scholarly journals Celiac Disease

2001 ◽  
Vol 47 (11) ◽  
pp. 2023-2028 ◽  
Author(s):  
Mabel Aleanzi ◽  
Ana María Demonte ◽  
Cecilia Esper ◽  
Silvia Garcilazo ◽  
Marta Waggener
Keyword(s):  
Celiac Disease ◽  
Tissue Transglutaminase ◽  
Gluten Free ◽  
Antibody Recognition ◽  
Modified Peptides ◽  
Gliadin Peptides ◽  
Circulating Antibodies ◽  
Native Peptides ◽  
Gliadin Antibody ◽  
Circulating Antibody

Abstract Background: Selective deamidation of glutamine residues by tissue transglutaminase (tTG) turns gliadin peptides into stronger activators of T cells from celiac disease (CD) patients. We examined the possibility that these modified peptides could be more specific epitopes for circulating antibodies than are native peptides. Methods: Two native synthetic peptides and their respective modified sequences were used as antigens for ELISA assays: peptide-1, with residues 56–75 of α-type gliadin; and peptide-2, with residues 134–153 of γ-type gliadin. We examined 40 CD patients [31 not being treated with a gluten-free diet (GFD) and 9 being treated with a GFD] and 30 non-CD patients. Results: An enhanced response against deamidated peptides was observed in 4 (IgA) and 22 (IgG) of 31 untreated CD patients for peptide-1 and in 25 (IgA) and 29 (IgG) patients for peptide-2. Higher anti-gliadin antibody and anti-tTG IgA concentrations correlated with increased IgA reactivity to modified peptides. Among the nine treated CD patients, eight also displayed an improved IgG signal for the deamidated sequence. Deamidation of peptides did not increase the reactivity of non-CD sera. Conclusions: Selective deamidation specifically increases circulating antibody recognition of gliadin peptides in CD patients. This suggests that deamidated gliadin peptides are more specific CD B-cell epitopes than native peptides; this finding may be relevant for designing improved diagnostic tests.

scholarly journals Case report: in focus IgA nephropathy as a gluten-related disorder

2021 ◽  
Author(s):  
М.Е. Манцаева ◽  
А.Г. Борисов ◽  
А.А. Стремоухов
Keyword(s):  
Blood Pressure ◽  
Celiac Disease ◽  
Iga Nephropathy ◽  
Tissue Transglutaminase ◽  
Clinical Manifestations ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Related Disorder ◽  
Laboratory Parameters ◽  
Gliadin Peptides

Почки могут вовлекаться в патологический процесс при целиакии как в связи с тяжелыми метаболическими нарушениями, так и в качестве ассоциированного заболевания. В мировой литературе имеются данные о различных типах поражения почек у пациентов с целиакией, включая IgA-нефропатию, диабетическую нефропатию, мембранозную нефропатию, мембранозно-пролиферативный гломерулонефрит, нефротический синдром, связанный с мальабсорбцией, оксалатную нефропатию и ассоциацию целиакии с хронической болезнью почек и терминальной почечной недостаточностью. В статье приводится клинический случай 46-летнего мужчины с выявленным нарушением обмена глютена, заподозренным и диагностированным после верификации хронического гломерулонефрита. Отсутствие характерных клинических проявлений со стороны желудочно-кишечного тракта, повышенные титры антител IgA к тканевой трансглютаминазе и деамидированным пептидам глиадина, морфологическая картина слизистой оболочки 12-перстной кишки не давали оснований в пользу диагноза «целиакия», но указывали на наличие нарушений обмена глютена. Пациенту назначена безглютеновая диета на 6 месяцев. В результате наблюдалось улучшение клинико-лабораторных показателей – более стабильные цифры артериального давления на стандартной гипотензивной терапии, снижение суточной протеинурии, гематурии и титров антител IgA к тканевой трансглютаминазе и деамидированным пептидам глиадина. Очевидно, что введение безглютеновой диеты в рацион пациентов с IgA-нефропатией может улучшить клинико-лабораторные показатели, такие как артериальное давление, суточная протеинурия, гематурия, и, вероятно, отсрочить прогрессирование хронической болезни почек. The kidneys can be involved in the pathological process in celiac disease, both in connection with severe metabolic disorders, and as an associated disease. In total, there is evidence of various types of kidney damage in patients with celiac disease, including IgA nephropathy, diabetic nephropathy, membranous nephropathy, membranoproliferative glomerulonephritis, nephrotic syndrome associated with malabsorption, oxalate nephropathy, and the association of celiac disease with chronic renal disease and terminal renal insufficiency in the literature. We describe a case of a 46-year-old man with gluten-related disorders. Given the absence of typical clinical manifestations from the gastrointestinal tract, increased antibodies IgA to tissue transglutaminase and deamidated gliadin peptides, the morphological picture of the duodenal mucosa, do not give grounds for diagnosing celiac disease, but indicate the presence of a gluten-related disorders in the patient. The patient was prescribed a gluten-free diet for a period of 6 months. As a result, an improvement in clinical and laboratory parameters was observed: more stable blood pressure values on standard antihypertensive therapy, a decrease in proteinuria, hematuria, and antibody IgA to tissue transglutaminase and deamidated gliadin peptides. The introduction of a gluten-free diet in the diet of patients with IgA-nephropathy can improve clinical and laboratory parameters, such as blood pressure, proteinuria, hematuria, and probably delay the progression of chronic renaldisease.

scholarly journals X6: A Novel Antibody for Potential Use in Gluten Quantification

Molecules ◽  
2020 ◽  
Vol 25 (14) ◽  
pp. 3107
Author(s):  
Aleksandrina Shatalova ◽  
Ivan Shatalov ◽  
Yuri Lebedin
Keyword(s):  
Celiac Disease ◽  
Specific Binding ◽  
Qualitative Assessment ◽  
Disease Manifestation ◽  
Antibody Recognition ◽  
Gliadin Peptides ◽  
Specificity Study ◽  
Highly Correlated ◽  
Gliadin Antibody ◽  
Potential Use

Gliadin is a fraction of gluten, known to trigger celiac disease in susceptible people. To date, the life-long gluten-free diet is used for the prevention of this disease. Hence, methods for gluten control in foods are of significant importance. Being one of the most-used methods used for this purpose, ELISA should use high-affinity antibodies to gliadin peptides involved into celiac process. This study investigates the characteristics of a novel anti-gliadin antibody X6. We found the QXQPFPXP site to be a recognized epitope that provides specific binding of the antibody to cereal prolamins involved in celiac disease manifestation. A specificity study using immunoblotting shows the recognition of wheat, barley and rye proteins—as well as α-gliadin homologs from non-edible cereals (Dasypyrum villosum). Reactivity to avenin was less pronounced, as this protein does not contain the PFP motif most critical for antibody recognition. The proteins of Zea mays and Setaria italica were not recognized by X6. X6-based ELISA highly correlated with R5 and G12, which are Codex Alimentarius standards in the quantitative assessment of gluten content (Pearson’s R = 0.86 and 0.87, respectively). Qualitative assessment revealed no significant differences between R5 and G12 and X6.

A Single Institution’s Experience of Primary Headache in Children With Celiac Disease

2019 ◽  
Vol 35 (1) ◽  
pp. 37-41 ◽  
Author(s):  
Grant L. Hom ◽  
Brian L. Hom ◽  
Barbara Kaplan ◽  
A. David Rothner
Keyword(s):  
Celiac Disease ◽  
Tissue Transglutaminase ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Phone Survey ◽  
Type Headache ◽  
The Impact ◽  
Histologic Changes

Background: Few studies exist examining the frequency of primary headache in children with celiac disease and the impact of a gluten-free diet on primary headache symptomology. This study explores characteristics and frequency of headaches in children with celiac disease and response to gluten-free diet at a single institution. Methods: Medical records were reviewed for children with celiac disease confirmed by the presence of elevated tissue transglutaminase IgA levels and histologic changes consistent with the diagnosis of celiac disease on small bowel biopsy. Eligible participants were contacted via letter for participation in a phone survey regarding headaches. Phone interviews were conducted 2 weeks after notification and lasted approximately 10 minutes. Headaches were classified according to ICHD-3 criteria. Results: 247 eligible patients or their families were contacted. A total of 132 (53.44%) agreed to participate. One participant was excluded due to insufficient information provided. Overall, 51 of 131 participants had recurrent headache defined as at least 1 episode per month (39%, 95% confidence interval [CI]: 31%-47%) and 33 had migraine with or without aura (25%, 95% CI: 18%-33%). Twenty-eight had frequent tension-type headache (22%, 95% CI: 15%-29%). Thirty-two participants noted headaches before a confirmed diagnosis of celiac disease. Twenty-two of 32 participants (68.75%) noticed decreased headache frequency or intensity, or both, after starting the gluten-free diet. Conclusion: This study suggests that at least one-third of children and adolescents with celiac disease have recurrent headaches at the time of diagnosis. A gluten-free diet led to improved headache symptomology in a significant number of these patients.

scholarly journals Antibodies against Synthetic Deamidated Gliadin Peptides for Celiac Disease Diagnosis and Follow-Up in Children

2009 ◽  
Vol 55 (1) ◽  
pp. 150-157 ◽  
Author(s):  
Daniela Basso ◽  
Graziella Guariso ◽  
Paola Fogar ◽  
Alessandra Meneghel ◽  
Carlo-Federico Zambon ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Predictive Value ◽  
Disease Diagnosis ◽  
Iga Deficiency ◽  
Serum Markers ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Gliadin Peptides ◽  
Celiac Disease Diagnosis ◽  
Cd Marker

AbstractBackground: AGA IgA II and AGA IgG II have recently been suggested as reliable tools for celiac disease (CD) diagnosis. We compared their utility for diagnosis and monitoring CD in children with that of tTG IgA, an established CD marker.Methods: We studied a cohort of 161 CD and 129 control children in whom CD was histologically confirmed or ruled out. We followed 37 children with CD on a gluten-free diet for 12–84 months. In fasting sera, we measured AGA IgA II, AGA IgG II, and tTG IgA using ELISAs.Results: The best sensitivity (92.5%), specificity (97.6%), positive predictive value (98%), and negative predictive value (91.2%) were obtained using tTG IgA. AGA IgG II correctly identified 3 of 3 children with CD with total IgA deficiency who had negative AGA IgA II and tTG IgA results. In children <2 years old without total IgA deficiency, AGA IgG II and tTG IgA performed equally well (sensitivity 96.4% and specificity 100%). AGA IgA II, AGA IgG II, and tTG IgA concentrations diminished significantly (P < 0.0001) after 1 year of a gluten-free diet, reaching values below the cutoff in 87%, 70%, and 51% of cases, respectively.Conclusions: The best available index for diagnosing CD in children was tTG IgA. In infants <2 years old, AGA IgG II performed as well as tTG IgA in cases without total IgA deficiency and allowed detection of CD when total IgA was <0.06 g/L. Gluten-free diet monitoring can be achieved using any of the studied serum markers.

scholarly journals IgG Antibodies against Deamidated Gliadin Peptides for Diagnosis of Celiac Disease in Patients with IgA Deficiency

2010 ◽  
Vol 56 (3) ◽  
pp. 464-468 ◽  
Author(s):  
Danilo Villalta ◽  
Elio Tonutti ◽  
Christian Prause ◽  
Sibylle Koletzko ◽  
H Holm Uhlig ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Blood Donors ◽  
Tissue Transglutaminase ◽  
Iga Deficiency ◽  
Diagnostic Sensitivity ◽  
Igg Antibodies ◽  
Diagnostic Specificity ◽  
Gliadin Peptides ◽  
Endomysium Antibodies ◽  
Monkey Esophagus

AbstractBackground: Assays for IgG antibodies against deamidated gliadin (IgG-anti-dGli) are comparable in performance with tests detecting IgA antibodies against tissue transglutaminase (IgA-anti-tTG) in diagnosing celiac disease (CD). IgA-anti-tTG are absent in IgA deficiency, a condition often associated with CD. In IgA deficiency, IgG-anti-tTG, which have a lower overall diagnostic accuracy, are routinely measured. We examined whether IgG-anti-dGli would be useful for diagnosing CD in patients with IgA deficiency.Methods: We studied 34 IgA-deficient CD patients, 185 IgA-competent newly diagnosed children with CD, 316 children without CD, 400 adult blood donors, and 6 control IgA-deficient individuals without CD. Anti-dGli and anti-tTG were measured by ELISA, and endomysium antibodies (EmA) were measured by immunofluorescence on monkey esophagus (IgA as well as IgG class for all antibodies). We calculated diagnostic sensitivity (percentage of patients above cutoff with 95% CIs) according to age-specific cutoffs for 95% diagnostic specificity and according to cutoffs proposed by the manufacturer of the assays.Results: No IgA-deficient CD patients were positive for any IgA-based antibody assay. Diagnostic sensitivity of IgG-anti-tTG was 91.2% (95% CI 76.3%–97.7%) according to age-specific cutoffs and 82.4% (66.1%–92.0%) according to manufacturer cutoffs. The diagnostic sensitivity of IgG-EmA was 75.8% (58.8%–87.4%) and the sensitivity of IgG-anti-dGli was 88.2% (72.8%–95.9%) according to both cutoffs.Conclusions: IgG-anti-dGli and IgG-anti-tTG have comparable diagnostic sensitivities for IgA-deficient celiac patients. IgG-anti-dGli may be useful for diagnosing CD in IgA-deficient patients.

scholarly journals Celiac Disease After Administration of Immune Checkpoint Inhibitors: A Case Report

2021 ◽  
Vol 12 ◽  
Author(s):  
Julie Leblanc ◽  
Solene Hoibian ◽  
Agathe Boucraut ◽  
Jean-Philippe Ratone ◽  
Louis Stoffaes ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Gastrointestinal Endoscopy ◽  
Checkpoint Inhibitors ◽  
Villous Atrophy ◽  
Tissue Transglutaminase ◽  
Gluten Free ◽  
Serum Iga ◽  
Iga Antibodies

Immune checkpoint inhibitors (ICI) reinvigorate the immune system to recognize and destroy tumor cells. Because of this biological mechanism, patients might develop autoimmune toxicities, notably in the digestive tract (most frequently, hepatitis or colitis). A 70-year-old man with relapsed mesothelioma was treated with nivolumab in 3rd line. He was hospitalized for watery and foul-smelling diarrhea. He underwent gastrointestinal endoscopy, showing duodenitis and villous atrophy and measurement of serum IgA antibodies to tissue transglutaminase (tTG-IgA+), leading to the diagnosis of ICI-induced celiac disease. He was treated with steroids, proton pump inhibitors, and a gluten-free diet. If ICI-induced celiac disease is rare in the literature, increasing reports suggest that celiac disease might represent an underestimated ICI toxicity. This case highlights the necessity of complementary investigation (including tTG-IgA and endoscopic biopsies) in patients with atypical digestive symptoms during immunotherapy.

scholarly journals Slow Decrease of Anti-Tissue Transglutaminase Antibody Positivity In Children With Celiac Disease After Starting the Gluten-Free Diet

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Chiara Monachesi ◽  
Anil K. Verma ◽  
Giulia Naspi Catassi ◽  
Simona Gatti ◽  
Elena Lionetti ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Tissue Transglutaminase ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Slow Decrease ◽  
Antibody Positivity

Serodiagnosis of Celiac Disease in Children Referred for Evaluation of Anemia: A Pediatric Hematology Unit’s Experience.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 1665-1665
Author(s):  
R.K. Marwaha ◽  
Deepak Bansal ◽  
Amita Trehan ◽  
Akash Patel
Keyword(s):  
Celiac Disease ◽  
Small Bowel ◽  
Tissue Transglutaminase ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Indian States ◽  
Duration Of Symptoms ◽  
Pulmonary Hemosiderosis ◽  
Proximal Small Bowel ◽  
The Mean

Abstract Celiac disease (CD) is a malabsorptive disorder wherein the proximal small bowel mucosa is damaged as a result of dietary exposure to gluten. Children with intractable diarrhea and failure to thrive are diagnosed with relative ease. Diagnosis can however be challenging and is often delayed when children present with ‘difficult to treat anemia’, without overt gastrointestinal manifestations. The case records of 77 patients with CD were scrutinized retrospectively. Diagnosis was established with serology (tissue transglutaminase-IgA assay) in 46 (59.7%), serology along with small bowel mucosal biopsy in 23 (29.9%) and with biopsy alone in the remaining 8 (10.4%). All children belonged to the predominantly wheat consuming northern Indian states. The mean age at presentation was 99.1±34.8 months (median: 102, range: 22–168). Males outnumbered females in a ratio of 1.96:1. The mean duration of symptoms was 41±31.2 months (median: 36, range: 1–132). The overwhelming majority, i.e., 75 (97.4%) children had anemia (Hemoglobin <11 g/dL). Mean hemoglobin (Hb) was 7.0±2.2 g/dL (median: 7.2, range: 2.3–12.5). 52 (67.5%) had received iron supplements for sufficient lengths, without benefit. The red cell morphology was microcytic hypochromic in 37 (48%) and dimorphic in 33 (42.9%). A history of diarrhea was not forthcoming in 32 (41.6%) cases. 59 (76.6%) were malnourished, with a weight less than 80 % of expected for the age and 30 (39 %) were stunted, with a height falling below the 90% of expected. Two children had skin bleeds secondary to coagulopathy, due to Vitamin K malabsorption. In another 2, recurrent anemia was attributed to pulmonary hemosiderosis; further investigations for secondary causes unearthed CD. All children were initiated on an austere gluten free diet, along with iron and folic acid supplements for the initial 6–9 months. Mean duration of follow was 17.7±20.9 months. Improvement was perceptible within days of initiating gluten free diet. Of the 38 (49.4%) children who had a follow up of a year or longer, the mean Hb at the last visit had risen to 12.9±1.2 g/dL. Conclusions: Hematologists need to be aware of the mono-symptomatic presentation of CD with anemia. The typical period of presentation of CD is described to be between 6 mo and 2 yr of age. Prolonged duration of symptoms and a diagnosis at a relatively older age is striking in the index study. In a suggestive clinical background, identification of CD with serodiagnosis alone, without resorting to small bowel biopsy is increasingly gaining acceptance, as the specificity of newer serological assays is 95–98%. This is particularly true in tropical countries, where some degree of flattening of villi may be attributed to malnutrition and or infections, such as rotavirus enteritis, Giardia lamblia, or tropical sprue. A biopsy may be misleading in such cases. Heightened awareness is essential to identify CD at an early age, especially, in children in whom anemia is the dominant manifestation. The benefits of gluten free diet are apparent with the rise in hemoglobin and the improvement in growth parameters are gratifying both for physicians and the caretakers.

scholarly journals Prevalence of IgA Antibodies to Endomysium and Tissue Transglutaminase in Primary Biliary Cirrhosis

2000 ◽  
Vol 14 (8) ◽  
pp. 672-675 ◽  
Author(s):  
Helen R Gillett ◽  
Karen Cauch-Dudek ◽  
E Jenny L Healthcote ◽  
Hugh J Freeman
Keyword(s):  
Celiac Disease ◽  
Primary Biliary Cirrhosis ◽  
Tissue Transglutaminase ◽  
Case Reports ◽  
Biliary Cirrhosis ◽  
Gluten Free ◽  
Iga Antibodies ◽  
Tissue Transglutaminase Antibodies ◽  
Untreated Celiac Disease ◽  
Endomysium Antibody

The association between celiac disease and primary biliary cirrhosis has been described in several case reports and small screening studies, with varying prevalence rates. Stored sera from 378 patients with primary biliary cirrhosis were tested for immunoglobulin (Ig) A endomysium and tissue transglutaminase antibodies. Ten patients were positive for both antibodies (2.6%); five of these patients had had small bowel biopsies confirming celiac disease. A further 44 patients (11.6%) had raised titres of IgA tissue transglutaminase antibody but were negative for IgA endomysium antibody. The increased prevalence of celiac-related antibodies in patients with primary biliary cirrhosis suggests that the two conditions are associated, although the reason for the association remains unclear. Patients with primary biliary cirrhosis should be considered to be at high risk for celiac disease. Although liver biochemistry does not improve when these patients are fed a gluten-free diet, the complications of untreated celiac disease warrant the identification and treatment of the condition in this population.

An Attempt of Specific Desensitising Treatment with Gliadin in Celiac Disease

2005 ◽  
Vol 18 (4) ◽  
pp. 709-714 ◽  
Author(s):  
G. Patriarca ◽  
N. Pogna ◽  
G. Cammarota ◽  
D. Schiavino ◽  
C. Lombardo ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Tissue Transglutaminase ◽  
Clinical Manifestations ◽  
Current Treatment ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Dietary Regimen ◽  
New Approach ◽  
Tissue Transglutaminase Antibodies

Gluten-free diet is the current treatment of celiac disease. We decided to verify the occurrence of histological and serological modification and/or clinical manifestations during a gradual and progressive introduction of gliadin in the diet and if it may induce a tolerance to food, as it occurs in allergic patients. We studied the case of a celiac woman with complete clinical and histological remittance after 10 years of gluten free diet. She took increasing daily doses of gliadin, reaching the final dose of 9 g of gliadin (15 g of gluten) in 6 months. Then she started a free dietary regimen. During the 15-month follow-up period esophago-gastro-duodenoscopy showed normal Kerckring folds and villi. Anti-gliadin, anti-endomysium and anti-tissue-transglutaminase antibodies, as well as the haematological and biochemical parameters remained normal. Our results represent a new approach in the research concerning celiac disease, and could provide a future line of study for its management.

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