Ulcerative jejunitis in a child with celiac disease

Sigman, T.; Nguyễn, Văn Hùng; Costea, Florin; Sant’Anna, Ana; Seidman, Ernest G.

doi:10.1186/1471-230x-14-29

Cited by 12 publications

(5 citation statements)

References 25 publications

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“…Intestinal permeability and barrier function are regulated by the expression of TJ proteins including occludin, claudin, and ZO-1 ( 59 ). Gut inflammation, such as IBD ( 60 ), coeliac disease ( 61 ), and ulcerative jejunitis ( 62 ) may lead to impaired gut-epithelial barrier function, thus causing the diffusion of pathogens, toxins, and allergens from the lumen into the circulatory system. In this study, we assayed for changes in TEER of the mouse jejunal epithelium, as an indicator of intestinal epithelial integrity and permeability ( 63 ).…”

Section: Discussionmentioning

confidence: 99%

A Novel Cecropin-LL37 Hybrid Peptide Protects Mice Against EHEC Infection-Mediated Changes in Gut Microbiota, Intestinal Inflammation, and Impairment of Mucosal Barrier Functions

Xin

Zhang

et al. 2020

Front. Immunol.

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Intestinal inflammation can cause impaired epithelial barrier function and disrupt immune homeostasis, which increases the risks of developing many highly fatal diseases. Enterohemorrhagic Escherichia coli (EHEC) O157:H7 causes intestinal infections worldwide and is a major pathogen that induces intestinal inflammation. Various antibacterial peptides have been described as having the potential to suppress and treat pathogen-induced intestinal inflammation. Cecropin A (1-8)-LL37 (17-30) (C-L), a novel hybrid peptide designed in our laboratory that combines the active center of C with the core functional region of L, shows superior antibacterial properties and minimized cytotoxicity compared to its parental peptides. Herein, to examine whether C-L could inhibit pathogen-induced intestinal inflammation, we investigated the anti-inflammatory effects of C-L in EHEC O157:H7-infected mice. C-L treatment improved the microbiota composition and microbial community balance in mouse intestines. The hybrid peptide exhibited improved anti-inflammatory effects than did the antibiotic, enrofloxacin. Hybrid peptide treated infected mice demonstrated reduced clinical signs of inflammation, reduced weight loss, reduced expression of pro-inflammatory cytokines [tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interferon-gamma (IFN-γ)], reduced apoptosis, and reduced markers of jejunal epithelial barrier function. The peptide also affected the MyD88-nuclear factor κB signaling pathway, thereby modulating inflammatory responses upon EHEC stimulation. Collectively, these findings suggest that the novel hybrid peptide C-L could be developed into a new anti-inflammatory agent for use in animals or humans.

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Section: Discussionmentioning

confidence: 99%

A Novel Cecropin-LL37 Hybrid Peptide Protects Mice Against EHEC Infection-Mediated Changes in Gut Microbiota, Intestinal Inflammation, and Impairment of Mucosal Barrier Functions

Xin

Zhang

et al. 2020

Front. Immunol.

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“…The term complicated CD encompasses a spectrum of different conditions, namely refractory CD (RCD), ulcerative jejunoileitis (UJI), and enteropathy-type-associated T cell lymphoma (EATL), which represent a biological continuum and are estimated to affect only a few cases in the adult CD population [ 2 , 3 , 163 ]. The only two exceptions are an eight-year-old boy suffering from refractory CD, who was successfully treated with azathioprine [ 168 ], and a 13-year-old girl with CD and evidence of ulcerative lesions in the jejunum, who responded to a GFD [ 169 ]. However, in our opinion, the latter cannot be considered a true refractory case, firstly because of the response to a GFD and secondly for the absence of both a monoclonal re-arrangement of the T-cell receptor and an aberrant population of intraepithelial lymphocytes (IELs), which are the hallmarks of CD-associated UJI.…”

Section: Response To Gfd and Prognosismentioning

confidence: 99%

The Spectrum of Differences between Childhood and Adulthood Celiac Disease

et al. 2015

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An old saying states that ‘’children are not little adults” and this certainly holds true for celiac disease, as there are many peculiar aspects regarding its epidemiology, diagnosis, clinical presentations, associated diseases, and response to treatment in pediatric compared to adult populations, to such an extent that it merits a description of its own. In fact, contrary to the past when it was thought that celiac disease was a disorder predominantly affecting childhood and characterized by a malabsorption syndrome, nowadays it is well recognized that it affects also adult and elderly people with an impressive variability of clinical presentation. In general, the clinical guidelines for diagnosis recommend starting with specific serologic testing in all suspected subjects, including those suffering from extraintestinal related conditions, and performing upper endoscopy with appropriate biopsy sampling of duodenal mucosa in case of positivity. The latter may be omitted in young patients showing high titers of anti-transglutaminase antibodies. The subsequent management of a celiac patient differs substantially depending on the age at diagnosis and should be based on the important consideration that this is a lifelong condition.

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“…Ulcerative jejunitis is usually seen in middle aged patients with CD refractory to steroids [84]. Monoclonal aberrant T-cell abnormality is the postulated pathogenesis [53,85].…”

Section: Ulcerative Jejunitismentioning

confidence: 99%

Gluten and the Gut: A Brief Review of Gluten-Related Gastrointestinal Disorders

Shah¹

2017

SOJI

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We conducted online electronic searches (published manuscripts in English) of the Cochrane Library, pub med and manual searches of selected specialty journals to identify any pertinent literature. The search was conducted using the key words 'celiac disease', 'gluten related disorder', 'non celiac gluten sensitivity', 'wheat allergy', 'gluten', , 'gluten free diet'. Studies not published in English or published only in the abstract form were excluded. We also conducted a focused review of available references to identify subsequent pertinent papers. AbstractCeliac disease (CD) was the first gluten-related disorder to be described. Presently the realm of gluten-related disorders also includes non-celiac gluten sensitivity (NCGS) and wheat allergy (WA). CD is a multisystem immune mediated enteropathy observed in genetically susceptible individuals exposed to dietary gluten present in barley, rye and wheat. Although the prevalence of CD is on the rise, it still largely remains under diagnosed given that many cases can be silent, subtle or atypical. The Pathophysiology of CD includes both innate and adaptive immune response to dietary gluten. Patients present with a wide variety of intestinal and extra-intestinal symptoms and are at risk for non-Hodgkin's lymphoma and small intestinal adenocarcinoma. The corner stone for treatment of CD is a gluten-free diet (GFD). NCGS is an emerging condition associated with gluten ingestion and the diagnosis of which is based on exclusion of CD and WA. Further evidence and studies are required to fully appreciate the clinical entity of NCGS and WA to detail its epidemiology and pathogenesis. The symptoms of NCGS and WA may overlap with CD and hence it is imperative to differentiate these clinical entities and select patients for appropriate management.Keywords: Celiac disease, gluten related disorder, non-celiac gluten sensitivity, wheat allergy, gluten, epidemiology, clinical features, Pathophysiology, management, gluten free diet.Core tip: CD is largely under-diagnosed while the incidence and prevalence of gluten-related disorders are on the rise. A clear understanding of the various clinical presentations of gluten-related disorders can help differentiate CD from NCGS and WA. The management for these conditions differs and hence accurate diagnosis leads to improved patient outcomes with avoidance of longterm complications as well as unnecessary testing which can be both invasive and expensive. Celiac DiseaseThe term celiac is derived from the Greek word "koiliaks" meaning "abdominal". It was first described in the second century in modern day Turkey by a Greek physician Aretaeus of Cappadocia [1]. In 1888, Samuel Gee; a pediatrician from the United Kingdom gave the first modern-day description of the condition and associated diet to the treatment of celiac disease EpidemiologyCeliac disease occurs in about 1% of the general population worldwide [7]. Data from the USA suggests CD to be more common in Caucasians as compared to African-Americans and Hispanics [8,9]. The initial ...

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Ulcerative jejunitis in a child with celiac disease

Cited by 12 publications

References 25 publications

A Novel Cecropin-LL37 Hybrid Peptide Protects Mice Against EHEC Infection-Mediated Changes in Gut Microbiota, Intestinal Inflammation, and Impairment of Mucosal Barrier Functions

A Novel Cecropin-LL37 Hybrid Peptide Protects Mice Against EHEC Infection-Mediated Changes in Gut Microbiota, Intestinal Inflammation, and Impairment of Mucosal Barrier Functions

The Spectrum of Differences between Childhood and Adulthood Celiac Disease

Gluten and the Gut: A Brief Review of Gluten-Related Gastrointestinal Disorders

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