Recent PubMed Articles on Coeliac Disease (External)

Amelioration of adjuvant induced arthritis in Sprague Dawley rats through modulation of inflammatory mediators by Ribes alpestre Decne.

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Amelioration of adjuvant induced arthritis in Sprague Dawley rats through modulation of inflammatory mediators by Ribes alpestre Decne.

J Ethnopharmacol. 2019 Feb 13;:

Authors: Hassan UH, Alamgeer, Shahzad M, Shabbir A, Jahan S, Saleem M, Bukhari IA, Assiri AM

Abstract
ETHNOPHARMACOLOGICAL RELEVANCE: Ribes alpestre Decne has been commonly used in the treatment of joint complaints.
AIM OF STUDY: The present study was undertaken to evaluate the antiarthritic potential of ethanolic extract and fractions of Ribes alpestre and to explore its probable mechanism of action.
MATERIAL AND METHODS: Complete Freunds adjuvant induced arthritis in Sprague Dawley rats was used to assess antiarthritic activity of aqueous ethanol extract, butanol and aqueous fractions at 200mg/kg oral dose for 28 days. Paw volume and diameter, arthritic index, body weight, hematological and biochemical parameters, radiographic and histological analysis of ankle joints were carried out. An array of pro-inflammatory mediators (IL-1β, IL-6, NF-Kβ, TNF-α, COX-2, IL-4, IL-10 and PGE2) were estimated by RT-PCR and enzyme linked immunosorbent assay. Antioxidant capacity was assessed using DPPH and reducing power assays. Qualitative phytochemical screening, total phenolic and flavonoid content and HPLC analysis of aqueous fraction of Ribes alpestre were also carried out.
RESULTS: Significant (p<0.001) reduction in paw volume and thickness and arthritic score by aqueous ethanolic extract and its fractions has been found. Aqueous ethanolic extract and fractions in particular aqueous fraction considerably prevented decrease in body weight, alterations in hematological parameters. Radiographic and histological examination revealed no significant architectural changes in joints of treated rats. Significant (p<0.05-0.001) down regulation of pro-inflammatory genes IL-1β, TNF-α, IL-6, COX-2, PGE2 and NF-Kβ alongwith noteworthy increase in levels of IL-4 and IL-10 was recorded among treated animals. Aqueous ethanol extract and its fractions demonstrated notable and concentration dependent (50-6400ug/ml) antioxidant potential. Qualitative phytochemical analysis of active fraction (aqueous) displayed presence of flavonoids, alkaloids, tannins and glycosides. Besides total phenolic and flavonoid contents has been found to be 179.3mg GAE/ml and 389.40 ug QE/ml in aqueous fraction of Ribes alpestre respectively. HPLC profile demonstrated presence of quercitin, chlorogenic acid, vanillic acid and cinamic acid in aqueous fraction.
CONCLUSION: Present communication suggests Ribes alpestre a potent antiarthritic therapy by ameliorating adjuvant arthritis in rats by downregulating proinflammatory mediators with up regulation of anti-inflammatory cytokines.

PMID: 30771518 [PubMed - as supplied by publisher]

Long-Term Outcome of Potential Celiac Disease in Genetically at-Risk Children: The Prospective CELIPREV Cohort Study.

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Long-Term Outcome of Potential Celiac Disease in Genetically at-Risk Children: The Prospective CELIPREV Cohort Study.

J Clin Med. 2019 Feb 05;8(2):

Authors: Lionetti E, Castellaneta S, Francavilla R, Pulvirenti A, Naspi Catassi G, Catassi C, SIGENP Working Group of Weaning and CD Risk

Abstract
BACKGROUND: The long-term outcome of potential celiac disease (CD) is still a debated issue. We aimed to evaluate the progression of potential CD versus overt CD after 10-years of follow-up in a cohort of children genetically predisposed to CD.
METHODS: The CELIPREV study is prospectively following from birth 553 children with CD-predisposing HLA genes. Children with a diagnosis of potential CD continued to receive a normal diet and repeated the serological screening for CD every year. An intestinal biopsy was taken in presence of persistent positive serology.
RESULTS: Overall, 26 (4.7%) children received a diagnosis of potential CD (50% females, median age 24 months). All children were symptom-free. Twenty-three children continued a gluten-containing diet; at 10 years from the first biopsy, three children developed overt CD (13%), 19 (83%) became antibodies negative at 1 year from the first biopsy and remained negative up to 10 years of follow-up and one subject (4%) had fluctuating antibody course with transiently negative values and persistently negative biopsy.
CONCLUSIONS: In children genetically predisposed to CD with a diagnosis of potential CD the risk of progression to overt CD while on a gluten-containing diet is very low in the long-term.

PMID: 30764503 [PubMed]

Enterovirus as trigger of coeliac disease: nested case-control study within prospective birth cohort.

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Enterovirus as trigger of coeliac disease: nested case-control study within prospective birth cohort.

BMJ. 2019 Feb 13;364:l231

Authors: Kahrs CR, Chuda K, Tapia G, Stene LC, Mårild K, Rasmussen T, Rønningen KS, Lundin KEA, Kramna L, Cinek O, Størdal K

Abstract
OBJECTIVE: To determine whether infection with human enterovirus or adenovirus, both common intestinal viruses, predicts development of coeliac disease.
DESIGN: Case-control study nested within Norwegian birth cohort recruited between 2001 and 2007 and followed to September 2016.
SETTING: Norwegian population.
PARTICIPANTS: Children carrying the HLA genotype DR4-DQ8/DR3-DQ2 conferring increased risk of coeliac disease.
EXPOSURES: Enterovirus and adenovirus detected using real time polymerase chain reaction in monthly stool samples from age 3 to 36 months.
MAIN OUTCOME MEASURE: Coeliac disease diagnosed according to standard criteria. Coeliac disease antibodies were tested in blood samples taken at age 3, 6, 9, and 12 months and then annually. Adjusted odds ratios from mixed effects logistic regression model were used to assess the relation between viral infections before development of coeliac disease antibodies and coeliac disease.
RESULTS: Among 220 children, and after a mean of 9.9 (SD 1.6) years, 25 children were diagnosed as having coeliac disease after screening and were matched to two controls each. Enterovirus was found in 370 (17%) of 2135 samples and was significantly more frequent in samples collected before development of coeliac disease antibodies in cases than in controls (adjusted odds ratio 1.49, 95% confidence interval 1.07 to 2.06; P=0.02). The association was restricted to infections after introduction of gluten. High quantity samples (>100 000 copies/μL) (adjusted odds ratio 2.11, 1.24 to 3.60; P=0.01) and long lasting infections (>2 months) (2.16, 1.16 to 4.04; P=0.02) gave higher risk estimates. Both the commonly detected enterovirus species Enterovirus A and Enterovirus B were significantly associated with coeliac disease. The association was not found for infections during or after development of coeliac disease antibodies. Adenovirus was not associated with coeliac disease.
CONCLUSIONS: In this longitudinal study, a higher frequency of enterovirus, but not adenovirus, during early childhood was associated with later coeliac disease. The finding adds new information on the role of viral infections in the aetiology of coeliac disease.

PMID: 30760441 [PubMed - in process]

Celiac crisis, a rare occurrence in adult celiac disease: A systematic review.

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Celiac crisis, a rare occurrence in adult celiac disease: A systematic review.

World J Clin Cases. 2019 Feb 06;7(3):311-319

Authors: Balaban DV, Dima A, Jurcut C, Popp A, Jinga M

Abstract
BACKGROUND: Celiac crisis (CC), a potentially life-threatening condition, is one of the rare clinical presentations of celiac disease (CD). Several cases have been documented in the literature, mostly in children.
AIM: To perform a review of CC cases reported in adult CD patients.
METHODS: A systematic search of the literature was conducted in two databases, PubMed/MEDLINE and EMBASE, using the term "celiac crisis" and its variant "coeliac crisis", from January 1970 onwards. Altogether, 29 articles reporting 42 biopsy-proven cases were found in the search. Here, we summarized the demographic, clinical characteristics, laboratory and diagnostic work-ups, and therapeutic management in these patients.
RESULTS: Among the 42 CD cases, the median age was 50 years (range 23-83), with a 2:1 female to male ratio. The majority of patients (88.1%) developed CC prior to CD diagnosis, while the remaining were previously diagnosed CD cases reporting low adherence to a gluten-free diet (GFD). Clinically, patients presented with severe diarrhea (all cases), weight loss (about two thirds) and, in particular situations, with neurologic (6 cases) or cardiovascular (1 case) manifestations or bleeding diathesis (4 cases). One in four patients had a precipitating factor that could have triggered the CC (e.g. trauma, surgery, infections). Laboratory workup of patients revealed a severe malabsorptive state with metabolic acidosis, dehydration, hypoalbuminemia and anemia. The evolution of GFD was favorable in all cases except one, in whom death was reported due to refeeding syndrome.
CONCLUSION: Celiac crisis is a rare but severe and potentially fatal clinical feature of CD. A high index of suspicion is needed to recognize this clinical entity and to deliver proper therapy consisting of supportive care and, subsequently, GFD.

PMID: 30746372 [PubMed]

Increased prevalence of disordered eating in the dual diagnosis of type 1 diabetes mellitus and celiac disease.

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Increased prevalence of disordered eating in the dual diagnosis of type 1 diabetes mellitus and celiac disease.

Pediatr Diabetes. 2018 06;19(4):749-755

Authors: Tokatly Latzer I, Rachmiel M, Zuckerman Levin N, Mazor-Aronovitch K, Landau Z, Ben-David RF, GrafBar-El C, Gruber N, Levek N, Weiss B, Stein D, Lerner-Geva L, Pinhas-Hamiel O

Abstract
BACKGROUND: Disordered eating behaviors (DEBs) may lead to full blown eating disorders. Both type 1 diabetes mellitus (T1DM) and celiac disease (CD) have been linked to DEBs.
OBJECTIVE: To compare the presence of DEBs between adolescents and young adults with a dual diagnosis of T1DM and CD, and individuals with only one of the diagnoses.
METHODS: Individuals with a dual diagnosis of T1DM and CD ("T1DM + CD group" n = 39), with a diagnosis of T1DM only ("T1DM group" n = 97) and with a diagnosis of CD only ("CD group" n = 267) filled the Eating Attitude Test-26 (EAT-26) questionnaire. Those with T1DM completed in addition to the Diabetes Eating Problem Survey-Revised (DEPS-R).
RESULTS: The study population comprised of 403 individuals, of whom 65% were females. There were no statistically significant differences among the groups in distribution of sex, age, hemoglobin A1c (HbA1c) levels, age of disease diagnosis and duration. The prevalence of DEBs in the T1DM + CD group was 3-fold higher (26.0%) than in the T1DM (8.2%) and CD (8.2%) groups (P = .003). This trend was observed for both females and males. Multivariate analysis demonstrated that the T1DM + CD group had an increased risk for DEBs (odds ratio, OR: 4.7, 95% confidence interval, CI: 1.9-11.2, P = .001) after adjustment for age, sex, and body mass index. Additionally, being female, older and overweight increased the risk for DEBs. HbA1c values were not associated with an increased DEBs rate.
CONCLUSIONS: Individuals with the dual diagnoses of T1DM and CD have an increased likelihood to develop DEBs compared to those with only one of these diagnoses.

PMID: 29493097 [PubMed - indexed for MEDLINE]

Sex- and age-dependent effects of celiac disease on growth and weight gain in children with type 1 diabetes: Analysis of the type 1 diabetes Exchange Clinic Registry.

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Sex- and age-dependent effects of celiac disease on growth and weight gain in children with type 1 diabetes: Analysis of the type 1 diabetes Exchange Clinic Registry.

Pediatr Diabetes. 2018 06;19(4):741-748

Authors: Simmons JH, Foster NC, Riddlesworth TD, DuBose SN, Redondo MJ, Liu E, Freemark M, T1D Exchange Clinic Network

Abstract
BACKGROUND: Celiac disease (CD) is common in patients with type 1 diabetes (T1D) and effects of CD on growth in children with T1D remain unclear.
METHODS: We analyzed heights, weights, and body mass index (BMI) in 215 matched pediatric CD/control pairs in the T1D Exchange Clinic Registry. CD was defined by a clinic-reported diagnosis and positive celiac serology (n = 80) and/or positive small bowel biopsy (n = 135). Cases and controls were matched by age (mean: 14 years), diabetes duration (median: 7 years), sex (57% female), and clinic site. There were 5569 height/weight measurements.
RESULTS: Gluten was restricted for varying periods of time in 61% of females and 51% of males with CD. Females with CD were shorter than female controls at all ages (P = 0.01). Weight z-scores were initially lower in preschool females with CD but similar to controls by middle childhood. Males with CD were initially shorter but adult heights were similar. Height in both sexes and weight in males were lower in CD participants diagnosed at younger age. Growth in T1D children with biopsy-proven CD, 76% of them were gluten-restricted, was comparable to that of T1D controls.
CONCLUSION: Concurrent CD impairs linear growth in T1D females at all stages of development and in young T1D males. Young females with CD have lower weights, but both sexes have similar weights by middle childhood. Children younger at CD onset remain shorter throughout childhood; males younger at CD onset have persistently lower weights. Long-term gluten restriction may restore weight gain and linear growth in children with CD and T1D.

PMID: 29271067 [PubMed - indexed for MEDLINE]

Chronic Inflammation Permanently Reshapes Tissue-Resident Immunity in Celiac Disease.

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Chronic Inflammation Permanently Reshapes Tissue-Resident Immunity in Celiac Disease.

Cell. 2019 Feb 05;:

Authors: Mayassi T, Ladell K, Gudjonson H, McLaren JE, Shaw DG, Tran MT, Rokicka JJ, Lawrence I, Grenier JC, van Unen V, Ciszewski C, Dimaano M, Sayegh HE, Kumar V, Wijmenga C, Green PHR, Gokhale R, Jericho H, Semrad CE, Guandalini S, Dinner AR, Kupfer SS, Reid HH, Barreiro LB, Rossjohn J, Price DA, Jabri B

Abstract
Tissue-resident lymphocytes play a key role in immune surveillance, but it remains unclear how these inherently stable cell populations respond to chronic inflammation. In the setting of celiac disease (CeD), where exposure to dietary antigen can be controlled, gluten-induced inflammation triggered a profound depletion of naturally occurring Vγ4+/Vδ1+ intraepithelial lymphocytes (IELs) with innate cytolytic properties and specificity for the butyrophilin-like (BTNL) molecules BTNL3/BTNL8. Creation of a new niche with reduced expression of BTNL8 and loss of Vγ4+/Vδ1+ IELs was accompanied by the expansion of gluten-sensitive, interferon-γ-producing Vδ1+ IELs bearing T cell receptors (TCRs) with a shared non-germline-encoded motif that failed to recognize BTNL3/BTNL8. Exclusion of dietary gluten restored BTNL8 expression but was insufficient to reconstitute the physiological Vγ4+/Vδ1+ subset among TCRγδ+ IELs. Collectively, these data show that chronic inflammation permanently reconfigures the tissue-resident TCRγδ+ IEL compartment in CeD. VIDEO ABSTRACT.

PMID: 30739797 [PubMed - as supplied by publisher]

Deamidated gliadin peptide in pediatric patients with moderately increased tissue transglutaminase; does it help?

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Deamidated gliadin peptide in pediatric patients with moderately increased tissue transglutaminase; does it help?

Clin Chim Acta. 2019 Feb 03;:

Authors: Dickerson JA, Lee D, Pacheco MC

Abstract
BACKGROUND: Deamidated gliadin peptide (DGP) is a relatively new serologic assay used in diagnosis and monitoring of celiac disease. DGP IgG is recommended by some in pediatric patients <2 y. Use in other pediatric populations is not well established. The utility of the DGP screen (IgG + IgA) in patients with moderate increase of tissue transglutaminase (TTG) IgA has not been studied.
METHODS: Cases between January 2015 and October 2017 in which a patient had TTG IgA greater >19 and <100, DGP screen, and biopsy were collected. Indication for biopsy and diabetes diagnosis were recorded. Of 495 patients screened, 31 met criteria.
RESULTS: The sensitivity and specificity of DGP screen were calculated, and were 87.4% and 56%, respectively; though lower in patients with diabetes.
CONCLUSIONS: The study suggests in patients with moderately increased TTG-IgA, DGP screen lacks specificity and does not provide additional information about whether or not to biopsy.

PMID: 30726722 [PubMed - as supplied by publisher]

Dietary Intake and Micronutrient Supplementation in Youth with Celiac Disease with and without Type 1 Diabetes.

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Dietary Intake and Micronutrient Supplementation in Youth with Celiac Disease with and without Type 1 Diabetes.

Can J Diet Pract Res. 2018 09 01;79(3):118-124

Authors: Liu A, Marcon M, Assor E, Mahmud FH, Turner J, Mager D

Abstract
The study purpose was to describe dietary intake and the factors influencing micronutrient supplements (MS) use in Celiac Disease (CD) ± Type 1 Diabetes (T1D). Three-day food records collected from parents of youth (3-18 years) with CD (n = 14) ± T1D (n = 10) were assessed for macro and micronutrient intake, diet quality (DQ), glycemic index (GI), glycemic load (GL), and food group intake. Focus group methodology and thematic concept analysis were conducted to determine factors influencing adolescent MS use. Mean ± SD age was 11 ± 4.4 (CD) and 13 ± 3.7 (CD + T1D) (P = 0.32). Body mass index was within healthy reference ranges (17.9 ± 2.5 [CD]; 19.3 ± 3.8 [CD + T1D] kg/m2; P = 0.61). The majority of youth with CD ± T1D (>90%) had high intakes of sugar and saturated fat, had high GI and GL, and met food serving recommendations and DQs that were indicative of "needs improvement." With the exception of vitamin D, vitamin E, folate, calcium, and potassium, youth in both groups met the estimated average requirements (EAR) for most micronutrients. MS use corrected suboptimal vitamin D intake; however, vitamin E, folate, calcium, and potassium intake remained below the EAR. Variables influencing adolescent MS use included daily routine, health professional influence, disease management (CD + T1D), and lack of knowledge about the need for MS. Strategies to elicit adolescent MS use varied between parent and adolescents.

PMID: 29893137 [PubMed - indexed for MEDLINE]

Prevalence and Clinical Features of Celiac Disease in Healthy School-Aged Children.

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Prevalence and Clinical Features of Celiac Disease in Healthy School-Aged Children.

Dig Dis Sci. 2019 01;64(1):173-181

Authors: Beser OF, Gulluelli E, Cullu Cokugras F, Erkan T, Kutlu T, Yagci RV, Erbek Alp F, Ercal G, Kepil N, Kucur M, Northern Cyprus Celiac Study Group

Abstract
BACKGROUND/AIMS: The aim of this study was to determine the prevalence of celiac disease (CD) in healthy school-aged children in the northern region of Cyprus and to investigate the existence of potential markers that may accompany CD. This is the first study to measure the prevalence of CD in the northern region of Cyprus.
METHODS: This study included 3792 school-aged children who were between the ages of 6 and 10 years between January 2015 and October 2016. CD was screened using total serum IgA, IgA anti-tissue transglutaminase (tTG), and IgA antiendomysial (EMA) antibodies. Subjects with selective IgA deficiency were further tested for IgG-tTG. Small intestinal biopsies were performed on all subjects with tTG antibody positivity. Risk factors and symptoms related to CD were evaluated using questionnaires in both the CD and control groups.
RESULTS: Of the 3792 subjects, 39 were antibody positive (IgA-tTG was positive only in 14 subjects, IgA-tTG plus IgA-EMA in 21 subjects, and IgG-tTG in 4 subjects). IgA deficiency was detected in 11 subjects (0.29%). IgG-tTG was positive in 4 subjects with IgA deficiency (36.3%). Intestinal biopsies were performed on 28 of the 39 seropositive subjects. The biopsy findings of 15 children were consistent with CD (IgA-tTG positive in 3, IgA-tTG and IgA-EMA positive in 10, and IgG-tTG positive in 2). Thus, biopsies confirmed CD in 1:256 children (0.39%).
CONCLUSIONS: Our study, which is the first study of school-aged children from the northern region of Cyprus, revealed that CD is a prevalent disease in this region.

PMID: 30311156 [PubMed - indexed for MEDLINE]

Psychotropic medication use among patients with celiac disease.

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Psychotropic medication use among patients with celiac disease.

BMC Psychiatry. 2018 03 27;18(1):76

Authors: Zylberberg HM, Ludvigsson JF, Green PHR, Lebwohl B

Abstract
BACKGROUND: Celiac disease is a multi-system disorder with manifestations that may result in psychiatric disorders. We assessed the prevalence of medication use to treat psychiatric disorders in celiac disease patients.
METHODS: We conducted a cross-sectional study of patients undergoing esophagogastroduodenoscopy over 9-years at a celiac disease referral center. We compared the prevalence of psychotropic medication use among celiac disease patients (n = 1293) to a control group (n = 1401) with abdominal pain or reflux.
RESULTS: Among all patients the mean age was 48.4 years, most were female (69.5%), and 22.7% used any psychotropic medication. There was no difference between overall psychotropic medication use among celiac disease patients and controls (23.9% vs 21.8%, OR 1.16; 95% CI 0.96-1.39, p = 0.12). However, those with celiac disease were more likely to use antidepressants on univariate (16.4% vs 13.4%, p = 0.03) and multivariate analysis (OR 1.28; 95% CI 1.03-1.59; p = 0.03). Use of psychotropic medications was not associated with disease duration or mode of presentation of celiac disease.
CONCLUSIONS: Celiac disease patients use psychotropic medications at similar rates as those with other gastrointestinal diseases, though subgroup analysis suggests they may use more antidepressants. Future studies should investigate whether celiac disease is associated with mood disorders that are not treated with medications.

PMID: 29580225 [PubMed - indexed for MEDLINE]

Persistent mucosal damage and risk of epilepsy in people with celiac disease.

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Persistent mucosal damage and risk of epilepsy in people with celiac disease.

Eur J Neurol. 2018 03;25(3):592-e38

Authors: Kurien M, Ludvigsson JF, Sanders DS, Zylberberg HM, Green PH, Sundelin HEK, Lebwohl B

Abstract
BACKGROUND AND PURPOSE: Celiac disease (CD) is associated with an increased risk of developing epilepsy, a risk that persists after CD diagnosis. A significant proportion of patients with CD have persistent villous atrophy (VA) on follow-up biopsy. The objective of this study was to determine whether persistent VA on follow-up biopsy affected long-term epilepsy risk and epilepsy-related hospital emergency admissions.
METHODS: This was a nationwide cohort study. We identified all people in Sweden with histological evidence of CD who underwent a follow-up small intestinal biopsy (1969-2008). We compared those with persistent VA with those who showed histological improvement, assessing the development of epilepsy and related emergency hospital admissions (defined according to relevant International Classification of Diseases codes in the Swedish Patient Register). Cox regression analysis was used to assess outcome measures.
RESULTS: Villous atrophy was present in 43% of 7590 people with CD who had a follow-up biopsy. The presence of persistent VA was significantly associated with a reduced risk of developing newly-diagnosed epilepsy (hazard ratio, 0.61; 95% confidence interval, 0.38-0.98). On stratified analysis, this effect was primarily amongst males (hazard ratio, 0.35; 95% confidence interval, 0.15-0.80). Among the 58 patients with CD with a prior diagnosis of epilepsy, those with persistent VA were less likely to visit an emergency department with epilepsy (hazard ratio, 0.37; 95% confidence interval, 0.09-1.09).
CONCLUSIONS: In a population-based study of individuals with CD, persisting VA on follow-up biopsy was associated with reduced future risk of developing epilepsy but did not influence emergency epilepsy-related hospital admissions. The mechanism as to why persistent VA confers this benefit requires further exploration.

PMID: 29316034 [PubMed - indexed for MEDLINE]

Common shared genetic variation behind decreased risk of breast cancer in celiac disease.

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Common shared genetic variation behind decreased risk of breast cancer in celiac disease.

Sci Rep. 2017 07 19;7(1):5942

Authors: Ugalde-Morales E, Li J, Humphreys K, Ludvigsson JF, Yang H, Hall P, Czene K

Abstract
There is epidemiologic evidence showing that women with celiac disease have reduced risk of later developing breast cancer, however, the etiology of this association is unclear. Here, we assess the extent of genetic overlap between the two diseases. Through analyses of summary statistics on densely genotyped immunogenic regions, we show a significant genetic correlation (r = -0.17, s.e. 0.05, P < 0.001) and overlap (P permuted < 0.001) between celiac disease and breast cancer. Using individual-level genotype data from a Swedish cohort, we find higher genetic susceptibility to celiac disease summarized by polygenic risk scores to be associated with lower breast cancer risk (ORper-SD, 0.94, 95% CI 0.91 to 0.98). Common single nucleotide polymorphisms between the two diseases, with low P-values (P CD < 1.00E-05, P BC ≤ 0.05), mapped onto genes enriched for immunoregulatory and apoptotic processes. Our results suggest that the link between breast cancer and celiac disease is due to a shared polygenic variation of immune related regions, uncovering pathways which might be important for their development.

PMID: 28725034 [PubMed - indexed for MEDLINE]

Celiac Disease in Asia.

Celiac Disease in Asia.

Gastroenterol Clin North Am. 2019 Mar;48(1):101-113

Authors: Makharia GK, Catassi C

Abstract
Celiac disease, once thought to be very uncommon in Asia, is now emerging in many Asian countries. Although the absolute number of patients with celiac disease at present is not very high, this number is expected to increase markedly over the next few years/decades owing to increasing awareness. It is now that the medical community across the Asia should define the extent of the problem and prepare to handle the impending epidemic of celiac disease in Asia.

PMID: 30711203 [PubMed - in process]

Epidemiology of Celiac Disease.

Epidemiology of Celiac Disease.

Gastroenterol Clin North Am. 2019 Mar;48(1):1-18

Authors: Ludvigsson JF, Murray JA

Abstract
Celiac disease is a common, chronic inflammatory disorder of the small intestine triggered by exposure to gluten in individuals with certain genetic types. This disorder affects people of any age or gender. Although often thought to be European in origin, it is now global in extent. Presentations are variable, from asymptomatic patients to severe malnutrition. Initial detection usually relies on celiac-specific serology, and confirmation often requires intestinal biopsy. There have been substantial increases in prevalence and incidence over the last 2 decades for reasons that are almost certainly environmental but for which there is no clarity as to cause.

PMID: 30711202 [PubMed - in process]

Preteen children's health related quality of life in Sweden: changes over time and disparities between different sociodemographic groups.

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Preteen children's health related quality of life in Sweden: changes over time and disparities between different sociodemographic groups.

BMC Public Health. 2019 Jan 31;19(1):139

Authors: Baroudi M, Petersen S, Namatovu F, Carlsson A, Ivarsson A, Norström F

Abstract
BACKGROUND: Assessing disparities in health-related quality of Life (HRQoL) is important as a part of health-related disparities in the society. The aim of this study was to explore HRQoL among 12-year-olds in Sweden in terms of differences between years 2005 and 2009 and disparities related to sociodemographic background.
METHODS: During the school years 2005 and 2009, a total of 18,325 sixth grade students in Sweden were invited to a celiac disease screening study; 13,279 agreed to participate. Jointly with the celiac screening, the children answered a questionnaire that included EuroQol 5 Dimensions-youth (EQ-5D-Y) and their parents responded to separate questionnaires about their own and their child's country of birth, family structure, their employment status, occupation, and education. In total 11,009 child-parent questionnaires were collected. Logistic regression was used to study differences in HRQoL between 2005 and 2009, and between various sociodemographic subgroups.
RESULTS: Compared with 2005, children in 2009 reported more pain (OR: 1.20, 95% CI: 1.1-1.3) and more mood problems (OR: 1.35, 95% CI: 1.2-1.5). In general, girls reported more pain and mood problems and had more disparities than boys. There were no significant differences based on parents' occupation, however, children of parents with low or medium education levels reported less "mood problems" than those of parents with high education levels (OR: 0.65, 95% CI: 0.46-0.92) and (OR: 0.84, 95% CI: 0.73-0.96), respectively. A slight variation was seen in HRQoL between children with different migration background. Girls living in small municipalities reported more pain (OR: 1.51, 95% CI: 1.14-2.01), and problems performing usual activities (OR: 3.77, 95% CI: 2.08-6.84), compared to girls living in large municipalities. In addition, children living with two parents had less mood problems than children living in other family constellations.
CONCLUSION: More children reported pain and mood problems in 2009 compared with 2005. To study future trends, health outcomes among children in Sweden should continue to be reported periodically. More efforts should be invested to increase the awareness of health-related disparities as highlighted in this study especially for girls living in small municipalities and children of parents with high education level.

PMID: 30704442 [PubMed - in process]

Cohort profile: ESPRESSO (Epidemiology Strengthened by histoPathology Reports in Sweden).

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Cohort profile: ESPRESSO (Epidemiology Strengthened by histoPathology Reports in Sweden).

Clin Epidemiol. 2019;11:101-114

Authors: Ludvigsson JF, Lashkariani M

Abstract
The ESPRESSO study constitutes a novel approach to examine the etiology and prognosis of gastrointestinal disease in which histopathology plays a prominent role. Between 2015 and 2017, all pathology departments (n=28) in Sweden were contacted and asked to procure histopathology record data from the gastrointestinal tract (pharynx to anus), liver, gallbladder, and pancreas. For each individual, local histopathology IT personnel retrieved data on personal identity number, date of histopathology, topography (where the biopsy is taken), morphology (biopsy appearance), and where available free text. In total, between 1965 and 2017, histopathology record data were available in 2.1 million unique individuals, but the number of data entries was 6.1 million because more than one biopsy was performed in many of the study participants. Index individuals with histopathology data were matched with up to five controls from the general population. We also identified all first-degree relatives (parents, children, full siblings), and the index individual's first spouse. The total study population consisted of 13.0 million individuals. Data from all the study participants have been linked to Swedish National Healthcare Registers allowing research not only on such aspects as fetal and perinatal conditions and the risk of future gastrointestinal disease but also on the risk of comorbidity and complications (including cancer and death). Furthermore, the ESPRESSO database allows researchers and practitioners to identify diagnoses and disease phenotypes not currently indexed in national registers (including disease precursors). The ESPRESSO database increases the sensitivity and specificity of already-recorded diseases in the national health registers. This paper is an overview of the ESPRESSO database.

PMID: 30679926 [PubMed]

Celiac plexus block increases quality of life in patients with pancreatic cancer.

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Celiac plexus block increases quality of life in patients with pancreatic cancer.

J Pain Res. 2019;12:307-315

Authors: Molnár I, Hegyi G, Zsom L, Saahs C, Vagedes J, Kapócs G, Kovács Z, Sterner MG, Szőke H

Abstract
Background: Pancreatic cancer is a malignant disease with a high mortality rate and severe pain that is challenging to manage. To reduce the excruciating abdominal pain, opioids and adjuvant agents are conventionally used.
Objectives: PRNCPB is a treatment of neural therapy. The number of studies assessing the effect on patients' QoL is limited and inconsistent. With this study, we intended to address this issue.
Study design: A prospective nonrandomized study with a series of cases of unresectable pancreatic cancer was conducted.
Setting: The study was performed at our pain clinic under real life conditions.
Materials and methods: A total number of 16 patients with severe abdominal pain were enrolled in the study all of whom had responded to combined systemic analgesic therapy inadequately and had intolerable side effects contraindicating further increase in dose. The efficacy of this invasive, palliative analgesic procedure was evaluated 35 days after PRNCPB was performed. Primary outcomes were changed in pain intensity using the VAS questionnaire. Secondary outcomes were improved in QoL using the SF-36 questionnaire. Changes in pain medications and adverse reactions were monitored.
Results: After PRNCPB patients experienced a significant decrease (P=0.002) in pain intensity as shown by the VAS score, and a decreased opiate demand. Their QoL scores considering effect sizes also improved (P<0.001). No complications attributable to PRNCPB were observed during the study period. Additionally, no adverse drug reactions were observed.
Limitations: Detection, observation, and reporting bias can be estimated as moderate. Selection bias was not detected.
Conclusion: Our results give preliminary evidence that PRNCPB might be helpful as an additional treatment to conventional pain management in end-stage pancreatic cancer patients. PRNCPB seems to improve QoL in these patients in a time frame of at least 5 weeks after intervention.

PMID: 30679920 [PubMed]

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