Family ties: the impact of celiac disease on children and caregivers

2022 ◽  
Author(s):  
Monique M. Germone ◽  
Merlin Ariefdjohan ◽  
Marisa Stahl ◽  
Mary Shull ◽  
Pooja Mehta ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Family Ties ◽  
The Impact

scholarly journals Gut-Ex-Vivo system as a model to study gluten response in celiac disease

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Mara Gagliardi ◽  
Nausicaa Clemente ◽  
Romina Monzani ◽  
Luca Fusaro ◽  
Eleonora Ferrari ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Intestinal Epithelium ◽  
Complex Disease ◽  
Ex Vivo ◽  
Dynamic Condition ◽  
Model Systems ◽  
In Vivo Models ◽  
Effective Manner ◽  
Junction Protein ◽  
The Impact

AbstractCeliac disease (CD) is a complex immune-mediated chronic disease characterized by a consistent inflammation of the gastrointestinal tract induced by gluten intake in genetically predisposed individuals. Although initiated by the interaction between digestion-derived gliadin, a gluten component, peptides, and the intestinal epithelium, the disorder is highly complex and involving other components of the intestine, such as the immune system. Therefore, conventional model systems, mainly based on two- or three-dimension cell cultures and co-cultures, cannot fully recapitulate such a complex disease. The development of mouse models has facilitated the study of different interacting cell types involved in the disorder, together with the impact of environmental factors. However, such in vivo models are often expensive and time consuming. Here we propose an organ ex vivo culture (gut-ex-vivo system) based on small intestines from gluten-sensitive mice cultivated in a dynamic condition, able to fully recapitulate the biochemical and morphological features of the mouse model exposed to gliadin (4 weeks), in 16 h. Indeed, upon gliadin exposure, we observed: i) a down-regulation of cystic fibrosis transmembrane regulator (CFTR) and an up-regulation of transglutaminase 2 (TG2) at both mRNA and protein levels; ii) increased intestinal permeability associated with deregulated tight junction protein expression; iii) induction and production of pro-inflammatory cytokines such as interleukin (IL)-15, IL-17 and interferon gamma (IFNγ); and iv) consistent alteration of intestinal epithelium/villi morphology. Altogether, these data indicate that the proposed model can be efficiently used to study the pathogenesis of CD, test new or repurposed molecules to accelerate the search for new treatments, and to study the impact of the microbiome and derived metabolites, in a time- and cost- effective manner.

scholarly journals Relative Rates of Gluten Digestion by Nine Commercial Dietary Digestive Supplements

2021 ◽  
Vol 8 ◽  
Author(s):  
Gregory John Tanner
Keyword(s):  
Amino Acids ◽  
Celiac Disease ◽  
Initial Rate ◽  
Relative Rate ◽  
Elisa Method ◽  
Fasting Stomach ◽  
The Mean ◽  
Stomach Volume ◽  
The Impact

Endopeptidases containing supplements may digest gluten and reduce the impact on celiac and gluten-sensitive subjects who inadvertently consume gluten. We investigated the relative rate of disappearance of coeliac relevant epitopes in extracts of nine commercial supplements, using two competitive enzyme-linked immunosorbent assays (ELISAs)—Ridascreen (detects QQPFP, QQQFP, LQPFP, and QLPFP) and Gluten-Tec (detects Glia-α20 and PFRPQQPYPQ). All epitopes are destroyed by cleavage after P and Q amino acids. Rates at pH 3.5 and pH 7.0 were measured. These experiments were designed to measure relative rates of epitope digestion not to mimic in vivo digestion. The supplements were: 1 GluteGuard, 2 GlutenBlock, 3 GliadinX, 4 GlutnGo, 5 GlutenRescue, 6 Eat E-Z Gluten+, 7 Glutenease, 8 Glutezyme, and 9 Gluten Digest. The mean initial rate and half-lives of epitope digestion were deduced and extrapolated to rates at the recommended dose of one supplement in a fasting stomach volume. At pH 7, supplement 1 was the fastest acting of the supplements, with Ridascreen ELISA, more than twice as fast as the next fastest supplements, 5, 6, 7, and 8. Supplements 2, 3, and 4 showed little activity at pH 7.0. Supplement 1 was also the fastest acting at pH 7 with Gluten-Tec ELISA, more than three times the rate for supplements 2 and 3, with supplements 4–9 showing minimal activity. At pH 3.5, supplement 1 acted more than five times as fast as the next fastest supplements, 2 and 3, when measured by Ridascreen, but supplements 2 and 3 were over two times faster than supplement 1 when measured by Gluten-Tec. Supplements 4–9 demonstrated minimal activity at pH 3.5 with either ELISA. Supplement 1 most rapidly digested the key immuno-reactive gluten epitopes identified by the R5 antibody in the Codex-approved competitive Ridascreen ELISA method and associated with the pathology of celiac disease.

Culture and income across countries: evidence from family ties

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Sokchea Lim ◽  
Simran K. Kahai ◽  
Channary Khun
Keyword(s):  
Survey Data ◽  
Growth Model ◽  
Design Methodology ◽  
Macro Level ◽  
Second Step ◽  
Content Type ◽  
Family Ties ◽  
Highly Educated ◽  
Married Individuals ◽  
The Impact

PurposeThe purpose of the paper is to examine how much difference in income can be explained by familial culture that persists in different societies.Design/methodology/approachWe employ a two-step methodology to evaluate the impact of familial culture on income across countries. In the first step, we construct the macro measures of familial culture from micro survey data. In the second step, the growth model is estimated.FindingsFirst-step micro regression results show that family is more important to female, richer, highly educated, unemployed and married individuals. Male, poorer, less educated and unemployed individuals are more likely to respect and love parents unconditionally. The same group is also more likely to think that parents must do the best for their kids. Finally, the macro results show that the strength of national familial ties explains significant differences in income across countries.Research limitations/implicationsWe show that countries with weak family ties are richer than those with strong family ties. These results are useful for policymakers who design public policies that accommodate the type of familial culture that persists in their society.Originality/valueWe construct the macro measures of familial culture from the micro survey data. The paper adds to the literature on the effect of culture on income at the macro level.

scholarly journals Atherosclerotic Risk Factors in Children with Celiac Disease

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Anna Rybak ◽  
Aldona Wierzbicka ◽  
Piotr Socha ◽  
Anna Stolarczyk ◽  
Bożena Cukrowska ◽  
...  
Keyword(s):  
Risk Factors ◽  
Celiac Disease ◽  
Folic Acid ◽  
Lipid Profile ◽  
Total Cholesterol ◽  
Reference Group ◽  
Autoimmune Disorder ◽  
Healthy Children ◽  
Positive Correlation ◽  
The Impact

Introduction and Objectives. Celiac disease (CD) is a complex autoimmune disorder occurring in genetically susceptible individuals. There is limited data on the impact of gluten-free diet (GFD) on the risk of developing cardiovascular diseases. Hereby, we present our study regarding the impact of treatment with GFD on the biochemical risk factors of atherosclerosis. Material and Methods. 277 patients with CD from 7 Polish clinics were enrolled in the study (210 children treated for at least 5 years and 67 children included in the study on the day of CD diagnosis and observed for 1 year on a GFD). We obtained selected clinical data, and we assessed lipid profile, apolipoproteins (A1, B, and E), lipoprotein (a), homocysteine, as well as antioxidants (folic and uric acid), and high-sensitivity CRP (hsCRP) for all patients. The compliance to GFD was verified using anti-transglutaminase antibodies and deamidated gliadin peptide antibodies. As a reference group, the data of 95 healthy children recruited for another project was used, for which we had the results of selected parameters. Results. We found significantly lower concentrations of total cholesterol, lipoprotein LDL-C, apolipoproteins A1 and B, as well as hCRP in all children with CD. We showed decreased level (<5 ng/mL) of folic acid among 46% of children treated for >5 years. Moreover, we showed significant decrease of folic acid level already after 1 year of a GFD (12 vs. 5.6 ng/mL; p<0.001). We also found significant negative correlation of z-score body mass index (BMI) with HDL and APOA1 level (r=−0.33; p=0.015 and r=−0.28; p=0.038, respectively) and modest positive correlation of z-score BMI with atherogenic factor of total cholesterol-HDL ratio and LDL-HDL ratio (r=0.40; p=0.002 and r=0.36; p=0.006, respectively). Analysis of physical activity showed an increase in the insulin levels with inactivity (r=0.36; p=0.0025). We also found positive correlation of the sleep duration with the adiponectin level (r=0.41; p=0.011). Conclusions. In children with CD treated with a GFD, decreased level of folic acid together with increased BMI, sedentary behavior, and an improper lipid profile may predispose them to atherosclerosis in the long run. This data suggests the need of further studies to determine the need for metabolic cardiovascular risk screening in children with CD.

A Single Institution’s Experience of Primary Headache in Children With Celiac Disease

2019 ◽  
Vol 35 (1) ◽  
pp. 37-41 ◽  
Author(s):  
Grant L. Hom ◽  
Brian L. Hom ◽  
Barbara Kaplan ◽  
A. David Rothner
Keyword(s):  
Celiac Disease ◽  
Tissue Transglutaminase ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Phone Survey ◽  
Type Headache ◽  
The Impact ◽  
Histologic Changes

Background: Few studies exist examining the frequency of primary headache in children with celiac disease and the impact of a gluten-free diet on primary headache symptomology. This study explores characteristics and frequency of headaches in children with celiac disease and response to gluten-free diet at a single institution. Methods: Medical records were reviewed for children with celiac disease confirmed by the presence of elevated tissue transglutaminase IgA levels and histologic changes consistent with the diagnosis of celiac disease on small bowel biopsy. Eligible participants were contacted via letter for participation in a phone survey regarding headaches. Phone interviews were conducted 2 weeks after notification and lasted approximately 10 minutes. Headaches were classified according to ICHD-3 criteria. Results: 247 eligible patients or their families were contacted. A total of 132 (53.44%) agreed to participate. One participant was excluded due to insufficient information provided. Overall, 51 of 131 participants had recurrent headache defined as at least 1 episode per month (39%, 95% confidence interval [CI]: 31%-47%) and 33 had migraine with or without aura (25%, 95% CI: 18%-33%). Twenty-eight had frequent tension-type headache (22%, 95% CI: 15%-29%). Thirty-two participants noted headaches before a confirmed diagnosis of celiac disease. Twenty-two of 32 participants (68.75%) noticed decreased headache frequency or intensity, or both, after starting the gluten-free diet. Conclusion: This study suggests that at least one-third of children and adolescents with celiac disease have recurrent headaches at the time of diagnosis. A gluten-free diet led to improved headache symptomology in a significant number of these patients.

Evaluation of the impact of celiac disease and its dietary manipulation on children and their caregivers

2015 ◽  
Vol 34 (2) ◽  
pp. 112-116 ◽  
Author(s):  
Bisman Khurana ◽  
Avinash Lomash ◽  
Sumaira Khalil ◽  
Malvika Bhattacharya ◽  
K. Rajeshwari ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Dietary Manipulation ◽  
The Impact

scholarly journals Health related QoL in celiac disease patients in Slovenia

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Eva Turk ◽  
Dušanka Mičetić-Turk ◽  
Maja Šikić-Pogačar ◽  
Alojz Tapajner ◽  
Veljko Vlaisavljević ◽  
...  
Keyword(s):  
Celiac Disease ◽  
General Population ◽  
Urban Setting ◽  
Academic Education ◽  
Cross Sectional ◽  
North East ◽  
Holistic Management ◽  
Validated Questionnaire ◽  
Health Related ◽  
The Impact

Abstract Background Measurements of health-related quality of life (HRQoL) among celiac disease patients using a validated questionnaire have been lacking in Slovenia. This study aims to measure HRQoL in celiac disease (CD) patients using EQ-5D internationally validated questionnaire and comparing it to the HRQoL of the general population. Methods In this cross sectional analysis all of the approximately 2000 members of the Slovenian Celiac Society were invited to take part. We used a 3 step approach for recruitment and data collection. HRQoL was evaluated through the EuroQoL EQ-5D-5L instrument (Slovenian version) and analysed using the ordinal logistic regression. Results Out of 321 patients who gave their consent, 247 celiac patients were included in the study (77%). 68% of the participants were female and 53% of them lived in an urban setting. Most patients originated from North-East Slovenia, whereas approximately 30% of patients came from other Slovenian regions. The EQ-5D respondents’ self-reported health status at the time of the study show that most patients have slight or no problems when living with CD. The duration of the gluten-free diet, academic education and rare (< 1 × year) doctor visits affect EQ-5D in a positive way. On the other hand, higher age and chronic rheumatic disease were negatively associated with EQ-5D also when compared to the general population. Conclusion This is the first Slovenian study to measure the HRQoL of Slovenian CD patients, using an internationally validated questionnaire. The results of our study show that HRQoL is slightly impaired among Slovenian patients with CD. Clinical characteristics are better determinants of their HRQoL than socio-demographic factors. Greater awareness of the impact of CD on patients’ HRQoL would improve the holistic management of CD patients.

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