Could a Low-Gluten Diet During Pregnancy Protect Offspring from Diabetes?

MedicalResearch.com Interview with:
Knud Josefsen, senior researcher
Bartholin Institute, Rigshospitalet,
Copenhagen K, Denmark

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In a large population of pregnant women, we found that the risk of the offspring being diagnosed with type 1 diabetes before the age of 15.6 years (the follow up period) was doubled in the group of women ingesting the highest amounts of gluten (20-66 g/day) versus the group of women ingesting the lowest amounts of gluten (0-7 g/day). For every additional 10 grams of gluten ingested, the risk for type 1 diabetes in the child increased by a factor of 1.31.

It the sense that it was a hypothesis that we specifically tested, we were not surprised. We had seen in animal experiments that a gluten-free diet during pregnancy protected the offspring from diabetes, and we wanted to see if we could prove the same pattern in humans. There could be many reasons why we would not be able to show the association, even if it was there (sample size, low quality data, covariates we could not correct for and so on), but we were off course pleasantly surprised that we found the association that we were looking for, in particular because it is quite robust Continue reading

Amgen Tests IL-Blocker To Treat Symptoms of Hidden Gluten Consumption in Celiac Disease

MedicalResearch.com Interview with:

Markku Mäki, MD, PhD Professor (emeritus) at the University of Tampere and Presently research director at the Tampere University Hospital Tampere, Finland

Prof. Mäki

Markku Mäki, MD, PhD
Professor (emeritus) at the University of Tampere and
Presently research director at the
Tampere University Hospital
Tampere, Finland

MedicalResearch.com: What is the background for this study?

Response: The only treatment for this life-long gluten-induced autoimmune systemic disease is a strict avoidance of wheat, rye and barley, the food cereals which contain gluten, the environmental trigger and driving force in celiac disease.  Gluten causes intestinal
inflammation, usually with (but sometimes without) gastrointestinal or
nutritional symptoms or signs, and with frequent extra-intestinal
diseases. However, it is impossible for celiac disease patients to
avoid gluten entirely and indefinitely and a third of patients report
symptoms on a strict gluten-free diet. Gut mucosal healing is not
optimal in half of the patients, and inflammation and injury is
detected for years after starting the diet, presumably due to
contamination with gluten in the diet. This is why patients are
requesting, and academia and industry are looking for novel adjunct
therapies for celiac disease. Initially, these therapies are tested to
prevent the consequences of hidden gluten; the ultimate goal being
that also celiacs could one day eat safely wheat, barley and rye
products. Some 20 novel experimental therapies are at present actively
being investigated (modifying wheat or different drugs, devices and
vaccines/immunotherapy).

The present study investigated whether blocking interleukin 15, an
important mediator of celiac disease, reduces or prevents
gluten-driven ill health, both the inflammation and injury at the
small intestinal mucosal level and gluten-induced symptoms. The
experimental drug used was Amgen’s AMG 714, a human monoclonal
antibody, used at a low and high dose, in the presence or absence of a
high-dose gluten challenge. Continue reading

Review of Celiac Disease and Nonceliac Gluten Sensitivity

MedicalResearch.com Interview with:

Maureen Leonard, MD MMSc Clinical Director, Center for Celiac Research and Treatment Instructor in Pediatrics, Harvard Medical School Associate Investigator, Nutrition Obesity Research Center, Harvard Medical School MassGeneral Hospital for Children | Pediatric Gastroenterology & Nutrition

Dr. Leonard

Maureen Leonard, MD MMSc
Clinical Director, Center for Celiac Research and Treatment
Instructor in Pediatrics
Associate Investigator, Nutrition Obesity Research Center
Harvard Medical School
Pediatric Gastroenterology & Nutrition
MassGeneral Hospital for Children  

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In this systematic review, we discuss the clinical approach to celiac disease and nonceliac gluten sensitivity, highlighting how to distinguish between these two conditions and their management. These disorders cannot be distinguished based on symptoms. A single elevated serology test is not diagnostic for celiac disease, and patients with abnormal serologic testing must be referred to a gastroenterologist for further testing and remain on a gluten-containing diet until their diagnostic evaluation is completed. While the treatment for both conditions is a gluten-free diet, the possibility of long-term complications differs.

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First Report Of A Therapeutic Vaccine For Gluten Sensitive Celiac Disease

MedicalResearch.com Interview with:
Leslie Williams, BS, RN, MBA</strong> Director, Founder, President and Chief Executive Officer <strong>Dr Robert P Anderson MBChB BMedSc PhD FRACP</strong> Chief Scientific Officer ImmusanT Cambridge, MALeslie Williams, BS, RN, MBA

Director, Founder, President and
Chief Executive Officer and

Dr Robert P Anderson MBChB BMedSc PhD FRACP
Chief Scientific Officer
ImmusanT, Cambridge, MA

MedicalResearch.com: What is the background for this study?

Response: The 2 Phase 1 trials were randomized, double-blind, placebo-controlled, multi-center studies evaluating the safety, tolerability, and relevant bioactivity of Nexvax2 in HLA-DQ2.5+ patients with celiac disease. In one study, patients received three fixed doses of Nexvax2 or placebo once per week over a three-week period. In the other study, patients received 16 fixed doses of Nexvax2 or placebo twice per week over an eight-week period. Both studies evaluated a range of fixed, intradermal dose administrations in a series of ascending dose cohorts, which included a crossover, double-blind, placebo-controlled oral gluten challenge in the screening and post-treatment periods. The primary outcome measures were the number and percentage of adverse events in the treatment period.

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Insufficient Evidence To Screen Asymptomatic People For Celiac Disease

MedicalResearch.com Interview with:

Ann Kurth, Ph.D., C.N.M., R.N.

Dr. Ann Kurth

Dr. Ann Kurth, Task Force member
Dean of the Yale School of Nursing
Adjunct professor
New York University College of Nursing and the College of Global Public Health.

MedicalResearch.com: What is the background for this study?

Response: Celiac disease, an immune disorder where people should not eat food with gluten, is fairly prevalent. When people with celiac disease eat foods containing gluten, which is found in wheat, rye and barley, their body responds by inflaming or destroying villi—the tiny, fingerlike projections on the inner lining of the small intestine–which prevents the body from absorbing the necessary nutrients from food.

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More People Without Celiac Disease Eating Gluten Free Diet

MedicalResearch.com Interview with:

Brandon Hyunseok Kim, M.D., MPH Internal Medicine Resident Rutgers New Jersey Medical School

Dr. Brandon Hyunseok Kim

Brandon Hyunseok Kim, M.D., MPH
Internal Medicine Resident
Rutgers New Jersey Medical School

MedicalResearch.com: What is the background for this study?

Response: The background of this study was to investigate the time trends in the prevalence of celiac disease and gluten-free diet in the United States using most recent 6-year National Health And Nutrition Examination Survey. Previous studies using narrow populations or old study period mainly before mid 2000s suggested increasing prevalence of celiac disease. At the same time, there is a current popular trend of people following gluten-free diets beyond what would be expected if it were solely due to the increasing prevalence of celiac disease.

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Immune Markers Of Wheat Sensitivity In Patients Without Celiac Disease Identified

MedicalResearch.com Interview with:

Armin Alaedini, PhD Assistant Professor Department of Medicine & Institute of Human Nutrition Columbia University Medical Center New York, NY 10032

Dr. Armin Alaedini

Armin Alaedini, PhD
Assistant Professor
Department of Medicine & Institute of Human Nutrition
Columbia University Medical Center
New York, NY 10032

MedicalResearch.com: What is the background for this study?

Response: It has been a mystery why some people experience a range of symptoms in response to the ingestion of wheat and related cereals, even though they do not have celiac disease (an autoimmune disorder) or wheat allergy. Both gastrointestinal (GI) symptoms, most commonly abdominal pain, diarrhea, and bloating, as well as extra-intestinal symptoms, such as fatigue, anxiety, depressed mood, and cognitive difficulties are reported by patients. The identity of the component(s) of wheat responsible for triggering the symptoms remains uncertain and it is not clear if gluten or non-gluten molecules are involved. There is evidence to indicate that wheat sensitivity also affects a subset of patients with irritable bowel syndrome (IBS), a common disorder. Despite the interest from the medical community and the general public, the causes and mechanism of the associated symptoms have remained unknown and no biomarkers are available to aid in the diagnosis of patients.

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Celiac Disease: When Should Gluten Be Introduced to Infants?

Ketil Stordal Researcher/consultant paediatrician National Institute of Public Health NorwayMedicalResearch.com Interview with:
Ketil Stordal
Researcher/consultant paediatrician
National Institute of Public Health
Norway


MedicalResearch.com:
What are the main findings of the study?

Answer: The study identified 324 children with celiac disease from a cohort of 82 000. Start of gluten in the diet later than 6 months was associated with a 27% increased risk of celiac disease compared to those starting during the 5th or 6th month of life. Breastfeeding was not protective; the duration of breastfeeding was slightly longer among children with celiac disease (10.4 vs 9.9 months) and breastfeeding at the time of gluten introduction was not associated with the later risk of celiac disease. The participating mothers had submitted detailed data since pregnancy including infant feeding practices, and these were collected before onset of the disease.

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