Celiac disease diagnosis and gluten-free food analytical control

Abstract

Celiac disease (CD) is an autoimmune entero-pathy, characterized by an inappropriate T-cell-mediated immune response to the ingestion of certain dietary cereal proteins in genetically susceptible individuals. This disorder presents environmental, genetic, and immunological com-ponents. CD presents a prevalence of up to 1% in populations of European ancestry, yet a high percentage of cases remain underdiagnosed. The diagnosis and treatment should be made early since untreated disease causes growth retardation and atypical symptoms, like infertility or neurological disorders. The diagnostic criteria for CD, which requires endoscopy with small bowel biopsy, have been changing over the last few decades, especially due to the advent of serological tests with higher sensitivity and specificity. The use of serological markers can be very useful to rule out clinical suspicious cases and also to help monitor the patients, after adherence to a gluten-free diet. Since the current treatment consists of a life-long gluten-free diet, which leads to significant clinical and histological improvement, the standardization of an assay to assess in an unequivocal way gluten in gluten-free foodstuff is of major importance.

Propriospinal myoclonus associated with gluten sensitivity in a young woman

“…While high titers of GA may be observed in normal persons, high endomysial or tissue transglutaminase antibody levels are very specific for gluten sensitivity and should be used for additional confirmation of this diagnosis [12,13]. While this patient's biopsy showed findings suggestive of celiac disease, a definitive diagnosis would have required demonstrating villous atrophy that remitted on a gluten-free diet.…”

“…Progressive myoclonic ataxia with cortical and palatal myoclonus, as well as chorea, dystonia, stiff-person syndrome, myopathy, myelopathy, encephalopathy, epilepsy with occipital calcifications and migraine has been reported in association with gluten sensitivity [3,4,11]. Autoimmune mechanisms and direct toxicity are thought to play important roles in the pathogenesis of these disorders [3,12].…”

Modeling of celiac disease immune response and the therapeutic effect of potential drugs

“…It was set to the average inflow in a patient following a GFD diet, which according to the Codex Draft Revise Standard (2000) should contain less that 20 ppm of gluten for foodstuffs naturally gluten-free (GF) and less than 200 ppm for foodstuffs rendered gluten-free (GF) [44]. …”

Awareness of coeliac disease and the gluten status of ‘gluten‐free’ food obtained on request in catering outlets in Ireland

“…, 2005; Lester, 2008; Weber et al. , 2009; da Silva Neves et al. , 2010) (250 m m 2‐mercaptoethanol and 2 m guanidine hydrochloride), followed by R5 monoclonal antibody ELISA (r‐biopharm RIDA Screen gliadin kit 96‐well sandwich ELISA, LOD gluten 5 mg kg −1, part no.…”