Analysis of gluten immunogenic peptides in feces to assess adherence to the gluten-free diet in pediatric celiac patients

Roca, María; Aliaga, Ester Donat; Masip, Etna; Crespo-Escobar, Paula; Cañada-Martínez, Antonio José; Polo, Begoña; Ribes-Koninckx, Carmen

doi:10.1007/s00394-020-02404-z

Cited by 16 publications

(23 citation statements)

References 27 publications

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“…Although a significant correlation between gluten intake and excreted GIP concentration was reported, high variability is usually observed among subjects[ 9 , 29 , 30 , 43 ]. Interindividual diversity (weight, sex, age, gut microbiota, etc.…”

Section: Discussionmentioning

confidence: 99%

“…), the type of gluten-containing food (beer, pasta, bread, cookies, etc. ), the amount of daily liquid intake, and the accompanying diet may have a considerable impact on the resulting GIP concentration as well as the excretion time in urine and stool samples, especially when the gluten exposure is not regular[ 9 , 29 , 30 , 43 ].…”

Section: Discussionmentioning

confidence: 99%

“…It was observed that after consuming normal gluten containing diet, a negative result in both urine and stool samples was rarely observed in the following 6-12 h and 3-5 days, respectively, after the last gluten-containing meal[ 9 , 43 ]. Moreover, in individuals with multiple regular transgressions, the interval between gluten ingestion and urine sample collection for maximal sensitivity of detection was generally consistent between 4 and 24 h[ 29 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

“…Recent research demonstrated that both ELISA and LFIA methods confirmed suspected and unsuspected dietary exposure in stool samples of CeD children and adolescent patients on a long-term GFD. However, no significant association was found between longer GFD duration, and the amount of GIP recovered in stool[ 43 ]. GIP-positive results were obtained from 35% of patients by ELISA (47% of these were also confirmed by LFIA).…”

Section: Discussionmentioning

confidence: 99%

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Determination of gluten immunogenic peptides for the management of the treatment adherence of celiac disease: A systematic review

Coto¹,

Mendía²,

Sousa³

et al. 2021

WJG

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BACKGROUND Gluten is a complex mixture of proteins with immunogenic peptide sequences triggering the autoimmune activity in patients with celiac disease (CeD). Gluten immunogenic peptides (GIP) are resistant to gastrointestinal digestion and are then excreted via the stool and urine. Most common detection methods applied in the follow-up visits for CeD patients such as serology tests, dietetic interviews, questionnaires, and duodenal biopsy have been proved to be inefficient, invasive, or inaccurate for evaluating gluten-free diet (GFD) compliance. Determination of excreted GIP in stool and urine has been developed as a non-invasive, direct, and specific test for GFD monitoring. AIM To summarize published literature about the clinical utility of GIP determination in comparison to the tools employed for GFD monitoring. METHODS PubMed and Web of Science searches were performed using the keywords “gluten immunogenic peptides” or “gluten immunogenic peptide” and a combination of the previous terms with “feces”, “stools”, “urine”, “celiac disease”, “gluten-free diet”, and “adherence” to identify relevant clinical studies published in English and Spanish between 2012 to January 2021. Reference lists from the articles were reviewed to identify additional pertinent articles. Published articles and abstracts reporting the clinical use of GIP determination in stool and/or urine for the follow-up of patients with CeD in comparison with other tools in use were included. Case reports, commentaries, reviews, conference papers, letters, and publications that did not focus on the aims of this review were excluded. RESULTS Total of 15 publications were found that involved the use of GIP determination in stool and/or urine to monitor the adherence to the GFD in comparison to other tools. Studies included both children and adults diagnosed with CeD and healthy volunteers. Overall, these preliminary studies indicated that this novel technique was highly sensitive for the detection of GFD transgressions and therefore could facilitate the follow-up of patients with CeD. Tools identified in this work included the CeD-specific serology, dietetic questionnaires, symptomatology, and the duodenal biopsy. Review of the literature revealed that the rates of GFD adherence may vary between 30%-93% using either stool or urine GIP determination, 49%-96% by the serology, 59%-94% using the dietetic questionnaires, 56%-95% by the reported symptoms and 44%-76% with the duodenal biopsy. In addition, the association between the different methods and histological abnormalities (Marsh II-III) was found to be 33%-100% for GIP determination (stool and urine), 25%-39% for CeD-specific serology, 3%-50% for dietetic questionnaires, and 22%-28% for the symptomatology. CONCLUSION Excreted GIP detection is the precise approach for determining voluntary or involuntary gluten consumption in CeD patients pr...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Determination of gluten immunogenic peptides for the management of the treatment adherence of celiac disease: A systematic review

Coto¹,

Mendía²,

Sousa³

et al. 2021

WJG

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“… Studies reporting gluten exposure rates in CD patients on a supposed GFD. CD, celiac disease; GFD, gluten-free diet [ 23 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 ]. …”

Section: Figurementioning

confidence: 99%

New Insights into Non-Dietary Treatment in Celiac Disease: Emerging Therapeutic Options

et al. 2021

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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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Gluten‐free diet for pediatric patients with coeliac disease: A position paper from the ESPGHAN gastroenterology committee, special interest group in coeliac disease

Luque,

Crespo‐Escobar,

Hård af Segerstad

et al. 2024

J. pediatr. gastroenterol. nutr.

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Background and ObjectiveCoeliac disease is a chronic, immune‐mediated disorder for which the only treatment consists of lifelong strict adherence to gluten‐free diet (GFD). However, there is a lack of evidence‐based guidelines on the GFD dietary management of coeliac disease. This position paper, led by the Special Interest Group in coeliac disease of the European Society of Pediatric, Gastroenterology Hepatology, and Nutrition, supported by the Nutrition Committee and the Allied Health Professionals Committee, aims to present evidence‐based recommendations on the GFD as well as how to support dietary adherence.MethodsA wide literature search was performed using the MeSH Terms: “diet, gluten free,” “gluten‐free diet,” “diets, gluten‐free,” “gluten free diet,” and “coeliac disease” in Pubmed until November 8th, 2022.ResultsThe manuscript provides an overview of the definition of the GFD, regulations as basis to define the term “gluten‐free,” which foods are naturally gluten‐free and gluten‐containing. Moreover, it provides recommendations and educational tips and infographics on suitable food substitutes, the importance of reading food labels, risk of gluten cross‐contact at home and in public settings, nutritional considerations as well as factors associated to dietary adherence based on available evidence, or otherwise clinical expertise.ConclusionsThis position paper provides guidance and recommendations to support children with coeliac disease to safely adhere to a GFD.

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Analysis of gluten immunogenic peptides in feces to assess adherence to the gluten-free diet in pediatric celiac patients

Cited by 16 publications

References 27 publications

Determination of gluten immunogenic peptides for the management of the treatment adherence of celiac disease: A systematic review

Determination of gluten immunogenic peptides for the management of the treatment adherence of celiac disease: A systematic review

New Insights into Non-Dietary Treatment in Celiac Disease: Emerging Therapeutic Options

Gluten‐free diet for pediatric patients with coeliac disease: A position paper from the ESPGHAN gastroenterology committee, special interest group in coeliac disease

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