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Calado J, Verdelho Machado M. Celiac Disease Revisited. GE PORTUGUESE JOURNAL OF GASTROENTEROLOGY 2022; 29:111-124. [PMID: 35497669 PMCID: PMC8995660 DOI: 10.1159/000514716] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 01/08/2021] [Indexed: 08/30/2023]
Abstract
Celiac disease (CD) is a systemic disease triggered by gluten ingestion in genetically predisposed individuals. It manifests primarily as an autoimmune enteropathy associated with specific circulating autoantibodies and a human leukocyte antigen haplotype (HLA-DQ2 or HLA-DQ8). It afflicts roughly 1% of the population, though the majority of patients remain undiagnosed. Diarrhea and malabsorption are classic manifestations of CD; however, both children and adults can be paucisymptomatic and present extraintestinal manifestations such as anemia, osteoporosis, and abnormal liver tests. CD screening is not recommended for the general population, and it should be focused on high-risk groups. CD diagnosis is challenging and relies on serological tests, duodenal histology, and genetic testing. Particularly difficult presentations to manage are seronegative patients, seropositive patients without villus atrophy, and patients who have started a gluten-free diet before the diagnostic workup. The only proven treatment is a lifelong gluten-free diet. We present an in-depth review on the physiopathology and management of CD, with a particular emphasis on diagnostic challenges.
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Affiliation(s)
- João Calado
- Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Mariana Verdelho Machado
- Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Hospital de Vila Franca de Xira, Vila Franca de Xira, Portugal
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Jin Y, Acharya HG, Acharya D, Jorgensen R, Gao H, Secord J, Ng PKW, Gangur V. Advances in Molecular Mechanisms of Wheat Allergenicity in Animal Models: A Comprehensive Review. Molecules 2019; 24:molecules24061142. [PMID: 30909404 PMCID: PMC6471126 DOI: 10.3390/molecules24061142] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 03/16/2019] [Accepted: 03/18/2019] [Indexed: 12/27/2022] Open
Abstract
The prevalence of wheat allergy has reached significant levels in many countries. Therefore, wheat is a major global food safety and public health issue. Animal models serve as critical tools to advance the understanding of the mechanisms of wheat allergenicity to develop preventive and control methods. A comprehensive review on the molecular mechanisms of wheat allergenicity using animal models is unavailable at present. There were two major objectives of this study: To identify the lessons that animal models have taught us regarding the molecular mechanisms of wheat allergenicity and to identify the strengths, challenges, and future prospects of animal models in basic and applied wheat allergy research. Using the PubMed and Google Scholar databases, we retrieved and critically analyzed the relevant articles and excluded celiac disease and non-celiac gluten sensitivity. Our analysis shows that animal models can provide insight into the IgE epitope structure of wheat allergens, effects of detergents and other chemicals on wheat allergenicity, and the role of genetics, microbiome, and food processing in wheat allergy. Although animal models have inherent limitations, they are critical to advance knowledge on the molecular mechanisms of wheat allergenicity. They can also serve as highly useful pre-clinical testing tools to develop safer genetically modified wheat, hypoallergenic wheat products, novel pharmaceuticals, and vaccines.
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Affiliation(s)
- Yining Jin
- Department of Food Science and Human Nutrition, Food Allergy & Immunology Laboratory, Michigan State University, East Lansing, MI 48824, USA.
| | - Harini G Acharya
- Department of Food Science and Human Nutrition, Food Allergy & Immunology Laboratory, Michigan State University, East Lansing, MI 48824, USA.
| | - Devansh Acharya
- Department of Food Science and Human Nutrition, Food Allergy & Immunology Laboratory, Michigan State University, East Lansing, MI 48824, USA.
| | - Rick Jorgensen
- Department of Food Science and Human Nutrition, Food Allergy & Immunology Laboratory, Michigan State University, East Lansing, MI 48824, USA.
| | - Haoran Gao
- Department of Food Science and Human Nutrition, Food Allergy & Immunology Laboratory, Michigan State University, East Lansing, MI 48824, USA.
| | - James Secord
- Department of Food Science and Human Nutrition, Food Allergy & Immunology Laboratory, Michigan State University, East Lansing, MI 48824, USA.
| | - Perry K W Ng
- Cereal Science Laboratory, Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA.
| | - Venugopal Gangur
- Department of Food Science and Human Nutrition, Food Allergy & Immunology Laboratory, Michigan State University, East Lansing, MI 48824, USA.
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Hrncir T, Hrncirova L, Kverka M, Tlaskalova-Hogenova H. The role of gut microbiota in intestinal and liver diseases. Lab Anim 2018; 53:271-280. [PMID: 30580671 DOI: 10.1177/0023677218818605] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The world-wide incidence of many immune-mediated and metabolic diseases, including those of the intestines and liver, is steadily increasing. Gut microbiota plays a central role in the pathogenesis of these diseases as it mediates environmental changes to the intestinal immune system. Various environmental factors including diet, food additives and medication also trigger the compositional and functional alterations of microbiota, that is, dysbiosis, and this dysbiosis is closely associated with many chronic inflammatory diseases. However, the causal relationship remains unclear for the majority of these diseases. In this review, we discuss essential epidemiological data, known pathogenetic factors including those of genetic and environmental nature, while mainly focusing on the role of gut microbiota in the development of selected intestinal and liver diseases. Using specific examples, we also briefly describe some of the most widely-used animal models including gnotobiotic models and their contribution to the research of pathogenetic mechanisms of the host-microbiota relationship.
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Affiliation(s)
- Tomas Hrncir
- 1 Institute of Microbiology, The Czech Academy of Sciences, Czech Republic
| | - Lucia Hrncirova
- 1 Institute of Microbiology, The Czech Academy of Sciences, Czech Republic.,2 Faculty of Medicine, Charles University, Czech Republic
| | - Miloslav Kverka
- 1 Institute of Microbiology, The Czech Academy of Sciences, Czech Republic
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Makovický P, Chrenková M, Makovický P, Fľak P, Formelová Z, Novosadová V, Rajský M, Vannucci L. The effect of selected feed mixtures on the duodenal morphology: comparison study. Physiol Res 2018; 67:955-962. [PMID: 30204462 DOI: 10.33549/physiolres.933816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The objective of this work was to compare the effect of selected feed mixtures on the duodenal morphology. One-hundred-four rats of the Wistar strain were divided to thirteen groups per eight rats. The experiment started in 35-day-old rats after birth and lasted for 32 days. The groups (A-M) were fed by commercial diet, 85 % wheat and 15 % oat diet, 85 % wheat and 15 % triticale, 85 % wheat and 15 % barley, 85 % wheat and 15 % amaranth, 85 % wheat and 15 % lantern, 85 % wheat and 15 % buckwheat, 100 % wheat, 100 % white lupine, 100 % flock peas - variety Garden, 100 % native peas - variety Garden, 100 % native peas - variety Zekon or 100 % extruded peas - variety Zekon diet, respectively. Samples from the duodenum were taken. The height of the villi and the depth of the crypts were measured. The tallest villi were measured in group F (474.33+/-114.36 microm) and the shortest villi were observed in group B (294.08+/-88.52 microm). The deepest crypts were measured in group K (166.41+/-35.69 microm) and the shallowest crypts were observed in group E (77.85+/-17.61 microm). The work documents that gluten-free and classical cereals combination can be a better choice for people who want to limit the gluten content of the diet.
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Affiliation(s)
- P Makovický
- Czech Centre for Phenogenomics, Division BIOCEV, Vestec, Czech Republic, Laboratory of Immunotherapy, Institute of Microbiology of the Czech Academy of Sciences, Prague, Czech Republic.
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Hulst M, Jansman A, Wijers I, Hoekman A, Vastenhouw S, van Krimpen M, Smits M, Schokker D. Enrichment of in vivo transcription data from dietary intervention studies with in vitro data provides improved insight into gene regulation mechanisms in the intestinal mucosa. GENES AND NUTRITION 2017; 12:11. [PMID: 28413565 PMCID: PMC5390468 DOI: 10.1186/s12263-017-0559-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 03/28/2017] [Indexed: 12/30/2022]
Abstract
Background Gene expression profiles of intestinal mucosa of chickens and pigs fed over long-term periods (days/weeks) with a diet rich in rye and a diet supplemented with zinc, respectively, or of chickens after a one-day amoxicillin treatment of chickens, were recorded recently. Such dietary interventions are frequently used to modulate animal performance or therapeutically for monogastric livestock. In this study, changes in gene expression induced by these three interventions in cultured “Intestinal Porcine Epithelial Cells” (IPEC-J2) recorded after a short-term period of 2 and 6 hours, were compared to the in vivo gene expression profiles in order to evaluate the capability of this in vitro bioassay in predicting in vivo responses. Methods Lists of response genes were analysed with bioinformatics programs to identify common biological pathways induced in vivo as well as in vitro. Furthermore, overlapping genes and pathways were evaluated for possible involvement in the biological processes induced in vivo by datamining and consulting literature. Results For all three interventions, only a limited number of identical genes and a few common biological processes/pathways were found to be affected by the respective interventions. However, several enterocyte-specific regulatory and secreted effector proteins that responded in vitro could be related to processes regulated in vivo, i.e. processes related to mineral absorption, (epithelial) cell adherence and tight junction formation for zinc, microtubule and cytoskeleton integrity for amoxicillin, and cell-cycle progression and mucus production for rye. Conclusions Short-term gene expression responses to dietary interventions as measured in the in vitro bioassay have a low predictability for long-term responses as measured in the intestinal mucosa in vivo. The short-term responses of a set regulatory and effector genes, as measured in this bioassay, however, provided additional insight into how specific processes in piglets and broilers may be modulated by “early” signalling molecules produced by enterocytes. The relevance of this set of regulatory/effector genes and cognate biological processes for zinc deficiency and supplementation, gluten allergy (rye), and amoxicillin administration in humans is discussed. Electronic supplementary material The online version of this article (doi:10.1186/s12263-017-0559-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marcel Hulst
- Animal Breeding and Genomics Centre, Wageningen University and Research, Wageningen, The Netherlands.,Wageningen Bioveterinary Research, Wageningen University and Research, Lelystad, The Netherlands
| | - Alfons Jansman
- Wageningen Livestock Research, Wageningen University and Research, Wageningen, The Netherlands
| | - Ilonka Wijers
- Animal Breeding and Genomics Centre, Wageningen University and Research, Wageningen, The Netherlands
| | - Arjan Hoekman
- Animal Breeding and Genomics Centre, Wageningen University and Research, Wageningen, The Netherlands
| | - Stéphanie Vastenhouw
- Wageningen Bioveterinary Research, Wageningen University and Research, Lelystad, The Netherlands
| | - Marinus van Krimpen
- Wageningen Livestock Research, Wageningen University and Research, Wageningen, The Netherlands
| | - Mari Smits
- Animal Breeding and Genomics Centre, Wageningen University and Research, Wageningen, The Netherlands.,Wageningen Bioveterinary Research, Wageningen University and Research, Lelystad, The Netherlands
| | - Dirkjan Schokker
- Animal Breeding and Genomics Centre, Wageningen University and Research, Wageningen, The Netherlands
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Piscaglia AC, Rutella S, Laterza L, Cesario V, Campanale M, Cazzato IA, Ianiro G, Barbaro F, Di Maurizio L, Bonanno G, Cenci T, Cammarota G, Larocca LM, Gasbarrini A. Circulating hematopoietic stem cells and putative intestinal stem cells in coeliac disease. J Transl Med 2015; 13:220. [PMID: 26160352 PMCID: PMC4498508 DOI: 10.1186/s12967-015-0591-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 06/30/2015] [Indexed: 12/23/2022] Open
Abstract
Background The intestinal stem cells (ISC) modulation and the role of circulating hematopoietic stem cells (HSC) in coeliac disease (CD) are poorly understood. Our aim was to investigate the longitudinal modifications in peripheral blood HSC traffic and putative ISC density induced by gluten-free diet (GFD) in CD. Methods Thirty-one CD patients and 7 controls were enrolled. Circulating CD133+ and CD34+ HSC were measured by flow cytometry, at enrolment and after 7 days and 1, 3, 6, 12, and 24 months of GFD. Endoscopy was performed at diagnosis and repeated at 6, 12, and 24 months following GFD. We used the Marsh-Oberhuber score to evaluate the histological severity of duodenal damage; immunohistochemistry was employed to measure the intraepithelial lymphoid infiltrate (IEL, CD3+ lymphoid cells) and the putative ISC compartment (CD133+ and Lgr5+ epithelial cells). Results At enrolment, circulating HSCs were significantly increased in CD patients and they further augmented during the first week of GFD, but progressively decreased afterwards. CD patients presented with villous atrophy, abundant IEL and rare ISC residing at the crypt base. Upon GFD, IEL progressively decreased, while ISC density increased, peaking at 12 months. After 24 months of GFD, all patients were asymptomatic and their duodenal mucosa was macroscopically and histologically normal. Conclusions In active CD patients, the ISC niche is depleted and there is an increased traffic of circulating HSC versus non-coeliac subjects. GFD induces a precocious mobilization of circulating HSC, which is followed by the expansion of the local ISC compartment, leading to mucosal healing and clinical remission.
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Affiliation(s)
- Anna Chiara Piscaglia
- Endoscopy and Gastroenterology Unit, State Hospital, Borgo Maggiore, Republic of San Marino. .,Institute of Internal Medicine and Gastroenterology, "A. Gemelli" Hospital, Catholic University, Rome, Italy.
| | - Sergio Rutella
- Division of Translational Medicine, Clinical Research Centre, Sidra Medical and Research Centre, PO Box 26999, Burj Doha, 8th Floor, Doha, Qatar.
| | - Lucrezia Laterza
- Institute of Internal Medicine and Gastroenterology, "A. Gemelli" Hospital, Catholic University, Rome, Italy.
| | - Valentina Cesario
- Endoscopy and Gastroenterology Unit, State Hospital, Borgo Maggiore, Republic of San Marino. .,Institute of Internal Medicine and Gastroenterology, "A. Gemelli" Hospital, Catholic University, Rome, Italy.
| | - Mariachiara Campanale
- Institute of Internal Medicine and Gastroenterology, "A. Gemelli" Hospital, Catholic University, Rome, Italy.
| | | | - Gianluca Ianiro
- Institute of Internal Medicine and Gastroenterology, "A. Gemelli" Hospital, Catholic University, Rome, Italy.
| | - Federico Barbaro
- Institute of Internal Medicine and Gastroenterology, "A. Gemelli" Hospital, Catholic University, Rome, Italy.
| | - Luca Di Maurizio
- Institute of Internal Medicine and Gastroenterology, "A. Gemelli" Hospital, Catholic University, Rome, Italy.
| | - Giuseppina Bonanno
- Institute of Gynecology, "A. Gemelli" Hospital, Catholic University, Rome, Italy.
| | - Tonia Cenci
- Institute of Pathology, "A. Gemelli" Hospital, Catholic University, Rome, Italy.
| | - Giovanni Cammarota
- Institute of Internal Medicine and Gastroenterology, "A. Gemelli" Hospital, Catholic University, Rome, Italy.
| | - Luigi Maria Larocca
- Institute of Pathology, "A. Gemelli" Hospital, Catholic University, Rome, Italy.
| | - Antonio Gasbarrini
- Institute of Internal Medicine and Gastroenterology, "A. Gemelli" Hospital, Catholic University, Rome, Italy.
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