The following summaries are provided from the last year's worth of magazines, to give you an indication of what is going on. More can be found in our Celiac in the News Archive.
9 Meters Biopharma Announces Interim Analysis of Phase 3 Study of Larazotide for Celiac Disease Does Not Support Trial Continuation CedLara® (Celiac disease Larazotide), cancelled the Phase 3 trial as it concluded the additional number of patients needed to determine a significant clinical outcome between the placebo and larazotide was too large. They will continue to analyze the data to see if subset of patients could be helped by the drug.
For more information: Read the Press Release - https://feeds.issuerdirect.com/news-release.html?newsid=4598003219390084
CD hospitalizations: a challenge in the US
A US national sample of adult patients hospitalized with primary discharge diagnosis of CD between 2007 and 2017 was analyzed. Trend was an increase in hospitalization with the mean age of 57.85 years, however declining age trend. Females account for over 70% of patients who were predominantly white. The mean cost of treatment went from $26,299 in 2007 to $49,282 in 2017. In-patient mortality increased 1.3% over the period. The study did not comment on the general increase in hospital costs or lengths of stays, so it is very hard to interpret the data.
For more information: Ann Gastroenterol 2022 Jul-Aug;35(4):383-392. doi: 10.20524/aog.2022.0724. Epub 2022 Jun 2.
Link between CD and autoimmune thyroid disease This study looked at the prevalence of Hashimoto’s thyroiditis and Graves disease (autoimmune thyroid diseases) and the frequency of association with CD. It is thought that there is a shared genetic background between these diseases. A gluten free diet is found to help all these diseases. Further research is required to develop treatments for patients who have concurrent disorders.
For more information: Ashok T, Patni N, Fatima M, et al. (June 23, 2022) Celiac Disease and Autoimmune Thyroid Disease: The Two Peas in a Pod. Cureus 14(6): e26243. doi:10.7759/cureus.26243
Gluten induces subtle histological changes in the duodenal mucosa of patients with non-celiac gluten sensitivity (NCGS) Histological changes in NCGS in the duodenal mucosa are poorly defined. In this study 261 CD patients and 175 NCGS patients were compared with those with normal gastroscopy and histologic findings. It was found that the people with NCGS had villi that were significantly shorter indicating some damage is occurring even in NCGS.
For more information: Nutrients. 2022 Jun 15;14(12):2487. doi: 10.3390/nu14122487.
Impact of CD on Dating A study in Digestive Diseases and Sciences that included researchers Benjamin Lebwohl and Peter Green analyzed the results of an online study. 86.8% of the respondents were female. 68.4% reported that CD had a major/ moderate impact on the dating life. While on dates, approximately 40% were uncomfortable explaining precautions to waiters, and 28% said they engaged in riskier eating behaviors. 7.5% intentionally consumed gluten. 39% were hesitant to kiss their partner. The researchers felt that this was a major impact on dating and intimacy.
For more information: https://link.springer.com/article/10.1007/s10620-022-07548-y
Serum and salivary tissue transglutaminase (tTG IgA) level in celiac patients This small study of 78 people found that those with CD comparing serum and saliva had higher levels of amylase, as well as IL-6, IL-18, IL-21 and salivary and serum tTG. The study concluded that CD may reduce some salivary enzymes and increase inflammatory cytokines and salivary and serum tTG.
For more information: https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-022-02456-x?fbclid=IwAR2KOzbD03QE7b2V0wIRikm-d5b87Uhek2SBbuEEbqWTDz5WLu7p8ujSydY BMC Gastroenterology volume 22, Article number: 375 (2022)
International Symposium – April 2022 – Videos of presenters from Celiac Disease where are the patients and the therapies?
To view videos on-line: https://celiacdiseasecenter.columbia.edu/education/international-symposium/
Links between celiac disease and small intestinal bacterial overgrowth (SIBO): A systematic review and meta-analysis 14 studies, with 742 CD patients and 178 controls were reviewed. Utilizing breath tests, SIBO prevalence in CD patients was 20.8%. SIBO prevalence in CD patients nonresponsive to a gluten free diet (GFD) was not statistically higher as compared with those responsive to GFD. Antibiotic therapy of SIBO-positive CD patients resulted in improvement in gastrointestinal symptoms in 95.6% (95% CI: 78.0-99.9) and normalization of breath tests.
For more information: https://pubmed.ncbi.nlm.nih.gov/3573
The Significance of Low Titre Antigliadin Antibodies in the Diagnosis of Gluten Ataxia Patients with gluten antigliadin antibodies in the normal range and gluten ataxia were studied. A sample of 21 patients were involved. The study found that all patients benefited from a gluten free diet, even if the autoantibodies for celiac disease were normal (they did not technically have celiac disease). The study recommends an urgent need to redefine the serological cut-off for circulating antigliadin autoantibodies in diagnosing gluten ataxia.
For more information: Nutrients 2018, 10(10), 1444; https://www.mdpi.com/2072-6643/10/10/1444
Celiac Disease and Gluten Sensitivity – Dr. Stefano Guandalini, Professor Emeritus, U. of Chicago Celiac Disease
Centre The following Q and A is from the GIG newsletter. Dr. Guandalini is an expert in celiac disease, and he talks about the genetics,
testing and after the celiac diagnosis. One of the excellent pieces of advice in the article with regards to cross-contamination is
“Being nervous is never a good idea; being vigilant is.” “Do not put your child in a bubble, which causes social isolation.”
For more information: https://gluten.org/2022/02/17/renowned-expert-weighs-in-on-celiac-disease-and-gluten-sensitivity/
Low FODMAP diet improves gastrointestinal symptoms in patients with celiac disease
In additions to a strict gluten-free diet, a short term low FODMAP (low fermentable oligo-, di-, monosaccharides and polyols) diet
may help those celiac patients who are having intestinal symptoms. Alberto Rubio Tapia, MD, in a perspective written on this
study, stated that before starting a FODMAP diet that is further restrictive, a systematic evaluation must be completed for other
issues: “small bowel bacterial overgrowth, exocrine pancreatic insufficiency, microscopic colitis, irritable bowel syndrome and,
rarely, true refractory CeD.” Because the FODMAP diet is complex, it requires dietitian instruction and close clinical follow up to
see if symptom improvement is seen.
For more information: https://www.healio.com/news/gastroenterology/20220204/low-fodmap-diet-improves-gastrointestinalsymptoms-in-patients-with-celiac-disease
Kids who had no symptoms when diagnosed with CD through screening often do not stick with the gluten-free diet as
young adults A 20-year Italian retrospective study indicates that children who have symptoms when diagnosed are more likely to manage their diet and disease. Being asymptomatic seemed to cause poorer adherence, to the diet. 20% in the study abandoned the diet, and 40% never had follow-up testing of tTG antibody levels. They therefore need closer monitoring and better education after
diagnosis and during transition to adult care. Interestingly, the Italian follow-up study also found that 16 percent of patients
diagnosed through screening and 18 percent diagnosed with symptoms had developed other autoimmune diseases. These
included Hashimoto thyroiditis, type 1 diabetes, psoriasis, Graves’ disease, and vitiligo. Compliance with the gluten-free diet did
not correlate with development of other autoimmune conditions, the study says.
For more information: https://journals.lww.com/jpgn/Abstract/2022/01000/20_Year_Follow_up_Study_of_Celiac_Patients
Journal of Pediatric Gastroenterology and Nutrition: January 2022 - Volume 74 - Issue 1 - p 91-95
doi: 10.1097/MPG.0000000000003295
Organoid technologies for the study of intestinal microbiota–host interactions
Intestinal organoids are models of the gut made from intestinal stem cells that enable the study of the microbiota. This
technology is used for unraveling the effect of microbial communities on homeostasis, inflammation, idiopathic diseases
including celiac disease, and cancer in the gut.
For more information: Valentina Bozzetti, Stefania Senger, Organoid technologies for the study of intestinal microbiota–host
interactions, Trends in Molecular Medicine, Volume 28, Issue 4, 2022, Pages 290-303, ISSN 1471-4914,
https://doi.org/10.1016/j.molmed.2022.02.001 . (https://www.sciencedirect.com/science/article/pii/S1471491422000405)
Study of effect of gluten-free diet on vitamin D levels and bone mineral density in celiac disease patients
A study in the pediatrics department showed that after 6 months on a GFD, patients had positive effects on hemoglobin, Vit D
levels, and DEXA scan parameters (bone density)
For more information: J Family Med Prim Care. 2022 Feb;11(2):603-607. doi: 10.4103/jfmpc.jfmpc_1190_21 Epub 2022 Feb
16. https://pubmed.ncbi.nlm.nih.gov/35360767/
Cancer risk in over 47K individual with celiac disease is low
Increased risk of cancer in those with CD is confined to those diagnosed with CD after age 40 and it is primarily found within the
first year of diagnosis, with the highest risk in those diagnosed after 60 years. Cancer risk is not any higher in those with CD
who are under 40 years. After the gut has started to heal, the risk of cancer reduces to that of the general population.
For more information: Alimentary Tract, volume 20, Issue 2, E111-E131, February 1, 2022, DOI:
https://doi.org/10.1016/j.cgh.2021.05.034 https://www.cghjournal.org/article/S1542-3565(21)00572-3/fulltext
Association Between Atopic Dermatitis and Celiac Disease Adults with atopic dermatitis were 1.609 times more likely to have celiac disease than the general population. The study suggested that gastrointestinal morbidities be reviewed in any patient who has atopic dermatitis to prevent long-term complications.
For more information: https://link.springer.com/article/10.1007/s40257-019-00474-2
Five-year follow-up of new cases after a coeliac disease mass screening
77% or 230 seropositive children diagnosed with celiac disease were followed up five years after their diagnosis. 39 of these had been seropositive but had a negative biopsy. Of those with potential CD, 32% had CD after 5 years. There is a high risk of converting to CD if you have positive serology.
For more information: https://adc.bmj.com/content/early/2022/02/06/archdischild-2021-322755
Runners with bone stress injury should be tested for celiac disease
100 runners with bone stress injuries were tested for CD: 6% had positive blood tests, 5% were confirmed to CD with biopsy. This was 5 time higher than general population results. 3 of those diagnosed with CD were also found to have osteopenia. 70% of the runners were female.
For more information: https://pubmed.ncbi.nlm.nih.gov/32032163/
Risk of skin disorders in patients with celiac disease
Swedish data from 28 pathology departments between 1969 and 2016 identified CD patients and calculated the risk of any skin disease and specific skin diseases. Increased risks were present for eczema, psoriasis, urticaria, vitiligo, acne and alopecia areata. CD patients have increased risks for multiple common skin disorders and the risks persist in the long term.
For more information: https://pubmed.ncbi.nlm.nih.gov/33144153/
Prevalence of migraine in adults with CD
Headache especially migraine is more prevalent in CD than healthy controls. In addition, abdominal pain, diarrhea, and constipation are more common in CD with migraine than in CD with non-migraines headaches. This is especially true of CD female patients.
For more information: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0259502#pone.0259502.ref022
Use of Activated Charcoal for ingestion of Gluten is not recommended
In the Journal of American Pharmacists Association, an article reviewed use of activated charcoal for treatment of accidental gluten ingestion. 26% of CD respondents to a web-based survey (1,613 responses) had heard of using activated charcoal and 12% had used it. The review of the literature in this area found there is not enough evidence to support use of activated charcoal as a treatment for gluten ingestion.
For more information: https://www.sciencedirect.com/science/article/abs/pii/S1544319121004453
9 Meters Biopharma Announces Interim Analysis of Phase 3 Study of Larazotide for Celiac Disease Does Not Support Trial Continuation CedLara® (Celiac disease Larazotide), cancelled the Phase 3 trial as it concluded the additional number of patients needed to determine a significant clinical outcome between the placebo and larazotide was too large. They will continue to analyze the data to see if subset of patients could be helped by the drug.
For more information: Read the Press Release - https://feeds.issuerdirect.com/news-release.html?newsid=4598003219390084
CD hospitalizations: a challenge in the US
A US national sample of adult patients hospitalized with primary discharge diagnosis of CD between 2007 and 2017 was analyzed. Trend was an increase in hospitalization with the mean age of 57.85 years, however declining age trend. Females account for over 70% of patients who were predominantly white. The mean cost of treatment went from $26,299 in 2007 to $49,282 in 2017. In-patient mortality increased 1.3% over the period. The study did not comment on the general increase in hospital costs or lengths of stays, so it is very hard to interpret the data.
For more information: Ann Gastroenterol 2022 Jul-Aug;35(4):383-392. doi: 10.20524/aog.2022.0724. Epub 2022 Jun 2.
Link between CD and autoimmune thyroid disease This study looked at the prevalence of Hashimoto’s thyroiditis and Graves disease (autoimmune thyroid diseases) and the frequency of association with CD. It is thought that there is a shared genetic background between these diseases. A gluten free diet is found to help all these diseases. Further research is required to develop treatments for patients who have concurrent disorders.
For more information: Ashok T, Patni N, Fatima M, et al. (June 23, 2022) Celiac Disease and Autoimmune Thyroid Disease: The Two Peas in a Pod. Cureus 14(6): e26243. doi:10.7759/cureus.26243
Gluten induces subtle histological changes in the duodenal mucosa of patients with non-celiac gluten sensitivity (NCGS) Histological changes in NCGS in the duodenal mucosa are poorly defined. In this study 261 CD patients and 175 NCGS patients were compared with those with normal gastroscopy and histologic findings. It was found that the people with NCGS had villi that were significantly shorter indicating some damage is occurring even in NCGS.
For more information: Nutrients. 2022 Jun 15;14(12):2487. doi: 10.3390/nu14122487.
Impact of CD on Dating A study in Digestive Diseases and Sciences that included researchers Benjamin Lebwohl and Peter Green analyzed the results of an online study. 86.8% of the respondents were female. 68.4% reported that CD had a major/ moderate impact on the dating life. While on dates, approximately 40% were uncomfortable explaining precautions to waiters, and 28% said they engaged in riskier eating behaviors. 7.5% intentionally consumed gluten. 39% were hesitant to kiss their partner. The researchers felt that this was a major impact on dating and intimacy.
For more information: https://link.springer.com/article/10.1007/s10620-022-07548-y
Serum and salivary tissue transglutaminase (tTG IgA) level in celiac patients This small study of 78 people found that those with CD comparing serum and saliva had higher levels of amylase, as well as IL-6, IL-18, IL-21 and salivary and serum tTG. The study concluded that CD may reduce some salivary enzymes and increase inflammatory cytokines and salivary and serum tTG.
For more information: https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-022-02456-x?fbclid=IwAR2KOzbD03QE7b2V0wIRikm-d5b87Uhek2SBbuEEbqWTDz5WLu7p8ujSydY BMC Gastroenterology volume 22, Article number: 375 (2022)
International Symposium – April 2022 – Videos of presenters from Celiac Disease where are the patients and the therapies?
To view videos on-line: https://celiacdiseasecenter.columbia.edu/education/international-symposium/
Links between celiac disease and small intestinal bacterial overgrowth (SIBO): A systematic review and meta-analysis 14 studies, with 742 CD patients and 178 controls were reviewed. Utilizing breath tests, SIBO prevalence in CD patients was 20.8%. SIBO prevalence in CD patients nonresponsive to a gluten free diet (GFD) was not statistically higher as compared with those responsive to GFD. Antibiotic therapy of SIBO-positive CD patients resulted in improvement in gastrointestinal symptoms in 95.6% (95% CI: 78.0-99.9) and normalization of breath tests.
For more information: https://pubmed.ncbi.nlm.nih.gov/3573
The Significance of Low Titre Antigliadin Antibodies in the Diagnosis of Gluten Ataxia Patients with gluten antigliadin antibodies in the normal range and gluten ataxia were studied. A sample of 21 patients were involved. The study found that all patients benefited from a gluten free diet, even if the autoantibodies for celiac disease were normal (they did not technically have celiac disease). The study recommends an urgent need to redefine the serological cut-off for circulating antigliadin autoantibodies in diagnosing gluten ataxia.
For more information: Nutrients 2018, 10(10), 1444; https://www.mdpi.com/2072-6643/10/10/1444
Celiac Disease and Gluten Sensitivity – Dr. Stefano Guandalini, Professor Emeritus, U. of Chicago Celiac Disease
Centre The following Q and A is from the GIG newsletter. Dr. Guandalini is an expert in celiac disease, and he talks about the genetics,
testing and after the celiac diagnosis. One of the excellent pieces of advice in the article with regards to cross-contamination is
“Being nervous is never a good idea; being vigilant is.” “Do not put your child in a bubble, which causes social isolation.”
For more information: https://gluten.org/2022/02/17/renowned-expert-weighs-in-on-celiac-disease-and-gluten-sensitivity/
Low FODMAP diet improves gastrointestinal symptoms in patients with celiac disease
In additions to a strict gluten-free diet, a short term low FODMAP (low fermentable oligo-, di-, monosaccharides and polyols) diet
may help those celiac patients who are having intestinal symptoms. Alberto Rubio Tapia, MD, in a perspective written on this
study, stated that before starting a FODMAP diet that is further restrictive, a systematic evaluation must be completed for other
issues: “small bowel bacterial overgrowth, exocrine pancreatic insufficiency, microscopic colitis, irritable bowel syndrome and,
rarely, true refractory CeD.” Because the FODMAP diet is complex, it requires dietitian instruction and close clinical follow up to
see if symptom improvement is seen.
For more information: https://www.healio.com/news/gastroenterology/20220204/low-fodmap-diet-improves-gastrointestinalsymptoms-in-patients-with-celiac-disease
Kids who had no symptoms when diagnosed with CD through screening often do not stick with the gluten-free diet as
young adults A 20-year Italian retrospective study indicates that children who have symptoms when diagnosed are more likely to manage their diet and disease. Being asymptomatic seemed to cause poorer adherence, to the diet. 20% in the study abandoned the diet, and 40% never had follow-up testing of tTG antibody levels. They therefore need closer monitoring and better education after
diagnosis and during transition to adult care. Interestingly, the Italian follow-up study also found that 16 percent of patients
diagnosed through screening and 18 percent diagnosed with symptoms had developed other autoimmune diseases. These
included Hashimoto thyroiditis, type 1 diabetes, psoriasis, Graves’ disease, and vitiligo. Compliance with the gluten-free diet did
not correlate with development of other autoimmune conditions, the study says.
For more information: https://journals.lww.com/jpgn/Abstract/2022/01000/20_Year_Follow_up_Study_of_Celiac_Patients
Journal of Pediatric Gastroenterology and Nutrition: January 2022 - Volume 74 - Issue 1 - p 91-95
doi: 10.1097/MPG.0000000000003295
Organoid technologies for the study of intestinal microbiota–host interactions
Intestinal organoids are models of the gut made from intestinal stem cells that enable the study of the microbiota. This
technology is used for unraveling the effect of microbial communities on homeostasis, inflammation, idiopathic diseases
including celiac disease, and cancer in the gut.
For more information: Valentina Bozzetti, Stefania Senger, Organoid technologies for the study of intestinal microbiota–host
interactions, Trends in Molecular Medicine, Volume 28, Issue 4, 2022, Pages 290-303, ISSN 1471-4914,
https://doi.org/10.1016/j.molmed.2022.02.001 . (https://www.sciencedirect.com/science/article/pii/S1471491422000405)
Study of effect of gluten-free diet on vitamin D levels and bone mineral density in celiac disease patients
A study in the pediatrics department showed that after 6 months on a GFD, patients had positive effects on hemoglobin, Vit D
levels, and DEXA scan parameters (bone density)
For more information: J Family Med Prim Care. 2022 Feb;11(2):603-607. doi: 10.4103/jfmpc.jfmpc_1190_21 Epub 2022 Feb
16. https://pubmed.ncbi.nlm.nih.gov/35360767/
Cancer risk in over 47K individual with celiac disease is low
Increased risk of cancer in those with CD is confined to those diagnosed with CD after age 40 and it is primarily found within the
first year of diagnosis, with the highest risk in those diagnosed after 60 years. Cancer risk is not any higher in those with CD
who are under 40 years. After the gut has started to heal, the risk of cancer reduces to that of the general population.
For more information: Alimentary Tract, volume 20, Issue 2, E111-E131, February 1, 2022, DOI:
https://doi.org/10.1016/j.cgh.2021.05.034 https://www.cghjournal.org/article/S1542-3565(21)00572-3/fulltext
Association Between Atopic Dermatitis and Celiac Disease Adults with atopic dermatitis were 1.609 times more likely to have celiac disease than the general population. The study suggested that gastrointestinal morbidities be reviewed in any patient who has atopic dermatitis to prevent long-term complications.
For more information: https://link.springer.com/article/10.1007/s40257-019-00474-2
Five-year follow-up of new cases after a coeliac disease mass screening
77% or 230 seropositive children diagnosed with celiac disease were followed up five years after their diagnosis. 39 of these had been seropositive but had a negative biopsy. Of those with potential CD, 32% had CD after 5 years. There is a high risk of converting to CD if you have positive serology.
For more information: https://adc.bmj.com/content/early/2022/02/06/archdischild-2021-322755
Runners with bone stress injury should be tested for celiac disease
100 runners with bone stress injuries were tested for CD: 6% had positive blood tests, 5% were confirmed to CD with biopsy. This was 5 time higher than general population results. 3 of those diagnosed with CD were also found to have osteopenia. 70% of the runners were female.
For more information: https://pubmed.ncbi.nlm.nih.gov/32032163/
Risk of skin disorders in patients with celiac disease
Swedish data from 28 pathology departments between 1969 and 2016 identified CD patients and calculated the risk of any skin disease and specific skin diseases. Increased risks were present for eczema, psoriasis, urticaria, vitiligo, acne and alopecia areata. CD patients have increased risks for multiple common skin disorders and the risks persist in the long term.
For more information: https://pubmed.ncbi.nlm.nih.gov/33144153/
Prevalence of migraine in adults with CD
Headache especially migraine is more prevalent in CD than healthy controls. In addition, abdominal pain, diarrhea, and constipation are more common in CD with migraine than in CD with non-migraines headaches. This is especially true of CD female patients.
For more information: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0259502#pone.0259502.ref022
Use of Activated Charcoal for ingestion of Gluten is not recommended
In the Journal of American Pharmacists Association, an article reviewed use of activated charcoal for treatment of accidental gluten ingestion. 26% of CD respondents to a web-based survey (1,613 responses) had heard of using activated charcoal and 12% had used it. The review of the literature in this area found there is not enough evidence to support use of activated charcoal as a treatment for gluten ingestion.
For more information: https://www.sciencedirect.com/science/article/abs/pii/S1544319121004453