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Coronary Artery Disease Prevalence Is Higher among Celiac Disease Patients

By: Peter Olins, PhD on June 21, 2014.

A survey of over 22 million U.S. patient records found that patients with celiac disease (CD) had about a 2-fold higher prevalence of coronary artery disease (CAD), compared to patients without celiac disease. The authors propose that this might be a result of the increased blood levels of inflammatory signaling molecules that are found in both CD and CAD.

Conference Abstract: Gajulapalli RD, et al.

Published in: 2014 American College of Cardiology conference proceeedings

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Time to Recognize "Core Benefits of Certain Probiotics": ISAPP

By: Peter Olins, PhD on June 20, 2014.

The global market for “probiotics” is huge—estimated at 30 Bn Euros annually: yet there is surprisingly little agreement about what constitutes a probiotic, and what evidence of actual health benefit is required. The recent “consensus statement” from the International Scientific Association for Probiotics and Prebiotics (ISAPP) proposed two main classes for probiotics: claims for general heath benefits, and claims for health benefits for a specific condition. In both cases, convincing clinical research data supporting these claims would be required. It is not clear that the majority of “probiotics” currently available would satisfy the criterion of a demonstrated health benefit.

In an apparent conflict with their proposed definition, the ISAPP took aim at the current strict EU requirements, suggesting that probiotics be treated as “foods”, with a rather lax requirement for evidence of efficacy.

Opinion Article: Shane Starling

Published in: NutraIngredients

Read more → Time to Recognize “Core Benefits of Certain Probiotics”: ISAPP

US perspective on gluten-related diseases

By: Peter Olins, PhD on June 19, 2014.

This journal article reviews the current status of knowledge and clinical practice for celiac disease, wheat allergy and non-celiac gluten sensitivity.

Journal Article: Leonard MM & Vasagar B

Published in: Clin Exp Gastroenterol. 2014; 7: 25–37.

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An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity

By: Peter Olins, PhD on June 18, 2014.

This is the most extensive study of non-celiac gluten sensitivity published so far, and lends further support that this is a real phenomenon. Patients attending 38 Italian ‘Gluten-Related Disorders’ clinical centers were surveyed for self-reported gluten sensitivity (defined as physical symptoms alleviated on a gluten-free diet, and returning after consuming gluten). It is not possible to estimate the overall prevalence of NCGS in the general population, since these patients were already suspected of having a gluten-related disorder. The study was also not “blinded”, so there is a significant chance that some of these patients may have had a ‘nocebo’ effect (i.e. a negative response resulting from a psychological expectation, rather than a true effect).

Journal Article: Volta U, et al.

Published in: BMC Medicine 2014, 12:85 doi:10.1186/1741-7015-12-85

Read moreAn Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity

Lactose intolerance: from diagnosis to correct management

By: Peter Olins, PhD on June 12, 2014.

About 75% of the world’s adults are lactose intolerant. The condition is also common in patients with celiac disease who have recently started on a gluten-free diet, since the intestinal villi that produce this enzyme take some time to heal. This scientific reviews the diagnosis and treatment of lactose intolerance, plus a discussion of the possible role of small intestinal bacterial overgrowth in producing false-positive results.

Journal Article by : di Rinzo T, et al.

Published in: Eur Rev Med Pharmacol Sci (2013) 17(Suppl 2): 18-25.

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When should we test for celiac disease?

By: Peter Olins, PhD on June 11, 2014.

Sophie Balzora, MD, gives an introduction to this topic, suitable for a general audience. She also highlights the latest diagnostic guidelines from the American College of Gastroenterology. Unfortunately, the rate of testing and diagnosis is very poor in the U.S.: only about 15% of cases have been identified, meaning that millions of people are suffering the consequences of this disease.

Published in: KevinMD.com website

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Glutenase ALV003 Attenuates Gluten-Induced Mucosal Injury in Patients With Celiac Disease

By: Peter Olins, PhD on June 10, 2014.

Alvine Pharmaceuticals continues to make progress in developing a drug for celiac disease patients that could neutralize the effects of gluten in the diet. In their latest Phase II clinical trial, the drug, ALV003, was effective in blocking the biological response to 2 grams of gluten, given daily over a period of 6 weeks. Damage to the intestinal villi was prevented (as measured by the ration of villus height to crypt depth). Infiltration of lymphocytes into the intestinal epithelium was also blocked.

ALV003 is a mixture of two enzymes designed to break down gluten into small fragments which would no longer provoke an immune reaction.

However, no statistically significant reduction in clinical symptoms was observed. It is not clear whether this was due to variation among the patients in this relatively small clinical trial (40 patients enrolled), or whether this was a real effect.

I discussed the Alvine Pharmaceuticals clinical research program in greater detail in a 2011 blog: Four Clinical Trials of ALV003

Journal Article: Lahdeaho ML, et al.

Abstract Published in: Gastroenterology

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Diagnosing and Managing Celiac Disease in Primary Care: Application of Current Guidelines

Dr. Joseph Murray, at the Mayo Clinic, is one of the most highly-regarded and prolific celiac disease researchers in the world. He is also the co-author of the 2013 celiac disease diagnosis guidelines from the American College of Gastroenterology. In his interview with Linda Brookes, at Medscape, he uses simple language to explain the current state of knowledge about the diagnosis of celiac disease. He also explores some of the myths and misinformation that are often found on the Internet and other popular media. I thoroughly recommend this article.

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Colon cancer risks no higher in treated coeliac disease

Poor compliance with a gluten-free diet was associated with a seven-fold increased risk of colorectal cancer in celiac patients in Argentina.

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Persistent Mucosal Damage and Risk of Fracture in Celiac Disease

Poor absorption of calcium from the diet is common among celiac patients. It seems likely that patients who do not heal fully might have greater problems in maintaining bone mass. This research study of about 3000 Swedish celiacs with persistent damage to their small intestine investigated the effect on the rate of bone fractures, compared to about 4000 patients whose small intestine had healed. Surprisingly,

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BioLineRx Enters Clinic with Novel Treatment for Celiac Disease

BioLineRx is developing a new compound that might “sequester” gluten, preventing it from activating the immune system of celiacs. Their chemical compound, BL-7010, has just entered the first Phase 1/II clinical trials, where the focus will be safety.

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Probiotic Therapy for Celiac Disease

The word “probiotic” is often used as a marketing term for foods containing microbes, often with little real evidence for efficacy! Nevertheless, there is increasing reason to think that intestinal microbes might play a role in the development of celiac disease. This research article explores the evidence that deliberately consuming microbes might help celiacs.

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Research seeks to make maize protein behave like gluten

Flour made from corn (maize) is gluten-free, but lacks some of the characteristics required for bread-making. This news article describes work to modify the main protein in corn (zein) to make it behave more like the gluten in wheat.

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Antibiotic Exposure and Celiac Disease

Most people do not develop celiac disease. Why? The actual triggers remain elusive, but since patients with celiac disease have altered bacteria in their intestines, one idea is that prior antibiotic treatment might be part of the trigger.

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Restaurants and Gluten-Free Labeling Claims

While the FDA has issued regulations for gluten-free labeling by manufacturers, the implications for restaurants and other food providers are less clear. There is still no official statement on this subject from the FDA, but a statement from a former FDA employee suggests that the FDA also expects restaurants to be accurate in labeling foods as being gluten-free.

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Possible Protective Role of Helicobacter in Celiac Disease

In a study of patients undergoing endoscopy of both the stomach and small intestine, patients with Helicobacter infection of the stomach had about a 50% reduction in the rate of celiac disease diagnosis. However, it’s too soon to conclude that Helicobacter is actually preventing the development of celiac disease.

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Some Celiac Disease Cases Missed by Typical Blood Tests

The typical blood tests used for diagnosing celiac disease are reasonably accurate, but one nagging concern is whether cases have been missed (i.e. false-negatives). In this study, the researchers found that by using an anti-gliadin antibody test, they were able to find a number of cases of celiac disease which had been previously missed.

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Encouraging Clinical Results for Eluxadoline, for Treating Irritable Bowel Syndrome

In two clinical trials, a new drug, Eluxadoline, is showing promise for the treatment of Irritable Bowel Syndrome (IBS).

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Higher Antibodies to Gluten Proteins in Children with Autism

You will probably be hearing a lot about this in the news, with many people trying to spin the story to conclude that gluten triggers autism. There is no current treatment for autism, but many parents are obviously desperate to find something to help their child, including modifying their diet. This was a well-conducted clinical trial demonstrating that autism is very different from celiac disease, and does NOT suggest that GF diet will help an autistic child.

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Non-Celiac Gluten Sensitivity: Gastrointestinal Hip or Hype?

In a lecture entitled, “Celiac Disease vs. Gluten Sensitivity: How Common?” Peter Green, MD, director of the Celiac Disease Center at Columbia University, explains that although there is a spectrum of gluten-related disorders with different definitions and proliferations of guidelines, specialists typically place gluten-related autoimmune conditions into three categories: wheat allergy, celiac disease and non-celiac gluten sensitivity.

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Levels of Antibodies Against Tissue Transglutaminase During Pregnancy are Associated with Reduced Fetal Weight and Birth Weight

It is known that celiac disease can reduce fertility in women, but the problems can continue, even after conception. A new study has found that after successful conception, babies born to celiac mothers had lower birth weights. In addition, mothers with the highest levels of the anti-TTG (the antibody that important for the autoimmune response in celiacs) had the greatest reduction in birth weight.

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Role of Fructose and Other Short-Chain Carbohydrates in Managing Gastrointestinal Symptoms

Some of the gastrointestinal symptoms of celiac disease can be similar to those experienced by people with IBS (irritable bowel syndrome). “FODMAPS” is a term used to describe a group of poorly-absorbed carbohydrates (such as fructose) that can result in discomfort and gastrointestinal symptoms when present in the diet. This article is a review of the recent research.

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Increasing Incidence of Celiac Disease in a North American Population

The prevalence of celiac disease has increased dramatically over the past few decades, but about 85% of people in the U.S. are still undiagnosed. The incidence of the disease (meaning how often it is actually diagnosed) has also increased substantially, meaning that doctors are getting better at recognizing the condition.

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Patients with Celiac Disease Have a Lower Prevalence of Diabetes and Metabolic Syndrome

For once, some positive news for celiac disease sufferers. Diabetes and the related disorder, “metabolic syndrome”, are an increasing problem in the U.S. and other parts of the world. People with celiac disease have a surprisingly low prevalence of these conditions.

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Fecal Microbial Transplantation

There is increasing evidence that the huge number of microbes that live in our intestines are important for health. Sometimes, major antibiotic treatment removes many of these microbes, allowing harmful ones to get a foothold, such as the bacterium called C. difficile. This kind of infection is dangerous, and can be very hard to treat. However,

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Are Ancient Durum Wheats Less Toxic to Celiac Patients?

It is surprising how often we read about how foods from “ancient times” are supposed to be be superior or safer than modern foods. This article helps to dispel some of the romantic myths that “ancient” grains are somehow safer for celiacs. They’re not!

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Sorghum, a Healthy and Gluten-free Food for Celiac Patients

This article helps to confirm what many of us have believed for a long time—that sorghum offers a nutritious, gluten-free, alternative to wheat. Like quinoa, sorghum is not in the grain family (wheat, barley, rice, corn), but is a more distant relative.

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The Gluten-Free Vegetarian — Food Options Are Plentiful

Going GF can be a challenge for vegetarians, and many newly-diagnosed celiacs already have a nutritional deficiency, so extra attention is needed in order to achieve balanced nutrition. (Thanks to Registered Dietitian Cheryl Harris for sharing this article).

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Online Intervention Improved Adherence to Gluten-Free Diet in Patients with Celiac Disease

It can be hard to stick to a GF diet rigorously: lack of compliance is believed to be one of the main reasons that the intestine can take so long to heal after being diagnosed with celiac disease. One research group has tried the approach of regularly engaging the patient using an online tool.

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Celiac disease: Management of Persistent Symptoms in Patients on a Gluten-Free Diet

Many celiac disease patients do not seem to respond well to a gluten-free diet (so-called, non-responsive celiac disease). This study found that 90% of these cases were actually caused by continuing exposure to gluten. In contrast, true Refractory Celiac Disease is quite rare.

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