Author, as appears in the article.: Comino, Isabel; Segura, Veronica; Ortigosa, Luis; Espin, Beatriz; Castillejo, Gemma; Antonio Garrote, Jose; Sierra, Carlos; Millan, Antonio; Ribes-Koninckx, Carmen; Roman, Enriqueta; Rodriguez-Herrera, Alfonso; Diaz, Jacobo; Silvester, Jocelyn Anne; Cebolla, Angel; Sousa, Carolina;

Department: Medicina i Cirurgia

URV's Author/s: Castillejo De Villasante, Gemma

Keywords: Transglutaminase Quality-of-life Mucosal recovery Management Guidelines Food Follow-up Antibodies Adults Adherence

Abstract: Background Treatment for coeliac disease is a lifelong strict gluten-free diet. Although guidelines recommend regular follow-up with dietary interviews and coeliac serology, these methods may be inaccurate. Aim To evaluate the usefulness of faecal gluten immunogenic peptides to support the diagnosis and to determine the adherence to the gluten-free diet in coeliac children. Methods Multicentre prospective observational study including 64 coeliac children. Faecal gluten peptides, and tissue transglutaminase and deamidated gliadin peptide antibodies were analyzed at diagnosis, and 6, 12 and 24 months thereafter. Gluten consumption was estimated from gluten peptide levels. Results Most children (97%) had detectable gluten peptides at diagnosis. On a gluten-free diet, the rate of gluten peptides increased from 13% at 6 months to 25% at 24 months. Mean estimated gluten exposure dropped from 5543 mg/d at diagnosis to 144 mg/d at 6 months, then increased to 606 mg/d by 24 months. In contrast, deamidated gliadin peptide antibodies normalised and only 20% had elevated tissue transglutaminase antibody by 24 months. The elevation of tissue transglutaminase antibody was more prolonged in patients with detectable gluten peptides (P < 0.05). Nevertheless, absolute levels of tissue transglutaminase antibody had low sensitivity to identify patients with detectable gluten peptides (P > 0.1). Dietitian assessment was only moderately correlated with gluten peptide detection (kappa = 0.5). Conclusions Faecal gluten peptides testing may guide treatment of coeliac disease prior to diagnosis and during the assessment diet adherence. Further studies could determine if early identification of gluten exposure reduces the need for expensive/invasive investigations for non-responsive coeliac disease. ClinicalTrials.gov Number: NCT02711397.

Thematic Areas: Pharmacology (medical) Pharmacology & pharmacy Odontología Medicina ii Medicina i Hepatology General medicine Gastroenterology & hepatology Gastroenterology Ciências biológicas ii

licence for use: https://creativecommons.org/licenses/by/3.0/es/

ISSN: 02692813

Author's mail: gemma.castillejo@urv.cat

Record's date: 2023-02-22

Papper version: info:eu-repo/semantics/publishedVersion

Link to the original source: https://onlinelibrary.wiley.com/doi/full/10.1111/apt.15277

Licence document URL: http://repositori.urv.cat/ca/proteccio-de-dades/

Papper original source: Alimentary Pharmacology & Therapeutics. 49 (12): 1484-1492

APA: Comino, Isabel; Segura, Veronica; Ortigosa, Luis; Espin, Beatriz; Castillejo, Gemma; Antonio Garrote, Jose; Sierra, Carlos; Millan, Antonio; Ribes-Kon (2019). Prospective longitudinal study: use of faecal gluten immunogenic peptides to monitor children diagnosed with coeliac disease during transition to a gluten-free diet. Alimentary Pharmacology & Therapeutics, 49(12), 1484-1492. DOI: 10.1111/apt.15277

Article's DOI: 10.1111/apt.15277

Entity: Universitat Rovira i Virgili

Journal publication year: 2019

Publication Type: Journal Publications