Comparison of Clinical Methods With the Faecal Gluten Immunogenic Peptide to Assess Gluten Intake in Coeliac Disease

Gerasimidis, Konstantinos; Zafeiropoulou, Konstantina; Mackinder, Mary; Ijaz, Umer Zeeshan; Duncan, H. J.; Buchanan, Evan G.; Cardigan, Tracey; Edwards, Christine; McGrogan, Paraic; Russell, Richard K.

doi:10.1097/mpg.0000000000002062

Cited by 46 publications

(39 citation statements)

References 12 publications

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“…The Biagi score is a self-reported questionnaire that did not necessarily reflect the real daily gluten intake; in fact, we have 15 patients who presented a slight increase of antibody tTG-IgA while reporting a strict adherence to a GFD. Recently in the literature, a new strategy to improve the identification of GFD non-compliance was reported as the quantification of faecal gluten immunogenic peptides [ 42 ]. The 15 subjects reported a significant reduction of their antibodies after six months from the dietician consultation we suggested.…”

Section: Discussionmentioning

confidence: 99%

Quality-of-Life Evaluation in Coeliac Patients on a Gluten-Free Diet

et al. 2020

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The treatment for coeliac disease (CD) has a considerable psychological impact on patients, which may vary depending on subjects and clinical characteristics. The aim of this study was to describe the quality of life (QoL) in CD patients during follow-up, evaluating which factors can influence it. Patients with CD who consecutively visited the outpatient clinic of CD Unit of the University Hospital of Padua from January to September 2019 were enrolled. Demographics and clinical information were collected, and all patients were asked to answer the CD-QoL and Biagi’s validated questionnaires. Student’s t-test and chi-square test were used to compare the continuous and categorical variables, respectively. One hundred patients were enrolled (86 females, mean age at test ± SD: 39.73 ± 13.51; mean age at diagnosis ± SD: 33.09 ± 12.92), with 61% of them having been diagnosed with CD within the previous 5 years. At the time of diagnosis, 43 CD patients reported classical CD presentation, 32 non-classical features, 16 only anaemia and 9 were asymptomatic. The mean CD-QoL value was overall high (80.54 ± 11.91). We found that the “health concerns” subscale score was significantly lower in subjects aged more than 35 years compared to younger subjects (p = 0.03). We also observed that the CD-QoL score in gluten-free diet (GFD)-adherent patients tended to be higher compared to subjects who were non-compliant, with a significantly higher percentage of patients with low score for the “dysphoria” subscale (p = 0.05). This study showed an overall good QoL in subjects on a GFD. However, subjects older and non-compliant to GFD appear to experience more health concerns and suffer from dysphoria, respectively.

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Section: Discussionmentioning

confidence: 99%

Quality-of-Life Evaluation in Coeliac Patients on a Gluten-Free Diet

et al. 2020

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“…In experts’ opinion [ 7 , 8 ], serological testing should not be done alone, without detailed evaluation of the clinical situation and a GFD adherence. However, in some groups of patients (especially children, adolescents, and seniors) dietary assessment may be difficult due to unreliable self-reports or a lack of cooperation with a dietitian, therefore, new laboratory tests to monitor adherence are awaited in clinical practice like detection of gluten immunogenic peptides in feces [ 17 , 18 , 19 ] or intestinal fatty acid binding protein (I–FABP) in the blood [ 20 ]. Nevertheless, dietary assessment is still of great importance [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Celiac Dietary Adherence Test and Standardized Dietician Evaluation in Assessment of Adherence to a Gluten-Free Diet in Patients with Celiac Disease

et al. 2020

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Adherence to a gluten-free diet (GFD) is currently the mainstay of treatment strategy for celiac disease (CD). The aim of our study was measuring a GFD adherence in CD patients using two newly validated methods of dietary assessment—Standardized Dietician Evaluation (SDE) and the Celiac Dietary Adherence Test (CDAT). Ninety-two adults with CD were evaluated by a registered dietitian with extensive experience with the use of SDE and CDAT. Duodenal biopsy was performed and blood was drawn for serum anti-endomysial, anti-deamidated gliadin peptide and anti-tissue transglutaminase antibodies in forty four of those patients. The results of CDAT and SDE were very convergent, but SDE scores better correlated with serologic and histologic findings. As many as 24–52% of study participants did not adhere well enough to a GFD. Insufficient adherence to a GFD in CD patients is still a significant problem. The knowledge about gluten content in food ingredients and additives is very low among adults with CD. SDE is the most accurate method in assessing compliance with a GFD and is especially helpful in determining hidden sources of gluten. The CDAT may be a fast tool for screening for a GFD adherence in CD patients.

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“…Gluten immunogenic peptide (GIP) are fragments of gluten which are resistant to digestion and therefore eliminated in the urine and the stool [99]. The presence of gluten in the urine or stool indicates recent consumption of gluten-containing food [100].…”

Section: Biomarker To Predict Dietary Adherencementioning

confidence: 99%

“…The presence of gluten in the urine or stool indicates recent consumption of gluten-containing food [100]. The α-gliadin 33-mer is the main immunodominant toxic peptide that interacts with the immune system of patients with CeD and a proportion of this peptide is absorbed in the GI tract and makes it way from blood to and partly excreted in the stool [99].…”

Section: Biomarker To Predict Dietary Adherencementioning

confidence: 99%

Non-Invasive Biomarkers for Celiac Disease

Singh

Pramanik

Acharya

et al. 2019

JCM

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Once thought to be uncommon, celiac disease has now become a common disease globally. While avoidance of the gluten-containing diet is the only effective treatment so far, many new targets are being explored for the development of new drugs for its treatment. The endpoints of therapy include not only reversal of symptoms, normalization of immunological abnormalities and healing of mucosa, but also maintenance of remission of the disease by strict adherence of the gluten-free diet (GFD). There is no single gold standard test for the diagnosis of celiac disease and the diagnosis is based on the presence of a combination of characteristics including the presence of a celiac-specific antibody (anti-tissue transglutaminase antibody, anti-endomysial antibody or anti-deamidated gliadin peptide antibody) and demonstration of villous abnormalities. While the demonstration of enteropathy is an important criterion for a definite diagnosis of celiac disease, it requires endoscopic examination which is perceived as an invasive procedure. The capability of prediction of enteropathy by the presence of the high titer of anti-tissue transglutaminase antibody led to an option of making a diagnosis even without obtaining mucosal biopsies. While present day diagnostic tests are great, they, however, have certain limitations. Therefore, there is a need for biomarkers for screening of patients, prediction of enteropathy, and monitoring of patients for adherence of the gluten-free diet. Efforts are now being made to explore various biomarkers which reflect different changes that occur in the intestinal mucosa using modern day tools including transcriptomics, proteomics, and metabolomics. In the present review, we have discussed comprehensively the pros and cons of available biomarkers and also summarized the current status of emerging biomarkers for the screening, diagnosis, and monitoring of celiac disease.

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Comparison of Clinical Methods With the Faecal Gluten Immunogenic Peptide to Assess Gluten Intake in Coeliac Disease

Abstract: Inclusion of faecal GIP measurements is likely to improve identification of GFD recent noncompliance in CD management and could be incorporated into current follow-up strategies.

Cited by 46 publications

References 12 publications

Quality-of-Life Evaluation in Coeliac Patients on a Gluten-Free Diet

Quality-of-Life Evaluation in Coeliac Patients on a Gluten-Free Diet

Celiac Dietary Adherence Test and Standardized Dietician Evaluation in Assessment of Adherence to a Gluten-Free Diet in Patients with Celiac Disease

Non-Invasive Biomarkers for Celiac Disease

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