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Sendid B, Cao C, Colombel JF, Poulain D. Coincidence of antibodies against Hwp1 and ASCA, two distinct molecular targets of Candida albicans, reinforces the link between this fungal species and coeliac disease. Virulence 2024; 15:2334085. [PMID: 38528835 DOI: 10.1080/21505594.2024.2334085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 03/19/2024] [Indexed: 03/27/2024] Open
Abstract
Candida albicans is an immunogen for anti-Saccharomyces cerevisiae antibodies (ASCA), a serological marker of Crohn's disease. ASCA has also been reported in other autoimmune diseases, including coeliac disease (CeD). A strong antibody response against Hwp1, a protein associated with invasive hyphal form of C. albicans which presents peptide sequence homologies with gliadin, has also been described in CeD. This observation supports the hypothesis that C. albicans hyphal transition in C. albicans may trigger CeD onset through a mechanism of molecular/antigenic mimicry. In this study, we assessed whether the anti-C. albicans oligomannose and anti-Hwp1 protein responses may be linked despite their different pathophysiological significance. The measurement of ASCA levels in a cohort of patients involved in our previous Hwp1 study showed a significant correlation between the two biomarkers. This new observation further reinforces the link between C. albicans and CeD.
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Affiliation(s)
- Boualem Sendid
- CNRS, UMR 8576 - UGSF - Unité de Glycobiologie Structurale et Fonctionnelle, Univ INSERM U1285, Lille, France
- CHU Lille, Laboratoire de Parasitologie-Mycologie, Lille, France
| | - Christopher Cao
- Dr Henry D Janowitz Division of Gastroenterology, Icahn School of Medicine, Mount Sinai Hospital, New York, USA
| | - Jean-Frederic Colombel
- Dr Henry D Janowitz Division of Gastroenterology, Icahn School of Medicine, Mount Sinai Hospital, New York, USA
| | - Daniel Poulain
- CNRS, UMR 8576 - UGSF - Unité de Glycobiologie Structurale et Fonctionnelle, Univ INSERM U1285, Lille, France
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Galli G, Uccheddu S, Menchetti M. Fly-catching syndrome responsive to a gluten-free diet in a French Bulldog. J Am Vet Med Assoc 2024; 262:1-3. [PMID: 38096663 DOI: 10.2460/javma.23.09.0515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 11/14/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVE Fly-catching syndrome (FCS) is a rare condition typically characterized by episodes during which affected dogs bite or lick the air and jump for no apparent reason. Among veterinary literature, obsessive-compulsive disorders, focal epileptic seizures, and underlying gastrointestinal diseases were considered the most likely triggering causes. Recently, gluten-sensitive dyskinesia has been described in dogs, but it has never been reported to be associated to FCS. ANIMAL A 6-year-old male French Bulldog. CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES The dog was presented for a 2-month history of episodes characterized by sudden onset of jumping while trying to catch something in the air without impaired consciousness or autonomic signs. The episodes could be interrupted by the owner and lasted several minutes. The dog suffered from chronic gastrointestinal signs. The neurological examination was within normal limits except for the episodes suggestive of FCS during the consultation. The serological test for anti-gliadin immunoglobulin G (AG IgG) and anti-transglutaminase-2 immunoglobulin A (ATG-2 IgA) antibodies resulted above the reference range (3.092 and 0.929, respectively; normal range < 0.6). TREATMENT AND OUTCOME An exclusively gluten-free diet was started. Complete resolution of the episodes was reported during a 3-month follow-up. CLINICAL RELEVANCE To the authors' knowledge, this is the first report of FCS associated to positive AG IgG and ATG-2 IgA antibodies responsive to a gluten-free diet. The typical manifestation of the episodes and response to diet support the hypothesis that FCS may be associated to gastrointestinal disorders. However, more studies are needed in order to confirm this hypothesis.
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Affiliation(s)
- Greta Galli
- 1Neurology and Neurosurgery Division, San Marco Veterinary Clinic, Veggiano, Italy
| | - Stefania Uccheddu
- 2Behavioural Medicine Division, San Marco Veterinary Clinic, Veggiano, Italy
| | - Marika Menchetti
- 1Neurology and Neurosurgery Division, San Marco Veterinary Clinic, Veggiano, Italy
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Auricchio R, Galatola M, Cielo D, Rotondo R, Carbone F, Mandile R, Carpinelli M, Vitale S, Matarese G, Gianfrani C, Troncone R, Auricchio S, Greco L. Antibody Profile, Gene Expression and Serum Cytokines in At-Risk Infants before the Onset of Celiac Disease. Int J Mol Sci 2023; 24:ijms24076836. [PMID: 37047806 PMCID: PMC10095049 DOI: 10.3390/ijms24076836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 03/23/2023] [Accepted: 03/30/2023] [Indexed: 04/14/2023] Open
Abstract
Immunological events that precede the development of villous atrophy in celiac disease (CeD) are still not completely understood. We aimed to explore CeD-associated antibody production (anti-native gliadin (AGA), anti-deamidated gliadin (DGP) and anti-tissue transglutaminase (anti-tTG)) in infants at genetic risk for CeD from the Italian cohorts of the PREVENT-CD and Neocel projects, as well as the relationship between antibody production and systemic inflammation. HLA DQ2 and/or DQ8 infants from families with a CeD case were followed from birth. Out of 220 at-risk children, 182 had not developed CeD by 6 years of age (CTRLs), and 38 developed celiac disease (CeD). The profiles of serum cytokines (INFγ, IL1β, IL2, IL4, IL6, IL10, IL12p70, IL17A and TNFα) and the expression of selected genes (FoxP3, IL10, TGFβ, INFγ, IL4 and IL2) were evaluated in 46 children (20 CeD and 26 CTRLs). Among the 182 healthy CTRLs, 28 (15.3%) produced high levels of AGA-IgA (AGA+CTRLs), and none developed anti-tTG-IgA or DGP-IgA, compared to 2/38 (5.3%) CeD infants (Chi Sq. 5.97, p = 0.0014). AGAs appeared earlier in CTRLs than in those who developed CeD (19 vs. 28 months). Additionally, the production of AGAs in CeD overlapped with the production of DGP and anti-tTG. In addition, gene expression as well as serum cytokine levels discriminated children who developed CeD from CTRLs. In conclusion, these findings suggest that the early and isolated production of AGA-IgA antibodies is a CeD-tolerogenic marker and that changes in gene expression and cytokine patterns precede the appearance of anti-tTG antibodies.
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Affiliation(s)
- Renata Auricchio
- Department of Translational Medical Science, University Federico II, 80131 Naples, Italy
- European Laboratory for Food Induced Diseases, University Federico II, 80131 Naples, Italy
| | - Martina Galatola
- Department of Translational Medical Science, University Federico II, 80131 Naples, Italy
| | - Donatella Cielo
- Department of Translational Medical Science, University Federico II, 80131 Naples, Italy
| | - Roberta Rotondo
- Department of Translational Medical Science, University Federico II, 80131 Naples, Italy
| | - Fortunata Carbone
- Laboratory of Immunology, Institute for Experimental Endocrinology and Oncology, National Research Council of Italy (IEOS-CNR), c/o Department of Molecular Medicine and Medical Biotechnology, University Federico II, 80131 Naples, Italy
- Neuroimmunology Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Roberta Mandile
- Department of Translational Medical Science, University Federico II, 80131 Naples, Italy
- European Laboratory for Food Induced Diseases, University Federico II, 80131 Naples, Italy
| | - Martina Carpinelli
- Department of Translational Medical Science, University Federico II, 80131 Naples, Italy
- European Laboratory for Food Induced Diseases, University Federico II, 80131 Naples, Italy
| | - Serena Vitale
- Institute of Biochemistry and Cell Biology, National Research Council of Italy (IBBC-CNR), 80131 Naples, Italy
| | - Giuseppe Matarese
- Laboratory of Immunology, Institute for Experimental Endocrinology and Oncology, National Research Council of Italy (IEOS-CNR), c/o Department of Molecular Medicine and Medical Biotechnology, University Federico II, 80131 Naples, Italy
| | - Carmen Gianfrani
- European Laboratory for Food Induced Diseases, University Federico II, 80131 Naples, Italy
- Institute of Biochemistry and Cell Biology, National Research Council of Italy (IBBC-CNR), 80131 Naples, Italy
| | - Riccardo Troncone
- Department of Translational Medical Science, University Federico II, 80131 Naples, Italy
- European Laboratory for Food Induced Diseases, University Federico II, 80131 Naples, Italy
| | - Salvatore Auricchio
- European Laboratory for Food Induced Diseases, University Federico II, 80131 Naples, Italy
| | - Luigi Greco
- European Laboratory for Food Induced Diseases, University Federico II, 80131 Naples, Italy
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Hadjivassiliou M, Croall ID, Grünewald RA, Trott N, Sanders DS, Hoggard N. Neurological Evaluation of Patients with Newly Diagnosed Coeliac Disease Presenting to Gastroenterologists: A 7-Year Follow-Up Study. Nutrients 2021; 13:nu13061846. [PMID: 34071336 PMCID: PMC8226493 DOI: 10.3390/nu13061846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 12/26/2022] Open
Abstract
We have previously shown that 67% of patients with newly diagnosed coeliac disease (CD) presenting to gastroenterologists have evidence of neurological dysfunction. This manifested with headache and loss of co-ordination. Furthermore 60% of these patients had abnormal brain imaging. In this follow-up study, we re-examined and re-scanned 30 patients from the original cohort of 100, seven years later. There was significant reduction in the prevalence of headaches (47% to 20%) but an increase in the prevalence of incoordination (27% to 47%). Although those patients with coordination problems at baseline reported improvement on the gluten free diet (GFD), there were 7 patients reporting incoordination not present at baseline. All 7 patients had positive serology for one or more gluten-sensitivity related antibodies at follow-up. In total, 50% of the whole follow-up cohort were positive for one or more gluten-related antibodies. A comparison between the baseline and follow-up brain imaging showed a greater rate of cerebellar grey matter atrophy in the antibody positive group compared to the antibody negative group. Patients with CD who do not adhere to a strict GFD and are serological positive are at risk of developing ataxia, and have a significantly higher rate of cerebellar atrophy when compared to patients with negative serology. This highlights the importance of regular review and close monitoring.
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Affiliation(s)
- Marios Hadjivassiliou
- Academic Department of Neurosciences, Sheffield Teaching Hospitals NHS Trust, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK;
- Correspondence:
| | - Iain D. Croall
- Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield S10 2JF, UK; (I.D.C.); (N.H.)
- Institute for in Silico Medicine, University of Sheffield, Sheffield S10 2JF, UK
| | - Richard A. Grünewald
- Academic Department of Neurosciences, Sheffield Teaching Hospitals NHS Trust, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK;
| | - Nick Trott
- Department of Dietetics, Sheffield Teaching Hospitals NHS Trust, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK;
| | - David S. Sanders
- Academic Department of Gastroenterology, Sheffield Teaching Hospitals NHS Trust, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK;
| | - Nigel Hoggard
- Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield S10 2JF, UK; (I.D.C.); (N.H.)
- Institute for in Silico Medicine, University of Sheffield, Sheffield S10 2JF, UK
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Dhattarwal N, Mahajan VK, Mehta KS, Chauhan PS, Yadav RS, Sharma SB, Sharma A, Sharma R, Rana A, Sondhi M. The association of anti-gliadin and anti-transglutaminase antibodies and chronic plaque psoriasis in Indian patients: Preliminary results of a descriptive cross-sectional study. Australas J Dermatol 2020; 61:e378-e382. [PMID: 32397002 DOI: 10.1111/ajd.13308] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 03/20/2020] [Accepted: 03/30/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Gluten sensitivity among psoriasis patients and its association with gender, age, disease duration and severity of psoriasis are under studied in Indians. OBJECTIVE To examine association among serum levels of anti-tTG and anti-gliadin antibodies and clinical features including gender, age, duration and severity of psoriasis. METHODS Serum levels of anti-transglutaminase and anti-gliadin antibodies were measured quantitatively in 80 (M:F 57:23) psoriasis patients aged 15 to 83 years and matched healthy subjects. RESULTS Forty-five (56.3%) patients were aged ≥41years, duration of disease was >5years in 43(53.8%) patients, and 22 (27.5%) patients had moderate-to-severe psoriasis. Two (2.5%) patients had arthritis and elevated serum anti-gliadin antibody. Significantly more patients than controls had elevated serum anti-gliadin antibody (67.5% vs. 2.5%) and anti-transglutaminase antibody levels (62.5% vs. 0%). Two patients, each with mild and moderate-to-severe psoriasis, had highly elevated serum anti-gliadin antibody and symptoms akin to coeliac disease. Except for a longer duration of psoriasis in patients with elevated anti-gliadin antibodies, there was no statistically significant difference in gender, age, and severity of psoriasis when compared with patients having normal levels. CONCLUSION Significant elevation of serum anti-transglutaminase and anti-gliadin antibodies levels is noted in psoriasis patients reflecting a possible link. However, results need careful interpretation for any significance of gluten sensitivity in pathogenesis of psoriasis/arthritis or as a stand-alone risk factor for chronicity/severity of psoriasis or whether gluten-free diet will be ameliorating. Small number of subjects, cross-sectional study design, lack of pathological/endoscopic diagnosis and follow-up are study limitations.
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Affiliation(s)
- Niharika Dhattarwal
- Departments of, Department of, Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra, India
| | - Vikram K Mahajan
- Departments of, Department of, Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra, India
| | - Karaninder S Mehta
- Departments of, Department of, Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra, India
| | - Pushpinder S Chauhan
- Departments of, Department of, Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra, India
| | - Rajinder S Yadav
- Department of, Biochemistry, Dr. R. P. Govt. Medical College, Kangra, India
| | | | - Anuj Sharma
- Departments of, Department of, Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra, India
| | - Reena Sharma
- Departments of, Department of, Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra, India
| | - Ashwani Rana
- Departments of, Department of, Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra, India
| | - Megha Sondhi
- Departments of, Department of, Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra, India
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Thomsen HL, Jessen EB, Passali M, Frederiksen JL. The role of gluten in multiple sclerosis: A systematic review. Mult Scler Relat Disord 2019; 27:156-63. [PMID: 30384202 DOI: 10.1016/j.msard.2018.10.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 10/08/2018] [Accepted: 10/22/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND There is an increasing interest in diet as a modifying factor in multiple sclerosis (MS), and gluten has been suggested to affect MS. OBJECTIVE The aim of this systematic review is to qualitatively evaluate the evidence on the role of gluten in MS. METHODS A review protocol was submitted to PROSPERO. A systematic literature search was conducted in PubMed, Web of Science, Scopus, Embase, Cab Abstracts, and Google Scholar. Studies on patients with MS, clinically isolated syndrome, or celiac disease presenting with MS-related markers were included, if they investigated effects of diets containing specified amounts of gluten or associations between gluten sensitivities and MS. RESULTS Forty-nine publications presenting 50 studies/cases met the inclusion criteria. Study designs, methods, and outcomes varied broadly across studies. Two intervention studies found a positive effect of a gluten-free diet on disease-related markers in patients with MS. One prospective cohort study also found a positive effect of a gluten-free diet, while a survey found intake of cereal/bread to be protective against MS. Four observational studies did not find increased comorbidity of MS and celiac disease. Seventeen studies investigated the level of different gluten-sensitivity markers in patients with MS with inconsistent results. Finally, 12 cases and 13 posters/abstracts/master's theses contributed to shed light on the topic. CONCLUSIONS There is still not sufficient evidence to state whether gluten plays a role in MS, but limitations of current evidence have been identified and directions of future research have been suggested.
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Józefczuk J, Konopka E, Bierła JB, Trojanowska I, Sowińska A, Czarnecki R, Sobol L, Józefczuk P, Surdy W, Cukrowska B. The Occurrence of Antibodies Against Gluten in Children with Autism Spectrum Disorders Does Not Correlate with Serological Markers of Impaired Intestinal Permeability. J Med Food 2017; 21:181-187. [PMID: 29072974 DOI: 10.1089/jmf.2017.0069] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
There is evidence that children with autism spectrum disorders (ASDs) display an increased immune reactivity against gluten, which is supposed to be the effect of intestinal barrier abnormalities. The aim of study was to evaluate the relation of antibody induced by gluten to zonulin and intestinal fatty acid binding proteins (I-FABP), that is, serological markers of an impaired gut barrier. The study included 77 patients with ASDs. Zonulin, I-FABP, celiac-specific antibodies, anti-gliadin antibodies (AGA), and antibodies against neural transglutaminase 6 (TG6) of immunoglobulin (Ig) A and IgG classes were detected in sera. Celiac-specific antibodies were negative in all ASD children, four children (5.2%) had positive anti-TG6 antibodies, and increased AGA-IgG production was found in 21 patients (27.3%). Mean levels of zonulin and I-FABP in ASD patients were similar to those found in healthy controls and revealed a negative correlation with age, whereas regression analysis revealed a significant positive relationship between antibody production and the age. Serum concentrations of zonulin and I-FABP showed no statistically significant association with antibody positivity. An increased production of antibodies related to gliadin and neural TG6 in ASD children is not related to serological markers of an impaired intestinal barrier.
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Affiliation(s)
- Jan Józefczuk
- 1 The Paediatric Ward with the Paediatric Cardiology Unit, Specialist Hospital of the Holy Spirit , Sandomierz, Poland
| | - Ewa Konopka
- 2 Laboratory of Immunology, Department of Pathology, The Children's Memorial Health Institute , Warsaw, Poland
| | - Joanna Beata Bierła
- 2 Laboratory of Immunology, Department of Pathology, The Children's Memorial Health Institute , Warsaw, Poland
| | - Ilona Trojanowska
- 2 Laboratory of Immunology, Department of Pathology, The Children's Memorial Health Institute , Warsaw, Poland
| | - Agnieszka Sowińska
- 2 Laboratory of Immunology, Department of Pathology, The Children's Memorial Health Institute , Warsaw, Poland
| | - Rafał Czarnecki
- 1 The Paediatric Ward with the Paediatric Cardiology Unit, Specialist Hospital of the Holy Spirit , Sandomierz, Poland
| | - Lucjan Sobol
- 3 Department of Pathology, Specialist Hospital of the Holy Spirit , Sandomierz, Poland
| | - Paweł Józefczuk
- 4 Foundation for Protection of the Immunological System "Immuno ," Warsaw, Poland
| | - Weronika Surdy
- 1 The Paediatric Ward with the Paediatric Cardiology Unit, Specialist Hospital of the Holy Spirit , Sandomierz, Poland
| | - Bożena Cukrowska
- 2 Laboratory of Immunology, Department of Pathology, The Children's Memorial Health Institute , Warsaw, Poland
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Lesiak A, Bednarski I, Pałczyńska M, Kumiszcza E, Kraska-Gacka M, Woźniacka A, Narbutt J. Are interleukin-15 and -22 a new pathogenic factor in pustular palmoplantar psoriasis? Postepy Dermatol Alergol 2016; 33:336-9. [PMID: 27881938 DOI: 10.5114/ada.2016.62838] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 10/23/2015] [Indexed: 01/11/2023] Open
Abstract
Introduction Pustular palmoplantar psoriasis (PPP) is a rare type of psoriasis affecting mainly distal parts of the limbs. Despite numerous theories about etiology of PPP, the pathogenesis still remains unclear. Recent data indicate that interleukin (IL)-15, IL-17 and IL-22 enhance a proinflammatory response in certain skin inflammatory diseases such as psoriasis and atopic dermatitis. There is also evidence that anti-endomysial (anti-EMA) and anti-gliadin (AGA) antibodies are engaged in PPP development. Aim To assess IL-15, IL-17, IL-22 serum levels and evaluate the presence of anti-endomysial and anti-gliadin antibodies in patients with PPP. Material and methods The study group consisted of 20 females of the mean age of 51.8 suffering from PPP. Additionally 29 healthy individuals, age and sex matched, served as controls. ELISA was performed to evaluate serum IL-15, IL-17, IL-22 concentrations while an indirect immunofluorescence test (IIF) was used to determine anti-EMA and AGA presence. Results The mean value of IL-15 and IL-22 serum concentrations was significantly higher in the study group than in the control group (IL-15: 6.48 vs. 4.88 pg/ml; IL-22: 81.47 vs. 4.90 pg/ml, respectively; p < 0.05 for all comparisons). The IL-17 serum level in the study group was higher when compared to the control group (2.0 vs. 0.75 pg/ml), however the results were not statistically significant (p = 0.26). There were no anti-EMA and AGA antibodies detected, both in the control and study group. Conclusions The results obtained may suggest involvement of IL-15 and IL-22 in the pathogenesis of PPP.
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Volta U, Bardella MT, Calabrò A, Troncone R, Corazza GR; Study Group for Non-Celiac Gluten Sensitivity. An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity. BMC Med 2014; 12:85. [PMID: 24885375 DOI: 10.1186/1741-7015-12-85] [Citation(s) in RCA: 216] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 03/31/2014] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Non-celiac gluten sensitivity (NCGS) is still an undefined syndrome with several unsettled issues despite the increasing awareness of its existence. We carried out a prospective survey on NCGS in Italian centers for the diagnosis of gluten-related disorders, with the aim of defining the clinical picture of this new syndrome and to establish roughly its prevalence compared with celiac disease. METHODS From November 2012 to October 2013, 38 Italian centers (27 adult gastroenterology, 5 internal medicine, 4 pediatrics, and 2 allergy) participated in this prospective survey. A questionnaire was used in order to allow uniform and accurate collection of clinical, biochemical, and instrumental data. RESULTS In total, 486 patients with suspected NCGS were identified in this 1-year period. The female/male ratio was 5.4 to 1, and the mean age was 38 years (range 3-81). The clinical picture was characterized by combined gastrointestinal (abdominal pain, bloating, diarrhea and/or constipation, nausea, epigastric pain, gastroesophageal reflux, aphthous stomatitis) and systemic manifestations (tiredness, headache, fibromyalgia-like joint/muscle pain, leg or arm numbness, 'foggy mind,' dermatitis or skin rash, depression, anxiety, and anemia). In the large majority of patients, the time lapse between gluten ingestion and the appearance of symptoms varied from a few hours to 1 day. The most frequent associated disorders were irritable bowel syndrome (47%), food intolerance (35%) and IgE-mediated allergy (22%). An associated autoimmune disease was detected in 14% of cases. Regarding family history, 18% of our patients had a relative with celiac disease, but no correlation was found between NCGS and positivity for HLA-DQ2/-DQ8. IgG anti-gliadin antibodies were detected in 25% of the patients tested. Only a proportion of patients underwent duodenal biopsy; for those that did, the biopsies showed normal intestinal mucosa (69%) or mild increase in intraepithelial lymphocytes (31%). The ratio between suspected NCGS and new CD diagnoses, assessed in 28 of the participating centers, was 1.15 to 1. CONCLUSIONS This prospective survey shows that NCGS has a strong correlation with female gender and adult age. Based on our results, the prevalence of NCGS seems to be only slightly higher than that of celiac disease.
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Osman M, Taha B, Al Duboni G. Assessment of the response to gluten-free diet in an Iraqi population with coeliac disease. A histological and serological follow-up study. Arch Med Sci 2014; 10:294-9. [PMID: 24904663 PMCID: PMC4042032 DOI: 10.5114/aoms.2012.31297] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Revised: 02/21/2012] [Accepted: 03/11/2012] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Coeliac disease (CD) is a common diagnosis among children and adults in Iraq; however, removal of gluten from the diet is essential for patients with CD. The aim of this study, the first such study in Iraq, was to assess the serological and histological recovery profiles of coeliac patients, in both children and adults groups after commencing a gluten-free diet (GFD) for at least 1 year ± 1 month. MATERIAL AND METHODS The study group comprised 78 proved coeliac patients (46 children and 32 adults, median age: 15 years, range: 1-66 years) who all agreed to undergo endoscopy in addition to serological assessment before and after treatment. The duodenal biopsies were interpreted histologically according to modified Marsh criteria and the sera were tested for anti-gliadin antibody (AGA), endomysium antibody (EMA) and anti-tissue transglutaminase antibody (tTG). RESULTS Complete histological remission was seen in 29 (63.1%) of 46 treated children CD patients, while only 5 (10.9%) showed Marsh IIIa changes compared with 11 (24%) before GFD. Similarly none of the 32 adults after GFD showed Marsh IIIb and Marsh IIIc compared with 46.9% and 28.1% before treatment respectively (p = 001). Meanwhile, there was strongly significant reduction in AGA, EMA, and tTG antibodies levels (p = 0.00001) following GFD. CONCLUSIONS Repeating the duodenal biopsy 1 year ±1 month after diagnosis and starting a GFD supports the routine measurement of using histological findings as a gold standard test to confirm recovery of Iraqi CD patients along with using known coeliac serology antibodies.
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Affiliation(s)
- Muhamed Osman
- Department of Pathology, Faculty of Medicine and Defence Health, University Pertahanan Malaysia (UPNM), Kuala Lumpur, Malaysia
| | - Balsam Taha
- Specialized Surgeries Hospital, Medical City, Baghdad, Iraq
| | - Ghada Al Duboni
- Clinical Immunologist, Department of Basic Sciences, College of Dentistry, University of Baghdad, Baghdad, Iraq
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Walker RH. Further Evidence for Celiac Disease-associated Chorea. Tremor Other Hyperkinet Mov (N Y) 2011; 1. [PMID: 23439937 PMCID: PMC3569904 DOI: 10.7916/d82806bc] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Accepted: 05/27/2011] [Indexed: 12/01/2022]
Abstract
Background A number of neurological conditions have been reported to be associated with gluten sensitivity, including ataxia, peripheral neuropathy, epilepsy, and occasionally, chorea. The pathogenic role of anti-gliadin antibodies has been questioned, and pathophysiology remains controversial. Case Report I report chorea in a patient with celiac disease, which responded to a gluten-restricted diet. The response of the movement disorder to change in diet strongly suggests a functional role for anti-gliadin antibodies in the generation of chorea, probably involving basal ganglia targets. Discussion Gluten sensitivity may be a treatable cause of chorea.
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Affiliation(s)
- Ruth H Walker
- Departments of Neurology, James J. Peters Veterans Affairs Medical Center, Bronx, New York ; Mount Sinai School of Medicine, New York, United States of America
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