1
|
Gambino CM, Agnello L, Vidali M, Lo Sasso B, Mansueto P, Seidita A, Giuliano A, Scazzone C, Massa D, Masucci A, Tamburello M, Vassallo R, Ciaccio AM, Candore G, Carroccio A, Ciaccio M. The role of Killer immunoglobulin-like receptors (KIRs) in the genetic susceptibility to non-celiac wheat sensitivity (NCWS). Clin Chem Lab Med 2024; 62:1814-1823. [PMID: 38639193 DOI: 10.1515/cclm-2024-0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/07/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVES Non-celiac wheat sensitivity (NCWS) is an emerging clinical condition characterized by gastrointestinal and extraintestinal symptoms following the ingestion of gluten-containing foods in patients without celiac disease (CD) or wheat allergy. Despite the great interest for NCWS, the genetic risk factors still need to be fully clarified. In this study, we first assessed the possible contribution of KIR genes and KIR haplotypes on the genetic predisposition to NCWS. METHODS Fifty patients with NCWS, 50 patients with CD, and 50 healthy controls (HC) were included in this study. KIR genes and KIR genotyping were investigated in all subjects by polymerase chain reaction with the sequence oligonucleotide probe (PCR-SSOP) method using Luminex technology. RESULTS We found a statistically different distribution of some KIR genes among NCWS, CD, and HC. Specifically, NCWS showed a decreased frequency of KIR2DL1, -2DL3, -2DL5, -2DS2, -2DS3, -2DS4, -2DS5, and -3DS1 genes, and an increased frequency of -3DL1 gene respect to both CD and HC. No difference was detected in the KIR haplotype expression. At the multivariate analysis, KIR2DL5, -2DS4, and -2DS5 were independent predictors of NCWS. CONCLUSIONS Our findings suggest a role of KIR genes in NCWS susceptibility, with KIR2DL5, -2DS4, and -2DS5 having a protective effect. Further large-scale multicentric studies are required to validate these preliminary findings.
Collapse
Affiliation(s)
- Caterina Maria Gambino
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, 18998 Institute of Clinical Biochemistry, Clinical Molecular Medicine, and Clinical Laboratory Medicine, University of Palermo , Palermo, Italy
- Department of Laboratory Medicine, University Hospital "P. Giaccone", Palermo, Italy
| | - Luisa Agnello
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, 18998 Institute of Clinical Biochemistry, Clinical Molecular Medicine, and Clinical Laboratory Medicine, University of Palermo , Palermo, Italy
| | - Matteo Vidali
- Clinical Pathology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Bruna Lo Sasso
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, 18998 Institute of Clinical Biochemistry, Clinical Molecular Medicine, and Clinical Laboratory Medicine, University of Palermo , Palermo, Italy
- Department of Laboratory Medicine, University Hospital "P. Giaccone", Palermo, Italy
| | - Pasquale Mansueto
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine, and Medical Specialties (PROMISE), Unit of Internal Medicine, 18998 University of Palermo , Palermo, Italy
| | - Aurelio Seidita
- Unit of Internal Medicine, "V. Cervello" Hospital, Ospedali Riuniti "Villa Sofia-Cervello", Palermo, Italy
| | - Alessandra Giuliano
- Unit of Internal Medicine, "V. Cervello" Hospital, Ospedali Riuniti "Villa Sofia-Cervello", Palermo, Italy
| | - Concetta Scazzone
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, 18998 Institute of Clinical Biochemistry, Clinical Molecular Medicine, and Clinical Laboratory Medicine, University of Palermo , Palermo, Italy
| | - Davide Massa
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, 18998 Institute of Clinical Biochemistry, Clinical Molecular Medicine, and Clinical Laboratory Medicine, University of Palermo , Palermo, Italy
| | - Anna Masucci
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, 18998 Institute of Clinical Biochemistry, Clinical Molecular Medicine, and Clinical Laboratory Medicine, University of Palermo , Palermo, Italy
| | - Martina Tamburello
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, 18998 Institute of Clinical Biochemistry, Clinical Molecular Medicine, and Clinical Laboratory Medicine, University of Palermo , Palermo, Italy
| | - Roberta Vassallo
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, 18998 Institute of Clinical Biochemistry, Clinical Molecular Medicine, and Clinical Laboratory Medicine, University of Palermo , Palermo, Italy
| | - Anna Maria Ciaccio
- Department of Health Promotion, Maternal and Child Health, Internal Medicine, and Specialty Excellence "G. D'Alessandro" (PROMISE), Internal Medicine and Stroke Care Ward, University of Palermo, Palermo, Italy
| | - Giuseppina Candore
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, 18998 Laboratory of Immunopathology and Immunosenescence, University of Palermo , Palermo, Italy
| | - Antonio Carroccio
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine, and Medical Specialties (PROMISE), Unit of Internal Medicine, 18998 University of Palermo , Palermo, Italy
- Unit of Internal Medicine, "V. Cervello" Hospital, Ospedali Riuniti "Villa Sofia-Cervello", Palermo, Italy
| | - Marcello Ciaccio
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, 18998 Institute of Clinical Biochemistry, Clinical Molecular Medicine, and Clinical Laboratory Medicine, University of Palermo , Palermo, Italy
- Department of Laboratory Medicine, University Hospital "P. Giaccone", Palermo, Italy
| |
Collapse
|
2
|
Cárdenas-Torres FI, Cabrera-Chávez F, Figueroa-Salcido OG, Ontiveros N. Non-Celiac Gluten Sensitivity: An Update. ACTA ACUST UNITED AC 2021; 57:medicina57060526. [PMID: 34073654 PMCID: PMC8224613 DOI: 10.3390/medicina57060526] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 05/13/2021] [Accepted: 05/19/2021] [Indexed: 12/12/2022]
Abstract
Non-celiac gluten sensitivity (NCGS) is a clinical entity characterized by the absence of celiac disease and wheat allergy in patients that trigger reproducible symptomatic responses to gluten-containing foods consumption. Due to the lack of sensitive and reproducible biomarkers for NCGS diagnosis, placebo-controlled gluten challenges must be carried out for its diagnosis. The gluten challenges can be either double- or single-blind, for research or clinical practice purposes, respectively. For improving our understanding about the magnitude and relevance of NCGS in different populations, epidemiological studies based on self-report have been carried out. However, the gluten challenge-based prevalence of NCGS remains to be estimated. Since NCGS was recently recognized as a clinical entity, more studies are needed to delve into NCGS pathogenesis, for instance, the molecular interactions between the suspected cereal grain components that trigger NCGS, such as fermentable oligo-, di-, monosaccharides, and polyols (FODMAPs) and amylase and trypsin inhibitors, and the immune system remains to be elucidated. Although still under debate, NCGS patients can be susceptible to only one or more than one of the NCGS triggers. The treatment of NCGS involves the dietary restriction of the suspected triggers of the disease, but there is controversial data about the effectiveness of different dietary interventions such as the gluten-free diet and low-FODMAP diet. Certainly, our understanding of NCGS is improving quickly due to the constant availability of new scientific information on this topic. Thus, the aim of the present narrative review is to present an up-to-date overview on NCGS from epidemiology to current therapy.
Collapse
Affiliation(s)
- Feliznando Isidro Cárdenas-Torres
- Doctorate Program in Nutrition Science, Faculty of Nutrition Sciences, University of Sinaloa, Culiacán 80019, Mexico; (F.I.C.-T.); (F.C.-C.)
| | - Francisco Cabrera-Chávez
- Doctorate Program in Nutrition Science, Faculty of Nutrition Sciences, University of Sinaloa, Culiacán 80019, Mexico; (F.I.C.-T.); (F.C.-C.)
| | - Oscar Gerardo Figueroa-Salcido
- Postgraduate in Health Sciences, Division of Biological and Health Sciences, University of Sonora, Hermosillo 83000, Mexico
- Correspondence: (O.G.F.-S.); (N.O.)
| | - Noé Ontiveros
- Clinical and Research Laboratory (LACIUS, URS), Department of Chemical, Biological, and Agricultural Sciences (DC-QB), Division of Sciences and Engineering, University of Sonora, Navojoa 85880, Mexico
- Correspondence: (O.G.F.-S.); (N.O.)
| |
Collapse
|
3
|
Organic food consumption and gluten-free diet, is there a link? Results in French adults without coeliac disease. Br J Nutr 2021; 125:1067-1078. [PMID: 32883398 DOI: 10.1017/s0007114520003323] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The rising popular belief that gluten is unhealthy has led to growth in gluten avoidance in people without coeliac disease. Little information is available on their dietary profiles and their dietary behaviours. Our aim was to compare the consumption of organic foods between gluten avoiders and non-avoiders, and their places of food purchase. We described their sociodemographic and dietary profiles. The study population included participants of the NutriNet-Santé cohort who completed both a food exclusion questionnaire and an organic semi-quantitative FFQ (n 23 468). Food intake and organic food consumption ratios were compared using multivariable adjusted ANCOVA models. Associations between gluten avoidance and organic food consumption as well as places of food purchase were investigated with multivariable logistic regression. Participants avoiding gluten were more likely to be women and had a healthier dietary profile. Organic food consumption was higher among gluten avoiders (48·50 % of total diet for total avoiders, 17·38 % for non-avoiders). After adjustments for confounders, organic food consumption and purchase in organic stores were positively associated with gluten avoidance: adjusted OR (aOR)Q5 v.Q1 organic food = 4·95; 95 % CI 3·70, 6·63 and aORorganic stores v.supermarkets = 1·82; 95 % CI 1·42, 2·33 for total avoiders. Our study highlights that individuals avoiding gluten are high organic consumers and frequently purchase their foods in organic stores which propose an extended offer of gluten-free food. Further research is needed to determine the underlying common motivations and the temporality of the dietary behaviours of healthy people avoiding gluten.
Collapse
|
4
|
Ontiveros N, Real-Delor RE, Mora-Melgem JA, Beltrán-Cárdenas CE, Figueroa-Salcido OG, Vergara-Jiménez MDJ, Cárdenas-Torres FI, Flores-Mendoza LK, Arámburo-Gálvez JG, Cabrera-Chávez F. Prevalence of Wheat/Gluten-Related Disorders and Gluten-Free Diet in Paraguay: An Online Survey-Based Study. Nutrients 2021; 13:396. [PMID: 33513886 PMCID: PMC7911221 DOI: 10.3390/nu13020396] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/19/2021] [Accepted: 01/23/2021] [Indexed: 12/14/2022] Open
Abstract
Gluten-related disorders (GRDs) are increasing around the world, but their magnitude and relevance remain unknown in most Latin American countries. Thus, an online survey was conducted to estimate the prevalence of GRDs as well as adherence to a gluten-free diet (GFD) in Paraguayan adult population. There were 1058 individuals surveyed using a validated questionnaire (response rate of 93.9%). The self-reported prevalence rates were as follows (95% CI): gluten sensitivity (GS), 10.30% (8.53-12.29); non-celiac GS (NCGS), 5.19% (3.94-6.71); physician-diagnosed celiac disease (PD-CD), 3.11% (2.15-4.35); wheat allergy (WA), 2.07% (1.30-3.13); and adherence to GFD, 15.69% (13.55-18.02). Excluding CD, more women than men met the criteria for GRDs, adverse food reactions, and GFD (p < 0.05). Eight respondents reported the coexistence of NCGS with PD-CD and/or WA. Most cases on a GFD indicated medical/dietitian advice for following the diet (68.07%). Non-self-reported GS individuals indicated weight control (46.4%) and the notion that the GFD is healthier (20.2%) as the main motivations for following the diet. GRDs are not uncommon in Paraguayan adult population. It seems that there is awareness about GRDs and the GFD, but training about the diagnosis of GRDs is desirable because of the informed overlapping diagnoses of CD or WA with NCGS. Future studies involving face-to-face interviews are necessary.
Collapse
Affiliation(s)
- Noé Ontiveros
- Clinical and Research Laboratory (LACIUS, URS), Department of Chemical, Biological, and Agricultural Sciences (DC-QB), Division of Sciences and Engineering, University of Sonora, Navojoa 85880, Sonora, Mexico; (N.O.); (L.K.F.-M.)
| | | | - José Antonio Mora-Melgem
- Nutrition Sciences Postgraduate Program, Faculty of Nutrition Sciences, University of Sinaloa, Culiacán 80019, Sinaloa, Mexico; (J.A.M.-M.); (C.E.B.-C.); (M.d.J.V.-J.); (F.I.C.-T.)
| | - Carlos Eduardo Beltrán-Cárdenas
- Nutrition Sciences Postgraduate Program, Faculty of Nutrition Sciences, University of Sinaloa, Culiacán 80019, Sinaloa, Mexico; (J.A.M.-M.); (C.E.B.-C.); (M.d.J.V.-J.); (F.I.C.-T.)
| | - Oscar Gerardo Figueroa-Salcido
- Postgraduate in Health Sciences, Division of Biological and Health Sciences, University of Sonora, Hermosillo 83000, Sonora, Mexico;
| | - Marcela de Jesús Vergara-Jiménez
- Nutrition Sciences Postgraduate Program, Faculty of Nutrition Sciences, University of Sinaloa, Culiacán 80019, Sinaloa, Mexico; (J.A.M.-M.); (C.E.B.-C.); (M.d.J.V.-J.); (F.I.C.-T.)
| | - Feliznando Isidro Cárdenas-Torres
- Nutrition Sciences Postgraduate Program, Faculty of Nutrition Sciences, University of Sinaloa, Culiacán 80019, Sinaloa, Mexico; (J.A.M.-M.); (C.E.B.-C.); (M.d.J.V.-J.); (F.I.C.-T.)
| | - Lilian Karem Flores-Mendoza
- Clinical and Research Laboratory (LACIUS, URS), Department of Chemical, Biological, and Agricultural Sciences (DC-QB), Division of Sciences and Engineering, University of Sonora, Navojoa 85880, Sonora, Mexico; (N.O.); (L.K.F.-M.)
| | - Jesús Gilberto Arámburo-Gálvez
- Nutrition Sciences Postgraduate Program, Faculty of Nutrition Sciences, University of Sinaloa, Culiacán 80019, Sinaloa, Mexico; (J.A.M.-M.); (C.E.B.-C.); (M.d.J.V.-J.); (F.I.C.-T.)
- Postgraduate in Health Sciences, Division of Biological and Health Sciences, University of Sonora, Hermosillo 83000, Sonora, Mexico;
| | - Francisco Cabrera-Chávez
- Nutrition Sciences Postgraduate Program, Faculty of Nutrition Sciences, University of Sinaloa, Culiacán 80019, Sinaloa, Mexico; (J.A.M.-M.); (C.E.B.-C.); (M.d.J.V.-J.); (F.I.C.-T.)
| |
Collapse
|
5
|
Cabanillas B. Gluten-related disorders: Celiac disease, wheat allergy, and nonceliac gluten sensitivity. Crit Rev Food Sci Nutr 2019; 60:2606-2621. [PMID: 31402697 DOI: 10.1080/10408398.2019.1651689] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The consumption of gluten-free products is becoming an increased alimentary habit in the general population. The scientific unfounded perception suggesting that the avoidance of gluten would improve health or that gluten could be toxic for humans are fostering medically unjustified adherences to a gluten-free diet. Currently, only patients diagnosed with celiac disease are advised to follow a strict lifelong gluten-free diet. In the same way, patients diagnosed with IgE-mediated wheat allergy must avoid exposure to wheat in any form. In that context, a third disorder, called nonceliac gluten sensitivity, characterized by distress after gluten consumption and in which neither celiac disease nor IgE-mediated allergy plays a role, has gained increased attention in the last years. Although important scientific advances have been made in the understanding of the pathologic mechanisms behind nonceliac gluten sensitivity, this disorder is still a matter of active debate in the scientific community. In the present review, the most recent advances in the immunopathology, diagnostic biomarkers and susceptibility determinants of gluten-related diseases are summarized and discussed. Furthermore, an updated overview of the new potential therapies that are currently underway for the treatment of gluten-related disorders is also provided.
Collapse
Affiliation(s)
- Beatriz Cabanillas
- Department of Dermatology and Allergy, University of Bonn Medical Center, Bonn, Germany
| |
Collapse
|
6
|
Figueroa-Salcido OG, Ontiveros N, Cabrera-Chavez F. Gluten Vehicle and Placebo for Non-Celiac Gluten Sensitivity Assessment. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E117. [PMID: 31035487 PMCID: PMC6572297 DOI: 10.3390/medicina55050117] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 04/20/2019] [Accepted: 04/23/2019] [Indexed: 12/13/2022]
Abstract
Non-celiac gluten sensitivity (NCGS) is a syndrome characterized by gastrointestinal and extraintestinal manifestations triggered after gluten ingestion in the absence of celiac disease and wheat allergy. Because of the lack of biomarkers for NCGS diagnosis, the cornerstone for its assessment is a single- or double-blind placebo-controlled (DBPC) gluten challenge. However, there are some non-standardized points in the diagnostic approach proposed by the experts. This complicate comparisons among the results published by different research groups. The gluten vehicle and placebo must be indistinguishable from each other, which entails sensory and technological evaluations of the designed gluten vehicle and placebo products. At the moment, there is no standardized method for the preparation of the gluten vehicle and placebo for carrying out DBPC gluten challenges for NCGS assessment. This review focuses on the challenges that researchers have to face, either for the development of an accepted gluten vehicle and placebo or for identifying NCGS cases on the basis of DBPC gluten challenges.
Collapse
Affiliation(s)
- Oscar Gerardo Figueroa-Salcido
- Nutrition Sciences Academic Unit, Autonomous University of Sinaloa, Cedros y Calle Sauces S/N, Fraccionamiento Los Fresnos, Culiacán 80019, Sinaloa, Mexico.
| | - Noé Ontiveros
- Division of Sciences and Engineering, Department of Chemical, Biological, and Agricultural Sciences (DC-QB), University of Sonora, Navojoa 85880, Sonora, Mexico.
| | - Francisco Cabrera-Chavez
- Nutrition Sciences Academic Unit, Autonomous University of Sinaloa, Cedros y Calle Sauces S/N, Fraccionamiento Los Fresnos, Culiacán 80019, Sinaloa, Mexico.
| |
Collapse
|
7
|
Kutteh MA, Abiad M, Norman GL, Kutteh WH. Comparison of celiac disease markers in women with early recurrent pregnancy loss and normal controls. Am J Reprod Immunol 2019; 82:e13127. [PMID: 30977932 DOI: 10.1111/aji.13127] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 03/29/2019] [Accepted: 04/02/2019] [Indexed: 12/20/2022] Open
Abstract
PROBLEM Celiac disease (CD) is an autoimmune intestinal inflammatory disease triggered by gluten in the diet. Untreated CD has been associated with pregnancy loss and infertility. The purpose of this study was to screen unselected women with recurrent pregnancy loss (RPL) for markers of CD to determine whether a correlation exists between RPL and CD serum markers. METHOD OF STUDY Frequencies of three serum markers of CD [tissue transglutaminase (TTG) IgA, endomysial (EMA) IgA, and deaminated gliadin peptide (DGP) IgA] were determined by enzyme-linked immunoassay (ELISA). Seven hundred and eight women who had two or more failed clinical pregnancies (cases) and one hundred women with at least one live birth and no miscarriages (controls) were included in this study. All cases had a full workup for RPL based on the American Society for Reproductive Medicine 2013 guidelines. Antiphospholipid antibodies (aPL) were correlated with CD markers based on their potential prothrombotic role. Results The results show no significant difference in the prevalence of CD autoantibodies when comparing the RPL patients with the controls. Over half of the patients who tested positive for serum markers for CD also had positive aPL. Conclusion Screening unselected women with RPL who are asymptomatic for CD is not supported based on these data. Women who test positive for CD may be candidates for aPL testing based on the association of adverse pregnancy outcomes.
Collapse
Affiliation(s)
- Michael A Kutteh
- University of Oklahoma College of Medicine, Oklahoma City, Oklahoma
| | - May Abiad
- American University of Beirut School of Medicine, Beirut, Lebanon
| | | | - William H Kutteh
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Vanderbilt University School of Medicine, Fertility Associates of Memphis, Memphis, Tennessee
| |
Collapse
|
8
|
Ehteshami M, Shakerhosseini R, Sedaghat F, Hedayati M, Eini-Zinab H, Hekmatdoost A. The Effect of Gluten Free Diet on Components of Metabolic Syndrome: A Randomized Clinical Trial. Asian Pac J Cancer Prev 2018; 19:2979-2984. [PMID: 30362336 PMCID: PMC6291063 DOI: 10.22034/apjcp.2018.19.10.2979] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background: This study aimed to assess the effects of Gluten free diet (GFD) on components of metabolic syndrome (MES). Materials and Methods: In this randomized clinical trial, 50 subjects diagnosed with MES were randomly divided into two groups (n=25). The first group received a GFD and the second group continued their regular diet. Biochemical markers of MES and blood pressure were measured before and after 8-week intervention. Results: Forty five subjects completed the study. A post-hoc comparison of the groups showed no effects of the GFD and control diet on LDL cholesterol, total cholesterol, fasting insulin, HOMA-IR, systolic and diastolic blood pressure levels. The GFD reduced fasting blood glucose, waist circumference (WC) and serum triglyceride concentration significantly compared with the control diet (p<0.05). Conclusion: Short-term GFD reduced WC and improved glycemic control and Triglyceride level in subjects with the metabolic syndrome.
Collapse
Affiliation(s)
- Mehdi Ehteshami
- Department of Clinical Nutrition and Dietetics,, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | | | | | | | | | | |
Collapse
|
9
|
Ontiveros N, Rodríguez-Bellegarrigue CI, Galicia-Rodríguez G, Vergara-Jiménez MDJ, Zepeda-Gómez EM, Arámburo-Galvez JG, Gracia-Valenzuela MH, Cabrera-Chávez F. Prevalence of Self-Reported Gluten-Related Disorders and Adherence to a Gluten-Free Diet in Salvadoran Adult Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040786. [PMID: 29670007 PMCID: PMC5923828 DOI: 10.3390/ijerph15040786] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 03/26/2018] [Accepted: 04/13/2018] [Indexed: 02/06/2023]
Abstract
Gluten-related disorders are not considered of relevance at public health level in Central America. The prevalence of gluten-related disorders, and adherence to a gluten-free diet, remain unknown in the Central American region. We conducted a cross-sectional survey of the Central American population from San Salvador, El Salvador, to estimate the prevalence rates of self-reported gluten-related disorders and adherence to a gluten-free diet. 1326 individuals were surveyed. Self-reported prevalence rates were (95% Confidence Interval): gluten sensitivity 3.1% (2.3–4.2); physician-diagnosed celiac disease 0.15% (0.04–0.5); wheat allergy 0.75% (0.4–1.3); non-celiac gluten sensitivity 0.98% (0.5–1.6). The prevalence rate of adherence to a gluten-free diet was 7.0% (5.7–8.5). Seven self-reported physician diagnosed gluten-sensitive cases informed the co-existence of non-celiac gluten sensitivity with celiac disease and/or wheat allergy. Among the non-self-reported gluten sensitivity individuals following a gluten-free diet, 50% reported that they were seeing a health professional for gluten-free dietary advice. Gluten sensitivity is commonly reported in Salvadoran population, but some health professionals acknowledge the coexistence of wheat allergy, celiac disease, and non-celiac gluten sensitivity. Among studies at population level, the prevalence of adherence to a gluten-free diet in Salvadoran population is the highest reported until now. However, just a few of the gluten-free diet followers were doing it for health-related benefits; the others reported weight control and the perception that the diet is healthier as the main motivation for adopting such a diet.
Collapse
Affiliation(s)
- Noé Ontiveros
- División de Ciencias e Ingeniería, Departamento de Ciencias Químico Biológicas y Agropecuarias, Universidad de Sonora, Navojoa, Sonora 85880, Mexico.
| | - Cecilia Ivonne Rodríguez-Bellegarrigue
- Facultad de Ciencias de la Salud Luis Edmundo Vasquez, Departamento de Salud Pública, Universidad Dr. José Matias Delgado, Antiguo Cuscatlán 1502, El Salvador.
| | - Gerardo Galicia-Rodríguez
- Nutrition Sciences Academic Unit, University of Sinaloa, Av. Cedros and Sauces Street, Los Fresnos, Culiacán, Sinaloa 80019, Mexico.
| | - Marcela de Jesús Vergara-Jiménez
- Nutrition Sciences Academic Unit, University of Sinaloa, Av. Cedros and Sauces Street, Los Fresnos, Culiacán, Sinaloa 80019, Mexico.
| | - Elia María Zepeda-Gómez
- Nutrition Sciences Academic Unit, University of Sinaloa, Av. Cedros and Sauces Street, Los Fresnos, Culiacán, Sinaloa 80019, Mexico.
| | - Jesús Gilberto Arámburo-Galvez
- Nutrition Sciences Academic Unit, University of Sinaloa, Av. Cedros and Sauces Street, Los Fresnos, Culiacán, Sinaloa 80019, Mexico.
| | | | - Francisco Cabrera-Chávez
- Nutrition Sciences Academic Unit, University of Sinaloa, Av. Cedros and Sauces Street, Los Fresnos, Culiacán, Sinaloa 80019, Mexico.
| |
Collapse
|
10
|
Sergi C, Shen F, Bouma G. Intraepithelial lymphocytes, scores, mimickers and challenges in diagnosing gluten-sensitive enteropathy (celiac disease). World J Gastroenterol 2017; 23:573-589. [PMID: 28216964 PMCID: PMC5292331 DOI: 10.3748/wjg.v23.i4.573] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 10/27/2016] [Accepted: 12/16/2016] [Indexed: 02/06/2023] Open
Abstract
The upper digestive tract is routinely scoped for several causes of malabsorption, and the number of duodenal biopsy specimens has increased notably in the last 10 years. Gluten-sensitive enteropathy (GSE) is an autoimmune disease, which shows an increasing prevalence worldwide and requires a joint clinico-pathological approach. The classical histopathology of GSE with partial or total villous blunting is well recognized, but the classification of GSE is not straightforward. Moreover, several mimickers of GSE with intraepithelial lymphocytosis have been identified in the last 20 years, with drug interactions and medical comorbidities adding to the conundrum. In this review, we report on the normal duodenal mucosa, the clinical presentation and laboratory diagnosis of GSE, the duodenal intraepithelial lymphocytes and immunophenotype of GSE-associated lymphocytes, the GSE mimickers, the differences "across oceans" among guidelines in diagnosing GSE, and the use of a synoptic report for reporting duodenal biopsies in both children and adults in the 21st century.
Collapse
|
11
|
Cabrera-Chávez F, Dezar GVA, Islas-Zamorano AP, Espinoza-Alderete JG, Vergara-Jiménez MJ, Magaña-Ordorica D, Ontiveros N. Prevalence of Self-Reported Gluten Sensitivity and Adherence to a Gluten-Free Diet in Argentinian Adult Population. Nutrients 2017; 9:nu9010081. [PMID: 28117706 PMCID: PMC5295125 DOI: 10.3390/nu9010081] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Revised: 12/30/2016] [Accepted: 01/16/2017] [Indexed: 12/23/2022] Open
Abstract
Background: Previous studies suggest that the prevalence of wheat/gluten sensitivity and adherence to a gluten-free diet (GFD) are high in Latin population despite a poor diagnosis of celiac disease. However, these prevalence rates still remain unknown in most Latin American countries. Methods: A cross-sectional survey study was conducted in Santa Fe, Argentina. Results: The estimated self-reported prevalence rates were (95% Confidence Interval [CI]): self-reported gluten sensitivity (SR-GS) 7.61% (6.2–9.2), SR-GS currently following a GFD 1.82% (1.2–2.7), celiac disease 0.58% (0.3–1.2), wheat allergy 0.33% (0.12–0.84), self-reported non-celiac gluten sensitivity (SR-NCGS) 6.28% (5.1–7.8), SR-NCGS currently following a GFD 0.91% (0.5–1.6), and adherence to a GFD 6.37% (5.1–7.9). SR-GS was more common in women (6.0%; p < 0.001) and associated with irritable bowel syndrome (p < 0.001). Among the GFD followers, 71.4% were doing it for reasons other than health-related benefits and 50.6% without medical/dietitian advice. In the non-SR-GS group, the main motivations for following a GFD were weight control and the perception that a GFD is healthier. Conclusion: In Argentina, gluten sensitivity is commonly reported and it seems that physicians/gastroenterologists are aware of celiac disease diagnosis. Trustable information about the benefits and potential consequences of following a GFD should be given to the general population.
Collapse
Affiliation(s)
- Francisco Cabrera-Chávez
- Nutrition Sciences Academic Unit, Universidad Autónoma de Sinaloa, Culiacán, Sinaloa 80019, Mexico.
| | - Gimena V A Dezar
- Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe 3000, Argentina.
| | - Anna P Islas-Zamorano
- Nutrition Sciences Academic Unit, Universidad Autónoma de Sinaloa, Culiacán, Sinaloa 80019, Mexico.
| | | | | | - Dalia Magaña-Ordorica
- Nutrition Sciences Academic Unit, Universidad Autónoma de Sinaloa, Culiacán, Sinaloa 80019, Mexico.
| | - Noé Ontiveros
- Nutrition Sciences Academic Unit, Universidad Autónoma de Sinaloa, Culiacán, Sinaloa 80019, Mexico.
- Regional Program for PhD in Biotechnology, FCQB, Universidad Autónoma de Sinaloa, Culiacán, Sinaloa 80019, Mexico.
| |
Collapse
|
12
|
Self-Reported Prevalence of Gluten-Related Disorders and Adherence to Gluten-Free Diet in Colombian Adult Population. Gastroenterol Res Pract 2016; 2016:4704309. [PMID: 27648068 PMCID: PMC5018322 DOI: 10.1155/2016/4704309] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 06/29/2016] [Accepted: 08/09/2016] [Indexed: 12/19/2022] Open
Abstract
Background. Celiac disease seems to be rare in Colombians, but there are currently no data about the prevalence rates of symptomatic adverse reactions to gluten or adherence to gluten-free diet (GFD) in this population. Aim. to evaluate the self-reported prevalence rates of adverse reactions to gluten, adherence to GFD, and gluten-related disorders at population level in Colombia. Methods. A self-administered questionnaire-based cross-sectional study was conducted in a population from Northwest Colombia. Results. The estimated prevalence rates were (95% CI) 7.9% (6.5–9.6) and 5.3% (4.1–6.7) for adverse and recurrent adverse reactions to wheat/gluten, respectively, adherence to GFD 5.9% (4.7–7.4), wheat allergy 0.74% (0.3–1.4), and nonceliac gluten sensitivity 4.5% (3.5–5.8). There were no self-reported cases of celiac disease. Prevalence of self-reported physician-diagnosis of gluten-related disorders was 0.41% (0.17–0.96). Most respondents reported adherence to GFD without a physician-diagnosis of gluten-related disorders (97.2%). The proportion of gluten avoiders was 17.2% (15.2–19.5). Most of them did not report recurrent adverse reactions to wheat/gluten (87.0%). Conclusions. Nonceliac gluten sensitivity is rarely formally diagnosed in Colombia, but this population has the highest prevalence rate of adherence to GFD reported to date. Consequently, most respondents were avoiding wheat- and/or gluten-based products for reasons other than health-related symptoms.
Collapse
|
13
|
Cuccioloni M, Mozzicafreddo M, Ali I, Bonfili L, Cecarini V, Eleuteri AM, Angeletti M. Interaction between wheat alpha-amylase/trypsin bi-functional inhibitor and mammalian digestive enzymes: Kinetic, equilibrium and structural characterization of binding. Food Chem 2016; 213:571-578. [PMID: 27451220 DOI: 10.1016/j.foodchem.2016.07.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 05/05/2016] [Accepted: 07/05/2016] [Indexed: 12/25/2022]
Abstract
Alpha-amylase/trypsin bi-functional inhibitors (ATIs) are non-gluten protein components of wheat and other cereals that can hypersensitise the human gastrointestinal tract, eventually causing enteropathies in predisposed individuals. These inhibitory proteins can act both directly by targeting specific pro-inflammatory receptors, and indirectly by impairing the activity of digestive enzymes, the latter event causing the accumulation of undigested peptides with potential immunogenic properties. Herein, according to a concerted approach based on in vitro and in silico methods we characterized kinetics, equilibrium parameters and modes of binding of the complexes formed between wheat ATI and two representative mammalian digestive enzymes, namely trypsin and alpha-amylase. Interestingly, we demonstrated ATI to target both enzymes with independent binding sites and with moderately high affinity.
Collapse
Affiliation(s)
- Massimiliano Cuccioloni
- School of Biosciences and Veterinary Medicine, Via Gentile III da Varano, 62032 Camerino (MC), Italy.
| | - Matteo Mozzicafreddo
- School of Biosciences and Veterinary Medicine, Via Gentile III da Varano, 62032 Camerino (MC), Italy
| | - Ishtiaq Ali
- School of Biosciences and Veterinary Medicine, Via Gentile III da Varano, 62032 Camerino (MC), Italy
| | - Laura Bonfili
- School of Biosciences and Veterinary Medicine, Via Gentile III da Varano, 62032 Camerino (MC), Italy
| | - Valentina Cecarini
- School of Biosciences and Veterinary Medicine, Via Gentile III da Varano, 62032 Camerino (MC), Italy
| | - Anna Maria Eleuteri
- School of Biosciences and Veterinary Medicine, Via Gentile III da Varano, 62032 Camerino (MC), Italy
| | - Mauro Angeletti
- School of Biosciences and Veterinary Medicine, Via Gentile III da Varano, 62032 Camerino (MC), Italy
| |
Collapse
|
14
|
Ontiveros N, López-Gallardo JA, Vergara-Jiménez MJ, Cabrera-Chávez F. Self-Reported Prevalence of Symptomatic Adverse Reactions to Gluten and Adherence to Gluten-Free Diet in an Adult Mexican Population. Nutrients 2015. [PMID: 26197336 PMCID: PMC4517044 DOI: 10.3390/nu7075267] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The prevalence of symptomatic adverse reactions to gluten and adherence to gluten-free diet in Latin American countries is unknown. These measurements are strongly linked to gluten-related disorders. This work aimed to estimate the prevalence of adverse reactions to oral gluten and the adherence to gluten-free diet in the adult Mexican population. To reach this aim, a self-administered questionnaire was designed and tested for clarity/comprehension and reproducibility. Then, a self-administered questionnaire-based cross-sectional study was conducted in the Mexican population. The estimated prevalence rates were (95% CI): 11.9% (9.9–13.5) and 7.8 (6.4–9.4) for adverse and recurrent adverse reactions to gluten respectively; adherence to gluten-free diet 3.7% (2.7–4.8), wheat allergy 0.72% (0.38–1.37); celiac disease 0.08% (0.01–0.45), and NCGS 0.97% (0.55–1.68). Estimated pooled prevalence of self-reported physician-diagnosis of gluten-related disorders was 0.88% (0.49–1.5), and 93.3% respondents reported adherence to gluten-free diet without a physician-diagnosis of gluten-related disorders. Symptom comparisons between those who reported recurrent adverse reactions to gluten and other foods showed statistically significant differences for bloating, constipation, and tiredness (p < 0.05). Gluten-related disorders may be underdiagnosed in the Mexican population and most people adhering to a gluten-free diet are doing it without proper diagnostic work-up of these disorders, and probably without medical/dietician advice.
Collapse
Affiliation(s)
- Noe Ontiveros
- Regional Program for PhD in Biotechnology, FCQB, University of Sinaloa, Culiacán, Sinaloa 80019, México; E-Mail:
| | - Jesús A. López-Gallardo
- Nutrition Sciences Academic Unit, University of Sinaloa, Culiacán, Sinaloa 80019, México; E-Mails: (J.A.L.-G.); (M.J.V.-J.)
| | - Marcela J. Vergara-Jiménez
- Nutrition Sciences Academic Unit, University of Sinaloa, Culiacán, Sinaloa 80019, México; E-Mails: (J.A.L.-G.); (M.J.V.-J.)
| | - Francisco Cabrera-Chávez
- Nutrition Sciences Academic Unit, University of Sinaloa, Culiacán, Sinaloa 80019, México; E-Mails: (J.A.L.-G.); (M.J.V.-J.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel./Fax: +52-667-753-5454
| |
Collapse
|