Celiac disease diagnosis and gluten-free food analytical control

How does a celiac iceberg really float? The relationship between celiac disease and gluten

Celiac disease (CD) is an autoimmune intestinal disease caused by intolerance of genetically susceptible individuals after intake of gluten-containing grains (including wheat, barley, etc.) and their products. Currently, CD, with "iceberg" characteristics, affects a large population and is distributed over a wide range of individuals. This present review summarizes the latest research progress on the relationship between CD and gluten. Furthermore, the structure and function of gluten peptides related to CD, gluten detection methods, the effects of processing on gluten and gluten-free diets are emphatically reviewed. In addition, the current limitations in CD research are also discussed. The present work facilitates a comprehensive understanding of CD as well as gluten, which can provide a theoretical reference for future research.

Pathophysiology and immunogenetics of celiac disease

Celiac disease (CD) is a chronic inflammatory enteropathy caused by gluten (protein from wheat, rye and, barley) in genetically predisposed individuals carrying the HLA-DQ2/HLA-DQ8 genotype. This pathology has a multifactorial etiology in which HLA genes, the microbiome, gluten and, other environmental factors are involved in the development of the disease. Its pathogenesis involves both innate and adaptive immunity as well as upregulation of IL-15. The objective of this review is to examine the results of current studies on genetic and environmental variables to better understand the pathogenesis of this enteropathy. The complex etiology of celiac disease makes our understanding of the pathogenesis of the disease incomplete, and a better knowledge of the many genetic and environmental components would help us better understand the pathophysiology of celiac disease.

Comparisons of Soybean and Wheat; in the Focus on the Nutritional Aspects and Acute Appetite Sensation

Soybean flour is often used as a gluten-free ingredient. We aimed to compare the nutrients and the difference in satiety of soybean and wheat after ingestion. We measured the amounts of polyphenol and oxygen radical absorbance capacity (ORAC) and examined the acute appetite sensation after the ingestion of soybean powder and bread powder. Japanese women were enrolled in the meal tests. Participants were provided with 18 g of bread or soybean powder, 180 g of yogurt, and 285 mL of bottled water. Subjective satiety (hunger, appetite, satiety, and stomach fullness) was measured using a visual analog scale 120 min after sample ingestion. The polyphenol content and ORAC were 2- and 12-folds higher, respectively, in soybean powder than in bread flour. In the meal tests, the area under the curve (AUC) of satiety 60–120 min after ingestion (n = 44) was significantly higher for soybean powder than bread powder. The AUCs of hunger and appetite 60–120 min after ingestion were significantly lower for soybean powder than bread powder. The effect sizes of hunger and appetite by soybean powder were 0.341 and 0.424, respectively. Thus, these results suggest that soybean is a healthy food and soybeans maintain satiety and suppress hunger more than bread flour.

Electrochemical Study of Dimensional Specific Carbon Nanomaterials Modified Glassy Carbon Electrode for Highly Sensitive Label-free Detection of Immunoglobulin A

Background:

Immunoglobulin A (IgA) accounts for 15% of total protein production per day and plays a crucial role in the first-line immune defence. Recently, IgA has been established as a vital clinical biomarker for nephropathy, allergic asthma, celiac disease (CD), pneumonia, and asthma as well as some neurological disorders. In this work, we have studied several carbon nanomaterials (CNMs) having different dimensions (D): carbon nano-onions (CNOs) - 0D, single-walled carbon nanotubes (SWCNTs) - 1D, and graphene nanoplatelets (GNPs) - 2D, on glassy carbon electrode (GCE) to identify which CNMs (CNOs/SWCNTs/GNPs) work best to fabricate IgA based electrochemical immunosensor.

Methods:

Different CNMs (CNOs, SWCNTs, GNPs) were tested for high electric current on GCE using square wave voltammetry (SWV), and among them, GNPs modified GCE platform (GNPs/GCE) showcased the highest electric current. Therefore, GNPs/GCE was utilized for the development of highly sensitive label-free electrochemical immunosensor for the detection of Immunoglobulin A using SWV.

Results:

Despite the simple fabrication strategies employed, the fabricated sensor demonstrated a low limit of detection of 50 fg mL-1 with an extensive linear range of detection from 50 fg mL-1 to 0.1 μg mL-1.

Conclusion:

Fabricated immunosensor represented high stability, repeatability, specificity and resistance to most common interferences as well as great potential to analyse the real sample.

Modeling of celiac disease immune response and the therapeutic effect of potential drugs

Background

Celiac disease (CD) is an autoimmune disorder that occurs in genetically predisposed people and is caused by a reaction to the gluten protein found in wheat, which leads to intestinal villous atrophy. Currently there is no drug for treatment of CD. The only known treatment is lifelong gluten-free diet. The main aim of this work is to develop a mathematical model of the immune response in CD patients and to predict the efficacy of a transglutaminase-2 (TG-2) inhibitor as a potential drug for treatment of CD.

Results

A thorough analysis of the developed model provided the following results:

1. TG-2 inhibitor treatment leads to insignificant decrease in antibody levels, and hence remains higher than in healthy individuals.

2. TG-2 inhibitor treatment does not lead to any significant increase in villous area.

3. The model predicts that the most effective treatment of CD would be the use of gluten peptide analogs that antagonize the binding of immunogenic gluten peptides to APC. The model predicts that the treatment of CD by such gluten peptide analogs can lead to a decrease in antibody levels to those of normal healthy people, and to a significant increase in villous area.

Conclusions

The developed mathematical model of immune response in CD allows prediction of the efficacy of TG-2 inhibitors and other possible drugs for the treatment of CD: their influence on the intestinal villous area and on the antibody levels. The model also allows to understand what processes in the immune response have the strongest influence on the efficacy of different drugs. This model could be applied in the pharmaceutical R&D arena for the design of drugs against autoimmune small intestine disorders and on the design of their corresponding clinical trials.

Differences in faecal bacteria populations and faecal bacteria metabolism in healthy adults and celiac disease patients

Differences in the intestinal microbiota between children and adults with celiac disease (CD) have been reported; however, differences between healthy adults and adults with CD have not been clearly demonstrated. The aim of this study was to evaluate the differences in the intestinal microbiota between adults with CD and healthy individuals. Microbial communities in faecal samples were evaluated by PCR-denaturing gradient gel electrophoresis (DGGE) and gas-liquid chromatography of short chain fatty acids (SCFAs). The study group included 10 untreated CD patients, 11 treated CD patients and 11 healthy adults (in normal gluten diet and in GFD). UPGMA clustered the dominant microbial communities of healthy individuals together and separated them from the dominant microbial communities of the untreated CD patients. Most of the dominant microbial communities of the treated CD patients clustered together with those of healthy adults. The treated CD patients showed a reduction in the diversity of Lactobacillus and Bifidobacterium species. The presence of Bifidobacterium bifidum was significantly higher in untreated CD patients than healthy adults. There was a significant difference between untreated CD patients and healthy adults, as well as between treated CD patients and healthy adults, regarding acetic acid, propionic acid, butyric acid, and total SCFAs.

IN CONCLUSION

healthy adults have a different faecal microbiota from that of untreated CD patients. A portion of the treated CD patients displayed a restored "normal" microbiota. The treated CD patients significantly reduce the Lactobacillus and Bifidobacterium diversity. Healthy adults have a different faecal SCFAs content from that of CD patients.

Propriospinal myoclonus associated with gluten sensitivity in a young woman

Propriospinal myoclonus (PSM) is a rare movement disorder characterized by involuntary axial jerks originating from muscles innervated by multiple spinal segments. Most cases of PSM are idiopathic. Gluten sensitivity is a multisystemic autoimmune condition which may be associated with various neurological disorders, most commonly peripheral neuropathy and cerebellar ataxia. We report a case of a young woman who developed PSM in the setting of gluten sensitivity, indicating that gluten sensitivity should be considered in the differential diagnosis of PSM such that a gluten challenge test may prove diagnostically useful.

Functional replacements for gluten

Celiac disease (CD) is an immune-mediated disease triggered in genetically susceptible individuals by ingested gluten from wheat, rye, barley, and other closely related cereal grains. Currently, the only therapy able to normalize the clinical and histological manifestation of the disease is a strict and life-long gluten-free (GF) diet. The replacement of gluten presents a significant technological challenge, as it is an essential structure-building protein, which is necessary for formulating high-quality baked goods. The objective of this paper is to review some basics about CD, its current prevalence, and the recent advances in the preparation of high-quality GF breads using GF flours, starches, hydrocolloids, gums, and novel functional ingredients and technologies.

Biosensors for diagnostic applications

Biosensors combine a transducer with a biorecognition element and thus are able to transform a biochemical event on the transducer surface directly into a measurable signal. By this they have the potential to provide rapid, real-time, and accurate results in a comparatively easy way, which makes them promising analytical devices. Since the first biosensor was introduced in 1962 as an "enzyme electrode" for monitoring glucose in blood, medical applications have been the main driving force for further biosensor development. In this chapter we outline potential biosensor setups, focusing on transduction principles, biorecognition layers, and biosensor test formats, with regard to potential applications. A summary of relevant aspects concerning biosensor integration in efficient analytical setups is included. We describe the latest applications of biosensors in diagnostic applications focusing on detection of molecular biomarkers in real samples. An overview of the current state and future trends of biosensors in this field is given.