Systematic Literature Review of the Economic Burden of Celiac Disease

Mearns, Elizabeth S.; Taylor, Aliki; Boulanger, Talia; Craig, Kelly Jean Thomas; Gerber, Michele; Leffler, Daniel A.; Drahos, Jennifer; Sanders, David S.; Lebwohl, Benjamin

doi:10.1007/s40273-018-0707-5

Cited by 30 publications

(15 citation statements)

References 79 publications

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“…A strict GFD is essential to ensure mucosal healing in CD and a failure to heal is correlated with higher morbidity and mortality (18, 19). This is an onerous, costly and restrictive treatment and its ability to induce CD remission is compromised by poor dietary adherence (20). The GFD is generally lower in dietary fiber and frequently higher in simple carbohydrates and fat (21).…”

Section: Introductionmentioning

confidence: 99%

Preparation and Characterization of Avenin-Enriched Oat Protein by Chill Precipitation for Feeding Trials in Celiac Disease

et al. 2019

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The safety of oats for people with celiac disease remains unresolved. While oats have attractive nutritional properties that can improve the quality and palatability of the restrictive, low fiber gluten-free diet, rigorous feeding studies to address their safety in celiac disease are needed. Assessing the oat prolamin proteins (avenins) in isolation and controlling for gluten contamination and other oat components such as fiber that can cause non-specific effects and symptoms is crucial. Further, the avenin should contain all reported immunogenic T cell epitopes, and be deliverable at a dose that enables biological responses to be correlated with clinical effects. To date, isolation of a purified food-grade avenin in sufficient quantities for feeding studies has not been feasible. Here, we report a new gluten isolation technique that enabled 2 kg of avenin to be extracted from 400 kg of wheat-free oats under rigorous gluten-free and food grade conditions. The extract consisted of 85% protein of which 96% of the protein was avenin. The concentration of starch (1.8% dry weight), β-glucan (0.2% dry weight), and free sugars (1.8% dry weight) were all low in the final avenin preparation. Other sugars including oligosaccharides, small fructans, and other complex sugars were also low at 2.8% dry weight. Liquid chromatography tandem mass spectrometry (LC-MS/MS) analysis of the proteins in these preparations showed they consisted only of oat proteins and were uncontaminated by gluten containing cereals including wheat, barley or rye. Proteomic analysis of the avenin enriched samples detected more avenin subtypes and fewer other proteins compared to samples obtained using other extraction procedures. The identified proteins represented five main groups, four containing known immune-stimulatory avenin peptides. All five groups were identified in the 50% (v/v) ethanol extract however the group harboring the epitope DQ2.5-ave-1b was less represented. The avenin-enriched protein fractions were quantitatively collected by reversed phase HPLC and analyzed by MALDI-TOF mass spectrometry. Three reverse phase HPLC peaks, representing ~40% of the protein content, were enriched in proteins containing DQ2.5-ave-1a epitope. The resultant high quality avenin will facilitate controlled and definitive feeding studies to establish the safety of oat consumption by people with celiac disease.

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Section: Introductionmentioning

confidence: 99%

Preparation and Characterization of Avenin-Enriched Oat Protein by Chill Precipitation for Feeding Trials in Celiac Disease

et al. 2019

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“…Indeed, in this country (based on the current health system organization), the economic factor has a significant impact on the diagnostic workup and, consequently, diagnostic rate of CD (23), which is likely to be still underdiagnosed based on our recent analyses of the CD-predisposing genetic background in this population and, in general, in Central Asia (24,25). However, the costs of screening test and diagnostic workup for CD is also relevant in developed countries, as discussed by several authors (26)(27)(28). Finally, if we consider children as a target population for the CD screening, the multiplex analysis by CytoBead CeliAK assay requires only one sample (thus, a lesser amount) of blood, rather than several collection tubes, which may be an issue especially in infants and younger children.…”

Section: Discussionmentioning

confidence: 98%

Reliability of the Multiplex CytoBead CeliAK Immunoassay to Assess Anti-tTG IgA for Celiac Disease Screening

et al. 2021

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Background and Objective: The diagnosis of Celiac Disease (CD) is first based on the positivity for specific serological markers. The CytoBead CeliAK immunoassay simultaneously measures antibodies (IgA) directed to tissue transglutaminase (tTG), endomysium (EMA), and deamidated gliadin (DG), in addition to providing a control for total IgA levels. The aim of this study is to assess the reliability of this multiplex assay to detect anti-tTG IgA positive patients, compared with a conventional single-parameter enzyme-linked immunosorbent assay (ELISA).Methods: Serum samples from 149 pediatric patients were assessed by both CytoBead CeliAK immunoassay and ELISA, in order to evaluate their concordance for the measurement of anti-tTG IgA.Results: The measurement of anti-tTG IgA by CytoBead CeliAK immunoassay basically showed a complete concordance rate with the conventional and single-parameter ELISA, according to the respective cutoff values (3 U/ml and 10 U/ml).Conclusions: Our comparative analysis demonstrates a substantial equivalency between multiplex CytoBead CeliAK assay and the single-parameter conventional ELISA to assess anti-tTG IgA antibody in the context of the screening for CD in children. Importantly, CytoBead CeliAK assay could present some preanalytic, analytic, and economic advantages.

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“…Quality certification programmes for clinics or health-care professionals involved in the care of patients with coeliac disease, recognized by scientific societies, can help to achieve this milestone ( coeliac disease centres ). The dearth of pharmaco-economic data 52 has led to an underappreciation of disease burden by employers, insurers and government, and has also severely limited the development of treatments.…”

Section: Milestones and Gaps In Managementmentioning

confidence: 99%

Society for the Study of Celiac Disease position statement on gaps and opportunities in coeliac disease

Sánchez

Silvester

Lebwohl

et al. 2021

Nat Rev Gastroenterol Hepatol

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Progress has been made in understanding coeliac disease, a relatively frequent and underappreciated immune-mediated condition that occurs in genetically predisposed individuals. However, several gaps remain in knowledge related to diagnosis and management. The gluten-free diet, currently the only available management, is not curative or universally effective (some adherent patients have ongoing duodenal injury). Unprecedented numbers of emerging therapies, including some with novel tolerogenic mechanisms, are currently being investigated in clinical trials. In March 2020, the Celiac Disease Foundation and the Society for the Study of Celiac Disease convened a consensus workshop to identify high-yield areas of research that should be prioritized. Workshop participants included leading experts in clinical practice, academia, government and pharmaceutical development, as well as representatives from patient support groups in North America. This Roadmap summarizes key advances in the field of coeliac disease and provides information on important discussions from the consensus approach to address gaps and opportunities related to the pathogenesis, diagnosis and management of coeliac disease. The morbidity of coeliac disease is often underestimated, which has led to an unmet need to improve the management of these patients. Expanded research funding is needed as coeliac disease is a potentially curable disease.

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Systematic Literature Review of the Economic Burden of Celiac Disease

Cited by 30 publications

References 79 publications

Preparation and Characterization of Avenin-Enriched Oat Protein by Chill Precipitation for Feeding Trials in Celiac Disease

Preparation and Characterization of Avenin-Enriched Oat Protein by Chill Precipitation for Feeding Trials in Celiac Disease

Reliability of the Multiplex CytoBead CeliAK Immunoassay to Assess Anti-tTG IgA for Celiac Disease Screening

Society for the Study of Celiac Disease position statement on gaps and opportunities in coeliac disease

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