Natural History of Potential Celiac Disease in Children

Tosco, Antonella; Salvati, V.M.; Auricchio, Renata; Maglio, Mariantonia; Borrelli, Melissa; Coruzzo, A.; Paparo, Francesco; Boffardi, Massimo; Esposito, Antonella; D’Adamo, Grazia; Malamisura, Basilio; Greco, Luigi; Troncone, Riccardo

doi:10.1016/j.cgh.2010.09.006

Cited by 108 publications

(117 citation statements)

References 20 publications

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“…If the potential CD patients are treated as blind samples and are subjected to classification by the previous statistical model, 24 out of 29 are classified as CD patients using CPMG serum spectra. Those results strongly suggest that potential CD subjects are more similar to overt CD than to healthy controls.…”

Section: Resultsmentioning

confidence: 99%

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Are Patients with Potential Celiac Disease Really Potential? The Answer of Metabonomics

et al. 2010

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Celiac disease (CD) is an autoimmune disorder caused by a permanent sensitivity to gluten in genetically susceptible individuals. Accurate diagnosis of CD at an early stage and its treatment with a gluten-free diet (GFD) are important for optimum treatment and prognosis. Recently, by employing a noninvasive metabonomic approach, we have shown that CD has a well-defined metabonomic signature. Here we address potential CD patients, defined as subjects who do not have, and have never had, a jejunal biopsy consistent with clear CD, and yet have immunological abnormalities similar to those found in celiac patients. Sixty-one overt CD patients at diagnosis, 29 patients with potential CD, and 51 control subjects were examined by 1 H NMR of their serum and urine: out of 29 potential CD patients, 24 were classified as CD and 5 as control subjects. Potential CD largely shares the metabonomic signature of overt CD. Most metabolites found to be significantly different between control and CD subjects were also altered in potential CD. Our results demonstrate that metabolic alterations may precede the development of small intestinal villous atrophy and provide a further rationale for early institution of GFD in patients with potential CD, as recently suggested by prospective clinical studies.

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Section: Resultsmentioning

confidence: 99%

“…There is increasing evidence that GFD has a beneficial effect, although the effect can be more 22,23 or less 24 marked. The comparison of the fingerprint of potential CD subjects with overt CD subjects and healthy controls can thus contribute to the open debate about whether or not it is necessary to put these patients on a GFD.…”

Section: Introductionmentioning

confidence: 99%

Are Patients with Potential Celiac Disease Really Potential? The Answer of Metabonomics

et al. 2010

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“…In the first case, the presence of intestinal deposits of anti-TG2 seems to be a marker of forthcoming overt CD [10,27] in patients with normal intestinal mucosa. This ability, if confirmed by larger studies, could help to solve the vexed question of whether or not potential CD patients must be put onto a gluten-free diet or remain on a gluten-containing diet.…”

Section: Discussionmentioning

confidence: 99%

“…In this group of patients intestinal deposits of IgA anti-TG2 are found less often [8,10]. However, their presence is relevant, as it has been associated with the risk of developing frank villous atrophy [10].…”

Section: Introductionmentioning

confidence: 99%

Intestinal anti-tissue transglutaminase antibodies in potential coeliac disease

Tosco

Aitoro

Auricchio

et al. 2012

Clinical and Experimental Immunology

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SummaryAnti-tissue transglutaminase 2 (anti-TG2) antibodies are present in the serum of the great majority of untreated coeliac disease (CD) patients. They are produced and deposited in the small intestinal mucosa. Potential CD patients present serum anti-TG2 antibodies higher than cut-off, but a normal duodenal mucosa where mucosal deposits of anti-TG2 are not always detectable. The aim of our work was to investigate the presence of anti-TG2 intestinal antibodies in patients with potential CD, and identify the most sensitive test to detect them. Twelve active CD patients, 28 potential CD patients and 39 non-CD controls were enrolled. Biopsy fragments from all patients were analysed by double immunofluorescence to detect mucosal deposits of anti-TG2 antibodies. Fragments from the same subjects were also cultured for 24 h with medium in the presence or absence of gliadin peptides. Anti-TG2 autoantibodies secreted into supernatants were measured by enzyme-linked immunosorbent assay. All active CD, 68% of potential CD patients and 20% of non-CD controls showed mucosal deposits of immunoglobulin (Ig)A anti-TG2; at the same time 100, 96 and 8% of active CD, potential CD and non-CD control patients secreted these antibodies in culture supernatants, respectively. Our data showed that, to detect intestinal anti-TG2 antibodies, the measurement of antibodies secreted into culture supernatants has higher sensitivity and specificity (97·5 and 92·3%, respectively) than the detection of mucosal deposits (77·5 and 80·0%, respectively). The measurement of intestinal anti-TG2 antibodies may prove useful in clinical practice to predict evolution towards mucosal atrophy in potential coeliac patients and identify patients with gluten sensitivity.

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“…[88][89][90][91] In addition, great emphasis has been placed by investigators on the diagnostic dilemma for patients presenting only minor or no changes at histological analysis of duodenal mucosa. [92][93] Do these patients have CD or not? Can we consider them as potential CD patients carrying a risk of developing the full-blown disease at a later stage?…”

Section: Anti-deamidated Gliadin Peptides (Dgp)mentioning

confidence: 99%