Gluten Related Disorders: People Shall not Live on Bread Alone

Once upon a time, gluten was not part of the human diet, and therefore, there were no gluten-related disorders. With the advent of agriculture 10,000 years ago, the introduction of gluten-containing grains in the human diet created conditions for human diseases related to gluten exposure. These diseases, including celiac disease, non-celiac gluten sensitivity, and wheat allergy, have distinct pathophysiological mechanisms, serological markers, and long-term treatments, but similar, often overlapping clinical presentations. Though current research strives to clarify the boundaries between these entities, their differences can be difficult to distinguish. For a very long time, awareness of these disorders has been limited and, therefore, the epidemiology of gluten-related disorders has been a “work in progress”. New epidemiological studies have revealed that gluten-related disorders are not limited to European regions; rather, they are present worldwide. After centuries of neglected attention to celiac disease and other forms of gluten reaction, now we are observing another interesting phenomenon that is generating great confusion among health care professionals. Nearly 25% of Americans (many more than the projected 3 million celiac disease (CD) patients in the U.S.) are reducing or cutting gluten from their diets. This remarkable trend in the general population reflects the misconception that gluten can be harmful for everybody and, therefore, should be avoided to stay healthy, to lose weight, or even to prevent severe diseases. This Special Issue Book of Nutrients contains contributions from leading experts in the field of gluten-related disorders that will help dissipate this confusion by sharing their evidence-based science, which will help the reader to distinguish facts from fantasies

Current approaches to diagnosis and treatment of celiac disease: An evolving spectrum

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PLoS One

Advancement of biomedical applications of carbonaceous nanomaterials is hampered by their biopersistence and pro-inflammatory action in vivo. Here, we used myeloperoxidase knockout B6.129X1-MPO (MPO k/o) mice and showed that oxidation and clearance of single walled carbon nanotubes (SWCNT) from the lungs of these animals after pharyngeal aspiration was markedly less effective whereas the inflammatory response was more robust than in wild-type C57Bl/6 mice. Our results provide direct evidence for the participation of MPO - one of the key-orchestrators of inflammatory response - in the in vivo pulmonary oxidative biodegradation of SWCNT and suggest new ways to control the biopersistence of nanomaterials through genetic or pharmacological manipulations.HL094488/HL/NHLBI NIH HHS/United StatesHL70755/HL/NHLBI NIH HHS/United StatesLM007994-05/LM/NLM NIH HHS/United StatesOH008282/OH/NIOSH CDC HHS/United StatesR01 ES019304/ES/NIEHS NIH HHS/United StatesR01ES019304/ES/NIEHS NIH HHS/United StatesU19AI068021/AI/NIAID NIH HHS/United StatesU54 GM103529/GM/NIGMS NIH HHS/United States22479306PMC331652

Lack of association between celiac disease and dental enamel hypoplasia in a case-control study from an Italian central region

<p>Abstract</p> <p>Background</p> <p>A close correlation between celiac disease (CD) and oral lesions has been reported. The aim of this case-control study was to assess prevalence of enamel hypoplasia, recurrent aphthous stomatitis (RAS), dermatitis herpetiformis and atrophic glossitis in an Italian cohort of patients with CD.</p> <p>Methods</p> <p>Fifty patients with CD and fifty healthy subjects (age range: 3–25 years), matched for age, gender and geographical area, were evaluated by a single trained examiner. Diagnosis of oral diseases was based on typical medical history and clinical features. Histopathological analysis was performed when needed. Adequate univariate statistical analysis was performed.</p> <p>Results</p> <p>Enamel hypoplasia was observed in 26% cases vs 16% in controls (p > 0.2; OR = 1.8446; 95% CI = 0.6886: 4.9414). Frequency of RAS in the CD group was significantly higher (36% vs 12%; p = 0.0091; OR = 4.125; 95% CI = 1.4725: 11.552) in CD group than that in controls (36% <it>vs </it>12%). Four cases of atrophic glossitis and 1 of dermatitis herpetiformis were found in CD patients <it>vs </it>1 and none, respectively, among controls.</p> <p>Conclusion</p> <p>The prevalence of enamel hypoplasia was not higher in the study population than in the control group. RAS was significantly more frequent in patients with CD.</p

在籍生徒の当校選択意識とその実態 : 不適応生徒発生の一条件として

Objective To determine whether the mode of delivery is associated with the risk of celiac disease (CD) in a cohort of children genetically predisposed to CD prospectively followed from birth. Study design By telephone interview, we recorded information on the mode of delivery of children participating in the Risk of Celiac Disease and Age at Gluten Introduction study, a multicenter, prospective intervention trial that compared early and delayed introduction of gluten in infants with at least 1 first-degree relative affected with CD. The human leukocyte antigen genotype was determined at 15 months of age, and serologic screening for CD was performed at 15, 24, and 36 months of age and at 5, 8, and 10 years of age. Patients with positive serologic findings underwent intestinal biopsy. The primary outcome of the current study was the prevalence of CD autoimmunity and overt CD at 5 years of age, according to the mode of delivery. Results The study-group included 553 children at CD risk because of positivity for human leukocyte antigen-DQ2, -DQ8, or both. We obtained data on the mode of delivery from 431 of 553 children; 233 of 431 children were born by vaginal delivery (54%). At 5 years of age, the prevalence of CD autoimmunity or overt CD was not different between children born by cesarean or vaginal delivery (24% and 19%, P=.2; 19% and 14%, P=.2 respectively, by the log-rank test). Conclusions In this cohort of children genetically predisposed to CD, the mode of delivery did not influence the risk of developing CD

Wheat consumption and prevalence of celiac disease: Correlation from a multilevel analysis

Celiac disease (CD) is triggered by both genetic and environmental factors. More than 1% of the world’s population is affected by CD. In recent years, studies have confirmed a worldwide rising trend in CD prevalence. "Westernized diet" is one of the main factors of this increasing prevalence. However, the relationship between wheat consumption, its dynamics, and CD has not been adequately investigated on a global scale. This study aimed to perform a multilevel analysis of the association between wheat consumption and CD. Wheat consumption data from countries and continents were obtained from the database. The relative increase/decrease in wheat consumption over a long period (since 1961) and a short period (since 2004) were calculated using various statistical tools. The relationship between wheat consumption and celiac frequency was determined using the R-commander R package version 2.6-2. Pearson's correlation coefficient (r = 0.88) confirmed a high positive correlation between wheat consumption and the prevalence of biopsy-proven CD by estimating continent-wide wheat consumption data, but an insignificant correlation was found when the data were compared country-wide.info:eu-repo/semantics/publishedVersio

Recent Progress and Recommendations on Celiac Disease From the Working Group on Prolamin Analysis and Toxicity

Celiac disease (CD) affects a growing number of individuals worldwide. To elucidate the causes for this increase, future multidisciplinary collaboration is key to understanding the interactions between immunoreactive components in gluten-containing cereals and the human gastrointestinal tract and immune system and to devise strategies for CD prevention and treatment beyond the gluten-free diet. During the last meetings, the Working Group on Prolamin Analysis and Toxicity (Prolamin Working Group, PWG) discussed recent progress in the field together with key stakeholders from celiac disease societies, academia, industry and regulatory bodies. Based on the current state of knowledge, this perspective from the PWG members provides recommendations regarding clinical, analytical and legal aspects of CD. The selected key topics that require future multidisciplinary collaborative efforts in the clinical field are to collect robust data on the increasing prevalence of CD, to evaluate what is special about gluten-specific T cells, to study their kinetics and transcriptomics and to put some attention to the identification of the environmental agents that facilitate the breaking of tolerance to gluten. In the field of gluten analysis, the key topics are the precise assessment of gluten immunoreactive components in wheat, rye and barley to understand how these are affected by genetic and environmental factors, the comparison of different methods for compliance monitoring of gluten-free products and the development of improved reference materials for gluten analysis

Statement of the Prolamin Working Group on the Determination of Gluten in Fermented Foods Containing Partially Hydrolyzed Gluten

On August 12, 2020, the U.S. Food and Drug Administration (FDA) has finalized a rule related to gluten-free labeling for foods containing fermented, hydrolyzed ingredients. The FDA believes that there is no scientifically valid analytical method e ective for determining gluten in fermented or hydrolyzed foods. In the absence of an analytical method, the FDA has decided to evaluate gluten-free claims on these foods based only on evidence that the food or ingredient used is gluten-free before fermentation or hydrolysis. For example, barley-based beers from which gluten is removed during brewing using special filtration, adsorption and/or enzymatic treatment are therefore excluded from bearing a gluten-free label. The Prolamin Working Group (PWG) acknowledges that the FDA rule is a regulatory act and might have to take into consideration several aspects other than scientific evidence, including risk assessment. Nevertheless, the PWG thinks that science has to be the most important driver for regulatory acts in risk management.Fil: Scherf, Katharina Anne. Karlsruher Institut Für Technologie; AlemaniaFil: Catassi, Carlo. Università Politecnica Delle Marche; ItaliaFil: Chirdo, Fernando Gabriel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Estudios Inmunológicos y Fisiopatológicos. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Instituto de Estudios Inmunológicos y Fisiopatológicos; ArgentinaFil: Ciclitira, Paul J.. University of East Anglia; Reino UnidoFil: Feighery, Conleth Francis. Universidad de Dublin; IrlandaFil: Gianfrani, Carmen. Institute of Biochemistry and Cell Biology; ItaliaFil: Koning, Frits. Leiden University; Países BajosFil: Lundin, Knut E. A.. University of Oslo; NoruegaFil: Masci, Stefania. No especifíca;Fil: Schuppan, Detlef. No especifíca;Fil: Smulders, Marinus J. M.. Wageningen University and Research; Países BajosFil: Tranquet, Olivier. No especifíca;Fil: Troncone, Riccardo. University Federico II; ItaliaFil: Koehler, Peter. No especifíca

Spectrum of gluten-related disorders: consensus on new nomenclature and classification

A decade ago celiac disease was considered extremely rare outside Europe and, therefore, was almost completely ignored by health care professionals. In only 10 years, key milestones have moved celiac disease from obscurity into the popular spotlight worldwide. Now we are observing another interesting phenomenon that is generating great confusion among health care professionals. The number of individuals embracing a gluten-free diet (GFD) appears much higher than the projected number of celiac disease patients, fueling a global market of gluten-free products approaching $2.5 billion (US) in global sales in 2010. This trend is supported by the notion that, along with celiac disease, other conditions related to the ingestion of gluten have emerged as health care concerns. This review will summarize our current knowledge about the three main forms of gluten reactions: allergic (wheat allergy), autoimmune (celiac disease, dermatitis herpetiformis and gluten ataxia) and possibly immune-mediated (gluten sensitivity), and also outline pathogenic, clinical and epidemiological differences and propose new nomenclature and classifications

Statement of the Prolamin Working Group on the Determination of Gluten in Fermented Foods Containing Partially Hydrolyzed Gluten

On August 12, 2020, the U.S. Food and Drug Administration (FDA) has finalized a rule related to gluten-free labeling for foods containing fermented, hydrolyzed ingredients. The FDA believes that there is no scientifically valid analytical method effective for determining gluten in fermented or hydrolyzed foods. In the absence of an analytical method, the FDA has decided to evaluate gluten-free claims on these foods based only on evidence that the food or ingredient used is gluten-free before fermentation or hydrolysis. For example, barley-based beers from which gluten is removed during brewing using special filtration, adsorption and/or enzymatic treatment are therefore excluded from bearing a gluten-free label