Ingestion Of Gluten Research Articles

Farmer vs. Industrial Practices: Impact of Variety, Cropping System and Process on the Quality of Durum Wheat Grains and Final Products.

The consumption of artisanal and organic pasta made on-farm from ancient varieties is increasing in France. Some people, namely, those suffering from digestive disorders following the consumption of industrial pasta, consider these artisanal pasta to be more digestible. Most of them have linked these digestive disorders to the ingestion of gluten. We analyzed in this study the impact of industrial and artisanal practices on the protein quality of durum wheat products. The varieties recommended by the industry (IND) were compared to those used by farmers (FAR): the FAR being on average much richer in protein. However, the solubility of these proteins analyzed by Size Exclusion-High Performance Liquid Chromatography (SE-HPLC) and their in vitro proteolysis by digestive enzymes vary little between the two groups of varieties, while differences between varieties in each group are observable. The location of grain production and the tested cropping systems (zero vs. low input) have a low impact on protein quality. Yet, more contrasting modalities should be studied to validate this point. The type of production process (artisanal vs. industrial) is, among those studied, the factor having the greatest impact on protein compositionPasta produced by the artisanal method contains a higher sodium dodecyl sulfate (SDS)-soluble protein fraction and are more in-vitro proteolyzed. Whether these criteria are indicative of what happens during a consumer's digestion remains to be determined. It also remains to be assessed which key stages of the process have the greatest influence on protein quality.

Evaluation of a Single Determination of Gluten Immunogenic Peptides in Urine from Unaware Celiac Patients to Monitor Gluten-Free Diet Adherence.

Usually, adherence to the gluten-free diet (GFD) in celiac patients is indirectly assessed through serological analysis, questionnaires, or invasive methods such as intestinal biopsy. The detection of gluten immunogenic peptides in urine (urinary gluten immunogenic peptides-uGIP) is a novel technique that directly evaluates the ingestion of gluten. The aim of this study was to evaluate the clinical efficacy of uGIP in the follow-up of celiac disease (CD). From April 2019 to February 2020, CD patients reporting complete adherence to the GFD were prospectively enrolled but were unaware of the reason for the tests. Urinary GIP, the celiac dietary adherence test (CDAT), symptomatic visual analog scales (VAS), and tissue transglutaminase antibodies (tTGA) titres were evaluated. Duodenal histology and capsule endoscopy (CE) were performed when indicated. A total of 280 patients were enrolled. Thirty-two (11.4%) had a positive uGIP test (uGIP+). uGIP+ patients did not show significant differences in demographic parameters, CDAT, or VAS scores. The tTGA+ titre was not related to the positivity of uGIP (14.4% vs. 10.9% in patients with tTGA+ and tTGA-). Regarding histology, 66.7% of the GIP+ patients had atrophy compared to 32.7% of the GIP patients (p-value 0.01). However, the presence of atrophy did not correlate with tTGA. Mucosal atrophy was detected in 29 (47.5%) out of 61 patients by CE. With this method, no noticeable dependence on uGIP results (24 GIP- vs. 5 GIP+) was observed. The single uGIP test was positive in 11% of CD cases referring a correct GFD adherence. Furthermore, uGIP results significantly correlated with the duodenal biopsy, formerly considered the gold standard for assessing CD activity.

Cognitive Impairment in Celiac Disease Patients: Scoping Review Exploring Psychological Triggers in a Chronic Condition

Celiac disease (CD), also known as gluten-sensitive enteropathy, is an inflammatory autoimmune reaction triggered by ingestion of gluten in genetically predisposed subjects. Celiac disease is often associated with a wide range of disorders, caused by immune responses and by malabsorption with subsequent nutritional deficiencies. Prevalent neurologic manifestations are ataxia, epilepsy, cerebral calcification, cerebral white matter lesions, peripheral neuropathy and myopathy, but also cognitive impairment. The study aimed to identify emerging and urgent research domains in order to establish a CD-specific patient-tailored protocol that includes both psychological and neuropsychological evaluations. We performed a systematic search of MEDLINE, PubMed, SCOPUS, Web of Science and Cochrane library in November 2022. We conducted a descriptive analysis of the characteristics of the included literature. Based on the exclusion/inclusion criteria, a total of seven articles were included in the scoping review process. This review demonstrated the lack of research on CD-related cognitive impairment key features and tries to focus on both cognitive and psychological manifestations as well as their two-way interaction. We tried to establish the specific areas involved, in order to have a comprehensive view of this condition and trying to determine a correct way of assessing CD cognitive impairment and its correlations with psychological distress and personal coping skills to a chronic condition. Nevertheless, research on this topic is progressively increasing and future studies should address specific key points.

Gluten and anxiety: a difficult balance in people with celiac disease

Introduction Celiac disease (CD), triggered by gluten ingestion, occurs in people genetically predisposed to develop this chronic autoimmune condition. The triggering environmental factor, gluten, is known as a protein present in wheat, rye and barley. In recent decades, specialists have found more knowledge about the disease mechanisms, how it develops and other disturbances which accompany it. The CD was considered a pediatric main gastrointestinal disorder, associated with symptoms of abdominal pain, diarrhea, constipation and bloating, and characterized by damage to the villi of the small intestine. People with CD may experience anemia, fatigue, osteopenia or osteoporosis, bone fracture, neurological and psychiatric problems beside anxiety as depression, ataxia, neuropathy. However, the results of several studies conducted on the fact that people with CD have an increased level of anxiety are mixed.ObjectivesThe present work is highlighting the importance of observing the anxiety levels in people diagnosed with CD beside the suitable interventions in reducing it.MethodsFor our study scientific databases were screened using certain keywords and combinations of it as: ”celiac disease”, ”gluten”, ”gastrointestinal disorder”, ”treatment”, ”neurological problems”, ”anxiety”. Inclusion criteria were studies that (1) investigated anxiety levels in CD people, (2) reported gender results, (3) were written in English, and (4) were published within the last 20 years.ResultsIn some cases, as main intervention in CD, gluten removal from the people’s diet usually reported improvements of the present symptoms. In addition, data from literature are describing a higher level of anxiety in females compared to males diagnosed with CD. This can be a consequence of females concerns about how they can manage the CD issues and, especially, what this is bringing in their lifestyle. On the opposite, there are reports which showed that demographic parameters (gender, age, education) are not associated with CD presence.ConclusionsThe balance between CD and anxiety needs to be more investigated in order to identify and fully understand what is the background mechanism and how this can be regulated through specific interventions.Disclosure of InterestM. Robea Grant / Research support from: ,Platformă multidisciplinară de cercetare-dezvoltare medicală în regiunea N-E,,, acronim: CENEMED, cod mySMIS: 127606, proiect cofinanțat prin Programul Operațional Competitivitate, Axa Prioritară: Cercetare, Dezvoltare tehnologică și Inovare (CDI)., A. Ciobica: None Declared, C. Stanciu: None Declared, A. Trifan: None Declared

THERMAL MODIFICATION OF NEW SORGHUM AND MILLET CULTIVARS: EFFECTS ON COMPOSITION, PROTEIN QUALITY AND FUNCTIONAL PROPERTIES OF FLOURS

Driven by consumers’ need to limit gluten intake in their diets, the demand for gluten‐free products continues to grow in the foodservice industry. Two newly released sorghum and millet cultivars were thermally modified and their responses to the pre-gelatinization (PG) determined by evaluating their chemical compositions, amino acids profile and functional properties using standard procedures. Protein efficiency ratio, essential amino acid index, biological value, nutritional index and amino acid score were calculated from the amino acid profile. PG increased the total carbohydrate by 7% and 3.7% in sorghum and millet respectively. The millet showed significantly (p < 0.05) higher values of fat, carbohydrate and energy than did the sorghum, whereas the latter exhibited higher ash and protein content. PG significantly (p < 0.05) lowered the ash, fat and protein contents of both sorghum and millet flours. Of the essential amino acids (EAA) of the raw flours, millet exhibited significantly (P<0.05) higher values of histidine, isoleucine, methionine, phenylalanine, threonine, tryptophan, and valine, with no significant difference in leucine and lysine between the two grains. While PG induced increase in all the EAA in sorghum except phenylalanine, millet showed decrease in histidine, lysine and threonine. PG increased the EAA millet in valine by 11% followed by isoleucine (8%), threonine (7.3%), methionine (4.4%), phenylalanine (4.3%) and leucine (2.6%). significant (p < 0.05) increase of 82% and 12% in isoleucine and threonine. The WAC of raw millet flour (192.2%) was significantly higher than that of sorghum flour (189.7%), but PG reduced the WAC of both sorghum and millet flours by 11.9% and 12.5%, respectively. Results from the study indicated that pregelatinized sorghum and millet flours are good replacement as source of gluten-free products to meet varied consumers choices and changing dietary habits.

Osteoporosis and Celiac Disease: Updates and Hidden Pitfalls

Celiac disease (CD) is an autoimmune disorder caused by gluten ingestion in genetically predisposed individuals. In addition to the typical gastrointestinal symptoms (e.g., diarrhea, bloating, and chronic abdominal pain), CD may also present with a broad spectrum of manifestations, including low bone mineral density (BMD) and osteoporosis. The etiopathology of bone lesions in CD is multifactorial and other conditions, rather than mineral and vitamin D malabsorption, may affect skeletal health, especially those related to the endocrine system. Here, we describe CD-induced osteoporosis in an attempt to enlighten new and less-known aspects, such as the influence of the intestinal microbiome and sex-related differences on bone health. This review describes the role of CD in the development of skeletal alterations to provide physicians with an updated overview on this debated topic and to improve the management of osteoporosis in CD.

Intervention strategies in early childhood to prevent celiac disease-a mini-review.

A higher intake of gluten during childhood is associated with increased risk of celiac disease, and the incidence of celiac disease peaks shortly after the time point when associations with higher gluten intake during the second and third year of life occur. Additional environmental factors are most likely necessary for celiac disease to develop. It is hypothesized that gastrointestinal infections increase gut permeability and exposure to gluten. Alternatively, infections may lead to gut dysbiosis and chronic inflammation, with leakage of self-antigens that mimic gluten peptides that leads to an autoimmune-like response. Different gluten interventions to prevent celiac disease have been proposed. Early clinical studies suggested an optimal time point introducing gluten between 4 and 6 months of age while the infant is being breastfed. However, later clinical trials on reduced gluten intake given to infants have shown no protection from celiac disease if gluten introduction was delayed or if gluten was introduced in small amounts during the child's first year of life. Still, more randomized clinical trials (RCTs) are warranted to answer the question if a reduced amount of gluten, not only at the time of introduction during infancy but also in a longer time frame, will prevent children at genetic risk from having lifelong celiac disease. It needs to be clarified whether dietary interventions are effective strategies to be proposed as future prevention of celiac disease in the general population. The present mini-review provides an overview of ongoing or completed RCTs that have focused on interventions during early childhood with the aim of preventing celiac disease.

Celiac Disease and the Gluten Free Diet during the COVID-19 Pandemic: Experiences of Children and Parents.

The COVID-19 pandemic perturbed the everyday life of children and those with chronic illnesses, along with the lives of their families. Patients with celiac disease (CD) follow a strict gluten-free diet (GFD), and gluten ingestion is associated with negative health outcomes. The aim of this study was to investigate the experiences of children with CD and their families concerning their GFD, symptoms and CD management during the first period of the COVID-19 pandemic. A cross-sectional questionnaire-based study was performed including 37 Dutch pediatric patients with CD, along with their parents. The majority reported good compliance to the GFD and stated that the diet was easier to follow during the pandemic, mainly due to eating more meals in the home. Some discovered a greater variety of GF products by utilizing online shopping, potentially increasing the financial burden of the GFD. Concerning general dietary habits, 21.6% reported a healthier eating pattern, in contrast to 37.8% and 10.8% who consumed more unhealthy snacks and fewer fruits and vegetables, respectively, than normal during the pandemic. The natural experiment of the COVID-19 pandemic provides valuable information regarding the management of pediatric CD. Education on healthy dietary patterns is important, especially for children with restrictive diets, and the findings of this study show that there is room for improvement in this respect, regardless of the current pandemic.

Gluten Exorphins Promote Cell Proliferation through the Activation of Mitogenic and Pro-Survival Pathways.

Celiac disease (CD) is a chronic and systemic autoimmune disorder that affects preferentially the small intestine of individuals with a genetic predisposition. CD is promoted by the ingestion of gluten, a storage protein contained in the endosperm of the seeds of wheat, barley, rye, and related cereals. Once in the gastrointestinal (GI) tract, gluten is enzymatically digested with the consequent release of immunomodulatory and cytotoxic peptides, i.e., 33mer and p31-43. In the late 1970s a new group of biologically active peptides, called gluten exorphins (GEs), was discovered and characterized. In particular, these short peptides showed a morphine-like activity and high affinity for the δ-opioid receptor (DOR). The relevance of GEs in the pathogenesis of CD is still unknown. Recently, it has been proposed that GEs could contribute to asymptomatic CD, which is characterized by the absence of symptoms that are typical of this disorder. In the present work, GEs cellular and molecular effects were in vitro investigated in SUP-T1 and Caco-2 cells, also comparing viability effects with human normal primary lymphocytes. As a result, GEs treatments increased tumor cell proliferation by cell cycle and Cyclins activation as well as by induction of mitogenic and pro-survival pathways. Finally, a computational model of GEs interaction with DOR is provided. Altogether, the results might suggest a possible role of GEs in CD pathogenesis and on its associated cancer comorbidities.

Practical Review on the Impact of Celiac Disease on the Patient

Celiac disease (CD) is a multisystem immune-mediated disorder resulting in enteropathy of the small intestine with the ingestion of gluten, in genetically susceptible individuals. This condition impact 1% of the population and can result in the development of other conditions such as chronic fatigue, anemia, osteoporosis, aphthous stomatitis, elevated liver enzymes, joint pain, infertility, peripheral neuropathy, and epilepsy. In this review, we outline the clinical presentation of CD, the physiological differences between CD and non-celiac gluten sensitivity, proper management and the need for thorough patient education to increase adherence to a gluten free diet and reduce GI symptoms.

Gluten-free diet adherence in children with screening-detected celiac disease using a prospective birth cohort study.

Celiac disease has an increasing incidence worldwide and is treated with lifelong adherence to a gluten-free diet. We aimed to describe gluten-free diet adherence rates in children with screening-identified celiac disease, determine adherence-related factors, and compare adherence to food records in a multinational prospective birth cohort study. Children in The Environmental Determinants of Diabetes in the Young study with celiac disease were included. Subjects had at least annual measurement of adherence (parent-report) and completed 3-day food records. Descriptive statistics, t-tests, Kruskal-Wallis tests and multivariable logistic and linear regression were employed. Two hundred ninety (73%) and 199 (67%) of subjects were always adherent to a gluten-free diet at 2 and 5 years post celiac disease diagnosis respectively. The percentage of children with variable adherence increased from 1% at 2 years to 15% at 5 years. Children with a first-degree relative with celiac disease were more likely to be adherent to the gluten-free diet. Gluten intake on food records could not differentiate adherent from nonadherent subjects. Adherent children from the United States had more gluten intake based on food records than European children (P < .001 and P = .007 at 2 and 5 years respectively). Approximately three-quarters of children with screening-identified celiac disease remain strictly adherent to a gluten-free diet over time. There are no identifiable features associated with adherence aside from having a first-degree relative with celiac disease. Despite good parent-reported adherence, children from the United States have more gluten intake when assessed by food records. Studies on markers of gluten-free diet adherence, sources of gluten exposure (particularly in the United States), and effects of adherence on mucosal healing are needed.

Celiac disease multi-purpose diet plan through integrated goal programming and Interval Type 2 Fuzzy TOPSIS method

Some people are genetically predisposed to Celiac disease, but the process of calling this disease is driven by the ingestion of gluten. This disease affects the person's immune system. Therefore, people must follow a gluten-free diet to prevent the progression of their disease and improve their quality of life. This research aims to raise awareness for celiac patients by providing a novel decision-support model and improving the daily nutritional diets of these patients in line with the determined objectives. A sample gluten-free diet is modeled for low-activity women aged 19–30. In the proposed diet sample, the composition of nutrients and objectives are provided by a dietician. The objective of this study is to minimize these target values in this diet. Celiac disease patients need to meet as much as possible predefined 8 objectives when the patients follow their diet. The Goal Programming (GP) methodology is applied to reach minimum deviations from these 8 objectives. Before GP, a Multi-Criteria Decision Making (MCDM) process is applied to rank and get the weights of objectives. For this process, the Interval Type 2 Fuzzy TOPSIS (IT2FT) method is preferred as an MCDM method. Criteria for IT2FT are determined by examining academic literature and by interviewing relevant dietitians. These criteria are defined as salary, gender, body weight, body length, age, and mobility level. Then, the diet model is created with the information obtained through IT2FT and GP. In the created model, the objectives are determined as constraints. Positive deviations or negative deviations according to the direction of each constraint are included in the calculation together with their weights. In this way, the patient will be fed with the lowest calories and cost, while at the same time she will act following her diet. In conclusion, the values of objectives are minimized.

Malignancies in Patients with Celiac Disease: Diagnostic Challenges and Molecular Advances.

Celiac disease (CD) is a multiorgan autoimmune disorder of the chronic intestinal disease group characterized by duodenal inflammation in genetically predisposed individuals, precipitated by gluten ingestion. The pathogenesis of celiac disease is now widely studied, overcoming the limits of the purely autoimmune concept and explaining its hereditability. The genomic profiling of this condition has led to the discovery of numerous genes involved in interleukin signaling and immune-related pathways. The spectrum of disease manifestations is not limited to the gastrointestinal tract, and a significant number of studies have considered the possible association between CD and neoplasms. Patients with CD are found to be at increased risk of developing malignancies, with a particular predisposition of certain types of intestinal cancer, lymphomas, and oropharyngeal cancers. This can be partially explained by common cancer hallmarks present in these patients. The study of gut microbiota, microRNAs, and DNA methylation is evolving to find the any possible missing links between CD and cancer incidence in these patients. However, the literature is extremely mixed and, therefore, our understanding of the biological interplay between CD and cancer remains limited, with significant implications in terms of clinical management and screening protocols. In this review article, we seek to provide a comprehensive overview of the genomics, epigenomics, and transcriptomics data on CD and its relation to the most frequent types of neoplasms that may occur in these patients.

Celiac Disease Genetics, Pathogenesis, and Standard Therapy for Japanese Patients.

Celiac disease is an autoimmune disease primarily affecting the small intestine that is caused by the ingestion of gluten in genetically susceptible individuals. The development of celiac disease is based on a complex immune response to gluten proteins. The global average prevalence in the general population is about 1%. In recent years, it has become clear that celiac disease is not less common in Asian countries than in Western countries but often remains undiagnosed. Although the number of patients with celiac disease in Asia is expected to increase with improving disease recognition and advances in diagnostic techniques, there remain few reports of celiac disease in the Far East region of Asia, especially in Japan. In this paper, we outline the epidemiology, diagnosis, and treatment of celiac disease. In addition, we summarize the reported Japanese cases of celiac disease with an overview in Japan.

MAFLD and Celiac Disease in Children.

Celiac disease (CD) is an immune-mediated systemic disorder elicited by the ingestion of gluten whose clinical presentation ranges from the asymptomatic form to clinical patterns characterized by multiple systemic involvement. Although CD is a disease more frequently diagnosed in patients with symptoms of malabsorption such as diarrhea, steatorrhea, weight loss, or failure to thrive, the raised rate of overweight and obesity among general pediatric and adult populations has increased the possibility to diagnose celiac disease in obese patients as well. Consequently, it is not difficult to also find obesity-related disorders in patients with CD, including "metabolic associated fatty liver disease" (MAFLD). The exact mechanisms linking these two conditions are not yet known. The going assumption is that a gluten-free diet (GFD) plays a pivotal role in determining an altered metabolic profile because of the elevated content of sugars, proteins, saturated fats, and complex carbohydrates, and the higher glycemic index of gluten-free products than gluten-contained foods, predisposing individuals to the development of insulin resistance. However, recent evidence supports the hypothesis that alterations in one of the components of the so-called "gut-liver axis" might contribute to the increased afflux of toxic substances to the liver triggering the liver fat accumulation and to the subsequent hepatocellular damage. The aim of this paper was to describe the actual knowledge about the factors implicated in the pathogenesis of hepatic steatosis in pediatric patients with CD. The presented review allows us to conclude that the serological evaluations for CD with anti-transglutaminase antibodies, should be a part of the general workup in the asymptomatic patients with "non-alcoholic fatty liver disease" (NAFLD) when metabolic risk factors are not evident, and in the patients with steatohepatitis when other causes of liver disease are excluded.

THERMAL MODIFICATION OF NEW SORGHUM AND MILLET CULTIVARS: EFFECTS ON COMPOSITION, PROTEIN QUALITY AND FUNCTIONAL PROPERTIES OF FLOURS

Driven by consumers’ need to limit gluten intake in their diets, the demand for gluten‐free products continues to grow in the foodservice industry. Two newly released sorghum and millet cultivars were thermally modified and their responses to the pre-gelatinization (PG) determined by evaluating their chemical compositions, amino acids profile and functional properties using standard procedures. Protein efficiency ratio, essential amino acid index, biological value, nutritional index and amino acid score were calculated from the amino acid profile. PG increased the total carbohydrate by 7% and 3.7% in sorghum and millet respectively. The millet showed significantly (p &lt; 0.05) higher values of fat, carbohydrate and energy than did the sorghum, whereas the latter exhibited higher ash and protein content. PG significantly (p &lt; 0.05) lowered the ash, fat and protein contents of both sorghum and millet flours. Of the essential amino acids (EAA) of the raw flours, millet exhibited significantly (P&lt;0.05) higher values of histidine, isoleucine, methionine, phenylalanine, threonine, tryptophan, and valine, with no significant difference in leucine and lysine between the two grains. While PG induced increase in all the EAA in sorghum except phenylalanine, millet showed decrease in histidine, lysine and threonine. PG increased the EAA millet in valine by 11% followed by isoleucine (8%), threonine (7.3%), methionine (4.4%), phenylalanine (4.3%) and leucine (2.6%). significant (p &lt; 0.05) increase of 82% and 12% in isoleucine and threonine. The WAC of raw millet flour (192.2%) was significantly higher than that of sorghum flour (189.7%), but PG reduced the WAC of both sorghum and millet flours by 11.9% and 12.5%, respectively. Results from the study indicated that pregelatinized sorghum and millet flours are good replacement as source of gluten-free products to meet varied consumers choices and changing dietary habits.&#x0D;

Grain, Gluten, and Dietary Fiber Intake Influence Gut Microbial Diversity: Data from the Food and Microbiome Longitudinal Investigation.

Regular consumption of whole grains and dietary fiber was associated with greater abundance of gut bacteria that may lower risk of colorectal cancer. Further research on the association of refined grains and gluten with gut microbial composition is needed to understand their roles in health and disease.

Extra-intestinal manifestations of Celiac disease in children: their prevalence and association with human leukocyte antigens and pathological and laboratory evaluations

BackgroundCeliac disease (CD) is an autoimmune disease caused by gluten intake. Traditionally CD was believed to be a disease of the gut, although a wide range of extra-intestinal manifestations (EIM) was recognized. The exact prevalence of EIM and the associated risk factors have not been well studied.AimWe aimed to assess the prevalence of EIM in children with CD and their association with human leukocyte antigen (HLA) typing, and pathological and laboratory indices.MethodWe conducted a cross-sectional study on children and adolescents with a definite diagnosis of CD. They were followed in the main Celiac Clinic of Southern Iran.ResultsWe included 204 children who were visited between 2012 and 2017. Nearly 85% of them were positive for HLA-DQ2 and 40.6% for HLA-DQ8. The most prevalent intestinal complaints reported were abdominal pain (42.6%) and chronic constipation (19.1%). Failure-to-thrive (32.7%), iron deficiency anemia (25%), short stature (20.5%), and eczema (18.6%) were the most common EIMs. However, failure-to-thrive and short stature were presented at significantly younger ages, whereas those patients with concomitant type 1 diabetes mellitus (DM) were significantly older. We also found significant relationships between autoimmune thyroid disease and HLA-DQ5, and the presence of headaches with HLA-DQ7. The prevalence of HLA types of DQ2, DQ8, DQ6, and DQ7 significantly varied among different Marsh groups. Patients who were positive for HLA-DQ8, were significantly older, taller, and weightier. No significant association was found between HLA types and any of the gastrointestinal symptoms, anti-tTG and compliance to gluten free diet. Moreover, there were no statistically significant differences detected between the presence of each individual EIM, the level of IgA anti-tTG, sex, and Marsh typing.ConclusionThis study highlights the presence of EIM in CD and their associated factors. We show the potential role of HLA typing in some EIMs, which may shed light for future studies.

The Effect of Nutrition Counseling on Mother’s Knowledge and Nutrition Information in Autistic Children in Banda Aceh City

Abstract&#x0D; &#x0D; Background: Autism Spectrum Disorder (Autism Spectrum Disorder), commonly abbreviated as ASD or autism, is a condition of neurodevelopmental brain disorder that causes sufferers to experience difficulties in communicating and socializing. Parents go through difficult phases after their child is diagnosed with ASD. Therefore, increasing the knowledge capacity of parents and nutritional intake in autistic children is very important. Children with autism often experience a lack of certain nutrients that affect the growth, development, and fulfillment of specific nutritional needs.&#x0D; &#x0D; AIM: Analyzing the Effect of Nutrition Counseling on Mother's Knowledge and Nutrient Intake in Autistic Children in Banda Aceh City&#x0D; &#x0D; Methods: The research design used in this study was quasi-experimental with a pre-posttest observational approach. This research was conducted in four locations, namely the Autism Child Service Center, The Nanny Children Center (TNCC), Bintang Kecil, and My Hope Special Need Center from October to December 2021 in Banda Aceh. The sample in this study was the entire population, which amounted to 30 children with autism—analysis of the data using univariate and bivariate using the T-test dependent.&#x0D; .&#x0D; Results: From the results of statistical tests, it is known that there is a significant effect of nutritional counseling on mothers' knowledge and intake of gluten and casein sources of food in autistic children with p-value &lt; 0.05). Nutritional counseling has been shown to increase maternal knowledge. The average knowledge of mothers before nutrition counseling was 84.56 and after 88.62. The average intake of gluten and casein sources before nutritional counseling was 82.59 and after 77.12.&#x0D; &#x0D; CONCLUSION: There

Elucidating the role of microbes in celiac disease through gnotobiotic modeling.

Celiac disease (CeD) is a common immune-mediated disease triggered by the ingestion of gluten in genetically predisposed individuals. CeD is unique in that the trigger (gluten), necessary genes (HLA-DQ2 and DQ8), and the autoantigen (tissue transglutaminase) have been identified, allowing additional environmental co-factors, like the intestinal microbiota, to be studied through relevant in vivo models. Murine models for CeD have come a long way in the past decade and there are now in vitro and in vivo tools available that mimic certain aspects of clinical disease. These models, many of which express the CeD risk genes, have recently been used to study the mechanisms through which the microbiota play a role in CeD pathogenesis through a gnotobiotic approach. Historically, the generation of gnotobiology technology in mid-20th century allowed for the study of immunity and physiology under a complete absence of microbes (axenic) or known colonized status (gnotobiotic). This enabled understanding of mechanisms by which certain bacteria contribute to health and disease. With this perspective, here, we will discuss the various murine models currently being used to study CeD. We will then describe how utilizing axenic and gnotobiotic CeD models has increased our understanding of how microbes influence relevant steps of CeD pathogenesis, and explain key methodology involved in axenic and gnotobiotic modeling.