Non-Celiac Gluten Sensitivity: The New Frontier of Gluten Related Disorders

Non Celiac Gluten sensitivity (NCGS) was originally described in the 1980s and recently a “re-discovered” disorder characterized by intestinal and extra-intestinal symptoms related to the ingestion of gluten-containing food, in subjects that are not affected with either celiac disease (CD) or wheat allergy (WA). Although NCGS frequency is still unclear, epidemiological data have been generated that can help establishing the magnitude of the problem. Clinical studies further defined the identity of NCGS and its implications in human disease. An overlap between the irritable bowel syndrome (IBS) and NCGS has been detected, requiring even more stringent diagnostic criteria. Several studies suggested a relationship between NCGS and neuropsychiatric disorders, particularly autism and schizophrenia. The first case reports of NCGS in children have been described. Lack of biomarkers is still a major limitation of clinical studies, making it difficult to differentiate NCGS from other gluten related disorders. Recent studies raised the possibility that, beside gluten, wheat amylase-trypsin inhibitors and low-fermentable, poorly-absorbed, short-chain carbohydrates can contribute to symptoms (at least those related to IBS) experienced by NCGS patients. In this paper we report the major advances and current trends on NCG

Pediatric Gastrointestinal Endoscopy: European Society of Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) and European Society of Gastrointestinal Endoscopy (ESGE) Guidelines

ABSTRACT: This Guideline refers to infants, children and adolescents aged 0–18 years. The areas covered include: indications for diagnostic and therapeutic esophagogastroduodenoscopy and ileo-colonoscopy; endoscopy for foreign body ingestion; corrosive ingestion and stricture/stenosis endoscopic management; upper and lower gastrointestinal bleeding; endoscopic retrograde cholangio-pancreatography and endoscopic ultrasonography. Percutaneous endoscopic gastrostomy and endoscopy specific to inflammatory bowel disease (IBD) has been dealt with in other Guidelines [1–3] and are therefore not mentioned in this Guideline. Training and ongoing skill maintenance are to be dealt with in an imminent sister publication to this

B7 costimulation and intracellular indoleamine-2,3-dioxygenase (IDO) expression in peripheral blood of healthy pregnant and non-pregnant women.

BACKGROUND: B7 costimulatory molecules are expressed on antigen presenting cells (APCs) and are important regulators of T cell activation. We investigated the role of the B7 family of costimulatory molecules in the development of the systemic maternal immune tolerance during healthy pregnancy (HP). We also aimed to investigate the intracellular expression of indoleamine-2,3-dioxygenase (IDO) and plasma levels of tryptophane (TRP), kynurenine (KYN) and kynurenic acid (KYNA), important molecules with immunoregulatory properties, in order to describe their potential contribution to the pregnancy-specific maternal immune tolerance. METHODS: We determined the frequency of activated (CD11b+) monocytes expressing B7-1, B7-2, B7-H1, and B7-H2, and that of T cells and CD4+ T helper cells expressing CD28, CTLA-4, PD-1, and ICOS in peripheral blood samples of healthy pregnant (HP) and non-pregnant (NP) women using flow cytometry. We also examined the intracellular expression of IDO applying flow cytometry and plasma levels of TRP, KYN and KYNA using high-performance liquid chromatography. RESULTS: A significant increase in the prevalence of CD28+ T cells was observed in HP compared to NP women. At the same time a decrease was shown in the expression of CTLA-4 on these cells. The frequency of CD80+ monocytes was lower in HP women. The prevalence of IDO-expressing T cells and monocytes was higher in HP compared to NP women. Plasma KYN, KYNA and TRP levels were lower, while at the same time, the KYN/TRP ratio was higher in HP than in NP women. CONCLUSIONS: Costimulation via CD28 may not contribute to the immunosuppressive environment, at least in the third trimester of pregnancy. The development of the pregnancy-specific immune tolerance in the mechanism of B7 costimulation may be more related to the altered expression of B7 proteins on APCs rather than that of their receptors on T cells. The elevated intracellular IDO expression in monocytes and T cells, as well as higher plasma enzymatic IDO activity are likely to contribute to the systemic immunosuppressive environment in the third trimester characteristic for healthy gestation

Special behavior of alkali beam emission spectroscopy in low-ion-temperature plasma

Beam emission spectroscopy (BES) is a powerful plasma diagnostic method especially suited for the measurement of plasma density and its fluctuations. As such, synthetic BES codes are regularly used to aid the design or utilization of these diagnostic systems. However, synthetic diagnostics can also be used to study the method in previously not yet explored operational conditions. This paper presents such an analysis utilizing the RENATE-OD synthetic diagnostic code for a hypothetical alkali BES system on the HSX stellarator. HSX is a device featuring an unusual operating regime in the world of fusion devices due to the low ion temperature and low plasma density. It was found that BES shows unusual tendencies in these conditions. The relation between beam energy and plasma penetration in low-ion-temperature plasma, together with unique emission features facilitated by low-density plasma, and the underlying reasons behind these features are explored in this paper

On the interaction between the island divertor heat fluxes, the scrape-off layer radial electric field and the edge turbulence in Wendelstein 7-X plasmas

The formation of the radial electric field, E-r in the scrape-off layer (SOL) has been experimentally studied for attached divertor conditions in stellarator W7-X. The main objective of this study is to test the validity in a complex three-dimensional (3D) island divertor of simple models, typically developed in tokamaks, relating E-r in the SOL to the sheath potential drop gradient at the target. Additionally, we investigate the effect of the edge E-r shear on the reduction of density fluctuation amplitude, a well-established phenomenon according to the existing bibliography. The main diagnostic for measurements in the SOL is a V-band Doppler reflectometer that can provide the measurement of the E-r and density fluctuations with good spatial resolution. 3D measurements of divertor parameters have been carried out using infrared cameras, with the exponential decay length of the divertor heat flux (lambda(q)) resulting in a suitable proxy for the model-relevant lambda(T), the exponential decay length of the temperature at the divertor. In the investigated attached regimes, it is shown for the first time that the formation of the E-r in the SOL depends on parameters at the divertor, following a E-r proportional to T-e/lambda(q) qualitatively similar to that found in a tokamak. Then, from the analyzed plasmas, the observed E-r shear at the edge is linked to a moderate local reduction of the amplitude of density fluctuations