RT Journal Article
T1 Prospective longitudinal study: use of faecal gluten immunogenic peptides to monitor children diagnosed with coeliac disease during transition to a gluten-free diet.
A1 Comino, Isabel
A1 Segura, Verónica
A1 Ortigosa, Luis
A1 Espín, Beatríz
A1 Castillejo, Gemma
A1 Garrote, José Antonio
A1 Sierra, Carlos
A1 Millán, Antonio
A1 Ribes-Koninckx, Carmen
A1 Román, Enriqueta
A1 Rodríguez-Herrera, Alfonso
A1 Díaz, Jacobo
A1 Silvester, Jocelyn Anne
A1 Cebolla, Ángel
A1 Sousa, Carolina
AB Treatment for coeliac disease is a lifelong strict gluten-free diet. Although guidelines recommend regular follow-up with dietary interviews and coeliac serology, these methods may be inaccurate. To evaluate the usefulness of faecal gluten immunogenic peptides to support the diagnosis and to determine the adherence to the gluten-free diet in coeliac children. Multicentre prospective observational study including 64 coeliac children. Faecal gluten peptides, and tissue transglutaminase and deamidated gliadin peptide antibodies were analyzed at diagnosis, and 6, 12 and 24 months thereafter. Gluten consumption was estimated from gluten peptide levels. Most children (97%) had detectable gluten peptides at diagnosis. On a gluten-free diet, the rate of gluten peptides increased from 13% at 6 months to 25% at 24 months. Mean estimated gluten exposure dropped from 5543 mg/d at diagnosis to 144 mg/d at 6 months, then increased to 606 mg/d by 24 months. In contrast, deamidated gliadin peptide antibodies normalised and only 20% had elevated tissue transglutaminase antibody by 24 months. The elevation of tissue transglutaminase antibody was more prolonged in patients with detectable gluten peptides (P  0.1). Dietitian assessment was only moderately correlated with gluten peptide detection (κ = 0.5). Faecal gluten peptides testing may guide treatment of coeliac disease prior to diagnosis and during the assessment diet adherence. Further studies could determine if early identification of gluten exposure reduces the need for expensive/invasive investigations for non-responsive coeliac disease. ClinicalTrials.gov Number: NCT02711397.
YR 2019
FD 2019-05-10
LK http://hdl.handle.net/10668/13935
UL http://hdl.handle.net/10668/13935
LA en
DS RISalud
RD Apr 5, 2025