The metabolic activity of the gut microbiota and the impact of gluten free diet in children with coeliac disease

The reason why only few coeliac patients develop the cutaneous manifestation of the disease, named dermatitis herpetiformis (DH), is still unknown. Epidermal transglutaminase (TG3) has been described as the main autoantigen of humoral immunity in DH but the mechanisms leading to this autoimmune response remain obscure. Here we characterized T cells from skin, gut and peripheral blood of DH and coeliac disease (CD) patients, evaluated the impact of the gluten-free diet on circulating T lymphocytes’ phenotype and investigated antigen specific T cell response toward epidermal and tissue transglutaminase (TG2). DH patients showed an increased frequency of skin-derived T cells producing TNFα when compared to CD patients. Moreover, circulating T cells producing TNFα and IL-17A positively correlated with clinical score of skin disease activity and decreased after gluten-free diet. Finally, TG2 and TG3-specific T cells resulted more reactive to antigens stimulation in DH patients and showed cross reactivity toward the two autoantigens in both the group of patients. Our data suggest a role of TNFα and IL-17A producing cells in the development of DH and, for the first time, show the existence of a crossed T cell response toward the two transglutaminases isoforms, thus suggesting new insights on T cells role in skin damage.

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The impact of a gluten-free diet on adults with coeliac disease: results of a national survey

Journal of Human Nutrition and Dietetics ◽

10.1111/j.1365-277x.2006.00659.x ◽

2006 ◽

Vol 19 (1) ◽

pp. 41-49 ◽

Cited By ~ 118

Author(s):

M. Zarkadas ◽

A. Cranney ◽

S. Case ◽

M. Molloy ◽

C. Switzer ◽

...

Keyword(s):

Coeliac Disease ◽

National Survey ◽

Gluten Free Diet ◽

Gluten Free ◽

The Impact

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Micronutrient deficiencies in children with coeliac disease; a double-edged sword of both untreated disease and treatment with gluten-free diet

Clinical Nutrition ◽

10.1016/j.clnu.2021.03.006 ◽

2021 ◽

Author(s):

Lorcan McGrogan ◽

Mary Mackinder ◽

Fiona Stefanowicz ◽

Maria Aroutiounova ◽

Anthony Catchpole ◽

...

Keyword(s):

Coeliac Disease ◽

Gluten Free Diet ◽

Gluten Free ◽

Micronutrient Deficiencies

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Wait-and-See Approach or Gluten-Free Diet Administration—The Rational Management of Potential Coeliac Disease

Nutrients ◽

10.3390/nu13030947 ◽

2021 ◽

Vol 13 (3) ◽

pp. 947

Author(s):

Anna Szaflarska-Popławska

Keyword(s):

Small Intestine ◽

Celiac Disease ◽

Prognostic Factors ◽

Coeliac Disease ◽

Gluten Free Diet ◽

Gluten Free ◽

Individual Basis ◽

Therapeutic Decisions ◽

Rational Management ◽

Wait And See

Potential celiac disease (PCD) is a heterogeneous disease; only some patients develop full celiac disease (CD), characterised by advanced atrophic changes in the small intestine. Few accurate prognostic factors exist for the progression of PCD; therefore, therapeutic decisions should be made on an individual basis in each case. Patients with clinical gastroenterological or parenteral symptoms often benefit from a gluten-free diet, and those left on a diet containing gluten should receive clinical, serological and histopathological supervision.

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The impact of symptoms on quality of life before and after diagnosis of coeliac disease: the results from a Polish population survey and comparison with the results from the United Kingdom

BMC Gastroenterology ◽

10.1186/s12876-021-01673-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Emilia Majsiak ◽

Magdalena Choina ◽

Dominik Golicki ◽

Alastair M. Gray ◽

Bożena Cukrowska

Keyword(s):

Quality Of Life ◽

United Kingdom ◽

Coeliac Disease ◽

Gluten Free Diet ◽

Gluten Free ◽

The United Kingdom ◽

Before And After ◽

The Mean ◽

The Uk

Abstract Background Coeliac disease (CD) is characterised by diverse clinical symptoms, which may cause diagnostic problems and reduce the patients’ quality of life. A study conducted in the United Kingdom (UK) revealed that the mean time between the onset of coeliac symptoms and being diagnosed was above 13 years. This study aimed to analyse the diagnostic process of CD in Poland and evaluate the quality of life of patients before and after CD diagnosis. In addition, results were compared to the results of the original study conducted in the UK. Methods The study included 2500 members of the Polish Coeliac Society. The patients were asked to complete a questionnaire containing questions on socio-demographic factors, clinical aspects and quality of life, using the EQ-5D questionnaire. Questionnaires received from 796 respondents were included in the final analysis. Results The most common symptoms reported by respondents were bloating (75%), abdominal pain (72%), chronic fatigue (63%) and anaemia (58%). Anaemia was the most persistent symptom, with mean duration prior to CD diagnosis of 9.2 years, whereas diarrhoea was observed for the shortest period (4.7 years). The mean duration of any symptom before CD diagnosis was 7.3 years, compared to 13.2 years in the UK. CD diagnosis and the introduction of a gluten-free diet substantially improved the quality of life in each of the five EQ-5D-5L health dimensions: pain and discomfort, anxiety and depression, usual activities, self-care and mobility (p < 0.001), the EQ-Index by 0.149 (SD 0.23) and the EQ-VAS by 30.4 (SD 28.3) points. Conclusions Duration of symptoms prior to the diagnosis of CD in Poland, although shorter than in the UK, was long with an average of 7.3 years from first CD symptoms. Faster CD diagnosis after the onset of symptoms in Polish respondents may be related to a higher percentage of children in the Polish sample. Introduction of a gluten-free diet improves coeliac patients’ quality of life. These results suggest that doctors should be made more aware of CD and its symptoms across all age groups.

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