Celiac Disease Research Articles

The Characteristics of Isolated Duodenal Bulb Coeliac Disease in Children: A Multicentre Retrospective Study.

A minority of patients with coeliac disease have mucosal pathology limited to the duodenal bulb. We aimed to describe the baseline characteristics of isolated duodenal bulb coeliac disease in children. In this retrospective multicentre study of paediatric patients diagnosed with coeliac disease, based on biopsies obtained separately from the duodenal bulb and distal duodenum, we evaluated the demographic, anthropometric, clinical, associated diseases and coeliac serology characteristics of the patients. Among the 586 children diagnosed with coeliac disease, 459 (78%) were classified as classic and 127 (22%) as isolated duodenal bulb coeliac disease-376 (64.2%) were female and the median age was 7 years (IQR 5-11). In multivariate logistic regression, scalloping of the duodenum (55.1% vs. 17.3%, p < 0.001, OR 4.7, 95% CI 2.8-8), growth impairment (9.8% vs. 9.4%, p = 0.012, OR 2.7, 95% CI 1.4-5.5) and baseline anti-tissue transglutaminase levels > 10 upper limit of norm (71.5% vs. 29.9%, p < 0.001, OR 4.5, 95% CI 2.8-7.2) were associated with a higher probability of having classic coeliac disease. Lack of growth impairment, anti-tissue transglutaminase levels > 10 upper limit of norm and duodenal scalloping are predictive of isolated duodenal bulb involvement, making duodenal bulb biopsies even more important during esophagogastroduodenoscopy for the diagnosis of coeliac disease.

Differential immune responses behind different celiac disease manifestations.

Differential immune responses behind different celiac disease manifestations.

Inflammatory Myopathies and Autoimmune Gluten-related Disorders: A Scoping Review of Pathophysiological Interconnections and Hypothesis.

Anecdotal reports describe patients with concurrent idiopathic inflammatory myopathy (IIM) and celiac disease (CeD) in whom the introduction of a gluten-free diet led to dramatic improvement of myositis. We first systematically reviewed all peer-reviewed publications on concomitant IIM and duodenal biopsy-verified CeD. The collected evidence was suggestive of associations between myositis disease activity and gluten exposure in some patients with IIM-CeD. To investigate possible explanations for the observations, an exploratory review of basic pathophysiological relationships between IIM and gluten-related disorders was performed using a combined strategy of systematic and non-systematic literature searches and forward and backward citation tracking. The investigations revealed close pathophysiological associations between IIM and the autoimmune gluten-related disorders CeD, dermatitis herpetiformis, and gluten ataxia. Common traits include shared genetic predisposition through HLA-DQ2.5/-DQ8, disease activity-associated autoantibodies, histopathological parallels with inflammatory cell infiltrates, and similarly distributed structural homologous transglutaminases (TGs). HLA-DQ2.5-restricted gluten-specific CD4+ T cells of a rare, uniform phenotype are reported in CeD and connective tissue disease. Expanded T-cell clones with identical phenotypes and CDR3β motifs indicate the presence of a continuous, antigen-driven T-cell response. The investigations revealed that the main components involved in the adaptive immune response in the CeD gut may be present in HLA-DQ2.5+/-DQ8+ IIM muscle. The collected evidence supports the notion that in some genetically predisposed patients with IIM, gluten may act as an exogenous antigen driving myositis. Further Research/Clinical Implications: To test the above hypothesis, clinical trials combined with immunological studies are needed. Meanwhile, the inclusion of HLA-DQ typing may be justified, and subsequent small-intestinal biopsies in HLA-DQ2.5/8+ individuals with IIM.

Gluten-free diet during pregnancy and pregnancy outcome: A retrospective cohort study.

A gluten-free diet (GFD) is becoming increasingly popular, especially among young females, and including those without diagnosed celiac disease (CD). Whether a GFD is appropriate during pregnancy remains unclear. Our primary aim was to evaluate the association of a GFD and neonatal birthweight and incidence of large for gestational age (LGA) and small for gestational age (SGA). Secondarily, we sought associations with other obstetric outcomes. The data was collected retrospectively from the Tampere University Hospital database. The study period was from January 2015 to April 2021. The diet information was obtained from self-reported questionnaires. All women following a GFD were included. A total of 79 had CD and 291 followed a GFD without CD diagnosis. The latter are referred to here as people without CD avoiding gluten (PWAG). A total of 456 omnivores were randomly chosen to constitute a control group. Outcomes were analyzed by comparing gluten-free groups to a control group. The median birth weight was higher in the GFD group compared to the controls (3533 vs. 3440 g, P < 0.003), but the incidences of SGA or LGA did not differ between the study groups. The incidence of pregnancy complications was comparable between the groups. Induction of labor was more frequent (aOR 1.52; 95% CI: 1.12-2.08), and the duration of labor was longer (aOR1.56; 95% CI: 1.18-2.06) in the GFD group, especially among PWAG. However, no difference in the cesarean section rate were found between the groups. In the present retrospective cohort study, a GFD did not appear to be associated with adverse pregnancy or neonatal outcomes.

The follow-up of patients with celiac disease.

The follow-up of patients with celiac disease.

Outcomes and complications of shoulder arthroplasty in patients with celiac disease: A large insurance claims matched cohort analysis

Outcomes and complications of shoulder arthroplasty in patients with celiac disease: A large insurance claims matched cohort analysis

Paediatric screening in Italy as a gateway to secondary prevention in type 1 diabetes.

Paediatric screening in Italy as a gateway to secondary prevention in type 1 diabetes.

Epidemiology of Pediatric Restless Leg Syndrome.

Epidemiology of Pediatric Restless Leg Syndrome.

Global aspects of celiac disease and food allergy.

Global aspects of celiac disease and food allergy.

Celiac disease biomarker quantification in human fluid microenvironment: A selective and ultrasensitive magnetosensing immunoplatform

Celiac disease biomarker quantification in human fluid microenvironment: A selective and ultrasensitive magnetosensing immunoplatform

Peptidomic insights into gluten peptide degradation: Exploring bacterial strains as a palliative strategy for celiac disease

Peptidomic insights into gluten peptide degradation: Exploring bacterial strains as a palliative strategy for celiac disease

Diagnostic potential of monocyte subsets, TNF-α, and IL-6 in pediatric celiac disease: A case-control study

Diagnostic potential of monocyte subsets, TNF-α, and IL-6 in pediatric celiac disease: A case-control study

Electrochemical tracking of gluten in marketed foods by using a recombinant antibody fragment based-platform.

Electrochemical tracking of gluten in marketed foods by using a recombinant antibody fragment based-platform.

Atopic dermatitis: Association of maternal and child history of celiac disease and the child's development of atopic dermatitis.

Atopic dermatitis: Association of maternal and child history of celiac disease and the child's development of atopic dermatitis.

Raman Hyperspectroscopy and Chemometric Analysis of Blood Serum for Diagnosing Celiac Disease in Adults

Celiac disease (CD) is a chronic autoimmune disorder triggered by an abnormal immune response to gluten, a protein found in wheat, barley, and rye. Current diagnostic methods, including serological assessments and biopsies, can be challenging due to the disease’s heterogeneous nature, creating a need for a reliable, noninvasive diagnostic approach. Here, in this study, we aimed to extend the Raman peak area ratios approach to the adult population. However, our findings indicate no significant differences in Raman peak area ratios between healthy and diseased adults based on blood serum samples. Nevertheless, genetic algorithm combined with partial least squares discriminant analysis (GA-PLS-DA) allowed differentiation with 92% sensitivity and 96% specificity at the spectral level in external validation. Receiver operating characteristic (ROC) analysis showed 100% classification at the donor level in external validation. These results demonstrate further that Raman spectroscopy, combined with chemometrics, is a promising, noninvasive tool for CD diagnosis.

Risk of new-onset type 1 diabetes in individuals with celiac disease and thyroid disease-An observational study.

The objective of this study was to compare the risk of developing type 1 diabetes in individuals with celiac disease, hyperthyroidism and hypothyroidism to that of individuals without those conditions. In this retrospective, observational, matched-cohort study based on real-world claims data, individuals with at least one diagnosis of celiac disease, hyperthyroidism (e.g. Graves' disease) or hypothyroidism (e.g. Hashimoto's disease) and a control cohort of individuals without any of these three conditions were included. Individuals from the disease and control cohorts were propensity score matched 1:1 based on baseline demographics and clinical characteristics. A Cox proportional hazards model was used to compare the risk of type 1 diabetes between cohorts. Type 1 diabetes developed in 0.14% (68/47 099) of individuals with celiac disease compared to 0.06% (27/47 099) of controls. Of those with hyperthyroidism, type 1 diabetes developed in 0.17% (281/164 830) compared to 0.06% (99/164 830) of controls. Of those with hypothyroidism, type 1 diabetes developed in 0.18% (1756/980 477) compared to 0.08% (764/980 477) of controls. The risk of developing type 1 diabetes was increased for each of the disease cohorts compared to their respective controls (celiac disease: HR = 2.54 [p < 0.0001]; hyperthyroidism: adjusted HR = 2.98 [p < 0.0001]; hypothyroidism: HR = 2.41 [p < 0.0001]); risk was highest among individuals aged <18 years. The risk of developing type 1 diabetes was significantly higher for individuals with celiac disease or thyroid disease compared to those without any of these conditions. These findings support the screening of individuals with these conditions for stage 2 type 1 diabetes.

Does A Dietitian-Led Celiac Disease Clinic (DLCC) Facilitate Timely Diagnosis and Nutrition Care for Patients With Celiac Disease?

Given lengthy diagnosis and treatment delays existed for adult outpatients with newly diagnosed celiac disease (CD), a dietitian-led celiac disease clinic (DLCC) was implemented in 2020. Under DLCC, the dietitian removed eligible patients from the gastroenterology waitlist and ordered pathology and endoscopy for CD diagnosis, and those with CD were given timely, regular dietetic education. This pretest/posttest study aimed to compare time to CD diagnosis and treatment, and the proportion of patients were offered gastroenterologist appointments between the previous (pre-DLCC) and the DLCC expanded scope (post-DLCC) clinics. Eligible patients were adults, referred to the gastroenterology dietitian between 2018 and 2021, with newly diagnosed CD. Demographic, medical, and appointment data were sourced from medical records. A satisfaction survey was administered to post-DLCC patients. Chi-squared and t-tests were used to compare groups. Fifty-four patients were eligible (69%F, 43 ± 15 years, 86% had anti-TTG > 20 U/mL, n = 33 post-DLCC). Time from gastroenterologist referral triage to treatment commencement was improved by 404 days from pre- to post-DLCC (p < 0.01) in those whose CD diagnosis was not led by nursing staff, with reductions observed in both time from referral triage to CD diagnosis and CD diagnosis to treatment (p < 0.05). These improvements were conservative given COVID-19 delayed services for most (n = 29/33) post-DLCC patients. Thirty-six percent fewer post-DLCC patients were offered gastroenterologist appointments (p < 0.01). All (100%) post-DLCC respondents reported satisfaction with the clinic. A DLCC expanded scope clinic may provide more timely diagnosis and treatment access for adult patients with newly diagnosed CD, with fewer requiring gastroenterologist appointments.

Role of Regulatory T Cells and Transglutaminase 2 Inhibitors in Celiac Disease: A Systematic Review

Role of Regulatory T Cells and Transglutaminase 2 Inhibitors in Celiac Disease: A Systematic Review

Diagnostic Yield of Video Capsule Endoscopy (VCE) in Celiac Disease (CD): A Systematic Review and Meta-analysis.

Celiac disease is an immune-mediated disorder triggered by the ingestion of gluten in genetically susceptible individuals. CD mainly involves the proximal small intestine and has diverse clinical features ranging from severe gastrointestinal symptoms to no symptoms. Diagnosis is based on CD-specific serology and small bowel biopsy. Video capsule endocopy (VCE) is a relatively safe method that provides high-resolution imaging of the entire small intestine mucosa. Today, VCE assists in CD diagnosis in many circumstances. We systematically searched the medical literature databases up to December 31, 2023, for English-language studies on CD diagnosis by the VCE. Our inclusion criteria comprised complete articles with extractable data and focused on the VCE yield of known celiac patients. Following data extraction, a Meta-Analysis was performed using Comprehensive Meta-Analysis Software (version 4; Biostat Inc., Englewood, NJ). We found 22 studies and 46 substudies published up to 31.12.2023 of VCE performed in CD and met our inclusion criteria. Together 1585 patients were studied, of whom 1253 (79.05%) were women. The average age of the patients was 51.94±9.98 SD. A complete small bowel investigation was achieved in 1533 (96.72%) of the patients. Any diagnostic pathology's effect size (ES) was 0.601, 95% CI: 0.518-0.678. Specific findings of villous atrophy, scalloping, mosaic pattern, fissuring, ulcers, or erosions were demonstrated with ES of 0.604, 0.571, 0.440, 0.445, and 0.252 of the cases, and as expected higher in refractory celiac disease. Our findings demonstrate pathognomonic features and supported CE diagnosis in about 60% of the patients.

Tofacitinib in the Treatment of Refractory Adult-Onset Still’s Disease Co-diagnosed With Celiac Disease: A Case Report

Tofacitinib in the Treatment of Refractory Adult-Onset Still’s Disease Co-diagnosed With Celiac Disease: A Case Report