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Soleimani Jevinani S, Mohammad Rahimi H, Asri N, Rostami-Nejad M, Ahmadipour S, Mirjalali H. Molecular epidemiology and subtyping of Blastocystis sp. and its subtypes in celiac patients; a case control study. Microb Pathog 2023; 179:106086. [PMID: 36963704 DOI: 10.1016/j.micpath.2023.106086] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/28/2023] [Accepted: 03/21/2023] [Indexed: 03/26/2023]
Abstract
Blastocystis sp. is a common intestinal protist, reported from symptomatic and asymptomatic subjects. Blastocystis sp. has been reported from a broad spectrum of gastrointestinal disorders. Celiac disease (CD) is an autoimmune disorder of the small intestine, which leads to the lack of tolerance against gluten. Long-term following of gluten-free diet in CD patients decreases the gut microbiota restoration and probably decreases the chance of Blastocystis sp. colonization. The current study aimed to investigate the prevalence of Blastocystis sp. and its subtypes in CD patients in comparison to healthy subjects. Stool samples were collected from 238 participants including 92 confirmed CD patients and 146 healthy subjects. upon DNA extraction, the presence of Blastocystis sp. was evaluated using amplification of discriminative regions of the small ribosomal RNA (ssu rRNA) gene. To characterize subtypes and alleles, amplified fragments were sequenced. Phylogenetic trees were constructed to visualize subtype correlation. Our findings showed that 21% (50) of samples including 16.3% (15/92) and 23.97% (35/146) were positive for Blastocystis sp. in CD patients and healthy controls, respectively. Except family relationship, other variables were not statistical correlated with the presence of Blastocystis sp.. Totally, 25 samples were successfully sequenced. Accordingly, ST1, ST2, and ST3 were present in 8 (32%), 9 (36%), and 8 (32%) of the samples, respectively. Allele discrimination showed that all ST1 were allele 4; alleles 11, 9, and 12 were retrieved from ST2, and alleles 34, 36, and 38 were observed in ST3. The relationship between colonization of Blastocystis sp. and alteration in the gut microbiota composition is indeterminate, however, this hypothesis that lower prevalence of Blastocystis sp. in CD patients who follow a gluten-free diet affect the colonization of Blastocystis sp. via alteration in the gut microbiota composition could be interesting for further investigations.
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Affiliation(s)
| | - Hanieh Mohammad Rahimi
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nastaran Asri
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Rostami-Nejad
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shokoufeh Ahmadipour
- Department of Pediatric, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Hamed Mirjalali
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Sharma N, Bhatia S, Chunduri V, Kaur S, Sharma S, Kapoor P, Kumari A, Garg M. Pathogenesis of Celiac Disease and Other Gluten Related Disorders in Wheat and Strategies for Mitigating Them. Front Nutr 2020; 7:6. [PMID: 32118025 PMCID: PMC7020197 DOI: 10.3389/fnut.2020.00006] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 01/20/2020] [Indexed: 12/12/2022] Open
Abstract
Wheat is a major cereal crop providing energy and nutrients to the billions of people around the world. Gluten is a structural protein in wheat, that is necessary for its dough making properties, but it is responsible for imparting certain intolerances among some individuals, which are part of this review. Most important among these intolerances is celiac disease, that is gluten triggered T-cell mediated autoimmune enteropathy and results in villous atrophy, inflammation and damage to intestinal lining in genetically liable individuals containing human leukocyte antigen DQ2/DQ8 molecules on antigen presenting cells. Celiac disease occurs due to presence of celiac disease eliciting epitopes in gluten, particularly highly immunogenic alpha-gliadins. Another gluten related disorder is non-celiac gluten-sensitivity in which innate immune-response occurs in patients along with gastrointestinal and non-gastrointestinal symptoms, that disappear upon removal of gluten from the diet. In wheat allergy, either IgE or non-IgE mediated immune response occurs in individuals after inhalation or ingestion of wheat. Following a life-long gluten-free diet by celiac disease and non-celiac gluten-sensitivity patients is very challenging as none of wheat cultivar or related species stands safe for consumption. Hence, different molecular biology, genetic engineering, breeding, microbial, enzymatic, and chemical strategies have been worked upon to reduce the celiac disease epitopes and the gluten content in wheat. Currently, only 8.4% of total population is affected by wheat-related issues, while rest of population remains safe and should not remove wheat from the diet, based on false media coverage.
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Affiliation(s)
- Natasha Sharma
- Agri-Food Biotechnology Laboratory, National Agri-Food Biotechnology Institute, Mohali, India
| | - Simran Bhatia
- Agri-Food Biotechnology Laboratory, National Agri-Food Biotechnology Institute, Mohali, India
| | - Venkatesh Chunduri
- Agri-Food Biotechnology Laboratory, National Agri-Food Biotechnology Institute, Mohali, India
| | - Satveer Kaur
- Agri-Food Biotechnology Laboratory, National Agri-Food Biotechnology Institute, Mohali, India
| | - Saloni Sharma
- Agri-Food Biotechnology Laboratory, National Agri-Food Biotechnology Institute, Mohali, India
| | - Payal Kapoor
- Agri-Food Biotechnology Laboratory, National Agri-Food Biotechnology Institute, Mohali, India
| | - Anita Kumari
- Agri-Food Biotechnology Laboratory, National Agri-Food Biotechnology Institute, Mohali, India
| | - Monika Garg
- Agri-Food Biotechnology Laboratory, National Agri-Food Biotechnology Institute, Mohali, India
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Kumar J, Kumar M, Pandey R, Chauhan NS. Physiopathology and Management of Gluten-Induced Celiac Disease. J Food Sci 2017; 82:270-277. [PMID: 28140462 DOI: 10.1111/1750-3841.13612] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 11/21/2016] [Accepted: 12/09/2016] [Indexed: 12/13/2022]
Abstract
Proline- and glutamine-rich gluten proteins are one of the major constituents of cereal dietary proteins, which are largely resistant to complete cleavage by the human gastrointestinal (GI) digestive enzymes. Partial digestion of gluten generates approximately 35 amino acids (aa) immunomodulatory peptides which activate T-cell-mediated immune system, followed by immunological inflammation of mucosa leading to the onset of celiac disease (CD). CD is an autoimmune disease associated with HLA-DQ2/DQ8 polymorphism and dysbiosis of gut microbiota. CD is either diagnosed using duodenal mucosal biopsis or serological testing for transglutaminase 2 (TG2) specific antibodies (IgA and IgG). Current therapy for CD management is gluten-free diet, while other therapies like glutenase, probiotics, immunomodulation, jamming of HLA-DQ2, inhibition of TG2, and gluten tolerance aided by gluten tolerizing vaccines are being developed.
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Affiliation(s)
- Jitendra Kumar
- Dept. of Biochemistry, M.D. Univ., Rohtak, 124001, Haryana, India
| | - Manoj Kumar
- Dept. of Biochemistry, M.D. Univ., Rohtak, 124001, Haryana, India
| | - Rajesh Pandey
- Ayurgenomics Unit-TRISUTRA, Inst. of Genomics and Integrative Biology, Council of Scientific and Industrial Research, New Delhi, 110020, India
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Nandiwada SL, Tebo AE. Testing for antireticulin antibodies in patients with celiac disease is obsolete: a review of recommendations for serologic screening and the literature. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2013; 20:447-51. [PMID: 23365209 PMCID: PMC3623418 DOI: 10.1128/cvi.00568-12] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Celiac disease (CD) is an autoimmune disorder that occurs in genetically susceptible individuals of all ages and is triggered by immune response to gluten and related proteins. The disease is characterized by the presence of HLA-DQ2 and/or -DQ8 haplotypes, diverse clinical manifestations, gluten-sensitive enteropathy, and production of several autoantibodies of which endomysial, tissue transglutaminase, and deamidated gliadin peptide antibodies are considered specific. Although antireticulin antibodies (ARA) have historically been used in the evaluation of CD, these assays lack optimal sensitivities and specificities for routine diagnostic use. This minireview highlights the advances in CD-specific serologic testing and the rationale for eliminating ARA from CD evaluation consistent with recommendations for diagnosis.
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Mišak Z, Hojsak I, Jadrešin O, Kekez AJ, Abdović S, Kolaček S. Diagnosis of coeliac disease in children younger than 2 years. J Pediatr Gastroenterol Nutr 2013; 56:201-5. [PMID: 23325441 DOI: 10.1097/mpg.0b013e3182716861] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND AIM To diagnose coeliac disease (CD) in children younger than 2 years, the old ESPGHAN criteria based on 3 small bowel biopsies were recommended until recently. The aim of the present study was to investigate the applicability of only 1 small intestinal biopsy plus positive serology for the diagnosis of CD in children younger than 2 years. METHODS A prospective cohort study included 81 patients younger than 2 years with symptoms suggestive of CD, who all completed the diagnostic procedure based on 3 small bowel biopsies. According to the finding of the third biopsy, patients were divided into group A-CD confirmed (N = 44), and group B-CD not confirmed, after the gluten challenge (N = 37). RESULTS At the time of the first biopsy, total villous atrophy (Marsh IIIc) was found more often in group A than in group B (77% vs 27%, P < 0.01). Also, all of the studied antibodies were more frequently positive in group A than in group B (P < 0.01 for all of the tested antibodies). Positive anti-endomysial antibodies and Marsh IIIc finding were the best discriminators between the group A and the group B and considerably contributed to the prediction of CD. CONCLUSIONS The second and the third biopsies (before and after the gluten challenge) may also be avoided when diagnosing CD in children younger than 2 years provided that the child, at the time of presentation, has positive anti-endomysial antibodies and Marsh IIIc on the small bowel biopsy. A gluten challenge should be still considered in all other children younger than 2 years.
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Affiliation(s)
- Zrinjka Mišak
- Referral Centre for Paediatric Gastroenterology and Nutrition, Children's Hospital Zagreb, Zagreb, Croatia.
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Ring Jacobsson L, Friedrichsen M, Göransson A, Hallert C. Does a Coeliac School increase psychological well-being in women suffering from coeliac disease, living on a gluten-free diet? J Clin Nurs 2011; 21:766-75. [PMID: 22039932 DOI: 10.1111/j.1365-2702.2011.03953.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIM AND OBJECTIVE To assess the effects of an active method of patient education on the psychological well-being of women with coeliac disease in remission. BACKGROUND Despite remission with a gluten-free diet, adults with coeliac disease and especially women experience a subjective poor health. Self-management education seems to be promising tool to help patients suffering from coeliac disease to cope with their disorder. DESIGN A randomised controlled trial. METHODS A total of 106 women, ≥ 20 years, with confirmed coeliac disease, who had been on a gluten-free diet for a minimum of five years. The intervention group (n = 54) underwent a 10-session educational programme, 'Coeliac School', based on problem-based learning. The controls (n = 52) received information regarding coeliac disease sent home on a regular basis. The primary outcomes were psychological general well-being measured with a validated questionnaire. RESULTS Participants in the Coeliac School reported a significant improvement in psychological well-being at 10 weeks, whereas the controls given usual care reported a worsening in psychological well-being. After six months, a significant improvement remained for the index of vitality. CONCLUSIONS Patient education increased psychological well-being in women with coeliac disease. There is a need to refine the methods of patient education to make the effects of well-being more pronounced over time. RELEVANCE TO CLINICAL PRACTICE Patient education using problem-based learning promotes self-management in coeliac disease by improving the well-being of patients who have been struggling with the gluten-free diet for years.
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Affiliation(s)
- Lisa Ring Jacobsson
- Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden.
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Hunger-Battefeld W, Fath K, Mandecka A, Kiehntopf M, Kloos C, Müller UA, Wolf G. [Prevalence of polyglandular autoimmune syndrome in patients with diabetes mellitus type 1]. ACTA ACUST UNITED AC 2009; 104:183-91. [PMID: 19337707 DOI: 10.1007/s00063-009-1030-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2008] [Accepted: 01/07/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND PURPOSE The aim of this study was to examine the prevalence of autoimmune antibodies (autoimmune hypophysitis, adrenalitis, thyropathy, pernicious anemia, celiac disease) and clinically relevant endocrine autoimmune disease (AIEK) in patients with type 1 diabetes in the course of 1 year. PATIENTS AND METHODS Antibody screening was performed in 139 diabetic patients (age 44 +/- 14 years; years since diagnosis 26 +/- 15 years; duration of diabetes 18 +/- 12 years; body mass index 26 +/- 4 kg/m(2); HbA(1c) 7.5% +/- 1.1% [normal range 4.4-5.9%]) who completed a routine clinic visit in 2003. Patients with pathologically increased antibody titers were further examined regarding the clinically relevant AIEKs. Reexamination was performed 1 year later. RESULTS In 2003, 63% of diabetic patients showed at least one pathologically increased antibody titer (2004: 60%). In 32% of the patients, increased antibody titers were clinically inapparent. Apart from diabetes mellitus type 1, in 2003, 31% suffered from other AIEK requiring therapy (2004: +3.6%): 22.3% harbored two additional AIEKs (2004: +2.2%) and 8.6% even > or = 3 AIEKs (2004: +1.5%). The following pathologically increased antibody titers/prevalences of clinically relevant AIEKs were found (in comparison with 2004): increased antithyroid autoantibodies: 47.5% (-0.7%)/autoimmune thyroiditis 24.5% (+2.8%) and Graves' disease 4.3% (+0.7%), respectively; adrenal cortex autoantibodies 0.7% (+1.5%)/Addison's disease 1.4% (+/-0), gliadin peptide antibodies and IgA to tissue transglutaminase, respectively: 18.7% (-5.0%)/celiac disease 1.4% (+0.8%), parietal cell antibodies: 15.8% (+7.2%)/pernicious anemia 7.2% (+1.4%), hypophysitis 0.7% (+/-0), hypogonadism 0.7% (+/-0). All new AIEK manifestations in 2004 had had an at least tenfold increased antibody titer in 2003. Comparing patients with and without polyglandular autoimmune syndrome (PAS), no difference in age (43 +/- 14 vs. 46 +/- 13 years), duration of diabetes (17 +/- 13 vs. 18 +/- 12 years), and HbA1c (7.3% +/- 0.9% vs. 7.6% +/- 1.1%) could be found. CONCLUSION In this study, more than half of the patients with diabetes mellitus type 1 had at least one pathologically increased antibody titer apart from diabetes without clinical sign of an additional AIEK. 31% of patients with increased antibodies presented with symptoms of another AIEK (increase by 3.6% within 1 year). Patients with diabetes mellitus type 1 should be screened for other AIEKs. Thyropathy had the greatest prevalence and increased by 3.5% within 1 year's time.
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Lee P, Samaras K. Coeliac disease in an Indian patient: an important diagnosis to consider. Med J Aust 2008; 189:336-7. [DOI: 10.5694/j.1326-5377.2008.tb02056.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2008] [Accepted: 04/28/2008] [Indexed: 11/17/2022]
Affiliation(s)
- Paul Lee
- Department of Endocrinology, St Vincent's Hospital, Sydney, NSW
- Pituitary Research Unit, Garvan Institute of Medical Research, Sydney, NSW
| | - Katherine Samaras
- Department of Endocrinology, St Vincent's Hospital, Sydney, NSW
- University of New South Wales, Sydney, NSW
- Diabetes and Obesity Clinical Group, Garvan Institute of Medical Research, Sydney, NSW
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Procaccini M, Campisi G, Bufo P, Compilato D, Massaccesi C, Catassi C, Muzio LL. Lack of association between celiac disease and dental enamel hypoplasia in a case-control study from an Italian central region. Head Face Med 2007; 3:25. [PMID: 17537244 PMCID: PMC1891285 DOI: 10.1186/1746-160x-3-25] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2006] [Accepted: 05/30/2007] [Indexed: 01/18/2023] Open
Abstract
Background A close correlation between celiac disease (CD) and oral lesions has been reported. The aim of this case-control study was to assess prevalence of enamel hypoplasia, recurrent aphthous stomatitis (RAS), dermatitis herpetiformis and atrophic glossitis in an Italian cohort of patients with CD. Methods Fifty patients with CD and fifty healthy subjects (age range: 3–25 years), matched for age, gender and geographical area, were evaluated by a single trained examiner. Diagnosis of oral diseases was based on typical medical history and clinical features. Histopathological analysis was performed when needed. Adequate univariate statistical analysis was performed. Results Enamel hypoplasia was observed in 26% cases vs 16% in controls (p > 0.2; OR = 1.8446; 95% CI = 0.6886: 4.9414). Frequency of RAS in the CD group was significantly higher (36% vs 12%; p = 0.0091; OR = 4.125; 95% CI = 1.4725: 11.552) in CD group than that in controls (36% vs 12%). Four cases of atrophic glossitis and 1 of dermatitis herpetiformis were found in CD patients vs 1 and none, respectively, among controls. Conclusion The prevalence of enamel hypoplasia was not higher in the study population than in the control group. RAS was significantly more frequent in patients with CD.
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Affiliation(s)
- Maurizio Procaccini
- Istituto di Scienze Odontostomatologiche, Università Politecnica delle Marche, Italy
| | | | - Pantaleo Bufo
- Dip. Scienze Chirurgiche, Università di Foggia, Italy
| | | | - Claudia Massaccesi
- Istituto di Scienze Odontostomatologiche, Università Politecnica delle Marche, Italy
| | - Carlo Catassi
- Istituto di Clinica Pediatrica, Università Politecnica delle Marche, Italy
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