A Comparison of Antibody Testing, Permeability Testing, and Zonulin Levels with Small-Bowel Biopsy in Celiac Disease Patients on a Gluten-Free Diet

Duerksen, Donald R.; Wilhelm-Boyles, C.; Veitch, Rebecca; Kryszak, Debby; Parry, David M.

doi:10.1007/s10620-009-0813-5

Cited by 52 publications

(40 citation statements)

References 26 publications

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“…Tissue levels of zonulin in the intestine were much higher in celiac patients compared to controls [21]. Higher levels of zonulin in serum correlate with higher intestinal permeability as measured with the L/M test [56,57]. This is in contrast with our study, where no abnormal L/M ratio was measured while we did find changes in zonulin levels.…”

Section: Case Seriescontrasting

confidence: 99%

Clinical Studies Evaluating Effects of Probiotics on Parameters of Intestinal Barrier Function

Hemert¹,

Verwer²,

Schütz³

2013

AiM

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The intestinal barrier is important in preventing translocation of bacteria, toxins and antigens from the lumen of the gut into the body. Enhanced permeability, or gut leakiness, has been associated with different diseases. Probiotics can, strain-specifically, improve the epithelial barrier function. However, so far most researches have used cell lines or animal models due to the difficulty of measuring the effects of products on the epithelial barrier function in vivo in humans. Here a systematic literature search was performed to find articles addressing the effects of probiotics on the barrier function in human trials. The Pubmed database was searched (January 2013) to identify human in vivo studies with probiotic products in which parameters for epithelial barrier function were measured. In total 29 studies were identified, but patients, bacterial characteristics and methods to measure intestinal barrier function caused large heterogeneity among these studies. About half of the studies showed positive results of probiotics on the epithelial barrier function, indicating a clear potential of probiotics in this field. In a case series of 14 patients using Ecologic  825, a probiotic food supplement with known effect on epithelial barrier function, different markers of intestinal integrity improved significantly. Further studies in this field should consider strain(s), dose and duration of the probiotic supplementation as well as the markers used to measure epithelial barrier function. Besides the lactulose/mannitol test, zonulin and α1-antitrypsin might be valuable markers to measure epithelial barrier function in future experiments.

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Section: Case Seriescontrasting

confidence: 99%

Clinical Studies Evaluating Effects of Probiotics on Parameters of Intestinal Barrier Function

Hemert¹,

Verwer²,

Schütz³

2013

AiM

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“…In our study, CD patients with lower expression of TJP1 had higher levels of anti-gliadin as well as anti-tTG IgA antibodies, which might reflect greater intestinal permeability to gluten in these persons [22,26]. The link between enhanced gut permeability to gliadin and production of anti-gliadin IgA antibodies was already reported by Bonamico et al [47] and was confirmed by other authors [20].…”

Section: Discussionsupporting

confidence: 87%

“…Antibodies to the autoantigen tissue transglutaminase (tTG) have also been shown to increase intestinal permeability in CD [25]. Duerksen et al [26] found positive correlation of tTG antibodies with the severity of intestinal lesions and intestinal permeability. Increased permeability of the small intestinal mucosa has also been shown in patients with T1D, which is suggested to be important in the pathogenesis of T1D [27,28,29].…”

Section: Introductionmentioning

confidence: 99%

Lower Expression of Tight Junction Protein 1 Gene and Increased FOXP3 Expression in the Small Bowel Mucosa in Coeliac Disease and Associated Type 1 Diabetes Mellitus

Vorobjova¹,

Uibo

Ojakivi³

et al. 2011

Int Arch Allergy Immunol

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Background: The role of regulatory T cells expressing FOXP3 in the pathogenesis of coeliac disease (CD) and type 1 diabetes (T1D) has been reported. Recent data have placed special focus on the interplay between the intestinal barrier and immunoregulatory processes. We aimed to determine whether the expression of tight junction protein 1 (TJP1), which reflects small bowel mucosa permeability, is changed in CD and T1D. Methods: Transcription levels of TJP1 and FOXP3 genes were evaluated in the small bowel biopsies of 14 children with CD, 12 with CD and coexisting T1D and 40 controls using real-time PCR. Serum IgA and IgG to deamidated gliadin, bovine β-lactoglobulin, bovine α-casein and human tissue transglutaminase (tTG) were determined by ELISA. Results: The highest expression of FOXP3 mRNA was seen in patients with CD and T1D compared to patients with CD alone and controls (p = 0.02). In contrast, the lowest level of TJP1 mRNA expression was found in patients with CD and T1D (p = 0.01). The levels of IgA to deamidated gliadin and tTG were highest in patients with CD and T1D (p = 0.0001 and 0.01, respectively). The expression of FOXP3 mRNA correlated highly with the level of anti-gliadin IgA (p = 0.02) and anti-tTG IgA antibodies (p = 0.004). Conclusion: The significant decline in TJP1 expression in CD patients, particularly in those with coexisting T1D, was accompanied by an increase in FOXP3 expression. This might reflect an attempt to maintain immune tolerance to counterbalance the loss of mucosal integrity in the small intestine in CD associated with T1D.

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“…Then, ASCA have been described in coeliac disease (CD) [4][5][6], in autoimmune hepatitis [7], in primary biliary cirrhosis [8], in Behçet's disease [9], in ankylosing spondylitis [10], and in systemic lupus erythematosus [11]. In all these diseases there is an increased intestinal permeability [12][13][14][15][16]. In addition, S. cerevisiae, an exogenous yeast, is found in foodstuffs especially in bread.…”

Section: Introductionmentioning

confidence: 99%

Anti-Saccharomyces cerevisiae Antibodies are Frequent in Type 1 Diabetes

et al. 2010

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Anti-Saccharomyces cerevisiae antibodies (ASCA) have been described in many autoimmune diseases in which there is an increased intestinal permeability. Also in type 1 diabetes (T1D), there is an increased intestinal permeability. Since no data are available about ASCA in T1D, we evaluated, retrospectively, the frequency of ASCA in this disease. ASCA, IgG, and IgA, were determined by ELISA in sera of 224 T1D patients in which coeliac disease has been excluded and 157 healthy control group. The frequency of ASCA (IgG or IgA) was significantly higher in T1D patients than in the control group (24.5% vs. 2.5%, p < 10(-7)). The same observation was found in children and in adult patients when we compare them to healthy children and blood donors group respectively. Compared to children, adult patients with T1D showed significantly higher frequencies of ASCA of any isotype (38% vs. 13.7%, p < 10(-4)), both ASCA IgG and IgA (12% vs. 1.6%, p = 0.002), ASCA IgG (35% vs. 9.8%, p < 10(-5)) and ASCA IgA (15% vs. 5.6%, p = 0.001). The frequency of ASCA was statistically higher in females of all T1D than in males (30.8% vs.17.7%, p = 0.03), in girls than in boys (22% vs.6.2%, p = 0.017), and significantly higher in men than in boys (35.7% vs. 6.2%, p < 10(-4)). The frequency of ASCA IgG was significantly higher than that of ASCA IgA in all T1D patients (21% vs. 9.8%, p < 0.002), in all females (26.5% vs. 10.2%, p < 0.002), in women (37.9% vs. 12%, p < 0.001). The frequency of ASCA was significantly higher in all long-term T1D than in an inaugural T1D (29% vs. 14.5%, p = 0.019). The same observation was found in adults (45.8% vs. 17.8%, p = 0.01). In long-term T1D patients, ASCA were significantly more frequent in adults than children (45.8% vs. 14.5%, p < 10(-4)). The frequency of ASCA IgG was significantly higher in long-term T1D than in an inaugural T1D (25.2% vs. 11.6%, p = 0.03). Patients with T1D had a high frequency of ASCA.

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A Comparison of Antibody Testing, Permeability Testing, and Zonulin Levels with Small-Bowel Biopsy in Celiac Disease Patients on a Gluten-Free Diet

Cited by 52 publications

References 26 publications

Clinical Studies Evaluating Effects of Probiotics on Parameters of Intestinal Barrier Function

Clinical Studies Evaluating Effects of Probiotics on Parameters of Intestinal Barrier Function

Lower Expression of Tight Junction Protein 1 Gene and Increased FOXP3 Expression in the Small Bowel Mucosa in Coeliac Disease and Associated Type 1 Diabetes Mellitus

Anti-Saccharomyces cerevisiae Antibodies are Frequent in Type 1 Diabetes

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