Author Interviews, Gastrointestinal Disease, Gluten, Microbiome, Nature / 17.11.2018

MedicalResearch.com Interview with: Professor Oluf Pedersen Novo Nordisk Foundation Center for Basic Metabolic Research University of Copenhagen MedicalResearch.com: What is the background for this study? Response: We focused our study on healthy people due to the world-wide bottom-up movement among healthy adults to live gluten-free or on a low-gluten diet. Therefore, we undertook a randomised, controlled, cross-over trial involving 60 middle-aged healthy Danish adults with two eight week interventions comparing a low-gluten diet (2 g gluten per day) and a high-gluten diet (18 g gluten per day), separated by a washout period of at least six weeks with habitual diet (12 g gluten per day). The two diets were balanced in number of calories and nutrients including the same total amount of dietary fibres. However, the composition of fibres differed markedly between the two diets. When the low-gluten trend started years back the trend was without any scientific evidence for health benefits. Now we bring pieces of evidence that a low-gluten diet in healthy people may be related to improved intestinal wellbeing due to changes in the intestinal microbiota which to our surprise is NOT induced by gluten itself but by the concomitant change in the type of dietary fibres linked to a low-gluten intake. (more…)
Author Interviews, Diabetes, Gluten, Lancet, OBGYNE, Pediatrics / 21.09.2018

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 (more…)
Amgen, Author Interviews, Gastrointestinal Disease, Gluten / 07.06.2018

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 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. (more…)
Author Interviews, Gastrointestinal Disease, JAMA / 15.08.2017

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Gastrointestinal Disease, Lancet, Vaccine Studies / 13.05.2017

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. (more…)
Author Interviews, Gastrointestinal Disease, JAMA / 04.04.2017

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Gastrointestinal Disease, Gluten, JAMA / 06.09.2016

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Gastrointestinal Disease, Gluten, Immunotherapy / 27.07.2016

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Gastrointestinal Disease, Gluten, Nutrition, Pediatrics / 08.10.2013

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. (more…)