The role of probiotics in the immune response and intestinal microbiota of children with celiac disease: a systematic review

ABSTRACT Objective: To evaluate changes in peripheral immunological response (decrease in blood proinflammatory cytokines) and fecal microbiota (especially Bacteroidetes and Firmicutes) after administration of probiotics in children with celiac disease on a gluten-free diet. Data source: The databases MEDLINE, LILACS, Springer and SciELO were used for this review, with the descriptors “celiac disease AND probiotics”. At the end of the search, 168 articles were retrieved, four of which were included in the final qualitative synthesis, having as inclusion criteria randomized clinical trials and pediatric population (1–19 years) and, as exclusion criteria, interventions other than probiotics, studies with patients with other diseases associated with celiac disease, or patients who did not meet the diagnostic criteria. All elected studies were published until September 2020, without language restriction, with patients receiving strains of Bifidobacterium breve or B. longum and on a gluten-free diet. Data synthesis: The studies show that the administration of probiotics along with a gluten-free diet, can approximate the fecal microbiota of celiac patients to typical conditions of healthy individuals, by restoring the abundance of some microbial communities that characterize the typical physiological condition. In addition, the administration of probiotics can reduce serum proinflammatory cytokines (mainly TNF-alpha). Conclusions: Despite the positive correlation between probiotics and fecal microbiota/serological markers in pediatric patients with celiac disease, we emphasize the need for future multicentric studies that should include a larger number of patients and a longer follow up period.%

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Adherence to the Gluten-free Diet and Health-related Quality of Life in an Ethnically Diverse Pediatric Population With Celiac Disease

Journal of Pediatric Gastroenterology and Nutrition ◽

10.1097/mpg.0000000000001873 ◽

2018 ◽

Vol 66 (6) ◽

pp. 941-948 ◽

Cited By ~ 13

Author(s):

Diana R. Mager ◽

Margaret Marcon ◽

Herbert Brill ◽

Amanda Liu ◽

Kristin Radmanovich ◽

...

Keyword(s):

Quality Of Life ◽

Celiac Disease ◽

Pediatric Population ◽

Ethnically Diverse ◽

Gluten Free Diet ◽

Gluten Free ◽

Health Related Quality ◽

Related Quality ◽

Health Related

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Baseline Fecal Microbiota in Pediatric Patients With Celiac Disease Is Similar to Controls But Dissimilar After 1 Year on the Gluten-Free Diet

JPGN Reports ◽

10.1097/pg9.0000000000000127 ◽

2021 ◽

Vol 2 (4) ◽

pp. e127

Author(s):

Dory Sample ◽

Janelle Fouhse ◽

Seema King ◽

Hien Q. Huynh ◽

Levinus A. Dieleman ◽

...

Keyword(s):

Celiac Disease ◽

Pediatric Patients ◽

Fecal Microbiota ◽

Gluten Free Diet ◽

Gluten Free

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Celiac Disease: Are Endomysial Antibody Test Results Being Used Appropriately?

Clinical Chemistry ◽

10.1373/clinchem.2007.090308 ◽

2007 ◽

Vol 53 (10) ◽

pp. 1775-1781 ◽

Cited By ~ 3

Author(s):

Kelly E McGowan ◽

Martha E Lyon ◽

Steven D Loken ◽

J Decker Butzner

Keyword(s):

Celiac Disease ◽

Antibody Test ◽

Gluten Free Diet ◽

Intestinal Biopsy ◽

Gluten Free ◽

Test Results ◽

Male And Female ◽

Serum Iga ◽

Number Of Patients

Abstract Background: The aim of this study was to retrospectively examine how positive IgA-endomysial antibody (EMA) test results for celiac disease were being interpreted and acted on by physicians in the Calgary Health Region. Methods: We reviewed consecutive EMA test results, with or without a serum IgA, obtained during a 17-month period. Seropositive tests were cross-referenced to the surgical database to determine the number of patients who underwent intestinal biopsy and the results of the biopsy. We sent questionnaires to the ordering physicians of positive tests with no record of intestinal biopsy. Results: Among 11 716 EMA tests in 9533 patients, 349 results were positive in 313 patients (3%). Intestinal biopsies were performed in 218 (70%) of the seropositive patients; 194 of them were diagnostic of celiac disease. Celiac disease was also found in 10 EMA-negative patients. Of the 109 positive tests performed in 95 patients with no subsequent biopsy, 28 had appropriate indications to not perform a biopsy; the most common reason being that the test had been ordered to follow up on a previous biopsy-proven diagnosis of celiac disease (n = 21). For 33 other positive test results without a subsequent biopsy, management appeared to be inappropriate, most commonly (n = 21) because of a recommendation to follow a gluten-free diet despite lack of a tissue diagnosis of celiac disease. For the remaining 48 positive EMA results, administrative issues prevented evaluation (n = 19), the patients refused further evaluation (n = 11), or physician surveys were not returned (n = 18). Conclusions: Celiac disease affected 2% of patients, with a similar prevalence in male and female patients. Most positive EMA tests (77%) were appropriately managed by physicians. Beginning a gluten-free diet without biopsy or failing to follow up on a positive EMA test remain common errors of management.

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Su1162 - Duodenal and Fecal Microbiota before and after a Gluten-Free Diet (GFD) in Patients with Celiac Disease, Non-Celiac Gluten Sensitivity and Controls

Gastroenterology ◽

10.1016/s0016-5085(18)31862-6 ◽

2018 ◽

Vol 154 (6) ◽

pp. S-490

Author(s):

Xaira J. Rivera Gutierrez ◽

Jose F. García-Mazcorro ◽

Orestes Cobos-Quevedo ◽

Francisco Javier Cabrera Jorge ◽

Arturo Meixueiro ◽

...

Keyword(s):

Celiac Disease ◽

Fecal Microbiota ◽

Gluten Free Diet ◽

Gluten Sensitivity ◽

Gluten Free ◽

Before And After

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LOWER BIFIDOBACTERIA COUNTS IN ADULT PATIENTS WITH CELIAC DISEASE ON A GLUTEN-FREE DIET

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032014000200013 ◽

2014 ◽

Vol 51 (2) ◽

pp. 139-143 ◽

Cited By ~ 28

Author(s):

Lisléia GOLFETTO ◽

Fernanda Duarte de SENNA ◽

Julia HERMES ◽

Bruna Teles Soares BESERRA ◽

Franciane da Silva FRANÇA ◽

...

Keyword(s):

Celiac Disease ◽

Healthy Subjects ◽

Microscopic Analysis ◽

Mucosal Damage ◽

Fecal Microbiota ◽

Pathological Process ◽

Selective Medium ◽

Gluten Free Diet ◽

Gluten Free ◽

Fecal Ph

ContextThe ingestion of gluten is responsible for the symptoms of Celiac disease, but other environmental factors can also influence. Strains of theBifidobacterium genus have been shown to afford protection against the inflammatory response and mucosal damage caused by gliadin peptides in vitro.ObjectivesThis study was designed to compare the concentration of fecal bifidobacteria and pH of patients with celiac disease on gluten-free diet and control subjects in order to identify if the imbalance on fecal microbiota still remain during the treatment of celiac disease and identify the necessity of dietary supplementation with pre- or probiotics.MethodsIt was analyzed the feces of 42 healthy subjects and 14 celiac patients. The bifidobacteria count in feces was done in selective medium BIM-25. Microscopic analysis of the colonies was performed by Gram stain. The identification of the genus Bifidobacterium was performed by determination of fructose-6-phosphate phosphoketolase. Fecal pH was measured using a pH meter.ResultsThe concentration of bifidobacteria per gram of feces was significantly higher in healthy subjects (controls) (1.5 ± 0.63 x108 CFU/g) when compared to celiac patients (2.5 ± 1.5 x107 CFU/g). The fecal pH was not different between celiac patients (7.19 ± 0.521) and controls (7.18 ± 0.522).ConclusionsThese results suggest that with lower levels of bifidobacteria, celiac patients have an imbalance in the intestinal microbiota, regardless of pH, even while on a gluten-free diet. This fact could favor the pathological process of the disorder.

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Positive Deamidated Gliadin Peptide Antibodies and Negative Tissue Transglutaminase IgA Antibodies in a Pediatric Population: To Biopsy or Not To Biopsy

Clinical and Vaccine Immunology ◽

10.1128/cvi.00425-09 ◽

2010 ◽

Vol 17 (5) ◽

pp. 884-886 ◽

Cited By ~ 9

Author(s):

Miriam Parizade ◽

Bracha Shainberg

Keyword(s):

Celiac Disease ◽

Clinical Laboratory ◽

Tissue Transglutaminase ◽

Pediatric Population ◽

Gluten Free Diet ◽

Gluten Free ◽

Negative Results ◽

Iga Antibodies ◽

Gliadin Peptide ◽

Peptide Antibodies

ABSTRACT Reports from our clinical laboratory database show that 75% of children <2 years old tested for celiac serology who were found positive for deamidated gliadin peptide (DGP) antibodies had negative results for tissue transglutaminase IgA. DGP levels were shown to decline and disappear without a gluten-free diet. This observation questions DGP's specificity for diagnosis of celiac disease.

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Diet, Perceived Intestinal Well-Being and Compositions of Fecal Microbiota and Short Chain Fatty Acids in Oat-Using Subjects with Celiac Disease or Gluten Sensitivity

Nutrients ◽

10.3390/nu12092570 ◽

2020 ◽

Vol 12 (9) ◽

pp. 2570

Author(s):

Lotta Nylund ◽

Salla Hakkola ◽

Leo Lahti ◽

Seppo Salminen ◽

Marko Kalliomäki ◽

...

Keyword(s):

Celiac Disease ◽

Well Being ◽

Short Chain Fatty Acids ◽

Study Groups ◽

Fecal Microbiota ◽

Gluten Free Diet ◽

Control Group ◽

Gluten Sensitivity ◽

Gluten Free ◽

Fiber Intake

A gluten-free diet may result in high fat and low fiber intake and thus lead to unbalanced microbiota. This study characterized fecal microbiota profiles by 16S MiSeq sequencing among oat-using healthy adult subjects (n = 14) or adult subjects with celiac disease (CeD) (n = 19) or non-celiac gluten sensitivity (NCGS) (n = 10). Selected microbial metabolites, self-reported 4d food diaries and perceived gut symptoms were compared. Subjects with NCGS experienced the highest amount of gut symptoms and received more energy from fat and less from carbohydrates than healthy and CeD subjects. Oat consumption resulted in reaching the lower limit of the recommended fiber intake. Frequent consumption of gluten-free pure oats did not result in microbiota dysbiosis in subjects with CeD or NCGS. Thus, the high number of gut symptoms in NCGS subjects was not linked to the microbiota. The proportion of fecal acetate was higher in healthy when compared to NCGS subjects, which may be linked to a higher abundance of Bifidobacterium in the control group compared to NCGS and CeD subjects. Propionate, butyrate and ammonia production and β-glucuronidase activity were comparable among the study groups. The results suggest that pure oats have great potential as the basis of a gluten-free diet and warrant further studies in minor microbiota disorders.

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Comparative Study of Salivary, Duodenal, and Fecal Microbiota Composition Across Adult Celiac Disease

Journal of Clinical Medicine ◽

10.3390/jcm9041109 ◽

2020 ◽

Vol 9 (4) ◽

pp. 1109 ◽

Cited By ~ 3

Author(s):

Simona Panelli ◽

Enrica Capelli ◽

Giuseppe Francesco Damiano Lupo ◽

Annalisa Schiepatti ◽

Elena Betti ◽

...

Keyword(s):

Celiac Disease ◽

Villous Atrophy ◽

Duodenal Mucosa ◽

Fecal Microbiota ◽

Gluten Free Diet ◽

Microbiota Composition ◽

Gluten Free ◽

Cross Sectional ◽

Adult Celiac Disease ◽

Tertiary Center

Background: Growing evidence suggests that an altered microbiota composition contributes to the pathogenesis and clinical features in celiac disease (CD). We performed a comparative analysis of the gut microbiota in adulthood CD to evaluate whether: (i) dysbiosis anticipates mucosal lesions, (ii) gluten-free diet restores eubiosis, (iii) refractory CD has a peculiar microbial signature, and (iv) salivary and fecal communities overlap the mucosal one. Methods: This is a cross-sectional study where a total of 52 CD patients, including 13 active CD, 29 treated CD, 4 refractory CD, and 6 potential CD, were enrolled in a tertiary center together with 31 controls. A 16S rRNA-based amplicon metagenomics approach was applied to determine the microbiota structure and composition of salivary, duodenal mucosa, and stool samples, followed by appropriate bioinformatic analyses. Results: A reduction of both α- and β-diversity in CD, already evident in the potential form and achieving nadir in refractory CD, was evident. Taxonomically, mucosa displayed a significant abundance of Proteobacteria and an expansion of Neisseria, especially in active patients, while treated celiacs showed an intermediate profile between active disease and controls. The saliva community mirrored the mucosal one better than stool. Conclusion: Expansion of pathobiontic species anticipates villous atrophy and achieves the maximal divergence from controls in refractory CD. Gluten-free diet results in incomplete recovery. The overlapping results between mucosal and salivary samples indicate the use of saliva as a diagnostic fluid.

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Neurological Disorders in Adult Celiac Disease

Canadian Journal of Gastroenterology ◽

10.1155/2008/824631 ◽

2008 ◽

Vol 22 (11) ◽

pp. 909-911 ◽

Cited By ~ 32

Author(s):

Hugh J Freeman

Keyword(s):

Celiac Disease ◽

Neurological Disorders ◽

Neurological Disorder ◽

Nutrient Deficiency ◽

Gluten Free Diet ◽

Gluten Free ◽

Number Of Patients ◽

Adult Celiac Disease ◽

Consistent Response ◽

Extensive Involvement

Celiac disease may initially present as a neurological disorder. Alternatively, celiac disease may be complicated by neurological changes. With impaired nutrient absorption, different deficiency syndromes may occur and these may be manifested clinically with neurological changes. However, in patients with deficiency syndromes, extensive involvement of the small intestine with celiac disease is often evident. There are a number of reports of celiac disease associated with neuropathy, ataxia, dementia and seizure disorder. In these reports, there is no clear relationship with nutrient deficiency and a precise mechanism for the neurological changes has not been defined. A small number of patients have been reported to have responded to vitamin E administration, but most do not. In some, gluten antibodies have also been described, especially in those with ataxia, but a consistent response to a gluten-free diet has not been defined. Screening for celiac disease should be considered in patients with unexplained neurological disorders, including ataxia and dementia. Further studies are needed, however, to determine if a gluten-free diet will lead to improvement in the associated neurological disorder.

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