Seroprevalence, Characteristics and Correlates of Undetected Coeliac Disease in England

Abstract

AIMS:The aim of this study was to investigate MlF expression and activity in human sporadic colorectal adenomas and in intestinal adenomas from the Apc mouse model of familial adenomatous polyposis. METHODS: lmmunohistochemistry was performed on archival formalin-fixed, paraffin-embedded human sporadic colorectal adenomas (n=56), and on small and large intestine of Apc mice and wild type littermates. Human MLF protein levels were analysed in fresh paired colorectal adenoma and normal mucosa samples by ELSA (n=16) and by Western blot analysis (n=8). A phydroxyphenylpyruvate (HPP) tautomerase assay was used to measure specific MIF activity in paired fresh tissue (n=20). RESULTS: In human colorectal tissue, immunohistochemistry and Western blot analysis both demonstrated increased MIF protein levels in adenomas compared with paired normal colorectal mucosa. MIF was localised to both epithelial (particularly the apical membrane) and stromal cells in adenomas. The ELISA demonstrated a mean 1.9-fold increase (95% CI 1.1-2.7) in immunoreactive MlF in adenomas compared with paired normal mucosa. The HPP tautomerase assay revealed a mean 1.5-fold increase (95% CI 1.2-1.7) in MIF activity in adenomas. Inmunohistochemical analysis in the Apc mouse intestine revealed a similar pattern of protein localisation in adenomas and histologically normal mucosa, with MIF localisation in dysplastic epithelial cells being prominent. CONCLUSIONS: MIF protein levels are increased in human sporadic colorectal adenomas and in intestinal adenomas from the Apc mouse. The precise role of MIF in epithelial and stromal cell compartments of adenomas during the early stages of intestinal tumorigenesis is currently being investigated.

Risk of malignancy in diagnosed coeliac disease: a 24‐year prospective, population‐based, cohort study

“…The observation of fewer cases of breast cancer than expected, although not statistically significant, is of interest particularly in the light of similar observations in previous reports. 10,16 The reasons for this decrease could be related to the lower body weight of people with coeliac disease 17 or their lower rates of smoking. 18 In conclusion, in this large, prospective, populationbased cohort study we found no overall increase in the risk of incident malignancy in clinically diagnosed coeliac disease.…”

Morbidity and Mortality Among Older Individuals With Undiagnosed Celiac Disease

“…[1][2][3] Undiagnosed CD in older adults is not associated with an increase in mortality but is associated with impaired bone density and lower ferritin levels. Furthermore, a minority of subjects with undiagnosed CD, especially women, will eventually be clinically diagnosed with CD.…”

“…Once thought to be rare, CD affects approximately 1% of the population [1][2][3] and appears to be associated with increased mortality [4][5][6] along with substantial morbidity, 7,8 much of which is preventable or reversible with the gluten free diet. 9,10 Well recognized are the gastrointestinal consequences of severe malabsorption with weight loss or growth failure, macro-and micronutrient deficiencies and a host of extra-gastrointestinal manifestations varying from autoimmune disorders to arthralgia to neurologic problems.…”

El efecto de la dieta libre de gluten en la alanina- aminotransferasa (ALT) en pacientes celíacos

“…Entre los países europeos la positividad de autoanticuerpos se describe como de 0,3% a 2,4% de la población y es menos común en Alemania y más en Finlandia. (5)(6)(7). En São Paulo la prevalencia de la enfermedad celíaca es del 0,6%, la cual es similar a las tasas reportadas en Portugal e Italia (5,7,8).…”