scholarly journals Probióticos en enfermedad celíaca: ¿estamos listos para su aplicación en la práctica clínica?

2021 ◽  
Vol 51 (4) ◽  
Author(s):  
Gastón H Rueda ◽  
M Inés Pinto-Sánchez
Keyword(s):  
Celiac Disease ◽  
Immune System ◽  
Gastrointestinal Symptoms ◽  
Mechanisms Of Action ◽  
Current Evidence ◽  
Future Research ◽  
Preclinical Studies ◽  
Gluten Free ◽  
Review Of The Literature ◽  
Areas Of Interest

Probiotics, live microorganisms that produce a beneficial effect on health, are a possible supplement to a gluten-free diet in the treatment of celiac disease. Several clinical studies have shown that celiac patients treated with probiotics improved their gastrointestinal symptoms. Although the mechanisms of probiotics in celiac disease are unclear, preclinical studies in mice suggest different mechanisms, such as the modulation of the intestinal microbiota and the immune system, or through the production of proteases. We conducted a review of the literature to address the current evidence on the efficacy of probiotics in the treatment of celiac disease, possible mechanisms of action, and areas of interest for future research studies.

Nutritional Management of Celiac Disease

2018 ◽  
Author(s):  
Ciarán P Kelly ◽  
Satya Kurada ◽  
Mariana Urquiaga
Keyword(s):  
Immune Response ◽  
Celiac Disease ◽  
Tight Junction ◽  
Villous Atrophy ◽  
Gastrointestinal Symptoms ◽  
Gluten Free Diet ◽  
Intestinal Biopsy ◽  
Nutritional Management ◽  
Gluten Free ◽  
Antigliadin Antibodies

Celiac disease (CD) is an autoimmune disorder characterized by an immune response to gluten peptides in wheat, barley, and rye. The diagnosis of celiac disease is confirmed by three important characteristics: consistent symptoms, positive celiac-specific serology, and small intestinal biopsy findings of inflammation, crypt hyperplasia, and villous atrophy. CD may present with overt gastrointestinal symptoms, including diarrhea (or constipation), weight loss, and abdominal bloating and discomfort, or covertly with micronutrient deficiencies such as iron deficiency with anemia. A gluten-free diet (GFD) remains the mainstay of treatment. The aim of this review is to highlight the pathogenesis of CD, concepts and challenges associated with a GFD, and nutritional management of CD applicable in clinical practice to internists, gastroenterologists, and dietitians. Patients should be referred to an expert celiac dietitian for education on adherence to a GFD to address gluten contamination in the diet, the psychosocial implications of following a GFD, and macro- and micronutrient disequilibria arising from celiac disease and the GFD. Several novel therapeutics are on the horizon in various stages of development, including glutenases, antigliadin antibodies, tight junction regulators, modulation of the immune response to gliadin, and efforts to engineer less toxic gluten-containing foodstuffs. This review contains 3 figures, 5 tables, and 61 references. Key words: celiac disease, genetic engineering, food engineering, gluten, glutenases, gluten-free diet, oats, IgY, nutrition, tight junction regulators, wheat

Nutritional Management of Celiac Disease

2017 ◽  
Author(s):  
Ciarán P Kelly ◽  
Satya Kurada ◽  
Mariana Urquiaga
Keyword(s):  
Immune Response ◽  
Celiac Disease ◽  
Tight Junction ◽  
Villous Atrophy ◽  
Gastrointestinal Symptoms ◽  
Gluten Free Diet ◽  
Intestinal Biopsy ◽  
Nutritional Management ◽  
Gluten Free ◽  
Antigliadin Antibodies

Celiac disease (CD) is an autoimmune disorder characterized by an immune response to gluten peptides in wheat, barley, and rye. The diagnosis of celiac disease is confirmed by three important characteristics: consistent symptoms, positive celiac-specific serology, and small intestinal biopsy findings of inflammation, crypt hyperplasia, and villous atrophy. CD may present with overt gastrointestinal symptoms, including diarrhea (or constipation), weight loss, and abdominal bloating and discomfort, or covertly with micronutrient deficiencies such as iron deficiency with anemia. A gluten-free diet (GFD) remains the mainstay of treatment. The aim of this review is to highlight the pathogenesis of CD, concepts and challenges associated with a GFD, and nutritional management of CD applicable in clinical practice to internists, gastroenterologists, and dietitians. Patients should be referred to an expert celiac dietitian for education on adherence to a GFD to address gluten contamination in the diet, the psychosocial implications of following a GFD, and macro- and micronutrient disequilibria arising from celiac disease and the GFD. Several novel therapeutics are on the horizon in various stages of development, including glutenases, antigliadin antibodies, tight junction regulators, modulation of the immune response to gliadin, and efforts to engineer less toxic gluten-containing foodstuffs. This review contains 3 figures, 5 tables, and 61 references. Key words: celiac disease, genetic engineering, food engineering, gluten, glutenases, gluten-free diet, oats, IgY, nutrition, tight junction regulators, wheat

scholarly journals Probiotics in Celiac Disease

Nutrients ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 1824 ◽  
Author(s):  
Fernanda Cristofori ◽  
Flavia Indrio ◽  
Vito Miniello ◽  
Maria De Angelis ◽  
Ruggiero Francavilla
Keyword(s):  
Celiac Disease ◽  
Gut Microbiota ◽  
Intestinal Microbiota ◽  
Gastrointestinal Symptoms ◽  
Human Microbiome ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Microbial Composition ◽  
Close Link ◽  
Host Protection

Recently, the interest in the human microbiome and its interplay with the host has exploded and provided new insights on its role in conferring host protection and regulating host physiology, including the correct development of immunity. However, in the presence of microbial imbalance and particular genetic settings, the microbiome may contribute to the dysfunction of host metabolism and physiology, leading to pathogenesis and/or the progression of several diseases. Celiac disease (CD) is a chronic autoimmune enteropathy triggered by dietary gluten exposure in genetically predisposed individuals. Despite ascertaining that gluten is the trigger in CD, evidence has indicated that intestinal microbiota is somehow involved in the pathogenesis, progression, and clinical presentation of CD. Indeed, several studies have reported imbalances in the intestinal microbiota of patients with CD that are mainly characterized by an increased abundance of Bacteroides spp. and a decrease in Bifidobacterium spp. The evidence that some of these microbial imbalances still persist in spite of a strict gluten-free diet and that celiac patients suffering from persistent gastrointestinal symptoms have a desert gut microbiota composition further support its close link with CD. All of this evidence gives rise to the hypothesis that probiotics might play a role in this condition. In this review, we describe the recent scientific evidences linking the gut microbiota in CD, starting from the possible role of microbes in CD pathogenesis, the attempt to define a microbial signature of disease, the effect of a gluten-free diet and host genetic assets regarding microbial composition to end in the exploration of the proof of concept of probiotic use in animal models to the most recent clinical application of selected probiotic strains.

scholarly journals Gut Microbiome and Its Interaction with Immune System in Spondyloarthritis

2020 ◽  
Vol 8 (11) ◽  
pp. 1727
Author(s):  
Jacqueline So ◽  
Lai-Shan Tam
Keyword(s):  
Immune System ◽  
Gut Microbiome ◽  
Current Evidence ◽  
Future Research ◽  
Hla B27 ◽  
Human Immune System ◽  
Gut Inflammation ◽  
Germ Free ◽  
Gut Microorganisms

Emerging evidence suggests there is a gut-joint axis in spondyloarthritis (SpA). In a study, subclinical gut inflammation occurred in nearly 50% of SpA. Chronic gut inflammation also correlated with disease activity in SpA. Trillions of microorganisms reside in the human gut and interact with the human immune system. Dysbiosis affects gut immune homeostasis and triggers different autoimmune diseases including SpA. The absence of arthritis in HLA-B27 germ-free mice and the development of arthritis after the introduction of commensal bacteria to HLA-B27 germ-free mice proved to be the important role of gut bacteria in shaping SpA, other than the genetic factor. The recent advance in gene sequencing technology promotes the identification of microorganisms. In this review, we highlighted current evidence supporting the link between gut and axial SpA (axSpA). We also summarized available findings of gut microbiota and its interaction with the immune system in axSpA. Future research may explore the way to modulate gut microorganisms in axSpA and bring gut microbiome discoveries towards application.

scholarly journals Dermatomyositis Associated with Celiac Disease: Response to a Gluten-Free Diet

2006 ◽  
Vol 20 (6) ◽  
pp. 433-435 ◽  
Author(s):  
Min Soo Song ◽  
David Farber ◽  
Alain Bitton ◽  
Jeremy Jass ◽  
Michael Singer ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Adult Population ◽  
Gastrointestinal Symptoms ◽  
Human Leukocyte ◽  
Gluten Free Diet ◽  
Nutritional Deficiencies ◽  
Deficiency Anemia ◽  
Gluten Free ◽  
Disease Response ◽  
Vitamin Deficiencies

The association between dermatomyositis and celiac disease in children has been well documented. In the adult population, however, the association has not been clearly established. A rare case of concomitant dermatomyositis and celiac disease in a 40-year-old woman is presented. After having been diagnosed with dermatomyositis and iron deficiency anemia, this patient was referred to the gastroenterology clinic to exclude a gastrointestinal malignancy. Blood tests revealed various vitamin deficiencies consistent with malabsorption. The results of gastroscopy with duodenal biopsy were consistent with celiac disease. After she was put on a strict gluten-free diet, both nutritional deficiencies and the dermatomyositis resolved. The patient’s human leukocyte antigen haplotype study was positive for DR3 and DQ2, which have been shown to be associated with both juvenile dermatomyositis and celiac disease. It is suggested that patients with newly diagnosed dermatomyositis be investigated for concomitant celiac disease even in the absence of gastrointestinal symptoms.

scholarly journals Coronavirus Disease 2019 and Gastrointestinal Involvement: A Systematic Review

Medicinus ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 62
Author(s):  
Moryella Monica ◽  
Andree Kurniawan
Keyword(s):  
Systematic Review ◽  
Assessment Tool ◽  
Controlled Trial ◽  
Intestinal Flora ◽  
Gastrointestinal Symptoms ◽  
Good Evidence ◽  
World Health ◽  
Current Evidence ◽  
Future Research ◽  
Gastrointestinal Involvement

<p><strong>Introduction: </strong>The World Health Organization (WHO) announced the Coronavirus 2019 (COVID-19) as a Public Health Emergency of International Concern (PHEIC) toward the end of January 2020. There is still limited evidence to explain the gastrointestinal involvement in COVID-19. In this study, we aimed to further investigate current evidence describing the gastrointestinal involvement in COVID-19 patients.</p><p><strong>Methods: </strong>This systematic review has been registered in PROSPERO (CRD42020181584). A systematic search of literature for observational and randomized controlled trial was conducted in PubMed, PubMed central, and Google Scholar through April 16, 2020. Two reviewers independently searched and selected. The risk of bias was evaluated using the Newcastle-Ottawa Quality assessment tool.<strong> </strong></p><p><strong>Results: </strong>A total of 1,480 articles were screened from which 12 articles with 5584 subjects were selected. SARS-CoV-2 can invade human body by binding to angiotensin converting enzyme 2 (ACE-2) receptor which also located to small intestinal epithelial cells, crypt cells and colon. The virus itself may cause disorders of the intestinal flora. The diagnosis should be based on a set of symptoms diarrhoea, nausea, vomiting, abdominal discomfort or pain, combined with positivity of faecal PCR test. Treatment of COVID-19 mainly is supportive care. The probiotic may modulate the gut microbiota to alter the gastrointestinal symptoms and reduced enteritis, ventilator associated pneumonia, and reverse certain side effect of antibiotics<strong>.</strong></p><p><strong>Conclusion: </strong>Our synthesis of literature showed that there was no good evidence yet in overall area of gastrointestinal manifestations in COVID-19. Future research is needed to explore all areas, especially in mechanism and treatments</p>

scholarly journals When to Start and Stop Bone-Protecting Medication for Preventing Glucocorticoid-Induced Osteoporosis

2021 ◽  
Vol 12 ◽  
Author(s):  
Kaleen N. Hayes ◽  
Ulrike Baschant ◽  
Barbara Hauser ◽  
Andrea M. Burden ◽  
Elizabeth M. Winter
Keyword(s):  
Osteoporosis Treatment ◽  
Current Evidence ◽  
Future Research ◽  
Current Guideline ◽  
Patient Case ◽  
Osteoporosis Therapy ◽  
Major Barrier ◽  
Increase Fracture Risk ◽  
Clear Guideline ◽  
Areas Of Interest

Glucocorticoid-induced osteoporosis (GIOP) leads to fractures in up to 40% of patients with chronic glucocorticoid (GC) therapy when left untreated. GCs rapidly increase fracture risk, and thus many patients with anticipated chronic GC exposures should start anti-osteoporosis pharmacotherapy to prevent fractures. In addition to low awareness of the need for anti-osteoporosis therapy among clinicians treating patients with GCs, a major barrier to prevention of fractures from GIOP is a lack of clear guideline recommendations on when to start and stop anti-osteoporosis treatment in patients with GC use. The aim of this narrative review is to summarize current evidence and provide considerations for the duration of anti-osteoporosis treatment in patients taking GCs based on pre-clinical, clinical, epidemiologic, and pharmacologic evidence. We review the pathophysiology of GIOP, outline current guideline recommendations on initiating and stopping anti-osteoporosis therapy for GIOP, and present considerations for the duration of anti-osteoporosis treatment based on existing evidence. In each section, we illustrate major points through a patient case example. Finally, we conclude with proposed areas for future research and emerging areas of interest related to GIOP clinical management.

scholarly journals Beneficial Effects of a Low-Nickel Diet on Relapsing IBS-Like and Extraintestinal Symptoms of Celiac Patients during a Proper Gluten-Free Diet: Nickel Allergic Contact Mucositis in Suspected Non-Responsive Celiac Disease

Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2277 ◽  
Author(s):  
Raffaele Borghini ◽  
Natascia De Amicis ◽  
Antonino Bella ◽  
Nicoletta Greco ◽  
Giuseppe Donato ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Rating Scale ◽  
Gastrointestinal Symptoms ◽  
Gluten Free Diet ◽  
Rank Test ◽  
Gluten Free ◽  
Gastrointestinal Symptom Rating Scale ◽  
Histological Remission ◽  
Allergic Contact ◽  
Age Range

Background and Aim: Nickel (Ni)-rich foods can induce allergic contact mucositis (ACM) with irritable bowel syndrome (IBS)-like symptoms in predisposed subjects. Ni ACM has a high prevalence (>30%) in the general population and can be diagnosed by a Ni oral mucosa patch test (omPT). Many celiac disease (CD) patients on a gluten-free diet (GFD) often show a recrudescence of gastrointestinal and extraintestinal symptoms, although serological and histological remission has been achieved. Since a GFD often results in higher loads of ingested alimentary Ni (e.g., corn), we hypothesized that it would lead to a consequent intestinal sensitization to Ni in predisposed subjects. We wanted to (1) study Ni ACM prevalence in still symptomatic CD patients on a GFD and (2) study the effects of a low-Ni diet (LNiD) on their recurrent symptoms. Material and Methods: We recruited 102 consecutive CD patients (74 female, 28 male; age range 18–65 years, mean age 42.3 ± 7.4) on a GFD since at least 12 months, in current serological and histological remission (Marsh–Oberhuber type 0–I) who complained of relapsing gastrointestinal and/or extraintestinal symptoms. Inclusion criteria: presence of at least three gastrointestinal symptoms with a score ≥5 on the modified Gastrointestinal Symptom Rating Scale (GSRS) questionnaire. Exclusion criteria: IgE-mediated food allergy; history of past or current cancer; inflammatory bowel diseases; infectious diseases including Helicobacter pylori; lactose intolerance. All patients enrolled underwent Ni omPT and followed a LNiD for 3 months. A 24 symptoms questionnaire (GSRS modified according to the Salerno Experts’ Criteria, with 15 gastrointestinal and 9 extraintestinal symptoms) was administered at T0 (free diet), T1 (GFD, CD remission), T2 (recurrence of symptoms despite GFD), and T3 (GFD + LNiD) for comparisons. Comparisons were performed using Wilcoxon signed-rank test. RESULTS: Twenty patients (all female, age range 23–65 years, mean age 39.1 ± 2.9) out of 102 (19.6%) were finally included. All 20 patients enrolled (100%) showed positive Ni omPT, confirming an Ni ACM diagnosis. A correct GFD (T0 vs. T1) induced the improvement of 19 out of the total 24 (79.2%) symptoms, and 14 out of 24 (58.3%) were statistically significant (p-value < 0.0083 according to Bonferroni correction). Prolonged GFD (T1 vs. T2) revealed the worsening of 20 out of the total 24 (83.3%) symptoms, and 10 out of 24 (41.7%) were statistically significant. LNiD (T2 vs. T3) determined an improvement of 20 out of the total 24 (83.4%) symptoms, and in 10 out of 24 (41.7%) symptoms the improvement was statistically significant. Conclusions: Our data suggest that the recrudescence of gastrointestinal and extraintestinal symptoms observed in CD subjects during GFD may be due to the increase in alimentary Ni intake, once gluten contamination and persisting villous atrophy are excluded. Ni overload can induce Ni ACM, which can be diagnosed by a specific Ni omPT. Improvement of symptoms occurs after a proper LNiD. These encouraging data should be confirmed with larger studies.

Nutritional Management of Celiac Disease

2017 ◽  
Author(s):  
Ciarán P Kelly ◽  
Satya Kurada ◽  
Mariana Urquiaga
Keyword(s):  
Immune Response ◽  
Celiac Disease ◽  
Tight Junction ◽  
Villous Atrophy ◽  
Gastrointestinal Symptoms ◽  
Gluten Free Diet ◽  
Intestinal Biopsy ◽  
Nutritional Management ◽  
Gluten Free ◽  
Antigliadin Antibodies

Celiac disease (CD) is an autoimmune disorder characterized by an immune response to gluten peptides in wheat, barley, and rye. The diagnosis of celiac disease is confirmed by three important characteristics: consistent symptoms, positive celiac-specific serology, and small intestinal biopsy findings of inflammation, crypt hyperplasia, and villous atrophy. CD may present with overt gastrointestinal symptoms, including diarrhea (or constipation), weight loss, and abdominal bloating and discomfort, or covertly with micronutrient deficiencies such as iron deficiency with anemia. A gluten-free diet (GFD) remains the mainstay of treatment. The aim of this review is to highlight the pathogenesis of CD, concepts and challenges associated with a GFD, and nutritional management of CD applicable in clinical practice to internists, gastroenterologists, and dietitians. Patients should be referred to an expert celiac dietitian for education on adherence to a GFD to address gluten contamination in the diet, the psychosocial implications of following a GFD, and macro- and micronutrient disequilibria arising from celiac disease and the GFD. Several novel therapeutics are on the horizon in various stages of development, including glutenases, antigliadin antibodies, tight junction regulators, modulation of the immune response to gliadin, and efforts to engineer less toxic gluten-containing foodstuffs. This review contains 3 figures, 5 tables, and 61 references. Key words: celiac disease, genetic engineering, food engineering, gluten, glutenases, gluten-free diet, oats, IgY, nutrition, tight junction regulators, wheat

scholarly journals Association Between Celiac Disease and Cancer

2020 ◽  
Vol 21 (11) ◽  
pp. 4155
Author(s):  
Irene Marafini ◽  
Giovanni Monteleone ◽  
Carmine Stolfi
Keyword(s):  
Celiac Disease ◽  
Gastrointestinal Tract ◽  
Life Expectancy ◽  
Complete Resolution ◽  
Benign Disease ◽  
Current Evidence ◽  
Western World ◽  
Gluten Free ◽  
Increased Risk ◽  
Intestinal Lymphomas

Celiac disease (CD) is a chronic enteropathy that develops in genetically susceptible individuals after the ingestion of gluten. There has been a substantial increase in CD prevalence in the last 50 years, and it is now estimated that this disease affects approximately 1% of the population in the Western world. In the large majority of cases, CD is a benign disease, characterized by the complete resolution of symptoms and a normal life expectancy after the onset of a gluten-free diet (GFD). However, failure to adhere to a strict GFD bears the risk of adverse events and increases mortality. A considerable number of studies have considered the possible association between CD and neoplasms. In particular, an increased risk of malignancies, such as cancers of the gastrointestinal tract and intestinal lymphomas, has been reported. In this review, we summarize and discuss the current evidence on the possible association between CD and cancer.

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