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Gene links to celiac disease may help drug search
LONDON
Sun Feb 28, 2010 1:02pm EST
Related News
LONDON (Reuters) - Scientists have identified new genetic links to celiac disease and say their findings could speed the search for better ways to diagnose and treat the gluten-intolerance disorder.
Health
British researchers scanned the genetic maps of more than 9,400 celiac patients and found areas of immune system disturbance which lead to the development of the auto-immune disease, which affects around one percent of people.
The researchers also found "substantial evidence" that genes associated with celiac disease may also be linked to many other common chronic immune diseases, such as type 1 diabetes and rheumatoid arthritis.
"We can now shed light on some of the precise immune disturbances leading to celiac disease," said David van Heel, a professor of gastrointestinal genetics at Barts and The London School of Medicine and Dentistry, who led an international team of researchers in conducting the study.
Celiac disease is a digestive disorder caused by an abnormal immune response to gluten, a protein found in wheat, rye and barley and many other everyday items like medicines and vitamins. The disease damages structures in the lining of the small intestine called villi, impairing the body's absorption of nutrients.
It can lead to severe health problems including anemia, poor bone health, fatigue and weight loss. There is no cure, and the only treatment is a life-long gluten-free diet.
Van Heel said his findings meant scientists could now see that many of the genetic risk factors for celiac disease work by altering the amount of immune system genes made by cells.
"The data also suggests that celiac disease is made up of hundreds of genetic risk factors, we can have a good guess at nearly half of the genetic risk at present," he wrote in the study published in the Nature Genetics journal on Sunday.
(Reporting by Kate Kelland)
http://www.reuters.com/article/idUSTRE61R27P20100228
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Gene links to celiac disease may help drug search
Sun Feb 28, 2010
LONDON (Reuters) - Scientists have identified new genetic links to celiac disease and say their findings could speed the search for better ways to diagnose and treat the gluten-intolerance disorder.
Health
British researchers scanned the genetic maps of more than 9,400 celiac patients and found areas of immune system disturbance which lead to the development of the auto-immune disease, which affects around one percent of people.
The researchers also found "substantial evidence" that genes associated with celiac disease may also be linked to many other common chronic immune diseases, such as type 1 diabetes and rheumatoid arthritis.
"We can now shed light on some of the precise immune disturbances leading to celiac disease," said David van Heel, a professor of gastrointestinal genetics at Barts and The London School of Medicine and Dentistry, who led an international team of researchers in conducting the study.
Celiac disease is a digestive disorder caused by an abnormal immune response to gluten, a protein found in wheat, rye and barley and many other everyday items like medicines and vitamins. The disease damages structures in the lining of the small intestine called villi, impairing the body's absorption of nutrients.
It can lead to severe health problems including anemia, poor bone health, fatigue and weight loss. There is no cure, and the only treatment is a life-long gluten-free diet.
Van Heel said his findings meant scientists could now see that many of the genetic risk factors for celiac disease work by altering the amount of immune system genes made by cells.
"The data also suggests that celiac disease is made up of hundreds of genetic risk factors, we can have a good guess at nearly half of the genetic risk at present," he wrote in the study published in the Nature Genetics journal on Sunday.
(Reporting by Kate Kelland)
http://www.reuters.com/article/idUSTRE61R27P20100228
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Celiac disease may strike elderly, too
Fri Jul 24, 2009
NEW YORK (Reuters Health) - Celiac disease doesn't only affect the young, new research from Finland confirms, but can strike a person for the first time in later life.
Health
In people with celiac disease, eating gluten-a protein found in many types of grain-causes the immune system to launch an attack on the small intestine. This can eventually damage the organ and lead to poor absorption of nutrients, especially fat. But people with celiac disease who cut gluten out of their diet can avoid symptoms and complications.
It's now possible to use blood tests to determine whether or not a person has celiac disease, which affects over 1% of Western populations, Dr. Anitta Vilppula of Päijät-Häme Central Hospital in Lahti and her colleagues note. In the United States, celiac disease is four times more common now than it was in the 1950s. (See Reuters Health eLine report, July 10, 2009.)
While people may think of the condition as a problem for children and young adults, they add, Vilppula and her team recently identified cases of celiac disease in elderly people. In some individuals, the condition had not been detected.
In the current study, the researchers investigated whether some older people had actually developed celiac disease later in their lives, or the disease had simply gone undetected. They looked at 2,815 people over 55 who had undergone blood tests for celiac disease in 2002, 2,216 of whom were screened again in 2005. The researchers also did biopsies of patients' small intestines to confirm the blood test findings.
In 2002, 2.13% of the study participants had biopsy-confirmed celiac disease, while 2.34% did in 2005. There were five new cases among people whose blood tests had initially been negative for the disease, and only two of these individuals had symptoms. That led the researchers to conclude that the elderly could develop the disease late in life.
Past research has shown that undetected celiac disease can lead to significant health problems in older people, the researchers note; in one study including 35 people 60 and older, 15 had been seeing their doctor for 28 years, on average, with symptoms without being diagnosed.
Doctors should be aware of the possibility that their older patients may have or develop celiac disease, Vilppula and colleagues say, and they should use blood tests to confirm the diagnosis-even though a negative test doesn't mean a person won't develop the condition later on.
SOURCE: BMC Gastroenterology, online June 29, 2009.
http://www.reuters.com/article/idUSTRE56N6BZ20090724
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April 8, 2010
Can You Be Intolerant to Foods Like Pasta?
By THE NEW YORK TIMES
Hundreds of readers had comments and questions for the New York Times Consults blog when the topic turned to celiac disease, an often overlooked digestive disorder that causes a range of problems, from infertility and anemia to digestive upset, when susceptible people eat gluten-rich foods like bread or pasta containing wheat, barley or rye.
Here, Dr. Sheila Crowe, a professor in the division of gastroenterology and hepatology in the department of medicine at the University of Virginia, responds to readers who asked whether you can be intolerant to gluten, the way some people might be intolerant to milk, without having full-blown celiac disease.
Intolerant to Gluten Without Having Celiac Disease?
Q.
What is your take on non-celiac gluten intolerance? There are some medical professionals who say that without the definitive markers of celiac disease (blunt villi, positive blood work), there is no reason to ever change to a gluten-free diet.
Could it be that the markers only become evident after a certain degree of damage and ill heath has been attained, and that celiac is really part of a spectrum of disease relating to the body's reaction to gluten? Thank you.
N Whittemore
Q.
Can Dr. Crowe address briefly gluten intolerance? Although the symptoms are not as severe as those that celiacs experience, they are serious.
Does intolerance lead inevitably to celiac disease, and does the intolerance ever disappear over time, with healing? Many thanks.
Katalin
A.
Dr. Sheila Crowe responds:
Your comments and queries introduce a very important and somewhat controversial topic: gluten sensitivity, sometimes referred to as gluten intolerance. In fact, as testimony to how difficult it is to discuss the issue of gluten sensitivity, my co-author Ian Blumer and I decided not to include this topic in our recently published book "Celiac Disease for Dummies" (John Wiley and Sons, Canada). Relatively little high quality research has been conducted on the topic, and much more needs to be learned.
To start, even trying to define gluten sensitivity is difficult. Some experts reserve this term for cases in which symptoms of celiac disease are present but the intestinal biopsy remains normal. This definition separates celiac disease from gluten sensitivity based on the biopsy results. Other experts use the term gluten sensitivity to take into account the various gluten-dependent symptoms that can occur outside the digestive tract, even in patients with apparently normal intestinal biopsies.
Another view of gluten sensitivity encompasses a spectrum of conditions that range from classical celiac disease, with its intestinal abnormalities, to a syndrome in which avoidance of gluten in the diet leads to resolution of symptoms that resemble those of irritable bowel syndrome.
Between these extremes are individuals who have abnormal immune system (antibody) responses to gluten but who do not have abnormal intestinal findings on biopsies. (See my earlier post, "Confirming a Diagnosis of Celiac Disease," for more on antibody findings.) By this definition of gluten sensitivity, as long as someone has abnormal biopsies or antibody tests, or clinical symptoms that respond to excluding gluten from the diet, one can consider the disorder as a case of gluten sensitivity. Most specialists, however, exclude those with celiac disease — that is, those who have intestinal biopsy abnormalities — from the rest of the gluten-sensitive patients.
It is unknown how gluten causes symptoms in some of the gluten sensitive syndromes other than celiac disease. Most cases do not involve abnormal T-cell responses, as in celiac disease. Damage to neurological tissue may be because of other types of immune responses to gluten, and some scientists have postulated that the components of gluten may be toxic for some. Gluten has also been thought to cause a condition known as "leaky gut." These putative mechanisms, however, are only theories without solid scientific backing at this time.
To add confusion to an already complex problem, studies show that some gluten-sensitive patients who do not have abnormal biopsies have abnormal celiac disease antibodies, while others do not. Very often, the antibody type that is abnormal is the antigliadin antibody, particularly the IgG class of antibody, while the TTG antibody is often negative or normal. (Again, see my earlier post, "Confirming a Diagnosis of Celiac Disease.")
Genetic testing, which I discussed previously in "Genetic Testing for Celiac Disease," is also variable in patients with gluten sensitivity. Some individuals who are gluten sensitive with normal biopsies have the H.L.A. DQ2 or DQ8 genes that place them at risk of celiac disease, while others do not have these genes. These findings further suggest that being gluten sensitive is not one condition but most likely several different disorders that probably have different long-term outcomes and that may respond to different kinds of treatments.
Celiac Disease or Gluten Intolerance?
Q.
I would like to know how the diagnosis is made between having celiac disease and just being "intolerant" to gluten. Intolerant is the diagnosis my friend got, so she eats low doses. Further, can you ever "recover" to the point of being able to eat some gluten, i.e., just being "intolerant"?
Holly
Q.
Is there evidence for a "mild gluten intolerance," similar to mild lactose intolerance?
I was trained as a dietitian many years ago, and like other health care professionals, I was taught that celiac disease was a severe reaction/intolerance to any small amount of gluten. I now realize that I have celiac. I've done an elimination diet, and my symptoms — bloating and mild cramping — receded. I do not have more extreme symptoms, like diarrhea, vomiting, eczema, anemia, etc. Occasionally, I can eat a small amount of wheat without symptoms. But I can't figure out why.
There is also a rumor that "older varieties of wheat" do not cause symptoms. Has anyone tested/studied this assertion?
Rose
Q.
Is it possible to be wheat or gluten intolerant, but not have celiac disease?
After having the stomach biopsy, my daughter tested negative for celiac, but she feels better if she doesn't eat wheat. If she is wheat/gluten "intolerant," can this cause organ damage, etc., in the same way as celiac disease?
Should she be as careful as someone who has tested positive for celiac? Many thanks.
Jane
A.
Dr. Sheila Crowe responds:
Holly, Rose and Jane all touch upon the important issue of how to best treat people with gluten sensitivity or gluten intolerance. Should they all be totally gluten-free or partly gluten-free? And does gluten actually harm them in the long run?
The bottom line is that no one really knows. Part of the problem is that it depends on what type of gluten sensitivity we are dealing with. Another concern is that there are no long-term, rigorously conducted scientific studies to tell us whether a specific diet or another treatment is helpful, harmful or makes no difference to gluten sensitive patients.
We know from many other studies that patients with digestive disorders like irritable bowel syndrome, or I.B.S., often feel better when taking placebos. This makes it difficult to show that a test drug or treatment, such as a gluten-free diet, has a real effect. My clinical experience suggests that quite a few patients with I.B.S. get better on a gluten-free diet, but this can be because of factors other than the harmful effects of gluten.
Gluten can be harder to digest than some other proteins in grains. Going gluten-free, as anyone who has tried this diet knows, eliminates lots of other factors from the diet. Most individuals on a gluten-free diet give up fast-food, prepared foods and packaged foods and instead eat more natural, fresh foods that are often prepared in the home. Feeling better may not necessarily be a result of excluding gluten in this setting. However, gluten may be causing problems in some people.
So how do we know who really needs to be gluten-free?
It depends on the type of patient. Some patients have symptoms of celiac disease but do not have an abnormal intestinal biopsy that is taken before starting a gluten-free diet (by definition, they are not categorized as having celiac disease). If blood tests show that such patients also have antibodies to tissue transglutaminase (TTG) or deamidated gliadin peptide (DGP), I would suggest that these individuals consider going on a truly gluten-free diet, since they are most likely on their way to celiac disease. The same advice could apply to those who have H.L.A. DQ2 or DQ8 genes without elevated antibodies, though in this case the recommendation is more ambiguous, since there are no immune abnormalities or intestinal damage.
Another scenario is the patient without an abnormal intestinal biopsy but who has neurological symptoms and an elevated antigliadin antibody (AGA). These individuals may not ever get celiac disease, but removing gluten from the diet may benefit their neurological problems.
For my patients without intestinal biopsy abnormalities, without celiac disease antibodies (including AGA IgG) and without H.L.A. celiac disease susceptibility (DQ2 or DQ8 genes), I advise a gluten-free diet only to control symptoms. Often these individuals can return to including gluten in their diets. This scenario likely applies to Holly's friend and to Rose. I would need more information, including antibody test results and genetic test results, to answer Jane's questions about her daughter.
I hope that, with time, we will understand gluten sensitivity better. It is likely that better defined subgroups of gluten sensitivity will emerge, which will allow us to make clearer recommendations for diagnosis and treatment.
http://consults.blogs.nytimes.com/2010/04/08/can-you-be-intolerant-to-foods-like-pasta/
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From Medscape Medical News
Celiac Disease Diagnosis Up 4-Fold Worldwide
Megan Brooks
July 30, 2010 — Studies from the United States, Europe, and elsewhere indicate that the prevalence of celiac disease (CD) has increased significantly in the last 3 decades — possibly by as much as a factor of 4.
"More and more studies indicate a prevalence of CD of more than 1% in both adults and children. This should be compared with lower prevalence figures [from] 20 to 30 years ago," Jonas Ludvigsson, MD, from the Department of Medicine, Epidemiology Unit, at the Karolinska Institute and Orebro University Hospital, Sweden, and an expert in CD, noted in an email to Medscape Medical News.
"The reason for this increase is mutlifactorial, but there is probably a true underlying increase. This has been shown when old sera have been analyzed with modern techniques, (eg, in Finland)," Dr. Ludvigsson pointed out.
Mayo Clinic Research Confirms Rise in CD
Researchers at the Mayo Clinic also report an increase in CD, according to an article in the summer issue of the Mayo Clinic's research magazine Discovery's Edge. Joseph Murray, MD, and colleagues analyzed stored blood samples, taken from Air Force recruits in the early 1950s, for gluten antibodies. They assumed that 1% would be positive, mirroring today's rate. That assumption was wrong — the number of positive results was far smaller, indicating that CD was "rare," Dr. Murray noted in the article.
This led him and his colleagues to compare those results with 2 more recently collected sets from Olmsted County, Minnesota. Their findings suggest that CD is roughly 4 times more common now than in the 1950s.
"This tells us that whatever has happened with CD has happened since 1950," Dr. Murray said. "This increase has affected young and old people. It suggests something has happened in a pervasive fashion from the environmental perspective," he added.
Excess Mortality Seen With CD and Latent CD
Recent research by Dr. Ludvigsson's team (JAMA. 2009;302:1171-1178) and others supports the concept of "latent CD" or "gluten sensitivity." Latent CD, defined in the Journal of the American Medical Association study by Dr. Ludvigsson's team as having normal small intestinal mucosa but positive CD serology, is something that is estimated to occur in at least 1 in 1000 individuals.
Dr. Ludvigsson's team has also reported evidence that in 1 year, 10 of 1000 individuals with CD will die compared with an expected 7 in 1000 without the disease.
"Not only is the mortality raised in patients with [CD] but also in those individuals with latent [CD]," Dr. Ludvigsson noted in a statement from the United European Gastroenterology Federation.
However, in comments to Medscape Medical News, he emphasized that "although patients with CD are at increased risk of a number of disorders, and at increased risk of death, the absolute risk increase is very small."
A Tricky Disease
CD remains a "tricky disease," Dr. Ludvigsson said. "It can be asymptomatic; have so-called traditional symptoms such as diarrhea, weight loss, failure to grow (in children), fatigue, and malnutrition; and have nontraditional symptoms such as osteoporosis, depression, adverse pregnancy outcome; and increased risks of both malignancy and death."
The onset of certain autoimmune disorders including autoimmune liver disease, thyroid disease, type 1 diabetes, and Addison's disease can actually signal CD, he noted. "This means that clinicians should consider CD in a number of symptoms and disorders."
CD Often Undetected; Cause Unknown
CD often goes undetected, although the percentage of undetected cases varies between countries, Dr. Ludvigsson noted. "In most countries, at least two thirds of individuals with CD have not received a diagnosis by a doctor." The reason for the high percentage of undetected disease is that the disease can be difficult to diagnose, and "it is sometimes almost asymptomatic," he added.
Detection Methods Are Improving
Over the years, Dr. Ludvigsson told Medscape Medical News, "we have improved existing means to diagnose CD. Antibody tests are becoming better and better, although a positive antibody test should be confirmed with a small intestinal biopsy before the diagnosis is certain. Transient increases in CD antibody levels occur. In the future, I expect microscopy in the very small intestine to become a tool for diagnosis."
Alternatives to the Gluten-Free Diet?
At this time, Dr. Ludvigsson said, the gluten-free diet remains the cornerstone of treatment for CD. However, "in the future, alternative treatment strategies may be available. The recent discovery of the structure of transglutaminase 2 may help in designing inhibitors of transglutaminase 2 to treat CD," he said. "Another potential treatment strategy is to ingest enzymes that digest gluten, thereby increasing the safe threshold for gluten intake.
"There is also ongoing research on the topic of decreasing the bowel's permeability to gluten, Dr. Ludvigsson told Medscape Medical News. He added, however, that the safety of this approach is unclear, as "a decreased permeability here might mean that the body cannot absorb other needed substances.
"Finally, agricultural research may mean that we can modify the gluten structure in wheat produce a kind of wheat that will not illicit an immune response in patients with CD," the researcher noted.
Counseling CD Patients Is Important
Although evidence is scarce, said Dr. Ludvigsson, "most researchers believe that a gluten-free diet will reduce the risk of complications/comorbidity in CD, and it is important for the doctor to underline this for the patients. In patients with CD who do not become better on a gluten-free diet, the most common reason is probably that the patients do not eat a strictly gluten-free diet," he said.
Dr. Murray advocates greater vigilance in CD patients. "It's not enough to say, 'You've got CD, be gluten-free, goodbye,' " he said. "CD requires medical follow-up."
This October, at the United European Gastroenterology Week in Barcelona, Spain, Dr. Ludvigsson will be 1 of 8 researchers to receive the Association of National European and Mediterranean Societies of Gastroenterology and United European Gastroenterology Federation Rising Stars award.
http://www.medscape.com/viewarticle/726127
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Am J Gastroenterol. 2011 Jan 11. [Epub ahead of print]
Gluten Causes Gastrointestinal Symptoms in Subjects Without Celiac Disease: A Double-Blind Randomized Placebo-Controlled Trial.
Biesiekierski JR, Newnham ED, Irving PM, Barrett JS, Haines M, Doecke JD, Shepherd SJ, Muir JG, Gibson PR.
Monash University Department of Medicine and Gastroenterology, Box Hill Hospital, Box Hill, Victoria, Australia.
Abstract
OBJECTIVES: Despite increased prescription of a gluten-free diet for gastrointestinal symptoms in individuals who do not have celiac disease, there is minimal evidence that suggests that gluten is a trigger. The aims of this study were to determine whether gluten ingestion can induce symptoms in non-celiac individuals and to examine the mechanism.
METHODS: A double-blind, randomized, placebo-controlled rechallenge trial was undertaken in patients with irritable bowel syndrome in whom celiac disease was excluded and who were symptomatically controlled on a gluten-free diet. Participants received either gluten or placebo in the form of two bread slices plus one muffin per day with a gluten-free diet for up to 6 weeks. Symptoms were evaluated using a visual analog scale and markers of intestinal inflammation, injury, and immune activation were monitored.
RESULTS: A total of 34 patients (aged 29-59 years, 4 men) completed the study as per protocol. Overall, 56% had human leukocyte antigen (HLA)-DQ2 and/or HLA-DQ8. Adherence to diet and supplements was very high. Of 19 patients (68%) in the gluten group, 13 reported that symptoms were not adequately controlled compared with 6 of 15 (40%) on placebo (P=0.0001; generalized estimating equation). On a visual analog scale, patients were significantly worse with gluten within 1 week for overall symptoms (P=0.047), pain (P=0.016), bloating (P=0.031), satisfaction with stool consistency (P=0.024), and tiredness (P=0.001). Anti-gliadin antibodies were not induced. There were no significant changes in fecal lactoferrin, levels of celiac antibodies, highly sensitive C-reactive protein, or intestinal permeability. There were no differences in any end point in individuals with or without DQ2/DQ8.
CONCLUSIONS: "Non-celiac gluten intolerance" may exist, but no clues to the mechanism were elucidated.Am J Gastroenterol advance online publication, 11 January 2011; doi:10.1038/ajg.2010.487.
PMID: 21224837 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/21224837?dopt=Abstract
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More People May Benefit From Going Gluten-Free
Related Health News
SUNDAY, May 8 (HealthDay News) -- People at risk for celiac disease ought to be screened for the disorder, even if they show no symptoms, a new study suggests.
Celiac disease is a disorder that causes digestive problems in the small intestine when the person consumes gluten, a protein found in wheat, rye and barley. The number of U.S. residents with the disease has grown rapidly in recent decades, but, according to the study authors, an estimated 2 million people have the disease but do not know it.
For the study, researchers screened 3,031 healthy people who were related to someone with celiac disease, but had no symptoms themselves, and selected 40 people who tested positive for antibodies specific to celiac disease. By random selection, members of that group were either put on a gluten-free diet or told to continue with their normal diet, containing gluten.
People on a gluten-free diet reported improved gastrointestinal health as well as an overall improvement in their health-related quality of life, compared with the others, according to the study.
"We found that regardless of the clinical presence of celiac disease, most screen-detected patients benefitted from early treatment of a gluten-free diet," Dr. Katri Kaukinen, from the gastroenterology department at Tampere University Hospital and School of Medicine in Finland, said in a news release from the American Gastroenterological Association.
"In addition, the results showed that endomysial-antibody positive patients had an evident gluten-dependent disorder and, therefore, it could be argued that detection of antibody positivity could be sufficient for the diagnosis of celiac disease," she explained.
After the study, 85 percent of the participants were willing to maintain a gluten-free diet, and 58 percent viewed their screening for celiac disease in a positive light, the researchers said.
"Based on our results, an intensified serological screening of at-risk populations of celiac disease is encouraged," Kaukinen said. "However, more research needs to be done before expanding screening to the general population."
Kaukinen was scheduled to present the findings Monday in Chicago at the Digestive Disease Week conference. Experts note that research presented at meetings should be considered preliminary because it has not been subjected to the rigorous scrutiny given to research published in medical journals.
More information
The U.S. National Digestive Diseases Information Clearinghouse has more on celiac disease.
SOURCE: American Gastroenterological Association, news release, May 8, 2011
Copyright © 2011 HealthDay. All rights reserved.
This is a story from HealthDay, a service of ScoutNews, LLC.
http://generic.e-healthsource.com/index.php?p=news1&id=652637
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Kids' Birth Month Seems to Be Linked to Celiac Disease: Study
Related Health News
SUNDAY, May 8 (HealthDay News) -- Celiac disease is more common among children born in the spring and summer months, according to a new study from the Massachusetts General Hospital for Children.
The findings suggest that the higher incidence of this autoimmune disease may be related to a combination of seasonal and environmental factors.
Celiac disease is a digestive disorder triggered by consuming the protein gluten, which is primarily found in bread and other foods containing wheat, barley or rye. It can damage the small intestine and make it difficult to absorb certain nutrients, causing problems ranging from abdominal pain to nerve damage.
Examining data on 382 Massachusetts children diagnosed with celiac disease at between 11 months and 19 years of age, researchers found that in the 15- to 19-year-old set, birth season appeared to make no difference. But among 317 children younger than 15 years of age, 57 percent were born in the "light" season of March through August, compared with 43 percent who were born in the "dark" season of September through February.
Even though the exact cause of celiac disease is unknown, potential triggers include the timing of infants' introduction to gluten, and viral infections contracted during the first year of life. The study's findings suggest the season of a child's birth is another potential risk factor for the disease.
The researchers pointed out that infants are generally introduced to solid foods containing gluten at around 6 months of age, which for spring and summer babies would coincide with cold and flu season.
Based on the findings, the study's lead researcher, Dr. Pornthep Tanpowpong, said that the age at which gluten is first offered to some babies may need to be altered.
"If you're born in the spring or the summer, it might not be appropriate to introduce gluten at the same point as someone born in the fall or winter," said Tanpowpong. "Although we need to further develop and test our hypothesis, we think it provides a helpful clue for ongoing efforts to prevent celiac disease."
The study also noted that exposure to sunlight may also play a role in celiac disease, since vitamin D deficiency has been associated with the disease.
The study is slated for presentation Sunday in Chicago during Digestive Disease Week, an international gathering sponsored by the American Gastroenterological Association and other organizations.
Because the study was presented at a medical meeting and is small, its findings should be considered preliminary until published in a peer-reviewed journal and confirmed in other research.
More information
The American Academy of Pediatrics provides detailed information on celiac disease in children.
SOURCE: American Gastroenterological Association, news release, May 8, 2011
Copyright © 2011 HealthDay. All rights reserved.
This is a story from HealthDay, a service of ScoutNews, LLC.
http://generic.e-healthsource.com/index.php?p=news1&id=652636
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Celiac Disease on the Rise in U.S.
Speculation on increase in digestive disorder centers on improvements in sanitation and hygiene
By Dennis Thompson
HealthDay Reporter
FRIDAY, Aug. 19 (HealthDay News) -- Complaints of celiac disease are on the rise in the United States, with more and more people growing ill from exposure to products containing gluten.
Nearly five times as many people have celiac disease today than did during the 1950s, according to one recent study. Another report found that the rate of celiac disease has doubled every 15 years since 1974 and is now believed to affect one in every 133 U.S. residents.
"It's quite widespread," said Dr. Alessio Fasano, director of the Center for Celiac Research and the Mucosal Biology Research Center at the University of Maryland School of Medicine. "We thought there were regional differences in the past, but now we know it's everywhere."
That increased incidence rate has left researchers scrambling to figure out why more people are developing the chronic digestive disorder. Doctors still can't explain the trend, but they are making some headway testing a number of hypotheses.
"There are many theories out there, not all independent of each other and not all of them true," Fasano said.
Celiac disease is an inherited autoimmune disorder that causes the body's immune system to attack the small intestine, according to the U.S. National Institutes of Health and the University of Chicago Celiac Disease Center. The attack is prompted by exposure to gluten, a protein found in such grains as wheat, rye and barley.
The disease interferes with proper digestion and, in children, prompts symptoms that include bloating, vomiting, diarrhea or constipation. Adults with celiac disease are less likely to show digestive symptoms but will develop problems such as anemia, fatigue, osteoporosis or arthritis as the disorder robs their bodies of vital nutrients.
Awareness of celiac disease has grown in recent years, evidenced by the growing number of gluten-free foods on the market. However, medical experts don't believe that the increase in celiac disease incidence can be chalked up simply to folks becoming more aware of the chronic digestive disorder or to improvements in diagnostic techniques.
Rather, the most popular potential explanations for the increase in celiac disease rates involve improvements in sanitation and hygiene in civilization overall, said Fasano and Carol McCarthy Shilson, executive director of the University of Chicago Celiac Disease Center.
According to the "hygiene hypothesis," Shilson said, people in industrialized countries are more at risk for celiac disease because their bodies have not had to fight off as many diseases.
"We're just too clean a society, so our immune systems aren't as developed as they should be," she said.
Another version of the hypothesis holds that the cleanliness of industrialized society has caused a fundamental change in the composition of the digestive bacteria contained within the gut, Fasano said.
"It's because this increase occurs primarily in industrialized countries, where things are cleaner," Fasano said. "We abuse antibiotics, we wash our hands too often, we are vaccinated more often."
Other potential explanations for the rise in celiac disease rates, according to Fasano, include:
An increase in the amount of gluten found in grains. "We eat grains that are much more rich in glutens than they were 70 or 80 years ago," he said.
Children being exposed to gluten from an early age. "We know for sure if we introduce grains too early, people at risk for developing celiac disease are more likely to contract it," he said.
Too few women breast-feeding their children. "There are theories out there that say breast-feeding will protect you, or prevent celiac disease," Fasano said.
It's possible, experts say, that each of these theories is correct to a degree and that a combination of factors will ultimately be found to contribute to celiac disease. "It may well be in one person, one plays a stronger role than another," Fasano said.
But while experts try to find a cause -- and then, they hope, a cure -- advocates urge people who are at risk for developing celiac disease to undergo screening for the disorder.
Researchers have shown a genetic predisposition for celiac disease, with about 30 percent of the population carrying genes that make them vulnerable, Shilson said.
But because adults with celiac disease often don't suffer the digestive symptoms associated with gluten intolerance, many people are unaware they have it or could pass it on. "About two-thirds of people with the active disease have no symptoms at all," Shilson said.
Studies also have found that the earlier people find out they have celiac disease, the better able they are to head off the disorder's more debilitating effects.
"There's not much you can do to prevent it, but you can be aware of it and catch it," Shilson said. "Early intervention is key."
However, people who suspect they have celiac disease should not go gluten-free before being tested. Doing that can interfere with the accuracy of the screening.
"It's very important that you don't change your diet before you are screened for celiac disease," Shilson said.
More information
To learn more about celiac disease, visit the Celiac Sprue Association.
SOURCES: Alessio Fasano, m.d., director of the Center for Celiac Research and the Mucosal Biology Research Center at the University of Maryland School of Medicine; Carol McCarthy Shilson, executive director, University of Chicago Celiac Disease Center
Last Updated: Aug. 19, 2011
Copyright © 2011 HealthDay. All rights reserved.
http://consumer.healthday.com/Article.asp?AID=651247
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By Anne-Marie Botek, AgingCare.com
Though more commonly thought of as a disease that manifests in youth and young-adulthood, celiac disease is being diagnosed in the elderly with increasing frequency.
Celiac disease is the name given to a specific type of autoimmune response that occurs when a person ingests gluten, a protein found in foods such as pasta and bread.
Recent research, conducted by scientists from the University of Maryland School of Medicine Center for Celiac Research, has discovered that celiac disease is about two and a half times more common among elderly people than it is in the population as a whole.
One of the lead researchers of this study, Dr. Alessio Fasano, M.D., Director of the University of Maryland Center for Celiac Research, discusses celiac disease in an interview for the University of Maryland.
According to Dr. Fasano, people with a genetic predisposition for celiac disease may develop it at any time, even if they have been eating gluten for years without any problems. He says this of the disease, "You cannot grow out of it, but you may grow into it."
If a person with celiac disease eats food containing gluten, their immune system will go on the defensive, injuring and sometimes destroying the hair-like villi that line the inside of the small intestine. Without villi, an elderly person will not be able to soak up essential vitamins and minerals from their food. A variety of different health problems can arise from the malnutrition caused by untreated celiac disease. When left untreated, celiac disease can pose serious health risks for the elderly that include osteoporosis (reduced bone density caused by thinning bones) and neuropathy (nerve damage).
The common symptoms associated with celiac disease are diarrhea and abdominal pain and cramping.
Other symptoms can include:
Joint pain
Irritability
Muscle cramps
Tingling in the lower extremities
Depression
Anemia
Fatigue
Celiac Disease in the Elderly originally appeared on AgingCare.com.
Read more: http://www.care2.com/greenliving/celiac-disease-in-the-elderly.html#ixzz1stlTiTwt
http://www.care2.com/greenliving/celiac-disease-in-the-elderly.html?page=1
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Heather is the Administrator of the IBS Message Boards. She is the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!
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