Predictive Factors and Clinical Impact of Deep Remission in Celiac Disease

Prevalence of a large panel of systemic autoantibodies in the Bavarian adult population

Objective

Autoimmune diseases commonly feature the presence of specific humoral autoantibodies. However, the prevalence of a large panel of systemic autoantibodies has never been assessed in the general population. We, therefore, described the prevalence of about 50 humoral systemic autoantibodies in a sample of the general Bavarian adult population.

Methods

Non-fasting venous serum samples from 331 participants were analyzed for 7 autoantibody screening tests (nuclear, cytoplasmic, and mitotic ANA, ANCA, cANCA and pANCA, anti-ENA autoantibodies) and 44 different monospecific humoral non-organ specific/systemic autoantibodies using indirect immunofluorescence tests, ELISAs, and line blots. In order to assess associations between sex, age, BMI, education level, smoking status and the presence of systemic autoantibodies, logistic regression analyses were conducted.

Results

At least one screening test was positive in 29.9% of the participants, and 42.3% of the participants were seropositive for at least one monospecific autoantibody. The most frequently found monospecific autoantibodies were rheumatoid factor (35.6%), ß2-glycoprotein 1 IgM (4.8%), and cardiolipin IgG (1.8%). Only few associations between sex, age, BMI, education, smoking status and autoantibody frequencies were observed.

Conclusion

Systemic autoantibodies are common in the general Bavarian population, and largely independent of sex, age, BMI, education, or smoking status. The study results may give orientation to clinicians about the occurrence of autoantibodies in the population, not (yet) associated with clinical symptoms.

Emerging Pharmaceutical Therapies to Address the Inadequacy of a Gluten-Free Diet for Celiac Disease

Celiac disease (CeD) is a chronic autoimmune disorder triggered by the ingestion of gluten, affecting around 1% of the global population. It is a multifactorial disease involving both genetics and environmental factors. Nowadays, the only available treatment for CeD is a life-long gluten-free diet (GFD), which can cause a significant burden for patients, since symptoms and mucosal injury can persist despite apparent compliance with a GFD. This could also lead to psychological consequences and affect the quality of life of these patients. Thankfully, recent advances in understanding the pathogenesis of CeD and the availability of various targets have made it feasible to explore pharmaceutical treatments specific to CeD. Recently, the FDA has highlighted the unmet needs of adult patients on a GFD who experience ongoing symptoms attributed to CeD and also show persistent duodenal villous atrophy. This review will outline the limitations of a GFD, describe the targets of potential novel treatment of CeD and provide an overview of the primary clinical trials involving oral and injectable agents for a non-dietary treatment of CeD.

Textural characteristics and color analyses of 3D printed gluten-free pizza dough and crust

A new methodology was developed to print pizza dough with a gluten free flour blend or commercial gluten whole wheat flour using extrusion-based 3-D printing technology. Their physical properties were compared to commercially available pizza dough and crust. The optimized nozzle size, print speed, ingredient flow speed, and line thickness for the 3-D printing of pizza dough were: 0.04 cm, 800 cm/minutes, 1.8, and 0.34 cm, respectively. The printed gluten-free pizza dough required 120 min of fermentation to obtain a comparable color and textural profile (P < 0.05) to that of the gluten whole wheat flour dough fermented for 60 min. The 3-D printed gluten free, whole-wheat pizza and commercially available wheat flour dough and standard crusts demonstrated identical Δ E ab ∗ values of 0.14 and 0.13, respectively with brownness index (BI) values of 1.47 and 1.62, respectively. Textural profile analysis (TPA) of 3-D printed gluten free and whole wheat pizza dough, crust and the commercial standard wheat flour pizza dough and crust demonstrated significant (P < 0.05) correlations in terms of hardness, fracturability, adhesiveness, springiness, cohesiveness, chewiness, and resilience. An optimized method was developed to prepare gluten-free pizza dough and crust with similar functional properties to that of gluten whole wheat flour dough and crust.