Articles producció científica> Medicina i Cirurgia

Prospective longitudinal study: use of faecal gluten immunogenic peptides to monitor children diagnosed with coeliac disease during transition to a gluten-free diet

  • Datos identificativos

    Identificador: imarina:5628997
    Autores:
    Comino, IsabelSegura, VeronicaOrtigosa, LuisEspin, BeatrizCastillejo, GemmaAntonio Garrote, JoseSierra, CarlosMillan, AntonioRibes-Koninckx, CarmenRoman, EnriquetaRodriguez-Herrera, AlfonsoDiaz, JacoboSilvester, Jocelyn AnneCebolla, AngelSousa, Carolina
    Resumen:
    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 disea
  • Otros:

    Autor según el artículo: 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;
    Departamento: Medicina i Cirurgia
    Autor/es de la URV: Castillejo De Villasante, Gemma
    Palabras clave: Transglutaminase Quality-of-life Mucosal recovery Management Guidelines Food Follow-up Antibodies Adults Adherence
    Resumen: 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.
    Áreas temáticas: Pharmacology (medical) Pharmacology & pharmacy Odontología Medicina ii Medicina i Hepatology General medicine Gastroenterology & hepatology Gastroenterology Ciências biológicas ii
    Acceso a la licencia de uso: https://creativecommons.org/licenses/by/3.0/es/
    ISSN: 02692813
    Direcció de correo del autor: gemma.castillejo@urv.cat
    Fecha de alta del registro: 2023-02-22
    Versión del articulo depositado: info:eu-repo/semantics/publishedVersion
    Enlace a la fuente original: https://onlinelibrary.wiley.com/doi/full/10.1111/apt.15277
    Referencia al articulo segun fuente origial: Alimentary Pharmacology & Therapeutics. 49 (12): 1484-1492
    Referencia de l'ítem segons les normes 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
    URL Documento de licencia: https://repositori.urv.cat/ca/proteccio-de-dades/
    DOI del artículo: 10.1111/apt.15277
    Entidad: Universitat Rovira i Virgili
    Año de publicación de la revista: 2019
    Tipo de publicación: Journal Publications
  • Palabras clave:

    Gastroenterology,Gastroenterology & Hepatology,Hepatology,Pharmacology & Pharmacy,Pharmacology (Medical)
    Transglutaminase
    Quality-of-life
    Mucosal recovery
    Management
    Guidelines
    Food
    Follow-up
    Antibodies
    Adults
    Adherence
    Pharmacology (medical)
    Pharmacology & pharmacy
    Odontología
    Medicina ii
    Medicina i
    Hepatology
    General medicine
    Gastroenterology & hepatology
    Gastroenterology
    Ciências biológicas ii
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