (TTG-IgA) antibodies as a potential predictor. Study Overview A recent study presented at Digestive Disease Week 2024 investigated the accuracy of TTG-IgA antibodies in diagnosing celiac disease without biopsy. The study looked at patients located at six U.S. sites who had undergone esophagogastroduodenoscopy (EGD) and TTG-IgA testing. Exclusions were made for prior celiac diagnosis, IgA deficiency, or adherence to a gluten-free diet to maintain result accuracy. Key Findings - Patient Demographics and Biopsy Results Among 4,312 patients, 27.5% showed villous atrophy, indicating celiac disease. These patients were typically younger (average age 41) and predominantly non-Hispanic white (89.5%). They had significantly higher TTG-IgA levels, averaging five times the upper limit of normal (ULN). Diagnostic Accuracy of TTG-IgA The study revealed that over a quarter of patients had elevated TTG-IgA levels. For any level above the ULN, sensitivity was 81.8%, and specificity was 95.7%. The positive predictive value (87.7%) and negative predictive value (93.3%) supported the test's overall accuracy, which was 91%. The area that was under the receiver operating characteristic curve (AUC) was 0.92, indicating high accuracy. High TTG-IgA Levels In patients with TTG-IgA levels of more than 10 times the ULN, only two out of 132 did not have villous atrophy, resulting in a false-positive rate of 0.1%. This suggests that very high TTG-IgA levels are a strong indicator of celiac disease and could potentially reduce the need for biopsy. Implications for Noninvasive Diagnosis Lead investigator Dr. Claire Jansson-Knodell noted the potential for TTG-IgA to serve as a noninvasive diagnostic tool, particularly for patients with very high antibody levels. However, caution is advised for cases with mildly elevated TTG-IgA, where diagnostic accuracy may not be sufficient to eliminate the need for a biopsy. Future Research The research team plans to conduct a prospective study to gather more data, aiming to confirm the practicality and reliability of using TTG-IgA as a noninvasive diagnostic tool in clinical practice. Conclusion This study suggests that TTG-IgA antibodies hold significant potential as a noninvasive diagnostic indicator for celiac disease, particularly in patients with very high antibody levels. While promising, further research is needed to validate these findings and ensure the accuracy and safety of using TTG-IgA as a standalone diagnostic tool. This could lead to a future where a simple blood test replaces the need for invasive biopsy in diagnosing celiac disease. Read more: gastroendonews.com
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Celiac.com 03/11/2024 - Celiac disease, a condition triggered by gluten sensitivity in genetically susceptible individuals, affects approximately 1% of the global population. Traditionally, diagnosing celiac disease involves a stepwise process, beginning with blood tests to detect antibodies against tissue transglutaminase (tTG), followed by an invasive duodenal biopsy to confirm the diagnosis. However, this biopsy procedure poses risks and discomfort to patients. Recent research has explored the feasibility of diagnosing celiac disease without the need for a biopsy, relying solely on serological markers. A team of scientists conducted a retrospective analysis of medical records from biopsy-diagnosed celiac disease patients. They specifically examined the correlation between the severity of intestinal damage, as assessed by Marsh grading, and levels of anti-tTGA antibodies in the blood. The research team included Parul Punia, Kiran Bala, Mansi Verma, Ankita Nandi, Parveen Mahlotra, Sunita Singh, Seema Garg, Aparna Parmar, and Devender Kumar. They are variously affiliated with the departments of Microbiology, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, IND; Microbiology, PGIMS, Rohtak, IND; Gastroenterology, PGIMS, Rohtak, IND; and Microbiology, bps khanpur gmch, Sonepat, IND. Severity of Marsh Lesions Corresponds to Anti-tTGA Antibody Levels Their study included 94 symptomatic celiac disease patients with available anti-tTGA antibody reports. Among these patients, those with more severe intestinal damage, categorized as Marsh grade 3 lesions, consistently exhibited higher levels of anti-tTGA antibodies. Remarkably, serum antibody levels exceeding ten times the upper limit of normal (ULN) were strongly associated with Marsh grade 3 lesions. These findings suggest that in symptomatic adults with celiac disease, the severity of intestinal damage may be accurately predicted using blood tests alone, without the need for invasive biopsies. Specifically, anti-tTGA antibody levels exceeding ten times the ULN could serve as a reliable indicator of Marsh grade 3 lesions. Adopting a non-biopsy approach to diagnose celiac disease could offer several benefits, including reduced patient discomfort, avoidance of procedural risks, and potentially faster diagnosis and initiation of treatment. However, further research and validation studies are warranted to confirm the reliability and effectiveness of this approach across diverse patient populations. In conclusion, the non-biopsy approach for diagnosing celiac disease represents a promising avenue for improving patient care, and diagnostic efficiency, in people with celiac disease. Read more at Cureus.com
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Celiac.com 03/13/2024 - Trichobezoar may sound like a term from a medical textbook, but for some individuals, it's a real and challenging condition. Imagine a solid mass forming in your stomach, composed of hair and food debris. This unusual condition, known as trichobezoar, is exceptionally rare, particularly in children. However, a recent case study has shed light on a unique connection between trichobezoar and celiac disease, emphasizing the importance of understanding these conditions and their treatment. A team of researchers present an unusual case involving the discovery of gastric trichobezoar in a 15-year-old girl who had undiagnosed celiac disease. The condition manifested after she experienced abdominal pain and pallor. Trichobezoar typically occurs in less than 1% of children, with most cases observed in young girls with psychiatric disorders. The condition arises from a compulsion to pull out hair (trichotillomania) and ingest it (trichophagia), leading to the accumulation of hair within the stomach lining. While trichobezoar is often associated with psychiatric conditions, its link to celiac disease is less common but noteworthy. In a recent case study, a 15-year-old girl presented with symptoms of trichobezoar, including abdominal pain, vomiting, and unexplained weight loss. Upon examination, doctors discovered a firm mass in her abdomen, along with signs of hair loss on her scalp. What made this case unique was the subsequent diagnosis of celiac disease, a condition characterized by an adverse reaction to gluten. Celiac disease is a chronic autoimmune disorder triggered by the ingestion of gluten, a protein found in wheat, barley, and rye. While the association between trichobezoar and celiac disease is unusual, researchers suggest two possible explanations. Firstly, deficiencies in iron and folic acid, common in individuals with celiac disease, may lead to behavioral disorders such as trichophagia. Secondly, celiac disease itself may directly contribute to the development of trichobezoar. Treatment for trichobezoar typically involves surgical removal of the mass, followed by psychological support to prevent recurrence. In cases associated with celiac disease, adopting a gluten-free diet is essential to manage symptoms and promote healing. This comprehensive approach addresses both the physical and psychological aspects of the condition, offering patients a chance at improved health and well-being. While trichobezoar and celiac disease are relatively rare on their own, their coexistence presents a unique challenge for patients and healthcare providers alike. By raising awareness of this uncommon association and emphasizing the importance of early detection and treatment, we can better support individuals living with these conditions. As medical research continues to advance, we hope to gain further insights into the complex relationship between trichobezoar, celiac disease, and other related disorders, ultimately improving outcomes for those affected. Read more at cureus.com The research team included Hassnae Tkak, Amal Hamami, Aziza Elouali, Nadir Miry, Amal Bennani, Houssain Benhaddou, Abdeladim Babakhouya, and Maria Rkain. They are variously affiliated with the Department of Pediatrics, University Hospital Mohamed V, Faculty of Medecine and Pharmacy, University Mohamed first, Oujda, MAR; the Department of Pediatrics, Mohammed VI University Hospital, Oujda, MAR; the Faculty of medicine and pharmacy of Oujda, Mohammed I University of Oujda, Morocco; Oujda, MAR; the Pathology department, Mohammed VI University Hospital; Oujda, MAR; the Histopathology department, Faculty of Medicine and Pharmacy, Oujda, MAR; the Department of Pediatric Surgery, Mohammed VI University Hospital, Oujda, MAR; the Service de Pédiatrie, CHU Mohammed VI, Oujda, Maroc. , Faculté de médecine et de pharmacie d'Oujda, Université Mohammed I d'Oujda, Maroc., CHU Mohammed Vi Oujda Morocco, Oujda, MAR; the Department of Pediatrics, Mohammed VI university hospital, Oujda, Morocco., Faculty of medicine and pharmacy of Oujda, Mohammed I University of Oujda, Morocco, Oujda, MAR; and the Pediatric Gastroenterology, CHU Mohammed Vi Oujda Morocco, Oujda, MAR.
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Celiac.com 02/26/2024 - A recent study, conducted by researchers Bodil Roth and Bodil Ohlsson, sheds light on the association between celiac disease and microscopic colitis, providing valuable insights into the clinical course, and subtypes of the disease in a female population. Microscopic colitis is characterized by chronic inflammation of the colon, and has long been linked to autoimmune conditions, smoking, and certain medications. Their study aimed to investigate this connection, considering various subtypes of microscopic colitis and their clinical presentations. The research, which involved 240 women aged 73 years or older diagnosed with microscopic colitis, revealed intriguing findings. Out of the 158 women who agreed to participate, half experienced the simultaneous onset of microscopic colitis and celiac disease. Notably, celiac disease was most prevalent in patients with lymphocytic colitis, with a significantly higher incidence compared to other subtypes of microscopic colitis. Analysis of blood samples also revealed the presence of anti-transglutaminase antibodies, a marker for celiac disease, in some participants with one episode of microscopic colitis. Moreover, corticosteroid use was more common in patients with collagenous colitis and refractory microscopic colitis, highlighting the diverse clinical manifestations of the disease. The study also explored the impact of smoking habits on the prevalence of microscopic colitis and associated symptoms. Past smokers showed a higher prevalence of one-episode microscopic colitis, while current smoking was associated with an increased likelihood of experiencing irritable bowel syndrome (IBS)-like symptoms. Significant Association Found Between Celiac Disease and Lymphocytic Colitis Upon adjusting for smoking habits, the researchers found a significant association between celiac disease and lymphocytic colitis, suggesting a potential link between these conditions. However, further research is needed to elucidate the nature of this relationship and whether lymphocytic colitis in conjunction with celiac disease should be classified as a distinct entity or a variant of celiac disease. These findings underscore the complex interplay between autoimmune conditions and gastrointestinal disorders, emphasizing the importance of comprehensive clinical evaluation and tailored management approaches. As researchers continue to unravel the intricacies of these diseases, advancements in diagnosis and treatment hold promise for improving the lives of individuals affected by celiac disease and microscopic colitis. Read more in BMC Gastroenterology volume 24, Article number: 70 (2024)
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Celiac.com 01/15/2024 - Celiac disease is a chronic autoimmune condition primarily affecting the small intestine due to gluten sensitivity. Celiac disease exhibits various extraintestinal features, with the pancreas being one of the affected organs. A team of researchers recently set out to provide a comprehensive overview of the pancreatic changes associated with celiac disease, with a particular focus on the exocrine aspect. The research team included Daniel Vasile Balaban, Iulia Enache, Marina Ciochina, Alina Popp, and Mariana Jinga. They are variously affiliated with the Department of Internal Medicine and Gastroenterology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Dr. Carol Davila Central Military Emergency University Hospital, Bucharest, Romania; the Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; and the National Institute for Mother and Child Health, Bucharest, Romania. While pancreatic endocrine changes in celiac disease, especially in relation to type 1 diabetes mellitus, have been extensively studied, the attention to the exocrine pancreas has been comparatively limited. The review addresses several facets of pancreatic involvement in celiac disease. Risk of Pancreatitis The review explores the connection between celiac disease and the risk of pancreatitis. Understanding this association is crucial for managing celiac patients effectively. Association with Autoimmune Pancreatitis The link between celiac disease and autoimmune pancreatitis is examined. Autoimmune pancreatitis is considered in the context of celiac disease, shedding light on potential shared mechanisms. Prevalence and Outcomes of Pancreatic Exocrine Insufficiency The prevalence and outcomes of pancreatic exocrine insufficiency are discussed concerning both newly diagnosed and gluten-free diet-treated celiac disease patients. The impact of gluten-free diet adherence on pancreatic function is a notable aspect. Link with Cystic Fibrosis The review delves into the association between celiac disease and cystic fibrosis. Understanding this link is essential for comprehensive care, especially when dealing with concurrent conditions. Mechanisms of Pancreatic Exocrine Impairment The mechanisms behind the associated pancreatic exocrine impairment in celiac disease are explored. This includes an understanding of the pathological processes leading to pancreatic changes. Recommendations for Clinical Practice The review concludes by highlighting recommendations for clinical practice. These recommendations encompass the need for assessing pancreatic involvement in celiac patients and recognizing concomitant pancreatic diseases. In summary, the review emphasizes that pancreatic alterations, encompassing both endocrine and exocrine aspects, are prevalent in celiac disease. Clinicians are urged to be vigilant for pancreatic involvement, and the recognition of concomitant pancreatic diseases in celiac patients is crucial for improving nutritional status and prognosis. Additionally, the review underscores the potential improvement in pancreatic function with a gluten-free diet, further emphasizing the importance of dietary management in celiac disease. Read more in World J Gastroenterol 2022; 28(24): 2680-2688
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Celiac.com 08/11/2023 - Celiac disease is a chronic autoimmune disorder marked by an immune-mediated response to gluten, resulting in small intestinal mucosal damage. Every so often, we share reports of individual cases that are relevant to celiac disease. Here, we share the case of a 52-year-old woman who was discovered to have celiac disease after being treated for extreme thrombocytosis and severe anemia. While gastrointestinal symptoms are commonly associated with celiac disease, atypical presentations can pose diagnostic challenges, particularly when hematological abnormalities are the primary manifestation. A team of clinicians report the case of a 52-year-old female patient who presented with unusual symptoms, including numbness in her hands and feet, extreme thrombocytosis, extreme thinness, severe anemia, high platelet count, and mild electrolyte imbalance. The Research Team The clinical team included Cuauhtemoc Jeffrey Soto, Lokeshwar Raaju Addi Palle, Mefthe Berhanu, Yordanos G. Negassi, Saima Batool, and Shaniah S. Holder. They are variously affiliated with the department of Research and Development at the Universidad Juarez del Estado de Durango, Mexico, the department of General Surgery, Hackensack Meridian Health-Palisades Medical Center, North Bergen, USA; the Department of Surgery, Kamala Children's Hospital in Chennai, India; the Health Science Department, University of Texas Health Science Center at Houston, Texas, USA; the department of Internal Medicine, Orotta, California, USA; the department of Internal Medicine, Hameed Latif Hospital in Lahore, Pakistan; and the department of Medicine, American University of Barbados School of Medicine in Bridgetown, Barbados. Physical examination of the patient showed nothing remarkable, except for notable thinness. The patient showed no gastrointestinal symptoms, and had no family history of gastroenterological diseases. Diagnostic tests, including blood tests and duodenal biopsy, confirmed the diagnosis of celiac disease with grade 4 Marsh 3C classification, even though the patient lacked typical gastrointestinal symptoms. Celiac Disease as a Cause of Thrombosis This case highlights the importance of considering celiac disease as a potential cause for atypical hematological manifestations, such as extreme thrombocytosis resulting from severe anemia. Prompt recognition and appropriate management, such as adhering to a gluten-free diet, can lead to symptom improvement and the resolution of hematological abnormalities. Identifying celiac disease even in the absence of typical gastrointestinal symptoms can lead to important treatment and improved quality of life for patients. Healthcare professionals need to be aware of such atypical presentations to ensure early diagnosis and better patient outcomes. Read more at cureus.com
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Celiac.com 01/13/2023 - Celiac disease is an autoimmune disorder in which gluten consumption triggers gut damage. The only effective treatment is a strict gluten-free diet. Can hookworms help celiacs eat gluten? The answer is yes and no, coupled with some trade-offs. Here's the rundown. Earlier studies have indicated that hookworm infection may restore some level of gluten tolerance in celiac patients, however, none of these approximately one dozen studies were placebo controlled. We've done a number of articles on hookworms and celiac disease. We've even done an article on health claims from at least one hookworm-infected celiac patient who claimed he was able to safely eat gluten. Can Hookworms Help Celiacs Eat Gluten? To get a more detailed answer, a research team recently undertook a randomized, placebo-controlled trial of hookworm infection in nearly sixty people with celiac disease. The team included John Croese, MD; Gregory C. Miller, FRCPA; Louise Marquart, PhD; Stacey Llewellyn, BSc; Rohit Gupta, FRACP; Luke Becker, BAppSci; Andrew D. Clouston, PhD; Christine Welch, FRACP; Julia Sidorenko, PhD; Leanne Wallace, BSc; Peter M. Visscher, PhD; Matthew L. Remedios, FRACP; James S. McCarthy, MD; Peter O'Rourke, PhD; Graham Radford-Smith, PhD; Alex Loukas, PhD; Mark Norrie, PhD; John W. Masson, FRACP; Richard B. Gearry, PhD; Tony Rahman, PhD; and Paul R. Giacomin, PhD. They are variously associated with the Department of Gastroenterology and Hepatology at The Prince Charles Hospital in Brisbane, Australia; the Center for Molecular Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australia; the Envoi Specialist Pathologists, Brisbane, Australia; the QIMR Berghofer Medical Research Institute, Brisbane, Australia; the Department of Gastroenterology, Townsville University Hospital, Townsville, Australia; the Institute for Molecular Bioscience at the University of Queensland, Brisbane, Australia; the Department of Gastroenterology and Hepatology, Royal Brisbane and Women's Hospital, Brisbane, Australia; the Gastroenterology and Hepatology, Logan Hospital, Brisbane, Australia; and the Department of Medicine, University of Otago, Christchurch and Canterbury District Health Board, Christchurch, New Zealand. Study Ran Nearly Two Years In a study that ran for just under two years, a research team of medical professionals treated celiac patients with with a placebo, or with either third stage larvae of the 20 or 40 Necator americanus hookworm (L3-20 group or L3-40 group). Patients then increased their gluten consumption to 5 grams per day for 12 weeks, 1 gram intermittent twice weekly for 12 weeks, and two grams sustained for six weeks, followed by liberal diet for 1 year. About forty to fifty percent of hookworm patients, and about fifty-five percent of placebo subjects made it to the main outcome point of 42 weeks, and hookworm-treated participants did show a sharp reduction in gluten-related events. Duodenal villous height: crypt depth deteriorated similarly compared with their enrollment values in each group, with an average change of −0.6 for the placebo group; -0.5 for the L3-20 group , −1.1 for the L3-40 group. A retrospective analysis showed that nearly one in four L3-treated participants failed to develop successful hookworm infection. Lower Quality of Life Scores for Hookworm Patients Between forty to fifty percent of participants in each group completed the study, but quality of life symptom scores after the gluten challenge were under forty percent in hookworm-positive participants, compared with over forty-five percent for the hookworm negative group. From their findings, the team concludes that hookworm infection DOES NOT restore gluten tolerance enough to allow sustained moderate consumption of gluten of two grams per day or more. However, hookworm infection did lead to better symptom scores after occasional consumption of lower doses of gluten. The findings undercut the idea that hookworm infection is some kind of magic bullet for gluten consumption for people with celiac disease. Hookworm Infection Not a Magic Bullet for Celiacs At best, the data support the idea that hookworm infection can help reduce symptoms of moderate gluten consumption in people with celiac disease, but that any reduction also likely comes with a lower overall quality of life score. This is the most definitive study we've yet seen on the effects of hookworm infection on the ability of celiac disease patients to tolerate gluten. The results are clear that any modest benefits of hookworm infection comes with some potential reduction in quality of life. Still, the ability of hookworms to help reduce symptoms of moderate gluten consumption in people with celiac disease merits further study. It's possible that hookworms hold some secrets in their biochemistry that might help to offer some extra protection against the inflammation triggered by limited gluten consumption. That is some exciting news. Read more at: Clin Transl Gastroenterol. 2020 Dec; 11(12): e00274.
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Celiac.com 01/09/2023 - Psoriasis is one of several skin conditions long associated with celiac disease. Several studies have found connections between psoriasis and celiac disease, but so far no study has shown a causal connection between these two autoimmune conditions. A new study shows that celiac disease patients face a higher risk of psoriasis, but not vice versa. Here's what they found. Genetic Study A team of researchers recently set out to explore the causal link between psoriasis and celiac disease with bidirectional 2-sample Mendelian Randomization (MR) study. The research team included Lin Li, Lixin Fu, Liwen Zhang & Yanyan Feng. They are affiliated with theDepartment of Dermatology, Chengdu Second People’s Hospital, Chengdu, Sichuan, China. The Psoriasis-Celiac Disease Connection The team set out to extract eligible instrument variables with genome-wide significance. To do so, the team used data from the published genome-wide association studies (GWAS) of the European population. They then performed sensitivity, post-MR, and inverse variance weighted (IVW) analyses. The MR analyses showed that genetically doubling the odds of celiac disease would increase the risk for psoriasis. Subsequent sensitivity analyses reinforced those results. Higher Psoriasis Risk for Celiac Patients However, the team's data showed that genetically determined psoriasis was not connected with the risk for celiac disease. This study offers new genetic evidence that celiac patients face an increased risk of psoriasis, while psoriasis patients face no higher celiac risk. For this reason, the team advises clinicians to be aware of the connections, and to closely watch for any psoriasis-associated skin symptoms in celiac patients, or in patients with celiac symptoms. This study offers another valuable insight into the many connections between celiac disease and the risk of other auto-immune conditions, and perhaps supports the idea that all non-genetically determined psoriasis patients should be screened for celiac disease. Read more at Scientific Reports volume 12, Article number: 21508 (2022)
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My wife was diagnosed a month ago with Celiac Disease and we pretty quickly developed tools and knowledge to eliminate any identifiable gluten from her diet. Her symptoms have rapidly abated but returned today in mild form with no apparent cause. We have carefully reviewed her food diary and decided to toss out some pre-mixed garam masala (spice mix). Do others have strategies for determining the cause of an apparent inadvertent 'glutening'?
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Celiac.com 07/19/2022 - The challenges of having celiac disease are numerous. A number of studies and articles have documented the many challenges faced by people with celiac disease in eating out, going to college, and more. Many people with celiac disease complain about difficulties in dating, or in finding suitable long term partners. Now, a new study is helping to shed some light on the nature of those challenges. To better understand the difficulties of navigating the social and dating landscape for people with celiac disease, a team of researchers recently set out to investigate dating-related behaviors in adults with celiac disease. The research team included Jessica Lebovits; Anne R. Lee; Edward J. Ciaccio; Randi L. Wolf; Rebecca H. Davies; Chloe Cerino; Benjamin Lebwohl; and Peter H. R. Green. They are variously affiliated with the The Celiac Disease Center, Columbia University Medical Center, New York, NY, USA; and the Program in Nutrition, Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY, USA. The team invited nearly 12,000 biopsy-diagnosed affiliates of the Celiac Disease Center at Columbia University to participate in an online survey. More than 5,000 opened the email, while 538 fully completed the survey, which included celiac-specific dating attitudes/behaviors questionnaire, a Social Anxiety Questionnaire (SAQ), a celiac-specific quality of life instrument (celiac disease-QOL), and a celiac disease Food Attitudes and Behaviors scale (celiac disease-FAB). Nearly nine in ten respondents of the questionnaire were female. Nearly half had dated with celiac disease, the vast majority, nearly seventy percent said that celiac disease had a moderate to major impact on their dating life. A major to moderate impact was more commonly reported among females, 23–35-year-olds, those with a household income under fifty thousand dollars per year, and those with a lower overall celiac disease QOL scores. Nearly forty percent reported being uncomfortable explaining their gluten-free dietary precautions to waiters, nearly thirty percent engaged in riskier eating behaviors, and more than two in five women and one in five men hesitant to kiss their partner because of celiac disease. The majority of celiacs who responded to the questionnaire felt that celiac disease had a major to moderate impact on their dating life. The affects can include hesitation toward dating and kissing, decreased QOL scores, greater social anxiety, and maladaptive eating attitudes and behaviors. Overall, the pressures of following a gluten-free diet have a major impact on dating and intimacy for people with celiac disease. The results of this study will likely not be news to people with celiac disease, especially those who have tried to date tor to maintain social relationships. Stay tuned for more on this and related stories. Read more in Digestive Diseases and Sciences
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Celiac.com 09/22/2017 - Misdiagnosed my sophomore/ junior year of High School, 3 years ago, with celiac disease, I became obsessed with the science of this ailment and how it was supposedly affecting me. I was shocked by how little is known about this autoimmune disease and the many gaps in research done on it. One such gap is that of cross-contamination in the household, where it is likely to have a daily impact on those following gluten-free diets. Because of this, I decided to help fill this gap in scientific knowledge with a manageable project based on cross-contamination in the home, asking whether one can share common kitchen cookware that is used with gluten containing foods, or if people, to help maintain a gluten-free diet, need designated ones for their food preparation. Either way that this research played out would be beneficial to the gluten-free community. For example, some families with members on gluten-free diets will spend a lot of money to buy all new ‘gluten-free' designated cookware and utensils to help minimize cross-contamination. Part of the relevancy of this project is economical, as designated cookware can be very costly. Despite the cost, other factors affect the value of this research, including the impracticality of having a double set of kitchen appliances, which would be very bulky and impractical for those with limited space. Another factor that influences the significance of this project is beyond one's home; celiac disease brings a lot of social stress. By assuring there is limited or no cross-contamination from common kitchen appliances after customary washing, these individuals would be able to have some confidence when eating at friends' or families' homes. On the other end, if this research shows that there is cross-contamination with shared supplies it will highlight the need for dedicated ones to maintain a strict gluten-free diet. Just because a gluten-free recipe is used, a given dish may not be genuinely gluten free if there is contamination from cookware. Hazards and Concerns To fully understand the hazards of gluten contamination, a few things must first be established: What is gluten? Who is it harmful to? How and to what extent must it be avoided? How does cross-contamination occur? What is Gluten? The United States Food and Drug Association (FDA) have been trying to define "gluten" for years. The current proposed definition is, "the proteins that naturally occur in a ‘prohibited grain' that may cause adverse health effects in persons with celiac disease."(1) These prohibited grains are any species belonging to triticum, hordeum and secale or more commonly called respectively: wheat, barley, and rye, though other prohibited grains exist as hybrids of any of the three.(2) That being said, not all proteins in these three types of grains are toxic to those with celiac disease as there are two parts to glutens: prolamins, the immunotoxic ones, and glutenins, the safe ones.(3) The prolamins in the three main prohibited grains, wheat, barley, and rye, are gliadin, hordein, and secalin.(4) Who Does Gluten Harm? Gluten is toxic to certain individuals with celiac disease, an autoimmune disease that also goes by the names of: coeliac disease, celiac sprue, nontropical sprue, and gluten-sensitive enteropathy.(5) A Thomson Healthcare Company study estimated that up to 1.5 Million Americans, or one in 133 people, have celiac disease, though other individuals avoid gluten as well, such as those with gluten intolerance, or other ailments where a gluten-free diet is believed to lessen their symptoms.(6) This strict abstention from gluten is because celiac disease cannot be cured, or mediated with medication as yet. The only way to help those affected is by following this strict diet. How and to What Extent Must it be Avoided? Foods that contain wheat, rye, and barley, or any hybrid of these grains contain gluten. Gluten is a very common protein in foods, whether from bread, or as an additive to provide a thicker texture, such as in soups. This versatility makes processed foods, in the eyes of those on gluten-free (gluten-free) diets, something to be wary of. Because of this caution, companies want their products to be certified gluten-free, which according to the FDA calls for Despite current unknowns regarding contamination, a strict gluten-free diet must exclude all foods that contain gluten and minimize cross-contamination. This means from eating out, to staying in, gluten must be avoided. Topical products where gluten is added, such as in some lotions or body washes, should also be avoided. Despite the widespread use of gluten there are gluten-free grains and foods, such as beans, rice, millet, corn, amaranth, and soy. How Does Cross-contamination Occur? Cross-contamination is a term usually directed toward accidental spread of bacteria due to not cooking food, washing hands or materials. However, in this article it refers to the accidental transfer or content of gluten, the protein that is toxic to those with celiac disease. In my personal experience and research on celiac forums, when a member of a family goes gluten-free the family will most likely continue eating a regular diet. In addition, as the average time it takes to be diagnosed from the first onset of symptoms is 10 years in the United States, these families have kitchen supplies that they have been using with gluten.(8) With little public knowledge about celiac disease and going gluten-free, people tend to overlook cross-contamination. Theoretically, in the simple act of making a sandwich with gluten-free bread there are many different ways for it to become contaminated. For example, from a shared jar of peanut butter or jelly with crumbs accidentally getting into it and then dipped out onto the gluten-free bread, or crumbs on the surface it's prepared on sticking to the gluten-free bread. Research Investigation The investigation of common kitchen appliances that are frequently exposed to gluten and cleaned by customary sanitation techniques calls for the conduction of an enzyme linked immunoassay (ELISA) test when using them to prepare gluten-free food. Various well used kitchen appliances, wood and plastic cutting boards, cast iron skillets, both seasoned and unseasoned, Teflon and aluminum pans, and ceramic and glass bowls were contaminated with gluten, using whole wheat flour slurry, and then washed by their standard cleaning technique, either scrubbing with hot soapy water, or wiping with a paper towel and water. Afterward a certified gluten-free substance, in this case millet flour, was added and let sit to allow adherence of any gluten remaining on the ‘cleaned' surface. Figure 1 illustrates the extraction solutions that were made from the samples and injected into the Microwell plates with the anti-body coating and the various washes of the ELISA test. Then, the gliadin, if present, bound to the walls of the wells due to its antibody coating and the wells were washed to eliminate remaining parts in the well. Next, the enzyme Horseradish Peroxidase, or HRP enzyme, adheres post-injection to any gliadin present as an amplifier and is again washed to remove extra parts. Lastly, a 3,3', 5,5'-Tetramethylbenzidine, or TMB substrate was added which turns blue in the presence of a peroxidase, in this case the adhered HRP enzyme, which can only be there if there was gliadin to attach to. This color after a acid stop solution, which turns it yellow, is added is then assessed using a Microwell plate reader for its absorbency which, when compared with a standards curve made from known samples, by the company, will be used to determine the gluten content, in parts per million, of all the samples individually. Results Intuition may lead one to think that well developed standard cleaning techniques for most appliances, and the difficulty in transferring proteins to a gluten-free medium from a surface that has been cleaned, will make gluten cross-contamination unlikely. However, due to factors such as porosity and oiliness, some surfaces may harbor gluten. Typically, far less rigorous cleaning techniques are used on the seasoned cast iron skillet and it is very porous and oily so the gluten proteins have a better chance of binding to it and then transferring to a gluten free medium. Given the test results of the ELISA test, this is mostly true. Despite the logic being the same, and it being the intuitive most likely candidate for cross-contamination a different appliance with the same sanitation technique proved to exceed the gluten parts per million limit where as the cast iron did not. The only absorbency ratings from the samples that interpolated to be greater than the 20 ppm of gluten allowance were two extractions from the Teflon pan. All other ratings, including two other Teflon pan extractions, were below the limit. Conclusion Ninety-four percent of the sample extractions showed less than the 20 parts per million of gluten which is the threshold for something to be declared gluten-free. Teflon had half of its extractions above the limit, as such Teflon should be deemed cross-contaminated. However, the Teflon's other extraction samples had well below 20ppm. This could have been due to the sample's gluten free sample being rather large and thus only part of it could have gotten contaminated (positive cross-contamination) and other parts not (negative cross-contamination). All others samples were classified as gluten-free due to being below the 20ppm allowance. In conclusion, the values of gluten cross-contamination, in ppm, were too small to hinder the integrity of the gluten-free medium in all but Teflon. Thus, to the extent of the experiment done, having tested only eight different kitchen appliances, with only two different sanitation techniques, common kitchen appliances that are frequently exposed to gluten, can be cleaned by customary methods and used to prepare gluten-free food with the exception of Teflon appliances. This research project could be extended by more trials. For example, eight types of common kitchen appliance were used, but only one appliance was used to represent each type. More trials could be done within each type, using different brands, variations in extent of wear, etc. In addition, the only type of contaminant used was whole-wheat slurry. Other forms of contaminant should be tested as well, to show the universality of the cross-contamination, or lack thereof. This should include different gluten-containing substances, as well as some dry and some wet. Unfortunately, this research question will have exceptions as the extent of washing and wear on an appliance is a more subjective issue. This means that even if it is found on a larger scale that certain appliances have been found to be safe for producing gluten-free foods, it should still be avoided when possible for those with celiac disease as if not washed properly; it could go beyond the 20ppm allowance and be immunotoxic to these individuals. Vested interest is always a concern with research, and thus it must be pointed out that no company or university holds any interest in this project and no help was given financially or academically, only that The University of Detroit Mercy allowed me to use their lab for the duration of the experiment and Microwell plate reader. In addition, both sides of the results would prove beneficial, so the data were not interpreted with a bias toward any desired result. Eleanore Dara is a "rising scientist" and is an incoming biochemistry student on a Research Track Major at the University of Scranton in Pensnsylvania. References: "Questions and Answers on the Gluten-Free Labeling Proposed Rule." U S Food and Drug Administration. N.p., 23 Jan. 2007. Web. 31 Jan. 2011. https://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/Allergens/ucm362880.htm Ibid. Amaya-González, et al. "Amperometric Quantification of Gluten in Food Samples Using an ELISA Competitive Assay and Flow Injection Analysis." Electoanaylsis 23.1 (2010): 108+. Wiley Online Library. Web. 8 Mar. 2011. "What Is Gliadin? What Is Its Role In Gluten Sensitivity?." Gluten Free Around The World, Traditional Foods Make Eating an Adventure. N.p., n.d. Web. 25 Mar. 2012. http://www.gluten-free-around-the-world.com/gliadin.html Snyder, Cara et al. "Celiac Disease Coeliac Disease, Celiac Sprue, Nontropical Sprue, Gluten-Sensitive Enteropathy." The National Center for Biotechnology Information. N.p., 3 June 2008. Web. 31 Jan. 2011. Cerrato, Paul L. "Gluten Intolerance: more common than thought. (Complementary Therapies Update)." RN 66.8 (2003): 23. General One File. Web. 28 Mar. 2011. "Questions and Answers on the Gluten-Free Labeling Proposed Rule." U S Food and Drug Administration. N.p., 23 Jan. 2007. Web. 31 Jan. 2011. https://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/Allergens/ucm362880.htm Adams, Scott. "USA - Average Time to Diagnosis = 10 Years - Celiac.com." Celiac Disease & Gluten-free Diet Information at Celiac.com. Scott Adams, 26 July 1996. Web. 16 Feb. 2012.
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Celiac.com 05/20/2013 - A team of researchers recently looked at the influence of various proteins on the quality of gluten-free bread formulas. Specifically, the team looked at the influence of different concentrates or isolates of protein on the structure, properties and aging of gluten-free bread. The research team included Rafał Ziobroa, Teresa Witczakb, Lesław Juszczakc, and Jarosław Korusa. They are affiliated with the Department of Carbohydrates Technology, the Department of Engineering and Machinery for Food Industry, and the Department of Analysis and Evaluation of Food Quality, at the University of Agriculture, in Krakow, Poland. For their study they made gluten-free breads from dough that included albumin, collagen, pea, lupine or soy protein. They then analyzed the rheological properties of the dough, and found that bread made with added test proteins showed major differences in its visco-elastic properties. Different flours had different effects on specific volume of the loaves. Soy protein and collagen reduced bread volume, while lupine and albumin significantly increased bread volume. In each case, the added proteins had a noticeable impact on the color and textural properties of bread crumbs. Most of the protein preparations significantly decreased hardness and chewiness of the crumb compared to the control sample. Overall, the dough that contained pea protein yielded bread with the most acceptable qualities. The study demonstrated that pea protein created the most acceptable flavor, color, smell and bread crumb in the final product. Soy protein proved to be the least acceptable of those tested, as it produced loaves with smaller volume and a compact structure. The results of this study show that adding pea protein can improve bread quality, and help to slow staling of starch based bread. Source: Science Direct
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Celiac.com 02/08/2022 - The numerous connections between celiac disease and diabetes have led many clinicians to screen diabetes patients for celiac disease, and vice versa. The case of a five year-old girl's recent celiac diagnosis during a diabetes study further highlights that connection. Shane and Staci Vogel, an Iowa couple with a family history of diabetes, enrolled their daughter Kemper, 5, and son Knox, 2, in Sanford Health's PLEDGE study, a large-scale screening of children under age 6 for type 1 diabetes and celiac disease. Fortunately, the study found no sign of diabetes in either child, but the process did lead to a celiac diagnosis for Kemper. Kemper didn't have any clear symptoms of celiac disease at the time of her diagnosis, the family quickly moved to rid their home of gluten ingredients, and get her on a gluten-free diet. Begun a year ago, with the modest goal of using a few clinics to test 1,000 children for diabetes and celiac disease, the PLEDGE project screened more than 2,000 children in its first year, study researcher Dr. Kurt Griffin told reporters. The PLEDGE study has grown from just a few clinics to over forty-two, Griffin said, including all of Sanford Health clinics in Sioux Falls, among others. According to Sanford's website, the study is now enrolling children under 6-years old, provided they are currently receiving annual checkups at Sanford Health, and are not diagnosed with type 1 diabetes. Sanford is offering the study at no cost to families. To learn more about the PLEDGE study and whether your child qualifies, call (877) 878-4825. Read more in the Sioux Falls Argus Leader
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Celiac.com 09/20/2021 - People with celiac disease face an increased risk of death, in part due to cancer. Most studies investigating this cancer risk involved patients diagnosed before widespread increases in celiac disease diagnosis rates and access to gluten-free food. A team of researchers recently conducted a population-based study to assess the risk of cancer for people with celiac disease. For their study, the team used the Epidemiology Strengthened by histoPathology Reports in a Swedish cohort to gather data from all celiac disease patients in Sweden, with celiac disease defined as duodenal/jejunal villus atrophy. They then matched each patient by age, sex, and county to five or fewer control subjects. Then, following patients from diagnosis until first cancer, or by December 31, 2016, they calculated hazards ratios using the stratified Cox proportional hazards model. Of nearly 50,000 celiac patients, 64% were diagnosed with celiac disease since 2000. After a median follow-up of 11.5 years, the incidence of cancer was 6.5 and 5.7 per 1000 person-years in celiac disease patients and controls, respectively. The risk of cancer rose overall, but it was most sharply elevated in the first year after celiac disease diagnosis, and not later on, although the risks of hematologic, lymphoproliferative, hepatobiliary, and pancreatic cancers remained. Risk levels were highest for people diagnosed with celiac disease after age 60 years of age, while those diagnosed before age 40 faced no such increase. Lastly, the cancer risk was similar among those diagnosed with celiac disease before or after the year 2000. The team's data showed an overall rise in cancer risk for celiac disease patients, even in recent years. However, the risk increase is only for those diagnosed with celiac disease after age 40, and then mostly within the first year of diagnosis. This is one of the first studies to give a solid picture of overall cancer risks for people with celiac disease. Stay tuned for more on this and related stories. Read more in Clinical Gastroenterology and Hepatology The research team included Benjamin Lebwohl; Peter H.R. Green; Louise Emilsson; Karl Mårild; Jonas Söderling; Bjorn Roelstraete; and Jonas F. Ludvigsson. They are variously affiliated with the Celiac Disease Center, Department of Medicine, Columbia University Medical Center, New York, New York; the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York; the Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden; the Department of Pediatric Gastroenterology, Queen Silvia Children’s Hospital, Gothenburg, Sweden; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; and the Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden. 12/06/2021 - A correction was made to the article "64% were diagnosed with celiac disease since 2000."
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Celiac.com 07/28/2016 - Celiac disease is an immune-mediated enteropathy triggered by gluten in genetically susceptible individuals. Researchers know that innate immunity plays a role in triggering celiac disease, but they don't understand the connection very well at all. Although previous in vitro work suggests that gliadin peptide p31-43 acts as an innate immune trigger, the underlying pathways are unclear and have not been explored in vivo. The research team included RE Araya, MF Gomez Castro, P Carasi, JL McCarville, J Jury, AM Mowat, EF Verdu, and FG Chirdo. They are variously affiliated with the Instituto de Estudios Inmunológicos y Fisiopatológicos (IIFP)(CONICET-UNLP), Facultad de Ciencias Exactas, Universidad Nacional de La Plata, La Plata, Argentina; the Catedra de Microbiología, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, La Plata, Argentina; the Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada; the Centre for Immunobiology, Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, Scotland, United Kingdom; and with the Instituto de Estudios Inmunológicos y Fisiopatológicos (IIFP)(CONICET-UNLP), Facultad de Ciencias Exactas, Universidad Nacional de La Plata, La Plata, Argentina. Their team observed that introduction of p31-43 into the gut of normal mice causes structural changes in the small intestinal mucosa consistent with those seen in celiac disease, including increased cell death and expression of inflammatory mediators. The effects of p31-43 were dependent on MyD88 and type I IFNs, but not Toll-like receptor 4 (TLR4), and were enhanced by co-administration of the TLR3 agonist polyinosinic:polycytidylic acid. Together, these results indicate that gliadin peptide p31-43 activates celiac-related innate immune pathways in vivo, such as IFN-dependent inflammation. These findings also suggest a common mechanism for the potential interaction between dietary gluten and viral infections in the pathogenesis of celiac disease, meaning that certain viral infections may pave the way for celiac disease to develop. Source: Am J Physiol Gastrointest Liver Physiol. 2016 Jul 1;311(1):G40-9. doi: 10.1152/ajpgi.00435.2015. Epub 2016 May 5.
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Celiac.com 09/26/2016 - Previous studies have indicated an increase in celiac disease rates in the United States, but these studies have been done on narrow populations, and did not produce results that are nationally representative. Researchers recently released an new comprehensive report, called, Time Trends in the Prevalence of Celiac Disease and Gluten-Free Diet in the US Population: Results From the National Health and Nutrition Examination Surveys 2009-2014. The research team included Hyun-seok Kim, MD, MPH; Kalpesh G. Patel, MD1; Evan Orosz, DO; Neil Kothari, MD; Michael F. Demyen, MD; Nikolaos Pyrsopoulos, MD, PhD, MBA; and Sushil K. Ahlawat, MD. They are variously affiliated with the Division of Gastroenterology and the Department of Medicine at Rutgers New Jersey Medical School in Newark. Using data from the National Health and Nutrition Examination Surveys, a team of researchers recently examined current trends in both celiac disease rates, and gluten-free diet adherence. Currently, far more people follow a gluten-free diet than have celiac disease. The numbers of people eating gluten-free food far outpace the levels of celiac disease diagnosis. This may be due to perceptions that the diet is healthier than a standard non-gluten-free diet. This research teams recent surveys examine the current trends in the prevalence of celiac disease and adherence to a gluten-free diet, including people without celiac disease, using nationally representative data from the National Health and Nutrition Examination Surveys (NHANESs) 2009-2014. The study evaluated 22,278 individuals over the age of 6 who completed surveys and blood tests for celiac disease. The subjects were interviewed directly regarding their prior diagnosis of celiac disease and adherence to a gluten-free diet. The researchers found that 106 (0.69%) individuals had a celiac disease diagnosis, and 213 (1.08%) followed a gluten-free diet but didn't have celiac disease. These results correlate to an estimated 1.76 million people with celiac disease, and 2.7 million people who follow a gluten-free diet without a diagnosis of celiac disease in the United States. Overall, the researchers found that the prevalence of celiac disease has remained steady (0.70% in 2009-2010, 0.77% in 2011-2012, and 0.58% in 2013-2014), however, those who follow a gluten-free diet but don't have celiac disease have increased over time (0.52% in 2009-2010, 0.99% in 2011-2012, and 1.69% in 2013-2014). The researchers conclude that the two might be related, as the decrease in gluten consumption could contribute to a plateau in those who are being diagnosed with celiac disease. Source: JAMA Intern Med. Published online September 06, 2016. doi:10.1001/jamainternmed.2016.5254
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More Than Half of Human Gut Bacteria Could Be Harmed by Glyphosate
Scott Adams posted an article in Latest Research
Celiac.com 12/07/2020 - A team of researchers has established the first bioinformatics method to determine and test the potential biological sensitivity of living organisms to glyphosate, the chemical in the herbicide commercially marketed as Roundup. Their research shows that glyphosate may negatively affect more than half of bacteria strains that make up the human gut microbiome. The research team included Lyydia Leinoa,Tuomas Talla, Marjo Helandera, Irma Saloniemia, Kari Saikkonen, Suvi Ruuskanena, and Pere Puigbòacd. They are variously affiliated with the Department of Biology, University of Turku, Turku, Finland, the Biodiversity Unit, University of Turku, Finland, the Nutrition and Health Unit, Eurecat Technology Centre of Catalonia, Reus, Catalonia, Spain, and the Department of Biochemistry and Biotechnology, Rovira i Virgili University, Tarragona, Catalonia, Spain. The team managed to identify the enzyme targeted by the broad-spectrum herbicide, glyphosate, and offers the first bioinformatics method for determining potential glyphosate sensitivity. Glyphosate targets an enzyme called 5-enolpyruvylshikimate-3-phosphate synthase (EPSPS) in the shikimate pathway, which synthesizes three essential aromatic amino acids (phenylalanine, tyrosine and tryptophan) in plants. "Based on the structure of the EPSPS enzyme, we are able to classify 80-90% of microbial species into sensitive or resistant to glyphosate," says Docent Pere Puigbò, developer of the new bioinformatics tool. Glyphosate has been regarded as safe to use because shikimate pathway is found only in plants, fungi and bacteria. However, the widespread use of glyphosate may reduce the diversity and composition of microbial communities, including the human gut microbiome. The team's new method has allowed them to create a dataset of EPSPS sequences from thousands of species that will enable major research advances. The method resulted in the classification of sequences from nearly 90% of eukaryotes and more than 80% of prokaryotes. Analysis made with the team's new bioinformatics tool shows that more than half of the human core gut bacterial species are potentially sensitive to glyphosate. "This groundbreaking study provides tools for further studies to determine the actual impact of glyphosate on human and animal gut microbiota and thus to their health," explains Docent Marjo Helander. Read more at the Journal of Hazardous Materials- 8 comments
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Celiac.com 06/22/2020 - Since 2004 data collected prospectively by The Environmental Determinants of Diabetes in the Young (TEDDY) study group has helped researchers to better understand T1D, and associated autoimmune conditions, like celiac disease. TEDDY is funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Celiac disease and T1D share a number of genetic factors. Seeking to explain why some children with high-risk genes develop T1D or celiac disease, while most do not, the TEDDY team monitors study subjects for both T1D and celiac disease. TEDDY research has already shown that genetically predisposed children who eat gluten at, or above, certain levels in early childhood, had higher rates of celiac disease. "An interesting finding from TEDDY has been how early the autoimmune destruction of insulin-producing cells begins–often in the initial two years of life," said study TEDDY co-chair Marian Rewers, MD, PhD, a professor of pediatrics and medicine and executive director of the Barbara Davis Center for Diabetes at the University of Colorado School of Medicine. The TEDDY study follows infants with high T1D risk factors for 15 years to look for certain beta-cell autoantibodies and diabetes. TEDDY has also looked at biomarkers that indicate faster or slower progression to diabetes after autoimmune destruction begins. "While T1D and celiac disease share a lot of genetic characteristics, there are intriguing differences in the ways these diseases develop and progress," says Dr. Rewers, adding that "TEDDY research and discovery will help drive the "design of future trials to prevent both T1D and celiac disease." TEDDY is looking to uncover viruses and nutritional factors that work with genes to initiate destruction of the beta cells by the immune system, which is signaled by the appearance of islet autoantibodies. Ultimately, TEDDY investigators are looking to uncover a way to prevent both diabetes and celiac disease in children. The latest information from TEDDY highlights potential "triggers" for the autoimmune process that generates type 1 diabetes (T1D), and how those triggers engage in children with with genetic risk factors for T1D. That information is highlighted in the "Update from the TEDDY Study" symposium today at the American Diabetes Association's (ADA's) 80th Virtual Scientific Sessions. Among TEDDY's latest findings are two new papers, Longitudinal Metabolome-Wide Signals Prior to the Appearance of a First Islet Autoantibody in Children Participating in the TEDDY Study; and Distinct Growth Phases in Early Life Associated With the Risk of Type 1 Diabetes. Read the original press release at PRNewswire.com. Stay tuned for more on TEDDY and related stories.
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Celiac.com 05/25/2020 - A food survey in India found that ten percent of grain-based foods labelled "gluten-free," and more than one-third of products that are "naturally gluten-free," have been found to be contaminated with gluten, with some products testing at 90 times permitted gluten levels. Gluten contamination is a serious and potentially dangerous problem for people with celiac disease, since gluten consumption by celiacs triggers an immune reaction that damages the small intestine, and can lead to serious health complications over time. For people with gluten or wheat allergies, gluten consumption can trigger serious allergic reactions, including anaphylactic shock, and potentially death. A research team at the National Institute of Nutrition (NIN) in Hyderabad, India bought 160 grain-based food products, including RTE foods, flours, grains, from regional retail shops and online grocers. They then analyzed these products for gluten content. A total of 51 products were labelled "Gluten-Free," while 109 were naturally gluten-free, and supposedly contained no added gluten, including dahl, millet, quinoa, buckwheat, oats, etc. Tests showed that many of these products labelled "Gluten-Free" contained gluten at levels above the legal limit of 20 ppm the Food Safety and Standards Authority of India (FSSAI). Other products contained gluten at levels above 200 ppm for products labelled "Low-Gluten." The team's analysis showed that nearly 40% of naturally gluten-free products and 10% of food products labelled "Gluten-Free" contained gluten levels above legally permitted limits. One of the biggest culprits was oats, with almost 85% of oat products showing gluten levels above 20ppm, and the most contaminated sample clocking in at 1,830ppm of gluten, over 90 times the permitted levels. Flours labelled "Gluten-Free" are "still risky no matter the source though - nearly 70% of the local brands, 30% of the flour mill samples and 13% of the branded samples were contaminated, likely due to cross-contamination from the usage of common collection bags, utility areas or handling procedures with wheat flour." Of the naturally gluten-free products, rice (44%), ragi (32%) and sorghum (20%) all showed significant levels of gluten contamination, as did all four samples of gram flour. By contrast, for products labelled "Gluten-Free," the biggest problem was seen in from multigrain products, with high gluten levels seen in 25% of those products. The team found no gluten contamination in branded rice, ragi or sorghum, but did find contamination in branded millets and gram flour, said principal investigator Dr Devindra. The safest products in this study turned out to be buckwheat, quinoa, pulses, millets and soy, none of which showed elevated gluten levels. Products labelled "Gluten-Free" were generally safer than those which are "naturally gluten-free." Prior studies have shown that celiac disease rates in India may be higher than 1% previously reported. In India, as in many countries, many people rely on naturally gluten-free foods to treat celiac disease and lower the financial costs of a gluten-free diet. That makes the revelations about the dangers of "naturally gluten-free" foods even more disturbing. The problem of gluten contamination in gluten-free foods is not limited to India, as Australia, Brazil, UK, and the United States have all had similar reports about gluten contamination in our otherwise gluten-free food supply chain. Contaminated products could be one reason that so many people with celiac disease, who are trying to follow a gluten-free diet, are exposed to gluten on a regular basis. Read more in Food Additives & Contaminants: Part A; Volume 37, 2020 - Issue 4
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