Summaries of important celiac research published in October 2012.
The following research summaries have been provided by NFCA volunteer Sam Master, a second year medical student at the University of Medicine and Dentistry of New Jersey, School of Osteopathic Medicine.
Coeliac Disease: The New Proposed ESPGHAN Diagnostic Criteria Do Work Well in a Selected Population. Klapp G, Masip E, Bolonio M, Donat E, Polo B, Ramos D, Ribes-Koninckx C. Journal of Pediatric Gastroenterology and Nutrition. 2012 Oct 29.
The European Society of Pediatric Gastroenterology and Nutrition (ESPGHAN) 1990 guidelines emphasized a biopsy to determine the health of the small intestine villi, but recent developments have put a focus on less invasive procedures. This study was performed to assess the validity of less invasive methods. One hundred and fifty three patients from the gastroenterology unit in La Fe University Hospital in Valencia, Spain were compared based on four separate tests – biopsy sample, 2 blood tests (tissue transglutaminase antibody and endomysial antibody), and a genetic test (HLA DQ2/DQ8). The results showed that the participants who tested positive for both the blood tests and genotyping were accurately diagnosed with celiac disease. While this supports the notion that diagnosis could be possible without a biopsy, it is important to note that the patients who met the inclusion criteria for this study had blood values 10 times the upper limit of normal for the antibody tests. Future studies with lower, but still abnormal blood values, hope to confirm that the biopsy may be spared in celiac disease diagnosis.
Factors Associated with Dietary Adherence in Celiac Disease: A Nationwide Study. Kurppa K, Lauronen O, Collin P, Ukkola A, Laurila K, Huhtala H, Mäki M, Kaukinen. Digestion. 2012 Oct 23;86(4):309-314.
Since a gluten-free diet is the only current treatment for celiac disease, this study sought to determine and identify any problems with diet adherence and the success of treatment. After interviewing 843 biopsy-proven celiac disease patients in Finland, only 12% reported “occasional dietary transgressions” by eating gluten. However, researchers found that participants who were a young age at diagnosis, specifically teenagers, were more likely to have trouble with adherence to the gluten-free diet. Interestingly, there was no association between adherence and any of the following factors: geographical location of diagnosis, sex, severity of symptoms before diagnosis, or duration of diet. Researchers also concluded that primary care providers can play a role in establishing good dietary adherence.
Allogeneic hematopoietic stem cell transplantation may restore gluten tolerance in patients with celiac disease. Ciccocioppo, Rachele; Bernardo, Maria Ester; Russo, Maria Luisa; Vanoli, Alessandro; Franco, Carla; Martinetti, Myriam; Catenacci, Laura; Giorgiani, Giovanna; Zecca, Marco; Piralla, Antonio; Baldanti, Fausto; Locatelli, Franco; Corazza, Gino Roberto. Journal of Pediatric Gastroenterology and Nutrition. 2012 Oct 18.
Beta-thalassemia is an inherited blood disorder affecting hemoglobin, and subsequently, the way one’s body is able to handle oxygen and iron content. Normally, an affected patient would require lifelong blood transfusions, but some individuals can be cured with a bone marrow/stem cell transplant. This article looked at two different patients with both beta-thalassemia and celiac disease who were given transplants to treat beta-thalassemia. Following the transplant, the reintroduction of gluten-containing foods did not result in an immune response in the patients. Such was the case throughout 5 years of follow-up. The researchers concluded that this specific type of transplant may be a possible treatment option for celiac disease in the future, but they did not make any definitive statements. It is important to note the extremely small population included in this study.