Celiac Disease Research Articles

S2214 Should We Assess Bone Density After a Celiac Disease Diagnosis in Young Adults?

S2214 Should We Assess Bone Density After a Celiac Disease Diagnosis in Young Adults?

S2260 Efficacy and Safety of LatiglutinaseIn Celiac Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

S2260 Efficacy and Safety of LatiglutinaseIn Celiac Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Parathyroid Hormone and Osteocalcin as Criteria for Osteoporosis in Patients with Celiac Disease

Background: Osteoporosis is a disease that affects the entire skeletal system. It is characterized by the deterioration of the fine structural structure of the bone and the decline in bone mass, which ultimately leads to an increase in the bone's susceptibility to fracture. Celiac disease, often known as wheat allergy, is a single condition with numerous names. Celiac disease is a chronic autoimmune disorder that mostly affects the small intestine. It occurs when patients develop an intolerance to gluten, a protein found in foods including wheat, rye, and barley. Aim of the study: The objective of our study is to track the levels of osteocalcin and parathyroid hormone in the blood serum of patients diagnosed with celiac disease in Wasit Governorate, Iraq. We will be using Human Anti-Deamidated Gliadin Peptide IgG and IgA to diagnose celiac disease and evaluate the progress of bone health. Materials and methods: This study examined a total of 80 samples, consisting of 50 samples from individuals with celiac disease. The sample group included 19 males and 31 women. There are 30 control samples, with an equal number of samples for each sexes. Utilized an Enzyme-linked immunosorbent assay (ELISA) kit to quantify the levels of osteocalcin, parathyroid hormone, and Human Anti-Deamidated Gliadin Peptide IgG and IgA. Results: The study revealed that individuals with celiac disease had significantly higher levels of osteocalcin, parathyroid hormone, and Human Anti-Deamidated Gliadin Peptide IgG and IgA compared to the control group, with a statistical significance of p≤(0.05). Conclusion: The examined parameters serve as indicators of the development of health risks to the body and bone health in individuals with celiac disease.

Diagnosing celiac disease in children using oral manifestations

PurposeCeliac disease (CD) may be frequently undiagnosed due to the absence of characteristic gastroenterologic symptoms in many CD patients. Our objective was to diagnose CD by utilizing documented oral manifestations such as Recurrent Aphthous Stomatitis (RAS) and Molar-Incisor Hypomineralization (MIH).MethodsThe study comprised sixty children who presented with complaints of RAS lesions. The MIH group consisted of 40 children, while the control group comprised 20 children without MIH lesions, ranging in age from 7 to 13 years. After the dental examination, all children were given a questionnaire to assess whether they had any previous history of general symptoms related to CD. Following that, diagnostic testing for celiac disease were conducted, including serological tests such as Tissue transglutaminase IgA (tTG-IgA), Endomysium Antibody (EMA), and Total IgA, as well as genetic tests for HLA-DQ2 and HLA-DQ8.ResultsThe statistical analysis, conducted using Fisher’s Exact, Yates’ Continuity Correction, Fisher Freeman Halton, and Student’s t tests, revealed no significant differences between the groups (p < 0.05). Within the MIH group, 3 children exhibited border tTG-IgA values, while another 3 had positive tTG-IgA results. Two of these 6 children had also positive EMA and HLA results. Following a biopsy procedure, these two children were ultimately diagnosed with celiac disease (CD).ConclusionsIn this study, while children initially presented to the clinic with complaints of recurrent aphthous stomatitis (RAS), 2 children (5% of the MIH group) were diagnosed with CD shortly after the onset of MIH lesions. CD enhanced the likelihood of observing some oral manifestations particularly recurrent aphtous stomatitis and developmental enamel defects. We recommend that dentists be cautious about diagnosing CD when RAS lesions and DEDs and/or MIH lesions are present, whether or not other indications of this systemic disease exist.

Evaluation of the Level of Alkaline Phosphatase, Calcium, and Vitamin D3 in Patients with Celiac Disease

Background: Celiac disease, sometimes called wheat allergy, is multiple names for one disease. It is a long-term acquired autoimmune disease that primarily affects the small intestine, as individuals develop intolerance to gluten, which is found in foods such as wheat, rye, and barley. Aim of the study: Our study aims to monitor biochemical parameters such as alkaline phosphatase, calcium, and vitamin D3 as an indicator to monitor the progress of bone health in the blood serum of patients with celiac disease in Wasit Governorate/Iraq. Materials and methods: In this research, studied 80 samples, including 50 samples from patients with celiac disease of both sexes, 19 men and 31 women With 30 control samples for both sexes equally. used an Enzyme-linked immunosorbent assay (ELISA) kit to measure the concentrations of vitamin D3 and alkaline phosphatase, while a Cobas c111 device was used for calcium. Results: The results showed that the level of alkaline phosphatase increased more in patients with celiac disease than in the control group at p≤(0.05), while the concentrations of calcium and vitamin D3 decreased more than in the control group at p≤(0.05). Conclusion: The studied criteria contribute as indicators of developing health risks to the body and bone health in patients with celiac disease.

SARS-CoV-2 Vaccination Coverage in Italian Children with Celiac Disease

Background: Celiac disease (CD) is the most common multisystemic autoimmune disorder affecting the pediatric population. However, little data is available regarding SARS-CoV-2 vaccination coverage in pediatric patients with CD. This study aims to evaluate the adherence to national recommendations for SARS-CoV-2 vaccination in children and adolescents with CD and its variation over time. Methods: We retrospectively analyzed medical charts and electronic registry records of SARS-CoV-2 vaccination of patients aged 0–19 years diagnosed with CD in a tertiary center. The vaccination coverage was evaluated according to age groups (young children, children, and adolescents), considering the patients’ eligibility for vaccination at different times. Results: Among the 172 patients enrolled, 44.8% received at least one dose of the SARS-CoV-2 vaccine, showing no significant differences compared to the Italian population of similar age. Vaccination coverage demonstrated a progressive reduction after an initial peak (up to 65.5% in December 2021) concomitant with a gradual extension of vaccinable eligibility and falling SARS-CoV-2 infections. Histological diagnosis and the presence of other associated autoimmune diseases were associated with higher levels of adherence to vaccination. Conclusions: Adherence to the SARS-CoV-2 vaccination in young Italian children with CD was very low, while it was better in adolescents and patients with other associated autoimmune diseases. Vaccine hesitancy remains a concern, particularly among those diagnosed using the biopsy-sparing approach. Hesitancy increased during the pandemic period, suggesting the need for ongoing efforts to improve adherence to SARS-CoV-2 vaccination recommendations.

Comparison of the activity of IL-6 and IL22 as more inflammatory cytokines related to the pathogenesis of celiac disease between active and gluten-free diet patient

This study aimed to investigate the activity of anti-inflammatory IL-6 (aIL-6) and pro-regenerative IL-22 in celiac disease patients based on their dietary habits. By comparing cytokine levels between patients on active gluten-containing diets and those on gluten-free diets, we sought to elucidate the potential role of diet in modulating inflammatory responses and clinical outcomes in celiac disease. The study made use of an enzyme-linked immunosorbent assay (ELISA) to evaluate the serum levels of interleukins IL6 and IL22. This was performed on three different groups: Group 1, which consisted of 40 recently identified active celiac patients; Group 2, which included 20 patients following a gluten-free diet; and Group 3, which contained 40 apparently healthy individuals .the individuals included in the study had been previously confirmed as celiac patients through serology, specifically by detecting both anti-IgA and IgG antibodies against tTG and gliadin using indirect immunofluorescence. The findings revealed a notable difference in IL6 levels between the patient and control groups, with a P-value of 0.041. However, when the patient groups were compared using the least significant difference (LSD) method, there were no significant differences between Group 1 (G1) and Group 2 (G2) with a P-value of 0.101, and between Group 1 and Group 3 (G3) with a P-value of 0.720. Yet, a more pronounced difference was observed between Group2 and Group3,with a P-value less than 0.015.Regarding IL22 levels, there was a significant difference between the patient and control groups, with a P-value of 0.002. Further comparisons using the LSD method revealed no significant differences between Group 1 and Group 2, with a P-value less than 0.154. However, a highly significant difference was found between Group 1 and Group 3, with a P-value less than 0.01. Also, significant differences were observed between Group 2 and Group 3, with a P-value less than 0.012. In conclusion, there is important role of the inflammatory cytokines il-6 and il-22 in the inflammation of celiac disease and potential role for these cytokines in the pathogenesis and management of the disease. Adherence to a gluten-free diet appears to have a beneficial effect on modulating the inflammatory response and improving clinical outcomes in celiac disease..

Comparison of the Activity of IL-6 and IL22 as More Inflammatory Cytokines Related to the Pathogenesis of celiac Disease Between Active and Gluten-Free Diet Patient

This study aimed to investigate the activity of anti-inflammatory IL-6 (aIL-6) and pro-regenerative IL-22 in celiac disease patients based on their dietary habits. By comparing cytokine levels between patients on active gluten-containing diets and those on gluten-free diets, we sought to elucidate the potential role of diet in modulating inflammatory responses and clinical outcomes in celiac disease. The study made use of an enzyme-linked immunosorbent assay (ELISA) to evaluate the serum levels of interleukins IL6 and IL22. This was performed on three different groups: Group 1, which consisted of 40 recently identified active celiac patients; Group 2, which included 20 patients following a gluten-free diet; and Group 3, which contained 40 apparently healthy individuals .the individuals included in the study had been previously confirmed as celiac patients through serology, specifically by detecting both anti-IgA and IgG antibodies against tTG and gliadin using indirect immunofluorescence. The findings revealed a notable difference in IL6 levels between the patient and control groups, with a P-value of 0.041. However, when the patient groups were compared using the least significant difference (LSD) method, there were no significant differences between Group 1 (G1) and Group 2 (G2) with a P-value of 0.101, and between Group 1 and Group 3 (G3) with a P-value of 0.720. Yet, a more pronounced difference was observed between Group2 and Group3,with a P-value less than 0.015.Regarding IL22 levels, there was a significant difference between the patient and control groups, with a P-value of 0.002. Further comparisons using the LSD method revealed no significant differences between Group 1 and Group 2, with a P-value less than 0.154. However, a highly significant difference was found between Group 1 and Group 3, with a P-value less than 0.01. Also, significant differences were observed between Group 2 and Group 3, with a P-value less than 0.012. In conclusion, there is important role of the inflammatory cytokines il-6 and il-22 in the inflammation of celiac disease and potential role for these cytokines in the pathogenesis and management of the disease. Adherence to a gluten-free diet appears to have a beneficial effect on modulating the inflammatory response and improving clinical outcomes in celiac disease.

Optimising the Diagnosis of Adult Coeliac Disease: Current Evidence and Future Directions.

Coeliac disease is a common autoimmune disorder that affects nearly 1% of the general population. Current diagnostic strategies involve active case finding, serological tests, and endoscopy with biopsies. However, many patients with coeliac disease remain undiagnosed due to a wide gap between clinical guidelines and real-world practice in the diagnosis of adult coeliac disease. This highlights the need for increased education, training, and targeted quality-improvement interventions to optimise the diagnosis of coeliac disease.

Awareness and Knowledge of Celiac Disease Among the General Population in Saudi Arabia

Celiac disease (CD) is an immune-mediated systemic disorder affecting nutrient absorption triggered by both environmental (gluten) and genetic factors. This study aimed to determine the level of awareness and knowledge of CD among the general population of Saudi Arabia. A community-based online cross-sectional study was conducted between August and October 2022 to examine the awareness regarding signs, symptoms, complications, and treatment of celiac disease. Data were collected and analyzed from 1,675 participants distributed across the five regions in Saudi Arabia. Analysis shows that 65.1% of the participants were familiar with the symptoms of celiac disease, and 49.6% confirmed that symptoms, blood tests, and endoscopy are the best way to diagnose celiac disease. The mean awareness score for the study participants was 71.8 (SD 13.9), with 5.2% of the participants needed a better level of awareness. Having a family history of celiac disease was an important predictor of having a higher level of awareness of celiac disease (p&lt;0.001). The general public in Saudi Arabia demonstrates a moderate to high level of awareness of CD, emphasizing the need for extensive efforts to maintain high awareness of CD among the general public.

Issue Information

On the Cover: “Clinical presentation and factors associated with gluten exposure in children with celiac disease” Krueger, et al., 895‐904

Role the (IL1, IL6, and TNF) with Chronic Autoimmune Diseases in Mosul City / Iraq

Objective: Our study examined the relationship of the levels of cytokines IL1, 6, and TNF in three different immune diseases with age and Sex. Material and methods: The samples of the study were obtained from in Mosul city hospitals for the period from October 2023 to February 29, 2024. The study included 90 different medical cases suffering from immune diseases, 50 of whom were suffering from rheumatoid arthritis, 16 were suffering from erythematosus, and 24 were suffering from Celiac disease. The ages of the study participants were between 10 years and 65 years. Outcomes: Serum samples were examined for IL1, 6, and TNF using the ELISA technique. The results of ELISA revealed that Concentrations of Interleukins and TNF were low in all patients because the patients in the chronic phase of Autoimmune Diseases take treatment to reduce the cytokines which is hyperactive Therefore, cytokines concentrations appeared lower than standard concentrations. However, the results show a significant association between measuring IL-1 for a CD and measuring IL-6, TNF for an SLE among Autoimmune disease patients and their sex, and age. Conclusion: significance and impact of study: IL1, 6, and TNF are one of the most common cytokines on the globe. It has been connected directly or indirectly with various disorders, including autoimmune diseases. However, the link between IL1, 6 - TNF and Autoimmune Diseases is still controversial. Our results indicate that they play a possible role in the development of autoimmune diseases; however, more studies on a larger scale are required to confirm the results.

Processing untraditional healthy crackers formula by using sprouted flour mixes for children

This study aimed to improve the nutritional content of crackers made from a germinated flour mixture for children affected by Attention Deficit Hyperactivity Disorder (ADHD). Chemical, physical, and sensory properties of crackers processed from germinated grain composite flours (maize, quinoa, finger millet, and fenugreek seeds) were compared to 100% maize crackers. Chemical analysis revealed that germinated mixture flour crackers (GMFCs) were higher in ash (2.14–2.40%), fiber (1.26–1.75%), protein (5.59–8.31%), and energy (379.64–404.77 kcal/100g) but lower in carbohydrates (70.51–61.05%). Five cracker formulas were prepared. Formula F5 (75% maize, 10% millet, and 5% fenugreek) had the highest calcium, magnesium, and total phenolic content. Formula F3 (85% maize, 10% quinoa, 10% millet, and 5% fenugreek) had the highest iron content, while Formula F4 (85% maize, 20% millet, and 5% fenugreek) had the highest zinc content and antioxidant activity. Maize crackers exhibited higher color characteristics (L*, a*, and b*) compared to the other GMFCs. Mean sensory evaluation indicated that the GMFCs were generally accepted by panelists. Overall acceptability and taste of crackers in Formula F4 were preferred by the panelists, particularly with the increased ratio of millet flour. This study demonstrated the potential of composite flours from GMFCs to produce acceptable, healthy, and nutritious crackers. All cracker formulas significantly contributed to the recommended dietary allowances for key nutrients in children, compared to the control. Therefore, it is recommended to use the studied grains to develop healthy bakery products suitable for people with celiac disease and ADHD.Graphical abstract

Comprehensive Evaluation of Sibling Cases with Type 1 Diabetes

OBJECTIVE:Type 1 diabetes mellitus (T1DM) is a polygenic disease influenced by genetic, environmental, immunological factors.There are few studies regarding siblings with T1DM.We aimed to evaluate the presentation, diagnosis, follow-up, sociodemographic characteristics of sibling T1DM cases. MATERIAL AND METHODS:We retrospectively reviewed characteristics of sibling cases followed with T1DM between January 2005 and May 2017. RESULTS: The prevalence of T1DM sibling diabetes in our clinic was 5.9%.We included 17 siblings (a total of 34 cases) who had diagnosis and follow-up data. One of the siblings was a twin.There were no statistically significant differences between the ages at diagnosis, presenting symptoms, duration of symptoms before diagnosis, glucose/C-peptide values at diagnosis, average HbA1c values in the first five years of follow-up, or hospitalization rates in the first five-years post-diagnosis between the first and second diagnosed siblings.Despite having a child diagnosed with T1DM, 23.6% of families had a second child diagnosed with diabetic ketoacidosis.Variations in antibody positivity were observed among siblings, there were no similarities between celiac disease, Hashimoto's thyroiditis.Vitamin D levels were significantly lower in siblings diagnosed secondarily. CONCLUSION:Our study is significant for being conducted at a reference center with a high number of diabetes patients under follow-up, for filling a gap in the literature with a detailed evaluation of sibling cases with T1DM.It serves as a comprehensive pilot study examining the manner, order of diagnosis, clinical, laboratory, and follow-up data of siblings with diabetes.There is a need for prospective studies with a larger number of sibling cases to further explore this topic.

Role of resilience and social support in dietary adherence and alleviating celiac disease symptoms

Role of resilience and social support in dietary adherence and alleviating celiac disease symptoms

Is it necessary to screen for celiac disease in all children with intussusception?

Is it necessary to screen for celiac disease in all children with intussusception?

Role of Gluten-Free Diet on HbA1c Level in Children with Type 1 Diabetes Mellitus and Celiac Disease

Background: Due to autoimmune mechanisms, celiac disease (CD) may affect patients with type 1 diabetes mellitus (T1DM) more than the general population. Objectives: We evaluated the effect of a gluten-free diet (GFD) on HbA1c levels in patients with both type 1 diabetes and CD. Methods: In this cross-sectional study, biochemical and clinical information was gathered from 174 children with T1DM from January 2013 to January 2019. Results: We assessed 174 children with T1DM (93 girls and 81 boys). Celiac disease was diagnosed in 18 out of 174 cases (10.34%). Height and weight percentiles showed significant differences between children with CD and those without CD (P = 0.015 and P = 0.026, respectively). The average HbA1c in the celiac group was 8.61 ± 2.20 (95% CI: 5.1 - 12.1) prior to GFD therapy. HbA1c was assessed six and twelve months following the initiation of the GFD and was found to be 8.32 ± 1.46 (95% CI: 6 - 9.8) and 8.37 ± 1.67 (95% CI: 6.1 - 10.2), respectively. No significant change in HbA1c was observed before and after therapy (P = 0.501). Conclusions: Diabetic children with CD exhibit lower weight and height compared to those without CD. Gluten-free diet therapy in patients with CD did not affect HbA1c levels.

Beyond the Grain: Navigating the Intersection of Gluten-Free Diets, Celiac Disease, and Cardiovascular Health.

Celiac disease (CD) is a complex autoimmune disorder triggered by gluten exposure in genetically susceptible individuals. This scoping review explores the intricate relationship between CD and cardiovascular manifestations, aiming to understand the impact of gluten-free diets (GFD) on cardiac health. A comprehensive search resulted in four pertinent studies revealing structural and functional abnormalities in the cardiovascular system of untreated CD patients. Among patients who did not adhere to a GFD, electrocardiogram abnormalities such as prolonged QT intervals and increased predisposition to arrhythmias were noted. Studies identified a significant prevalence of CD in patients with dilated cardiomyopathy or myocarditis, suggesting a potential association. GFD and immunosuppression were shown to improve cardiac function and reduce arrhythmias in CD patients exhibiting cardiovascular manifestations. However, limitations such as small sample sizes and incongruous cohorts make it difficult to assess the direct impact of GFD interventions on cardiac health. Future research should prioritize larger, longitudinal studies to fully understand mechanisms and treatment strategies. This review emphasizes the intricate interplay between CD and cardiac health, emphasizing the importance of early detection, comprehensive management, and further research for optimal clinical outcomes.

Prevalence of Celiac Disease in Romania.

Celiac disease (CD) is an autoimmune disorder that targets the small intestine, triggered by the ingestion of gluten in genetically predisposed individuals, causing damage to the villi and impairing nutrient absorption. Despite increased awareness and improved diagnostic techniques, CD remains significantly underdiagnosed, with many individuals suffering from unexplained symptoms or misdiagnosed conditions. This study aims to investigate the prevalence and demographic characteristics of CD in a Romanian population using rapid diagnostic tests followed by histological confirmation. This cross-sectional study aimed to determine the prevalence of CD in Romania using the BIOHIT Celiac Quick Test among adult participants recruited from tertiary healthcare centers and medical institutions. The prevalence of CD was calculated by dividing the number of confirmed positive cases by the total number of participants, with further evaluation including endoscopy and histological examination for those with positive quick test results. To our knowledge, this is the first prospective study in Romania to assess the prevalence of CD using a serological test. Out of 713 participants from Romania, 9 tested positive for CD using a rapid diagnostic test, confirmed by histological examination, resulting in a prevalence rate of 1.26%. The mean age of the CD-positive group was significantly younger (30.3 years) compared to the general population (49.2 years), and they had a lower mean BMI (22.2 vs. 28.1). Most CD-positive patients were female (66.7%) and resided in urban areas (55.6%). Our study found the prevalence of CD in a Romanian population to be slightly higher than the global average, highlighting the effectiveness of rapid diagnostic tests followed by histological confirmation. The significant regional variability in CD prevalence suggests the need for further research into environmental, dietary, and genetic factors, along with enhanced awareness and improved diagnostic protocols to better manage and prevent long-term complications of CD.

Analysis of the Association between Eosinophilic Esophagitis and MASLD: Retrospective, Observational, Cohort Analysis of the National Inpatient Sample 2016-2020.

Eosinophilic esophagitis (EoE) is a chronic immune-mediated inflammatory condition. Associated pathologies for EoE are similar to those with metabolic-dysfunction-associated steatotic liver disease (MASLD). This study assesses whether an association exists between MASLD and EoE. We used National Inpatient Sample (NIS) 2020 data to identify adult patients. ICD-10 codes were used to identify patients with MASLD and EoE. The relationship between MASLD and EoE was assessed by multivariate analysis after adjusting for confounding factors, such as patient demographics, hospital characteristics, Charlson comorbidity index, obesity, obstructive sleep apnea (OSA), diabetes, hypertension (HTN), hyperlipidemia (HLD), inflammatory bowel disease (IBD), celiac disease (CD), gastroesophageal reflux disease (GERD), smoking, alcohol use, and irritable bowel syndrome (IBS). Out of 26 million patients, 4,820 had a diagnosis of EoE. The majority of the patients were between 18 and 44 years of age (47.82%), male (54.05%), had private insurance (50.1%), and were in the highest income quartile (29.25%). A higher incidence of MASLD was noted in the EoE group than those without (6.1% vs.2.9%, p<0.001). After adjusting for confounding factors, MASLD had 2.38 times higher odds of having EoE (95% CI-1.82-3.11, p<0.001). Other factors noted to be associated with higher odds of EoE included younger age, Caucasian race, IBS, GERD, IBD, and CD. Our study reports a novel finding that MASLD and EoE are associated. Future prospective studies are needed to confirm and understand the clinical significance of this relationship and how one disease affects the other.