Association in Clinical Practice Between Gluten Intake and Gluten Immunogenic Peptides in Celiac Children

Meijer, C.; Bakker, Jaap; Boers, A. de; Jansen, Sophie; Mengi, Zeliha

doi:10.1016/j.gastha.2022.04.015

Cited by 6 publications

(4 citation statements)

References 21 publications

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“…In this multicenter study in the United States, we identified a lower rate of detectable gluten exposure using GIPs in both stool (9.1%) and urine (4.8%) in children with CeD on a GFD for at least 6 months when compared with previously published pediatric and adult studies of stool GIP (13%–25%) and urine GIP (5.4%–38%) (13–15). While the presence of gluten exposure for individuals with CeD following a GFD has been demonstrated in prior studies, our results are unique in that samples were collected in multiple settings, including endoscopy, clinic, and at home (13,14).…”

Section: Discussionmentioning

confidence: 72%

Low Levels of Detectable Urine and Stool GIPs in Children with Celiac Disease on a Gluten-Free Diet

et al. 2023

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Objectives: This study examines the prevalence of detectable gluten immunogenic peptides (GIPs) as a proxy for gluten exposure in children with celiac disease on a gluten-free diet in the United States, as estimated by gluten breakdown products excreted in urine and stool. Methods: Urine and stool samples were collected in 3 settings (home, gastroenterology clinic, and endoscopy) for pediatric participants (ages 6–21 years old) across 2 medical centers. Commercial ELISA assays were used to quantify the GIPs in each sample. Results: GIPs were detected in 4 out of 44 (9.1%) of stool samples and 6 out of 125 (4.8%) of urine samples provided by 84 children. These samples were collected across all settings, and most participants (70%) were asymptomatic at the time of sample collection. For the urine samples collected at the time of endoscopy, all subjects found to have persistent enteropathy had no detectable GIPs (0/12). Discussion: GIPs provide an additional method for screening for gluten exposures in individuals with celiac disease on a gluten-free diet, and may be used across multiple settings. We found a low detection rate of GIPs in children. Our finding of undetectable GIPs in individuals with persistent enteropathy may be expected of a single determination under close observation or represent a lack of gluten exposure within the detection window. More research is needed to understand the dynamics of gluten absorption and excretion in the US pediatric population.

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Section: Discussionmentioning

confidence: 72%

Low Levels of Detectable Urine and Stool GIPs in Children with Celiac Disease on a Gluten-Free Diet

et al. 2023

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“…Therefore, an adherence frequency of 59.4% in children and adolescents with CD was found when the adaptation of the CDAT questionnaire was carried out, modifying the content and scores of the original one 7 . In the same sense, a frequency of 94.2% of absence of gluten in urine was identified in a pediatric population with CD and medical follow‐up when the participants were informed about the urine test two to 3 weeks before participating in the research 21 …”

Section: Discussionmentioning

confidence: 97%

“…could be helpful to evaluate exposure to gluten in the past 6 h. This could serve as a complementary test in particular situations, such as patients who exhibit compliant behavior but still experience symptoms or maintain persistent positive serology. Also, in just one sample of stool or urine from children and adolescents with CD, Miaja et al 21 found a concordance percentage of 87.3% when evaluating CDAT and GIP content in the stool 20 and Meijer et al 21 found 74.4% concordance between a validated questionnaire in Dutch and u-GIP. On the other hand, Skodje et al, 22 in the adult population, found a discordance of 41.4% (n = 29) between the CDAT and the GIP content in stool, as well as a 47.1% (n = 33) discordance between CDAT and u-GIP, when the u-GIP was performed by research subjects.…”

Section: Discussionmentioning

confidence: 99%

“…7 In the same sense, a frequency of 94.2% of absence of gluten in urine was identified in a pediatric population with CD and medical follow-up when the participants were informed about the urine test two to 3 weeks before participating in the research. 21 This study had some limitations. Because this was a study with an interview, it is possible to think of interviewer and memory bias as difficulties that needed to be overcome.…”

Section: Characteristicsmentioning

confidence: 92%

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Gluten‐free diet adherence in pediatric celiac patients: Evaluating CDAT questionnaire and test for gluten detection in urine

Mello,

da Silva,

Lins

et al. 2024

J. pediatr. gastroenterol. nutr.

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ObjectivesThis study aimed to evaluate the contributions of the Adapted Celiac Dietary Adherence Test (CDAT) and the Rapid Urinary Gluten Detection Test (u‐GIP) in assessing gluten‐free diet adherence in children and adolescents with celiac disease.MethodsFifty‐four celiac patients from two pediatric gastroenterology outpatient clinics affiliated with university hospitals were evaluated. The original CDAT was adapted for children through a transcultural process, and the original cutoff point was adopted to define adherence. A single examiner carried out the u‐GIP test in fresh urine samples. Sociodemographic and clinical factors and family food security status were also evaluated.ResultsA total of 88.9% of participants (confidence interval [CI]: 77.4–95.8; p<0.001) adhered to the gluten‐free diet, as determined by the adapted CDAT score, while 87.0% (CI: 75.1–94.6; p<0.001) had negative u‐GIP results. Among the 48 children adhering to the CDAT, six exhibited positive u‐GIP results in a urine sample. Of the six nonadherent participants, only one had a positive u‐GIP result. Notably, none of the children and adolescents with celiac disease who tested positive for u‐GIP reported symptoms on the day of testing, and their growth rates remained stable.ConclusionsEven celiac children and adolescents adhering to the CDAT questionnaire may show a positive u‐GIP in a single measurement without accompanying symptoms or growth impairment. The u‐GIP could be helpful in complementary tests in specific situations, such as for patients who exhibit compliant behavior but still experience symptoms or maintain persistent positive serology.

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Celiac Disease Affects 1% of Global Population—Who Will Manage All These Patients? What Are Criteria to Prioritize Along Risk for Complications?

Kurppa,

Mulder,

Stordal

et al. 2024

Gastroenterology

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Association in Clinical Practice Between Gluten Intake and Gluten Immunogenic Peptides in Celiac Children

Cited by 6 publications

References 21 publications

Low Levels of Detectable Urine and Stool GIPs in Children with Celiac Disease on a Gluten-Free Diet

Low Levels of Detectable Urine and Stool GIPs in Children with Celiac Disease on a Gluten-Free Diet

Gluten‐free diet adherence in pediatric celiac patients: Evaluating CDAT questionnaire and test for gluten detection in urine

Celiac Disease Affects 1% of Global Population—Who Will Manage All These Patients? What Are Criteria to Prioritize Along Risk for Complications?

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