Recent advances in coeliac disease

Current Opinion in Gastroenterology

Volumn 25, Issue 2, 2009, Pages 100-109

  Armstrong, Matthew J ^a   Robins, Gerry G ^a   Howdle, Peter D ^a  

^a ST JAMES S UNIVERSITY HOSPITAL   (United Kingdom)

Author keywords

Antibody; Coeliac; Complications; Genes; Gluten

Indexed keywords

AT 1001; BACTERIAL PROTEIN; BUDESONIDE; CARNITINE; INFLIXIMAB; LEUKOCYTE ANTIGEN; PROPYL ENDOPROTEASE; PROTEIN GLUTAMINE GAMMA GLUTAMYLTRANSFERASE; PROTEINASE; UNCLASSIFIED DRUG;

ABSENCE OF SIDE EFFECTS; ADAPTIVE IMMUNITY; ARTICLE; ASPERGILLUS NIGER; CELIAC DISEASE; CLINICAL TRIAL; DISEASE ASSOCIATION; ENVIRONMENT; GASTROINTESTINAL SYMPTOM; GENETICS; GLUTEN FREE DIET; HEALTH SURVEY; HEREDITY; HIGH RISK POPULATION; HISTOLOGY; HLA SYSTEM; HUMAN; INNATE IMMUNITY; PANCREATITIS; PATHOGENESIS; PATIENT COMPLIANCE; PNEUMOCOCCAL INFECTION; SCREENING; SEPSIS; SEROLOGY; SIBLING; VIBRIO CHOLERAE;

CELIAC DISEASE; DIET, GLUTEN-FREE; FRACTURES, BONE; GENETIC PREDISPOSITION TO DISEASE; HLA ANTIGENS; HUMANS; LYMPHOMA; RISK FACTORS; SEROLOGIC TESTS;

EID: 64349116027     PISSN: 02671379     EISSN: None     Source Type: Journal    
DOI: 10.1097/MOG.0b013e32831ef20d     Document Type: Article

References (102)

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80. Gianfrani C, Siciliano RA, Facchiano AM. Transamidation of wheat flour inhibits the response to gliadin of intestinal t cells in celiac disease. Gastroenterology 2007; 133:780-789. This study recognizes that transamidation of wheat flour with microbial transglutaminase, a recognized dough improver, can be used to inhibit T cell-mediated gliadin toxicity. Considering the important role of adaptive immunity in the pathogenesis of coeliac disease, use of enzyme degradation, as seen in this study, may play a future role in preventing cereal toxicity in coeliac disease.
81. Brar P, Lee S, Lewis S, et al. Budesonide in the treatment of retractory celiac disease. Am J Gastroenterol 2007; 102:2265-2269. Due to the absence of side etfects, decreased bowel frequency and 55% complete RR, these authors advocate the use of enteric-coated budesonide as first-line therapy in RCD patients that require immunosuppression.
82. Al-Toma A, Verbeek WHM, Hadithi M. Survival in retractory celiac disease and enteropathy-associated T-cell lymphoma: retrospective evaluation of single-centre experience. Gut 2007; 56:1373-1378. The worrying 5-year survival rates of RCD II(58%)and EATL(8%)described in this large retrospective study prompt the need for more aggressive and targeted therapies in progressive RCD.
83. Costantino G, della Torre A, Lo Presti MA, et al. Treatment of life-threatening type 1 retractory celiac disease with long-term infliximab. Dig Liver Dis 2008; 40:74-77. The authors describe only the third case in the literature of RCD treated with infliximab. The marked clinical improvement witnessed in the case of this 68-year-old man with highly resistant RCD implies that anti-TNF therapy may be of use in caretully selected patients receiving close follow-up.
84. Al-Toma A, Mulder CJJ. Review article: stem cell transplantation for the treatment of gastrointestinal diseases: current applications and future perspectives. Aliment Pharmacol Ther 2007; 26:77-89. This review article describes a Dutch coeliac study in which high-dose chemotherapy followed by stem cell transplantation was successfully applied to type 2 RCD patients highly resistant to standard immunosuppressant therapy.
85. Paterson BM, Lammers KM, Arrieta MC, et al. The safety, tolerance, phar-macokinetic and pharmacodynamic etfects of single doses of AT-1001 in celiac disease subjects: a proof of concept study. Aliment Pharmacol Ther 2007; 26:757-766. The early findings of this small double-blind, randomized placebo-controlled study suggest that AT-1001, a recognized inhibitor of paracellular permeability, has potential as an oral treatment in coeliac disease.
86. Ludvigsson JF, Olen O, Bell M, et al. Coeliac disease and risk of sepsis. Gut. 2008;57:1074-1080. This extensive Swedish study(n > 15 000)is the first to find a significant association between coeliac disease(diagnosed in adulthood)and sepsis. Furthermore, this highlights the importance of bacterial vaccinations in coeliac disease.
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88. Olmos M, Antelo M, Vasquez E, et al. Systematic review and meta-analysis of observational studies on the prevalence of fractures in coeliac disease. Dig Liver Dis 2008; 40:46-53. Utilizing the data of eight case-control or cohort studies, these Argentinean authors confirmed the positive association between fractures and coeliac disease, but as a result of the heterogeneity between studies, it seemed evident that the risk of fractures is variable amongst the coeliac population.
89. Jafri MR, Nordstrom CW, Murray JA. Long-term fracture risk in patients with celiac disease: a population-based study in Olmsted County, Minnesota. Dig Dis Sci 2008; 53:964-971. This case-control study of 83 patients with coeliac disease found a two-fold fracture rate in coeliac disease versus controls prior to diagnosis(P=0.045)and 2.5-fold higher rate after diagnosis(P= 0.045).
90. Sood A, Midha V, Sood N, et al. Coexistence of chronic calcific pancreatitis and celiac disease. Indian J Gastroenterol 2007; 26:41-42.
91. Johnston SD, Robinson J. Fatal pneumococcal septicaemia in a coeliac patient. Eur J Gastroenterol Hepatol 1998; 10:353-354.
92. Leeds JS, Sanders DS. Risk of pancreatitis in patients with celiac disease: is autoimmune pancreatitis a biologically plausible mechanism? Clin Gastroenterol Hepatol 2008; 6:951.
93. Leeds JS, Hopper AD, Hurlstone DP, et al. Is exocrine pancreatic insufficiency in adult coeliac disease a cause of persisting symptoms? Aliment Pharmacol Ther 2007; 25:265-271.
94. DiSabatino A, Rosado MM, Cazzola P, et al. Splenic hypofunction and the spectrum of autoimmune and malignant complications in celiac disease. Clin Gastroenterol Hepatol 2006; 4:179-186.
95. Walters JRF, Bamford KB, Ghosh S. Coeliac disease and the risks of infections. Gut 2008; 57:1034-1035.
96. Ludvigsson JF, Welander A, Lassila R, et al. Risk of thromboembolism in 14000 individuals with coeliac disease. Br J Haematol 2007; 139:121-127. Using a large in-patient register, these Swedish authors found a modest association between coeliac disease in adults and thromboembolism, which they explained might be due to combination of chronic inflammation and hyperhomocysteinaemia.
97. Wei L, Spiers E, Reynolds N, et al. The association between celiac disease and cardiovascular disease. Aliment Pharmacol Ther 2007; 27:514-519. In this community-based cohort study, including 367 coeliac disease patients, the authors' findings suggest that coeliac disease appears to be associated with an increased risk of cardiovascular morbidity.
98. Hwang E, McBride R, Neugut Al, et al. Sarcoidosis in patients with celiac disease. Dig Dis Sci 2008; 53:977-981. Having identified 10 biopsy proven cases of sarcoidosis from a cohort of 866 coeliac disease patients, this study suggests that sarcoidosis is associated with coeliac disease.
99. Guariso G, Conte S, Presotto F, et al. Clinical, subclinical and potential autoimmune diseases in an Italian population of children with celiac
100. Olen O, Montgomery SM, Elinder G, et al. Increased risk of immune thrombocytopenic purpura among inpatients with coeliac disease. Scand J Gastroenterol 2008; 43:416-422. This large Scandinavian in-patient study highlights the potential risk of developing immune thrombocytopenic purpura in coeliac disease.
101. Dickey W, Ward M, Whittle CR, et al. Homocysteine and B-vitamin status in celiac disease: etfects of gluten exclusion and histological recovery. Scand J Gastroenterol 2008; 43:682-688. This is the first study to show higher homocysteine concentrations(>3(μmol/l)in coeliac disease patients than in healthy controls. GFD, with resultant villous recovery, was associated with increased folate status and subsequent normalization of homocysteine levels. Their findings are clinically significant, in that an early exclusion of gluten in coeliac disease may reduce the risk of homocysteine-related diseases.
102. Silano M, Volta U, De Vincenzi A, et al. etfect of a gluten-free diet on the risk of enteropathy-associated T-cell lymphoma in celiac disease. Dig Dis Sci 2008; 53:972-976. This Italian group followed over 1700 coeliac disease patients, for an average of 18 years, observing the cohort's GFD compliance and incidence of intestinal lymphoma. The results demonstrated that a strict GFD is protective towards the development of intestinal lymphoma.