@article {10443, title = {Immunohistologic analysis of the duodenal bulb: a new method for celiac disease diagnosis in children.}, journal = {Gastrointest Endosc}, volume = {88}, year = {2018}, month = {2018 Sep}, pages = {521-526}, abstract = {

BACKGROUND AND AIMS: Anti-tissue transglutaminase antibodies (anti-tTG) have simplified celiac disease (CD) diagnosis. However, in atypical forms of CD, intestinal biopsy sampling is still required. This prospective study investigates whether histologic analysis of the duodenal bulb combined with intestinal IgA anti-tTG deposit immunoassay makes CD diagnosis possible in at-risk children with low concentrations of serum anti-tTG.

METHODS: Histologic and intestinal IgA anti-tTG deposit immunoassays were used.

RESULTS: Two hundred forty-five symptomatic children positive for serum anti-tTG (>7 U/mL) were enrolled and~divided into 3 groups: extensive duodenal atrophy (n~= 209), with IgA anti-tTG deposits throughout the duodenum and high serum anti-tTG concentrations (157 {\textpm} 178 U/mL); bulb duodenal atrophy (n~= 22), with widespread IgA anti-tTG deposits in 9 and in the bulb alone in 13 and low serum anti-tTG concentrations (13.9~{\textpm} 8.7 U/mL); and normal duodenum (n~= 14), with widespread IgA anti-tTG deposits in 8 and in the bulb alone in 6 and low serum anti-tTG concentrations (10.6 {\textpm} 6.2 U/mL). All patients in the first 2 groups were diagnosed with CD and 8 from the third group. All improved after 1 year of gluten-free diet. Bulb duodenal analysis led to a 12\% (30/245) increase in CD diagnosis. No CD-related lesions were observed in the 30 control subjects.

CONCLUSIONS: In children at risk for CD, bulb duodenum biopsy sampling is essential to identify villous atrophy and detect IgA anti-tTG deposits even in absence of intestinal lesions. These mucosal autoantibodies could well represent a new standard for diagnosing CD.

}, keywords = {Adolescent, Autoantibodies, Celiac Disease, Child, Child, Preschool, Duodenum, Female, Humans, Immunoglobulin A, Immunohistochemistry, Infant, Male, Prospective Studies, Transglutaminases}, issn = {1097-6779}, doi = {10.1016/j.gie.2018.05.014}, author = {De Leo, Luigina and Villanacci, Vincenzo and Ziberna, Fabiana and Vatta, Serena and Martelossi, Stefano and Di Leo, Grazia and Zanchi, Chiara and Bramuzzo, Matteo and Giudici, Fabiola and Ventura, Alessandro and Not, Tarcisio} } @article {8346, title = {Innate and adaptive immunity in self-reported nonceliac gluten sensitivity versus celiac disease.}, journal = {Dig Liver Dis}, volume = {48}, year = {2016}, month = {2016 Jul}, pages = {745-52}, abstract = {

BACKGROUND: Immune mechanisms have been implicated in nonceliac gluten sensitivity (NCGS), a condition characterized by intestinal and/or extraintestinal symptoms caused by the ingestion of gluten in non-celiac/non-wheat allergic individuals.

AIMS: We investigated innate and adaptive immunity in self-reported NCGS versus celiac disease (CD).

METHODS: In the supernatants of ex vivo-cultured duodenal biopsies from 14 self-reported NCGS patients, 9 untreated and 10 treated CD patients, and 12 controls we detected innate cytokines - interleukin (IL)-15, tumor necrosis factor-α, IL-1β, IL-6, IL-12p70, IL-23, IL-27, IL-32α, thymic stromal lymphopoietin (TSLP), IFN-α-, adaptive cytokines - interferon (IFN)-γ, IL-17A, IL-4, IL-5, IL-10, IL-13-, chemokines - IL-8, CCL1, CCL2, CCL3, CCL4, CCL5, CXCL1, CXCL10-, granulocyte colony stimulating factor (G-CSF) and granulocyte-macrophage colony stimulating factor (GM-CSF).

RESULTS: Mucosal innate and adaptive cytokines, chemokines and growth factors did not differ between self-reported NCGS, treated CD and controls. On the contrary, IL-6, IL-15, IL-27, IFN-α, IFN-γ, IL-17A, IL-23, G-CSF, GM-CSF, IL-8, CCL1 and CCL4 were significantly higher in untreated CD than in self-reported NCGS, treated CD and controls, while TSLP was significantly lower in untreated CD than in self-reported NCGS, treated CD and controls.

CONCLUSION: In our hands, patients with self-reported NCGS showed no abnormalities of the mucosal immune response.

}, issn = {1878-3562}, doi = {10.1016/j.dld.2016.03.024}, author = {Di Sabatino, Antonio and Giuffrida, Paolo and Fornasa, Giulia and Salvatore, Chiara and Vanoli, Alessandro and Naviglio, Samuele and De Leo, Luigina and Pasini, Alessandra and De Amici, Mara and Alvisi, Costanza and Not, Tarcisio and Rescigno, Maria and Corazza, Gino Roberto} } @article {3476, title = {Influence of urine volume on the assessment of intestinal permeability in affected children by multiple sugar probes.}, journal = {Clin Chem Lab Med}, volume = {52}, year = {2014}, month = {2014 Feb}, pages = {227-35}, abstract = {

BACKGROUND: In this study we have looked at the reliability of a multi-sugar test in a pediatric patient population and its accuracy at small urine volumes to evaluate intestinal permeability.

METHODS: Out of 117 subjects enrolled, 31 were healthy and 86 were sick. A solution containing lactulose, rhamnose, sucrose, and sucralose was administered to subjects who were on fasting; the urine excreted during 5 h was collected and measured. Samples were analyzed by gas chromatography-tandem mass spectrometry and results were expressed as percentage of sugar recoveries and lactulose/rhamnose (L/R) ratio.

RESULTS: The analyses showed a clear effect of low urinary volumes (<=240 mL) particularly affecting rhamnose excretion in healthy subjects and sucrose and sucralose recovery in diseased children. Despite the low rhamnose recovery, as lactulose is not similarly affected, the diagnostic reliability of L/R ratio is well preserved at low diuresis conditions. However, this ratio can be useful to discriminate acute conditions vs. clinical remissions only at high urine volumes. Data also suggest potential diagnostic applicability of sucrose and sucralose in children at high urine volumes.

CONCLUSIONS: In conclusion, the multi-sugar test has a good predictivity in pediatric subjects but results must be carefully interpreted in the face of reduced diuresis.

}, keywords = {Carbohydrates, Child, Preschool, Diuresis, Female, Gas Chromatography-Mass Spectrometry, Gastrointestinal Diseases, Humans, Infant, Intestines, Lactulose, Male, Permeability, Rhamnose, Sucrose}, issn = {1437-4331}, doi = {10.1515/cclm-2013-0626}, author = {Addobbati, Riccardo and Pascolo, Lorella and Di Toro, Nicola and Sebastiani, Giulia B and Martellossi, Stefano and Not, Tarcisio} } @article {3521, title = {Intestinal-mucosa anti-transglutaminase antibody assays to test for genetic gluten intolerance.}, journal = {Cell Mol Immunol}, volume = {11}, year = {2014}, month = {2014 Nov}, pages = {617-20}, keywords = {Celiac Disease, Cell Surface Display Techniques, Child, Diet, Gluten-Free, Disease Progression, Early Diagnosis, Female, Follow-Up Studies, HLA-DQ Antigens, Humans, Immunoassay, Immunoglobulin A, Intestinal Mucosa, Male, Prospective Studies, Transglutaminases}, issn = {2042-0226}, doi = {10.1038/cmi.2014.32}, author = {Quaglia, Sara and De Leo, Luigina and Ziberna, Fabiana and Vatta, Serena and Villanacci, Vincenzo and Granzotto, Marilena and Petix, Vincenzo and Martelossi, Stefano and Di Leo, Grazia and Torelli, Lucio and Not, Tarcisio} }