Regression of conjunctival tumor during dietary treatment of celiac disease

To date, the only treatment for celiac disease (CD) consists of a strict lifelong gluten-free diet (GFD), which has numerous limitations in patients with CD. For this reason, dietary transgressions are frequent, implying intestinal damage and possible long-term complications. There is an unquestionable need for non-dietary alternatives to avoid damage by involuntary contamination or voluntary dietary transgressions. In recent years, different therapies and treatments for CD have been developed and studied based on the degradation of gluten in the intestinal lumen, regulation of the immune response, modulation of intestinal permeability, and induction of immunological tolerance. In this review, therapeutic lines for CD are evaluated with special emphasis on phase III and II clinical trials, some of which have promising results.

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Diets for Sick Children

PEDIATRICS ◽

10.1542/peds.37.4.705a ◽

1966 ◽

Vol 37 (4) ◽

pp. 705-705

Author(s):

J. W. GERRARD

Keyword(s):

Celiac Disease ◽

Dietary Treatment ◽

Pediatric Diseases ◽

Sick Children

It is axiomatic that many pediatric diseases require dietary treatment, sometimes as the sole form of therapy, for example, in celiac disease and phenylketonuria, and sometimes as an adjunct, as in nephrosis and diabetes. Diets for Sick Children gives very practical and careful guidance in the preparation of diets for all such children. The proprietary foods referred to in the text are those commonly available on the English market; its usefulness is, therefore, limited on this side of the Atlantic, but it should prove a useful addition to any pediatric dietetic department, and is recommended on this account.

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Celiac Disease in Infants: Prevention and Dietary Treatment

Nutrition in Infancy ◽

10.1007/978-1-62703-254-4_11 ◽

2012 ◽

pp. 145-151

Author(s):

Mukadder Ayşe Selimoğlu

Keyword(s):

Celiac Disease ◽

Dietary Treatment

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Daily Life Restrictions are Common and Associated with Health Concerns and Dietary Challenges in Adult Celiac Disease Patients Diagnosed in Childhood

Nutrients ◽

10.3390/nu11081718 ◽

2019 ◽

Vol 11 (8) ◽

pp. 1718 ◽

Cited By ~ 2

Author(s):

Heini Leinonen ◽

Laura Kivelä ◽

Marja-Leena Lähdeaho ◽

Heini Huhtala ◽

Katri Kaukinen ◽

...

Keyword(s):

Celiac Disease ◽

Rating Scale ◽

Daily Life ◽

Young Patients ◽

Dietary Treatment ◽

Well Being ◽

Diagnostic Features ◽

Health Concerns ◽

Gastrointestinal Symptom Rating Scale ◽

Adult Celiac Disease

The prevalence and associated factors of daily life restrictions due to a gluten-free diet in adult celiac disease patients diagnosed in childhood are poorly known. We investigated these issues by collecting the medical data of 955 pediatric patients and sending questionnaires evaluating various health outcomes to the 559 patients who had reached adulthood. Of the 231 respondents, 46% reported everyday life restrictions caused by dietary treatment. Compared with those without restrictions, they more often had anemia at diagnosis (37% vs. 22%, p = 0.014), but the groups were comparable in other diagnostic features. In adulthood, patients with restrictions reported more overall symptoms (32% vs. 17%, p = 0.006), although the symptoms measured with the Gastrointestinal Symptom Rating Scale questionnaire were comparable. Despite strict dietary adherence in both groups, the experience of restrictions was associated with dietary challenges (34% vs. 9%, p < 0.001), health concerns (22% vs. 13%, p = 0.050), and lower vitality scores in the Psychological General Well-Being questionnaire. The groups did not differ in their current age, socioeconomic status, family history of celiac disease, general health or health-related lifestyle, the presence of co-morbidities, or regular follow up. Our results encourage healthcare professionals to discuss the possible health concerns and dietary challenges with patients to avoid unnecessary daily life restrictions, especially when young patients start to take responsibility for their treatment.

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Up-Regulation of Specific Bioactive Lipids in Celiac Disease

Nutrients ◽

10.3390/nu13072271 ◽

2021 ◽

Vol 13 (7) ◽

pp. 2271

Author(s):

Rafael Martín-Masot ◽

Jose Daniel Galo-Licona ◽

Natàlia Mota-Martorell ◽

Joaquim Sol ◽

Mariona Jové ◽

...

Keyword(s):

Celiac Disease ◽

Phosphatidic Acid ◽

Metabolic Networks ◽

Dietary Treatment ◽

Bioactive Lipids ◽

Metabolic Defects ◽

Molecular Features ◽

Plasma Metabolome ◽

Lipid Species ◽

A Minor

Celiac disease (CD) is an autoimmune enteropathy linked to alterations of metabolism. Currently, limited untargeted metabolomic studies evaluating differences in the plasma metabolome of CD subjects have been documented. We engage in a metabolomic study that analyzes plasma metabolome in 17 children with CD treated with a gluten-free diet and 17 healthy control siblings in order to recognize potential changes in metabolic networks. Our data demonstrates the persistence of metabolic defects in CD subjects in spite of the dietary treatment, affecting a minor but significant fraction (around 4%, 209 out of 4893 molecular features) of the analyzed plasma metabolome. The affected molecular species are mainly, but not exclusively, lipid species with a particular affectation of steroids and derivatives (indicating an adrenal gland affectation), glycerophospholipids (to highlight phosphatidic acid), glycerolipids (with a special affectation of diacylglycerols), and fatty acyls (eicosanoids). Our findings are suggestive of an activation of the diacylglycerol-phosphatidic acid signaling pathway in CD that may potentially have detrimental effects via activation of several targets including protein kinases such as mTOR, which could be the basis of the morbidity and mortality connected with untreated CD. However, more studies are necessary to validate this idea regarding CD.

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Adherence to dietary treatment and clinical factors associated with anti-transglutaminase antibodies in celiac disease during the follow-up

Heliyon ◽

10.1016/j.heliyon.2021.e06642 ◽

2021 ◽

Vol 7 (4) ◽

pp. e06642

Author(s):

Marta Miró ◽

Manuel Alonso-Garrido ◽

Manuel Lozano ◽

Juanjo Peiró ◽

Lara Manyes

Keyword(s):

Celiac Disease ◽

Dietary Treatment ◽

Clinical Factors ◽

Factors Associated

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Novel Treatments for Celiac Disease: Glutenases and Beyond

Digestive Diseases ◽

10.1159/000369536 ◽

2015 ◽

Vol 33 (2) ◽

pp. 277-281 ◽

Cited By ~ 13

Author(s):

Katri Kaukinen ◽

Katri Lindfors

Keyword(s):

Celiac Disease ◽

Dietary Treatment ◽

Gluten Free Diet ◽

Intestinal Lumen ◽

Gluten Free ◽

Novel Treatments ◽

Gluten Peptides ◽

Downstream Effects ◽

Complete Digestion ◽

Novel Drug

Currently, the only effective treatment for celiac disease is a strict lifelong gluten-free diet. However, gluten-free dieting is restrictive, difficult to maintain and nutritionally less than optimal. The improved knowledge on celiac disease pathogenesis has enabled researchers to suggest alternative strategies to treat the disorder. The drug development poses a challenge as any novel drug for celiac disease should be simultaneously effective and as safe as the gluten-free diet. The rationale behind enzyme supplementation therapy as a future treatment option for celiac patients lies in the fact that gluten is only poorly digested by gastrointestinal proteases. Due to incomplete degradation in the gastrointestinal tract, fairly long gluten peptides enter the small-intestinal lumen and come into contact with the mucosal epithelium, and in celiac disease patients this encounter launches deleterious downstream effects. Enzyme supplement therapy using either bacterial or fungal endopeptidases or proteases from germinating cereals has been proposed to promote complete digestion of prolamins and destroy disease-inducing gluten peptides. A major advantage of these glutenases is that they work in the lumen of the small intestine and do not themselves take part in the immunological cascade of events in the lamina propria, thus being unlikely to cause harmful side effects to the host. Studies to test this rationale, e.g. with Aspergillus niger prolyl endoprotease and a combination enzyme product ALV003, are already ongoing. The development of a novel medication for celiac disease is still in its early days, and thus the conventional dietary treatment will hold its place for the time being.

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A sokarcú gluténérzékenység: gluténindukált autoimmunitás a bőrgyógyász szemével

Orvosi Hetilap ◽

10.1556/650.2021.32046 ◽

2021 ◽

Vol 162 (28) ◽

pp. 1107-1118

Author(s):

Tamás Malkovics ◽

Kamilla Koszorú ◽

Sarolta Kárpáti ◽

András Arató ◽

Anna Görög ◽

...

Keyword(s):

Celiac Disease ◽

Autoimmune Diseases ◽

Dermatitis Herpetiformis ◽

Early Recognition ◽

Dietary Treatment ◽

Transglutaminase 2 ◽

Interdisciplinary Treatment ◽

Tissue Type ◽

Neurological Involvement ◽

Organ Systems

Összefoglaló. A glutén, alimentáris környezeti antigénként, különböző szervrendszereket érintő autoimmun betegségeket tud kiváltani. A kórképek hátterében a gluténtolerancia veleszületett hiánya vagy az élet során bekövetkező elvesztése áll. A gluténindukált autoimmun betegségek között a leggyakoribb a coeliakia, melyet különböző súlyosságú enteropátia jellemez, és melynek a szöveti, 2-es típusú transzglutamináz az autoantigénje. A coeliakia extraintestinalis tünetei között azonban néha olyan bőr- és idegrendszeri kórképek jellegzetességei is megtalálhatók, melyek hátterében további transzglutamináz-autoimmunitás kialakulása áll. Idesorolható a hevesen viszkető, polimorf autoimmun bőrbetegség, a dermatitis herpetiformis (transzglutamináz-3-autoimmunitás) és a centrális és/vagy perifériás neurológiai károsodások egy jellegzetes csoportja (transzglutamináz-6-autoimmunitás). Az indukált autoimmunitás reverzibilis, a szigorúan tartott gluténmentes diéta mellett a coeliakia és a bőrtünetek elmúlnak, de az idegrendszeri tünetek egy része maradandó. Az elmúlt évtizedben beszámoltak gluténérzékeny, transzglutamináz-6-pozitív, nem coeliakiás (transzglutamináz-2-negatív) betegekről is. A gluténszenzitivitás sokféle megjelenését ma is erősen kutatják. Fontos a korai felismerés és a kórképek interdiszciplináris szemléletű kezelése. A coeliakia családi szűrővizsgálatokkal való korai felismerése és a tünetmentes egyének diétás kezelése is nagy jelentőségű a gluténérzékenység által kiváltott hiányállapotok és a társuló egyéb betegségek kialakulásának megelőzésében. Orv Hetil. 2021; 162(28): 1107–1118. Summary. Autoimmune diseases induced by digestion of gluten, an environmental antigen, can affect different organ systems. The diseases develop in individuals with congenital or acquired loss of gluten tolerance for life. Amongst the gluten-induced autoimmune diseases, celiac disease is the most common one, characterized by an enteropathy of varying severity. Here the target autoantigen is tissue (type 2) transglutaminase. While the extraintestinal manifestations of celiac disease are complex, they may include characteristics of certain skin and nervous system disorders that develop due to additional transglutaminase autoimmunities. Such diseases are the severely pruritic, polymorphic autoimmune skin disease, dermatitis herpetiformis due to epidermal (type 3) transglutaminase autoimmunity, and a distinctive group of gluten-sensitive neuropathies with central and/or peripheral neurological involvement caused by type 6 transglutaminase autoimmunity. While the celiac and skin autoimmune diseases gradually get into remission under a strict gluten-free diet, some neurological symptoms may persist. In the last decade, gluten-induced transglutaminase 6 positive but non-celiac (transglutaminase 2 negative) patients were reported. Today, various manifestations of gluten sensitivity are under extensive research. Early detection and interdisciplinary treatment of these disorders are important. Family screenings are of particular relevance in early recognition and dietary treatment of latent disease forms in order to prevent enteropathy-induced, malabsorption-related and other associated co-morbidities. Orv Hetil. 2021; 162(28): 1107–1118.

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