Celiac Disease and Malignancy

Cooper, B. T.; Holmes, Geoffrey; Ferguson, Roger K.; Cooke, W. T.

doi:10.1097/00005792-198007000-00002

Cited by 127 publications

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“…36 37 Adenocarcinoma of the small intestine, carcinoma of the oesophagus, and carcinoma of the mouth and pharynx are the main other malignancies that arise with greater than expected frequency in coeliac disease. [36][37][38] Swinson et al found 19 cases of small intestinal adenocarcinoma, compared with 0.23 expected cases, among 119 non-lymphomatous malignancies. Those tumours occurred predominantly in the jejunum and duodenum.…”

Section: Discussionmentioning

confidence: 99%

“…[36][37][38] Primary non-Hodgkin's lymphoma of the small intestine is the most common tumour, accounting for about 50% of the malignant conditions found in patients with coeliac disease. 36 37 Adenocarcinoma of the small intestine, carcinoma of the oesophagus, and carcinoma of the mouth and pharynx are the main other malignancies that arise with greater than expected frequency in coeliac disease.…”

Section: Discussionmentioning

confidence: 99%

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Immunohistochemical analysis of candidate gene product expression in the duodenal epithelium of children with coeliac sprue

Barshack

Goldberg²,

Chowers³

et al. 2001

Journal of Clinical Pathology

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Background-Coeliac sprue is a chronic disease, in which there is a characteristic mucosal lesion of the small intestine and impaired nutrient absorption, which improves upon the withdrawal of wheat gliadins and related grain proteins from the diet. Biopsy specimens demonstrate diffuse enteritis with pronounced atrophy or total loss of villi. There is also a long term risk of malignant disease. Aims-To compare the immunoexpression of DCC (deleted in colon cancer), p53, E-cadherin, and -catenin in the duodenal mucosa of children with coeliac disease with that seen in children with no evidence of small intestinal disease. Methods-To gain more insight into the genetic and immunohistochemical alterations of the duodenal epithelium in coeliac disease, 21 endoscopic biopsies from children with coeliac disease and 10 duodenal biopsies from children without coeliac disease were immunohistochemically evaluated for p53, DCC, E-cadherin, and -catenin. Results-DCC expression was not reduced in patients with coeliac disease compared with those without coeliac disease. p53 positive nuclear immunostaining was seen in seven of the 21 patients with coeliac disease. Positive nuclear staining was seen mainly in the deep and the lateral aspects of the crypts. All patients in the control group were negative for p53. In nine and three of the 21 patients with coeliac disease, respectively, the immunohistochemical expression of E-cadherin and -catenin was reduced. However, both E-cadherin and -catenin immunostaining in the control group was not altered.Conclusions-E-cadherin and -catenin were reduced in the duodenal epithelium of children with coeliac disease when compared with normal mucosa. p53 was overexpressed in the duodenal mucosa of patients with coeliac disease. The reduced expression of E-cadherin and -catenin and p53 overexpression may contribute to the morphological changes seen in the small intestinal mucosa in coeliac disease. (J Clin Pathol 2001;54:684-688)

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Immunohistochemical analysis of candidate gene product expression in the duodenal epithelium of children with coeliac sprue

Barshack

Goldberg²,

Chowers³

et al. 2001

Journal of Clinical Pathology

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“…Rudman et al (55) demonstrated that patients with regional enteritis suffer fr~m'~astroin-testinal bleeding, increased steatorrhea, fever, diarrhea, and abdominal discomfort due to inclusion of gluten in the diet. Moreover, temporary gluten intolerance (46) as well as gluten-sensitive diarrhea without evidence of celiac disease (12) and nonceliac gluten intolerance in infancy (48) have also been described.…”

Section: Resultsmentioning

confidence: 99%

An in Vitro Animal Model for the Study of Cereal Components Toxic in Celiac Disease

Auricchio¹,

Cardelli

Ritis³

et al. 1984

Pediatr Res

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ABSTRACT. Peptic-tryptic-Cotazym (PTC) digests were obtained, simulating in vivo protein digestion, from rice, maize, rye, oats, barley, and sorghum prolamines and tested on small intestine cultures from rat fetus. The PTC digests of the prolamine fractions from rice and maize, even when tested at a concentration as high as 0.5 mg/ml, did not affect in vitro differentiation and maturation of fetal rat jejunum that took place in vitro in a way comparable to what happens in vivo. On the contrary, the PTC digests of prolamines from rye, oats, barley, and sorghum were very active in slowing down in vitro development of fetal rat intestine. These results further strengthen earlier findings and all together show that there is a strong correlation between toxicity results of cereal and/or cereal components assessed with clinical trials or in vitro systems based on bioptic specimens of intestinal mucosa from celiac patients and with the culture of rat fetal intestine. Therefore, the rat fetal intestine culture is considered to be an adequate model for screening and investigating cereal peptides which are toxic for the celiac small intestinal mucosa. 18:1372-1378, 1984) Abbreviations PTC, peptic-tryptic-cotazym GP, gliadin peptides Celiac disease is an enteropathy occumng in genetically predisposed individuals (about 0.5/1000 of the general population) when wheat is a component of the diet. Under such circumstances, diarrhea and several malabsorption symptoms are observed in association with intestinal mucosa atrophy. Soon after the discovery that wheat is the environmental factor triggering the appearance of malabsorption symptoms, it was demonstrated that wheat toxicitv resulted from the gliadin protein fraction and that the other w h a t protein fractions, i.e. albumins, globulins, and glutenins, were harmless (6, 64, 65, 67). Later on it was shown (27, 28) that the ingestion of peptide mixtures obtained from wheat gluten after in vitro sequential digestion with proteolytic enzymes also induces the typical symptoms in patients affected by celiac disease. Moreover, clinical trials have shown Received July 29. 1983; February 7. 1984. Address correspondence to Salvatore Auricchio. Clinica Pediatrica, I1 Facolti di Medicina e Chirugia. Via Sergio Pansini 5 , 8013 1 Naples, Italy. This paper is dedicated by the authors to Professor Francesco Pocchiari on the occasion of his 60th birthday. (Pediatr Resthat, in addition to wheat, rye, barley, and probably oats also have toxicity (7, 41), whereas rice and maize are considered nontoxic and are usually used as wheat substitutes in the diet of celiac patients. It is presumed, but not demonstrated, that toxicity of cereals other than wheat is associated with prolamine fractions equivalent to gliadins in the grain of these other species.The detection and characterization of cereal components that are toxic in celiac disease are very difficult because no animal models exist for this disease. Falchuk et al. (19,20) have proposed the organ culture of human small intestinal biopsie...

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“…NCGS was first described as individual cases in the late 1970's and later as a case series in 1980 [101][102][103]. However, since 2010 a rapid increase in interest and case series has been published.…”

Section: Non-celiac Gluten Sensitivity (Ncgs)mentioning

confidence: 99%

Gluten and the Gut: A Brief Review of Gluten-Related Gastrointestinal Disorders

Shah¹

2017

SOJI

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We conducted online electronic searches (published manuscripts in English) of the Cochrane Library, pub med and manual searches of selected specialty journals to identify any pertinent literature. The search was conducted using the key words 'celiac disease', 'gluten related disorder', 'non celiac gluten sensitivity', 'wheat allergy', 'gluten', , 'gluten free diet'. Studies not published in English or published only in the abstract form were excluded. We also conducted a focused review of available references to identify subsequent pertinent papers. AbstractCeliac disease (CD) was the first gluten-related disorder to be described. Presently the realm of gluten-related disorders also includes non-celiac gluten sensitivity (NCGS) and wheat allergy (WA). CD is a multisystem immune mediated enteropathy observed in genetically susceptible individuals exposed to dietary gluten present in barley, rye and wheat. Although the prevalence of CD is on the rise, it still largely remains under diagnosed given that many cases can be silent, subtle or atypical. The Pathophysiology of CD includes both innate and adaptive immune response to dietary gluten. Patients present with a wide variety of intestinal and extra-intestinal symptoms and are at risk for non-Hodgkin's lymphoma and small intestinal adenocarcinoma. The corner stone for treatment of CD is a gluten-free diet (GFD). NCGS is an emerging condition associated with gluten ingestion and the diagnosis of which is based on exclusion of CD and WA. Further evidence and studies are required to fully appreciate the clinical entity of NCGS and WA to detail its epidemiology and pathogenesis. The symptoms of NCGS and WA may overlap with CD and hence it is imperative to differentiate these clinical entities and select patients for appropriate management.Keywords: Celiac disease, gluten related disorder, non-celiac gluten sensitivity, wheat allergy, gluten, epidemiology, clinical features, Pathophysiology, management, gluten free diet.Core tip: CD is largely under-diagnosed while the incidence and prevalence of gluten-related disorders are on the rise. A clear understanding of the various clinical presentations of gluten-related disorders can help differentiate CD from NCGS and WA. The management for these conditions differs and hence accurate diagnosis leads to improved patient outcomes with avoidance of longterm complications as well as unnecessary testing which can be both invasive and expensive. Celiac DiseaseThe term celiac is derived from the Greek word "koiliaks" meaning "abdominal". It was first described in the second century in modern day Turkey by a Greek physician Aretaeus of Cappadocia [1]. In 1888, Samuel Gee; a pediatrician from the United Kingdom gave the first modern-day description of the condition and associated diet to the treatment of celiac disease EpidemiologyCeliac disease occurs in about 1% of the general population worldwide [7]. Data from the USA suggests CD to be more common in Caucasians as compared to African-Americans and Hispanics [8,9]. The initial ...

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Celiac Disease and Malignancy

Cited by 127 publications

References 0 publications

Immunohistochemical analysis of candidate gene product expression in the duodenal epithelium of children with coeliac sprue

Immunohistochemical analysis of candidate gene product expression in the duodenal epithelium of children with coeliac sprue

An in Vitro Animal Model for the Study of Cereal Components Toxic in Celiac Disease

Gluten and the Gut: A Brief Review of Gluten-Related Gastrointestinal Disorders

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