Cybermedlife - Therapeutic Actions Dietary Modification - Wheat/Gluten Free

Reversal of IgM deficiency following a gluten-free diet in seronegative celiac disease.

Abstract Title: Reversal of IgM deficiency following a gluten-free diet in seronegative celiac disease. Abstract Source: World J Gastroenterol. 2014 Dec 14 ;20(46):17686-9. PMID: 25516687 Abstract Author(s): Lucia Montenegro, Domenico Piscitelli, Floriana Giorgio, Claudia Covelli, Maria Grazia Fiore, Giuseppe Losurdo, Andrea Iannone, Enzo Ierardi, Alfredo Di Leo, Mariabeatrice Principi Article Affiliation: Lucia Montenegro Abstract: Selective IgM deficiency (sIGMD) is very rare; it may be associated with celiac disease (CD). We present the case of an 18-year-old man with sIGMD masking seronegative CD. Symptoms included abdominal pain, diarrhea and weight loss. Laboratory tests showed reduced IgM, DQ2-HLA and negative anti-transglutaminase. Villous atrophy and diffuse immature lymphocytes were observed at histology. Tissue transglutaminase mRNA mucosal levels showed a 6-fold increase. The patient was treated with a gluten-free diet (GFD) and six months later the symptoms had disappeared, the villous architecture was restored and mucosal tissue transglutaminase mRNA was comparable to that of healthy subjects. After 1 year of GFD, a complete restoration of normal IgM values was observed and duodenal biopsy showed a reduction of immature lymphocytes and normal appearance of mature immune cells. Article Published Date : Dec 13, 2014

Lower bifidobacteria counts in adult patients with celiac disease on a gluten-free diet.

Abstract Title: Lower bifidobacteria counts in adult patients with celiac disease on a gluten-free diet. Abstract Source: Arq Gastroenterol. 2014 Apr-Jun;51(2):139-43. PMID: 25003267 Abstract Author(s): Lisléia Golfetto, Fernanda Duarte de Senna, Julia Hermes, Bruna Teles Soares Beserra, Franciane da Silva França, Flávia Martinello Article Affiliation: Lisléia Golfetto Abstract: CONTEXT: The ingestion of gluten is responsible for the symptoms of Celiac disease, but other environmental factors can also influence. Strains of the Bifidobacterium genus have been shown to afford protection against the inflammatory response and mucosal damage caused by gliadin peptides in vitro. OBJECTIVES: This study was designed to compare the concentration of fecal bifidobacteria and pH of patients with celiac disease on gluten-free diet and control subjects in order to identify if the imbalance on fecal microbiota still remain during the treatment of celiac disease and identify the necessity of dietary supplementation with pre- or probiotics. METHODS: It was analyzed the feces of 42 healthy subjects and 14 celiac patients. The bifidobacteria count in feces was done in selective medium BIM-25. Microscopic analysis of the colonies was performed by Gram stain. The identification of the genus Bifidobacterium was performed by determination of fructose-6-phosphate phosphoketolase. Fecal pH was measured using a pH meter. RESULTS: The concentration of bifidobacteria per gram of feces was significantly higher in healthy subjects (controls) (1.5± 0.63 x108 CFU/g) when compared to celiac patients (2.5 ± 1.5 x107 CFU/g). The fecal pH was not different between celiac patients (7.19 ± 0.521) and controls (7.18 ± 0.522). CONCLUSIONS: These results suggest that with lower levels of bifidobacteria, celiac patients have an imbalance in the intestinal microbiota, regardless of pH, even while on a gluten-free diet. This fact could favor the pathological process of the disorder. Article Published Date : Mar 31, 2014

Dramatic improvement of parkinsonian symptoms after gluten-free diet introduction in a patient with silent celiac disease.

Abstract Title: Dramatic improvement of parkinsonian symptoms after gluten-free diet introduction in a patient with silent celiac disease. Abstract Source: J Neurol. 2014 Feb ;261(2):443-5. Epub 2014 Jan 25. PMID: 24464413 Abstract Author(s): Vincenzo Di Lazzaro, Fioravante Capone, Giovanni Cammarota, Daniela Di Giuda, Federico Ranieri Article Affiliation: Vincenzo Di Lazzaro Abstract: Dramatic improvement of parkinsonian symptoms after gluten-free diet introduction in a patient with silent celiac disease. Article Published Date : Jan 31, 2014

Autism and Dietary Therapy: Case Report and Review of the Literature.

Abstract Title: Autism and Dietary Therapy: Case Report and Review of the Literature. Abstract Source: J Child Neurol. 2013 May 10. Epub 2013 May 10. PMID: 23666039 Abstract Author(s): Martha R Herbert, Julie A Buckley Article Affiliation: 1Pediatric Neurology and TRANSCEND Research, Massachusetts General Hospital, Boston, MA, USA. Abstract: We report the history of a child with autism and epilepsy who, after limited response to other interventions following her regression into autism, was placed on a gluten-free, casein-free diet, after which she showed marked improvement in autistic and medical symptoms. Subsequently, following pubertal onset of seizures and after failing to achieve full seizure control pharmacologically she was advanced to a ketogenic diet that was customized to continue the gluten-free, casein-free regimen. On this diet, while still continuing on anticonvulsants, she showed significant improvement in seizure activity. This gluten-free casein-free ketogenic diet used medium-chain triglycerides rather than butter and cream as its primary source of fat. Medium-chain triglycerides are known to be highly ketogenic, and this allowed the use of a lower ratio (1.5:1) leaving more calories available for consumption of vegetables with their associated health benefits. Secondary benefits included resolution of morbid obesity and improvement of cognitive and behavioral features. Over the course of several years following her initial diagnosis, the child's Childhood Autism Rating Scale score decreased from 49 to 17, representing a change from severe autism to nonautistic, and her intelligence quotient increased 70 points. The initial electroencephalogram after seizure onset showed lengthy 3 Hz spike-wave activity; 14 months after the initiation of the diet the child was essentially seizure free and the electroencephalogram showed only occasional 1-1.5 second spike-wave activity without clinical accompaniments. Article Published Date : May 09, 2013

Clinical impact of a gluten-free diet on health-related quality of life in seven fibromyalgia syndrome patients with associated celiac disease.

Abstract Title: Clinical impact of a gluten-free diet on health-related quality of life in seven fibromyalgia syndrome patients with associated celiac disease. Abstract Source: BMC Gastroenterol. 2013 ;13(1):157. Epub 2013 Nov 9. PMID: 24209578 Abstract Author(s): Luis Rodrigo, Ignacio Blanco, Julio Bobes, Frederick J de Serres Article Affiliation: Luis Rodrigo Abstract: BACKGROUND: Celiac disease (CD) is an autoimmune disorder, characterized by the presence of gastrointestinal and multisystem symptoms, which occasionally mimic those of Irritable Bowel Syndrome (IBS) and Fibromyalgia Syndrome (FMS). To assess the effectiveness of a Gluten-Free Diet (GFD) in seven adult female screening-detected CD subjects, categorized as severe IBS and FMS patients. METHODS: All subjects showed villous atrophy in duodenal biopsies, were HLA-DQ2/DQ8-positive, and fulfilled the Rome III and ACR 1990 criteria respectively for IBS and FMS classification. GFD effectiveness was assessed at baseline and after 1 year, examining the score changes in the Tender Points (TPs) test, Fibromyalgia Impact Questionnaire (FIQ), Health Assessment Questionnaire (HAQ), Short Form Health Survey (SF-36), Visual Analogue Scales (VAS) for gastrointestinal complaints, pain and tiredness, drug prescriptions and tissue-Trans-Glutaminase (tTG) serum levels. RESULTS: At baseline, all patients had poor Quality of Life and VAS scores, a high number of TPs and drug prescriptions, and increased tTG levels. After 1 year of GFD, all outcome measures significantly improved, with a decrease of 51-60% in TPs, FIQ, HAQ, and VAS scales, and in the number of prescribed drugs, accompanied by an increase of 48-60% in SF-36 Physical and Mental Component Summary scores, and a decrease of tTG to normal values. CONCLUSION: Results of this pilot study show that the adherence to a GFD by CD-related IBS/FMS patients can simultaneously improve CD and IBS/FMS symptoms, and indicate the merit of further research on a larger cohort. Article Published Date : Dec 31, 2012
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Therapeutic Actions DIETARY MODIFICATION Wheat-Gluten Free

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Lack of immunogenicity of hydrolysed wheat flour in patients with coeliac disease after a short-term oral challenge.

Related Articles Lack of immunogenicity of hydrolysed wheat flour in patients with coeliac disease after a short-term oral challenge. Aliment Pharmacol Ther. 2017 Aug;46(4):440-446 Authors: Mandile R, Picascia S, Parrella C, Camarca A, Gobbetti M, Greco L, Troncone R, Gianfrani C, Auricchio R Abstract BACKGROUND: A gluten-free diet is currently the only reliable therapeutic strategy that is approved for coeliac disease (CD). For many patients, however, compliance remains inadequate. AIM: To investigate the immunogenicity of wheat flour that was pre-treated with selected lactobacilli and fungal proteases (hydrolysed wheat gluten) in coeliac patients. METHODS: The immunogenicity of hydrolysed wheat gluten was evaluated both in vitro in intestinal T cell lines (TCLs) and in vivo in treated CD patients after a short-term gluten challenge. Twenty treated CD patients were enrolled and equally randomised into two groups. The patients ate bread that was prepared with hydrolysed wheat flour or natural wheat flour (10 g of gluten/d for 3 days). The interferon (INF)-γ responses to natural gliadin and a 33-mer peptide were assessed by the enzyme-linked immunospot (ELISPOT) assay on peripheral blood mononuclear cells (PBMCs) both before and 6 days after the start of the challenge. RESULTS: Hydrolysed wheat was not able to activate the TCLs from the coeliac intestinal mucosa. Consistent with the in vitro results, no significant increase in INF-γ secretion was observed in patients who consumed hydrolysed wheat flour. Conversely, the consumption of natural wheat gluten mobilised INF-γ secreting cells in the blood (P<.05). CONCLUSIONS: We confirm that fermentation of wheat flour with sourdough lactobacilli and fungal proteases is capable of abolishing the T cell immunogenicity of gluten in coeliac patients. Our data also validate the short-term oral challenge as a useful tool for testing the efficacy of novel therapeutic approaches. PMID: 28627070 [PubMed - indexed for MEDLINE]