Search Results (978)

Background/Objectives: Celiac disease (CD) is an autoimmune disorder characterized by small intestinal enteropathy triggered by gluten ingestion, often associated with gut dysbiosis. The most effective treatment is strict adherence to a gluten-free diet (GFD), which alleviates symptoms. This study uniquely integrates taxonomic, functional, and resistance profiling to evaluate the gut microbiota of women with CD on a GFD. Methods: To evaluate the long-term impact of a GFD, this study analyzed the gut microbiota of 10 women with CD on a GFD for over a year compared to 10 healthy controls with unrestricted diets. Taxonomic diversity (16S rRNA gene sequencing and the analysis of α and β-diversity), metabolic functionality (Biolog EcoPlates^®), and antibiotic resistance profiles (Cenoantibiogram) were assessed. Results: Metagenomic analysis revealed no significant differences in taxonomic diversity but highlighted variations in the abundance of specific bacterial genera. Women with CD showed increased proportions of Bacteroides, Streptococcus, and Clostridium, associated with inflammation, but also elevated levels of beneficial genera such as Roseburia, Oxalobacter, and Paraprevotella. Despite no significant differences in metabolic diversity, higher minimum inhibitory concentrations (MICs) in women in the healthy control group suggest that dietary substrates in unrestricted diets may promote the proliferation of fast-growing bacteria capable of rapidly developing and disseminating antibiotic resistance mechanisms. Conclusions: These findings indicate that prolonged adherence to a GFD in CD supports remission of gut dysbiosis, enhances microbiota functionality, and may reduce the risk of antibiotic resistance, emphasizing the importance of dietary management in CD. Full article

Introduction: Living with coeliac disease (CD) requires lifelong adherence to a strict gluten-free diet (GFD). This study assessed GFD adherence, symptom burden, autoimmune comorbidities, and dietetic support among Hellenic CD patients. Methods: A cross-sectional survey was completed by 272 adults with CD. Adherence was measured using the Hellenic version of the Celiac Dietary Adherence Test (H-CDAT). Results: The mean H-CDAT score was 13.5 ± 3.5. Good adherence was observed in 44.9% of participants, while 14.3% showed poor adherence. Symptom burden was high: 39.3% reported partial symptom resolution and 3.7% had ongoing symptoms. Among patients, 25.0% had multiple autoimmune conditions, ranging from two to four. Dietetic support was limited: 61.5% were not referred to a dietitian at diagnosis, and 75.4% had no regular follow-up. Higher H-CDAT scores, indicating poorer adherence, were significantly associated with younger age (p = 0.014), earlier diagnosis (p = 0.01), and ongoing symptoms (p < 0.01). Age at diagnosis was also positively associated with autoimmune comorbidity count. Conclusions: These findings highlight the need for earlier diagnosis, improved access to structured dietetic support, and individualized care to optimize GFD adherence and improve outcomes in patients with CD. Full article

Gluten-related disorders, including celiac disease (CeD) and non-celiac gluten sensitivity (NCGS), are triggered by the immune response to gluten peptides that resist complete digestion by human gastrointestinal enzymes. Microbial peptidases have emerged as promising biocatalysts capable of degrading these immunogenic peptides, offering potential therapeutic and industrial applications. This review explores the role of microbial peptidases in gluten degradation, highlighting key enzyme families, their mechanisms of action, and their effectiveness in reducing gluten immunogenicity. Additionally, we discuss advances in enzymatic therapy, food processing applications, and the challenges associated with optimizing microbial enzymes for safe and efficient gluten detoxification. Understanding the potential of microbial peptidases in mitigating gluten-related disorders paves the way for novel dietary and therapeutic strategies. Full article

Background/Objectives: Histological follow-up still lacks consensus in the long-term management of adult patients with celiac disease (CD) adhering to a gluten-free diet (GFD). Despite clinical and serological improvement, a significant proportion of patients continue to have persistent villous atrophy. We aimed to synthesize current evidence regarding histological outcomes after GFD treatment in adult CD, focusing on mucosal healing rates, assessment methods, and remission criteria. Methods: We conducted a literature search with extraction and analysis of published cohort studies that included adult patients with CD on GFD with follow-up biopsy data. Extracted parameters included demographic details, baseline histology, GFD duration and adherence, serologic status, and histologic recovery rates with corresponding remission criteria. Results: Data from 46 studies comprising 15,530 patients were analyzed. The overall mean age was 41 years, and 73.3% were female. Mean histologic remission across cohorts was 58.8%, with considerable interstudy variation. Remission criteria also varied widely, ranging from strict Marsh 0 control histology to more inclusive definitions that considered Marsh 1 or even non-atrophic mucosa (Marsh < 3) as indicative of recovery, while some studies relied on quantitative villous height-to-crypt depth ratio thresholds, substantially influencing reported remission rates. Longer GFD duration and rigorous diet adherence assessment using validated questionnaires and accurate laboratory tools were associated with higher remission rates. Conclusions: Histologic remission in GFD-treated adult patients with CD is highly variable and strongly influenced by remission definitions and adherence assessment methods. Standardized reporting using validated metrics for histologic outcome and dietary compliance is essential for harmonizing follow-up strategies in adult CD. Full article

Background/Objectives: Celiac disease (CD) alters nutrient absorption and body composition, especially during childhood. Although adherence to a gluten-free diet (GFD) promotes mucosal recovery, its impact on cellular functionality and metabolic balance remains underexplored. This study aims to evaluate the utility of bioelectrical impedance vector analysis (BIVA) in assessing nutritional status, inflammatory improvement, and body composition changes in pediatric patients with CD following a GFD. Methods: Seventy-nine children aged 5–14 years were studied. Three groups were analyzed: (1) 25 children with newly diagnosed CD, evaluated at diagnosis and after 12 months of GFD (prospective cohort); (2) 25 CD patients on a GFD for over 24 months (cross-sectional); and (3) 29 healthy controls. Body composition (fat mass (FM), fat-free mass (FFM), body cell mass (BCM), phase angle (PhA), and Na⁺/K⁺ ratio) was measured. GFD adherence was assessed and a dietary assessment was also performed. Results: After 12 months on a GFD, newly diagnosed CD patients showed significant increases in FM (from 8.2 to 10.1 kg, p = 0.001), FFM (p = 0.001), and BCM (p = 0.0001), along with a significant decrease in the Na⁺/K⁺ ratio (p = 0.015). Compared to healthy controls, CD children on GFD for more than 24 months had higher FM (12.2 vs. 8.8 kg, p = 0.013) and lower Na⁺/K⁺ ratios (p = 0.006). PhA increased slightly over time but did not reach statistical significance. Conclusions: Our study suggests that the adherence to a GFD leads to improved body composition and cellular homeostasis in children with CD, as reflected by increases in BCM and reductions in Na⁺/K⁺ ratio, making it a promising biomarker for monitoring inflammation and cellular recovery. Full article

Sourdough fermentation has emerged as a promising biotechnological approach to reducing gluten content and modifying gluten proteins in wheat-based products. This review assesses the current scientific literature on the enzymatic degradation and hydrolysis of gluten during lactic acid bacteria (LAB) sourdough fermentation. It explores implications for individuals with gluten-related disorders, including celiac disease, non-celiac gluten sensitivity and intolerance, as well as irritable bowel syndrome (IBS). In addition, LAB sourdough effect on fermentable oligo-, di-, monosaccharides and polyols (FODMAPs), amylase-trypsin inhibitors (ATIs), and phytate are revised. Selected homo- and heterofermentative LAB are capable of degrading gluten proteins, especially the polypeptides derived from the action of native cereal proteases. Mixed cultures of LAB degrade gluten peptides more effectively than monocultures. However, LAB sourdough is not sufficient to remove the toxic peptides to the minimal level (<20 ppm). This goal is achieved only if sourdough is combined with fungal proteases during sourdough fermentation. LAB sourdough directly contributes to lower FODMAPs but not ATIs and phytate. Phytate is reduced by the endogenous cereal phytases activated at acidic pHs (pH < 5.0), conditions generated during sourdough fermentation. ATIs are also lowered by endogenous cereal proteases instead of LAB proteases/peptidases. Despite LAB sourdough not fully degrading the gluten or directly reducing the ATIs and phytate, it participates through peptidases activity and acidic pH that trigger the action of endogenous cereal proteases and phytases. Full article

Background and Objectives: Celiac disease (CD) is a common gluten-related disorder associated with significantly worsened quality of life. The aim of this pilot study was to evaluate the quality of life of adult celiac patients living in Lithuania and their compliance with a gluten-free diet. Materials and Methods: This cross-sectional study was conducted on individuals aged 18 to 75 years diagnosed with CD and residing within the borders of Lithuania. This pilot study involved 73 participants, comprising 68 females and 5 males. The CD Specific Quality of Life Scale (CD-QOL) consisted of 20 items across four sub-dimensions. Responses to scale items were graded with a score ranging from 1 (not at all) to 5 (very much). The total score obtained from the scale can range up to 100, with a score < 40 classified as poor, 40–50 as moderate, and > 50 as good quality of life. Additionally, ten questions related to gluten-free diet-related quality of life were used. Results: The mean age of diagnosis for females (32.6 ± 11.7) was higher than that for males (22.0 ± 12.1), p < 0.05. The mean self-reported BMI for males (25.8 ± 4.5) was higher than that for females (22.3 ± 5.2), p < 0.05. The mean quality-of-life score (66.4 ± 12.5) was significantly higher in the good quality-of-life group compared to the poor group (33.7 ± 3.9), p < 0.001. Half of the respondents (50.7%) reported that gluten-free products are expensive, and 45.2% confirmed difficulties in dining out on a gluten-free diet. Conclusions: The results of this pilot study indicate that CD is associated with a worsened quality of life and that compliance with a gluten-free diet is primarily influenced by economic factors, such as the high cost of the diet. Full article

Due to consumer needs and the prevalence of gluten-related disorders such as celiac disease, the gluten-free food market is expanding rapidly and is expected to surpass USD 2.4 billion by 2036. The objective of this study was to substitute wheat flour with oat, black rice, brown rice, buckwheat, and rice flours in the production of gluten-free scones, to assess consumer acceptability, and to identify factors contributing to consumer acceptability using check-all-that-apply questions. The 10 attributes of appearance, color, texture, grainy flavor, sweetness, familiar flavor, novelty, familiarity, moistness, and consistency exhibited statistically significant differences among the samples (p < 0.001). One hundred consumers evaluated 18 attributes using a nine-point hedonic scale, and all attributes demonstrated statistically significant differences across six samples (p < 0.001). The samples from buckwheat and wheat scored the highest in consumer acceptability. The results indicate a strong positive correlation between overall liking and purchase intention, with sensory attributes such as nutty flavor, cohesiveness, appearance, moistness, color, texture, and inner softness positively influencing consumer acceptability. The attributes affecting negatively were thick throat sensation, unique flavor, and stuffiness. This study is expected to provide data to aid in the development of better-tasting gluten-free products that meet customer and market needs. Full article

Non-celiac villous atrophy (NCVA) is a multifaceted and under-recognized clinical entity with an etiology beyond celiac disease. This review critically examines the diverse pathophysiological mechanisms underlying NCVA, including autoimmune enteropathies, immune deficiency-related disorders, infectious processes, drug-induced trauma, and metabolic or environmental influences. A comprehensive synthesis of peer-reviewed literature, clinical studies, and case reports was conducted, adopting a multidisciplinary perspective that integrates immunologic, infectious, metabolic, and pharmacologic insights. The literature search was performed in three phases: identification of relevant studies, critical assessment of selected publications, and synthesis of key findings. Searches were carried out in PubMed, Scopus, Web of Science, and Google Scholar databases. The final search, completed in June 2025, included international, English-language articles, electronic books, and online reports. Studies were included if they addressed NCVA in the context of pathophysiology, clinical manifestations, or management strategies, with priority given to publications from the last ten years (2015–2025). The search strategy used the primary term “non-celiac villous atrophy” combined with supplementary keywords such as autoimmune enteropathy, common variable immunodeficiency, tropical sprue, drug-related enteropathy, pathophysiology, immunological mechanisms, chronic inflammation, genetic factors, environmental influences, and clinical management. Histopathological evaluations reveal that NCVA often manifests with varying degrees of villous blunting, crypt hypertrophy, and intraepithelial lymphocytosis, albeit without the gliadin-specific immune response seen in celiac disease. Various immune pathways are involved, such as autoimmune deregulation and chronic inflammatory responses, while drug-induced and environmental factors further complicate its clinical picture. These findings highlight significant diagnostic challenges and underscore the need to adapt diagnostic algorithms that combine clinical history, serologic evaluations, and histopathologic analysis. In conclusion, an in-depth understanding of the heterogeneous etiology of NCVA is critical to improving diagnostic accuracy and optimizing therapeutic strategies. Future research should prioritize the identification of specific biomarkers and the development of targeted interventions to address the unique mechanisms underlying NCVA, thereby improving patient management and outcomes. Full article

Introduction: Celiac disease (CD) impairs bone development in children through inflammation and nutrient malabsorption. Osteoprotegerin (OPG), a decoy receptor for RANKL, plays a role in bone remodeling and is increasingly recognized as a potential biomarker of bone metabolism and inflammation. However, its clinical significance in pediatric CD remains unclear. Aim: To evaluate the relationship between OPG levels, growth parameters, and delayed bone age in children with CD, and to assess OPG’s potential as a biomarker of bone health and disease activity. Methods: This three-year case–control study included 146 children: 25 with newly diagnosed CD (Group A), 54 with established CD on a gluten-free diet (Group B), and 67 healthy controls (Group C). Participants underwent clinical, anthropometric, and laboratory assessments at baseline and after 6 months (Groups A and B). OPG and osteocalcin were measured, and bone age was assessed radiologically. Statistical analyses included ANOVA, Spearman’s correlations, and binomial logistic regression. Results: OPG levels were highest in newly diagnosed children (Group A), showing a non-significant decrease after gluten-free diet initiation. OPG correlated negatively with age and height in CD patients and controls, and positively with hemoglobin and iron in Group B. Logistic regression revealed no significant predictive value of OPG for delayed bone age, although a trend was observed in Group B (p = 0.091). Children in long-term remission exhibited bone maturation patterns similar to healthy peers. Conclusions: OPG levels reflect disease activity and growth delay in pediatric CD but lack predictive power for delayed bone age. While OPG may serve as a secondary marker of bone turnover and inflammatory status, it is not suitable as a standalone biomarker for skeletal maturation. These findings highlight the need for integrative biomarker panels to guide bone health monitoring in children with CD. Full article

Background: A gluten-free diet (GFD) has been shown to be nutritionally inadequate for those with wheat-related disorders. However, the differences in findings and the absence of quantitative analysis limits the interpretation of previous reviews. Objectives: We conducted a systematic review and meta-analysis to identify the risk of micronutrient deficiencies in patients with celiac disease (CeD) and non-celiac gluten or wheat sensitivity (NCWS). Methods: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and Web of Science (Ovid) databases. The risk of bias was determined using the ROBINS-1, and the quality of evidence was assessed using the GRADE approach. Results We identified 7940 studies; 46 observational studies (11 cohort, 9 cross-sectional, and 26 case–control) were eligible for analysis. CeD patients had an increased risk of vitamin D and E deficiencies compared with the non-CeD controls. CeD on a GFD had a decreased risk of vitamin D, B12, E, calcium, and iron deficiencies compared with untreated CeD. NCWS had an increased risk of vitamin B12, folate, and iron deficiency compared to the controls. The overall quality of evidence was rated very low. Conclusions: The risk of various micronutrient deficiencies is increased in CeD but is decreased for some after a GFD. Adequately powered studies with a rigorous methodology are needed to inform the risk of nutrient deficiencies in patients with CeD and NCWS. Protocol registration: Prospero-CRD42022313508. Full article

The incidence of Hashimoto’s disease (HD) increases with age and in people who have other autoimmune diseases. It is characterized by lymphocytic infiltration, fibrosis, and atrophy of the thyroid parenchyma with the simultaneous presence of thyroid peroxidase antibodies (ATPO) and/or thyroglobulin antibodies (ATG). Eicosanoids are formed via the cyclooxygenase (COX), lipoxygenase (LOX), and monooxygenase (CYP450) pathways with arachidonic acid (ARA), resulting in the production of epoxyeicosatrienoic acids (EETs) or hydroxyeicosatetraenoic acids (HETEs). These eicosanoids can act in an autocrine or paracrine manner on target cells. This study aimed to examine whether a gluten-free diet (GFD) can modulate the enzymatic pathways of the pro-inflammatory ARA cascade. The study material consisted of serum samples from Caucasian female patients with HD aged 18–55 years. Participants were enrolled in the study based on the presence of an ultrasound characteristic of HD, and elevated serum levels of anti-thyroid peroxidase antibodies and anti-thyroglobulin antibodies. Patients with confirmed celiac disease did not participate in the study. A total of 78 samples were analyzed, with 39 collected after 3 months of following a GFD. Eicosanoids (thromboxane B2, prostaglandin E2, leukotriene B4, and 16R-hydroxy-5Z,8Z,11Z,14Z-eicosatetraenoic acid (16-RS HETE)) were extracted using high-performance liquid chromatography. The contribution of leukotriene (LTB) was analyzed in the LOX pathway, prostaglandins (PGE2) and thromboxane (TXB2) were selected for the involvement of the COX pathway, and 16RS HETE was used for the CYP450 pathway. All parameters were analyzed before and after a 3-month dietary intervention that included a gluten-free diet. In the obtained results, only one mediator, leukotriene B4, was significant (p < 0.05). The mean level on the initial visit was 0.202 ± 0.11 (SD), while it was 0.421 ± 0.27 (SD) on the subsequent visit, indicating a significant increase in its level after implementing a GFD. Although there was a trend in the CYP 450 pathway of decreased 16-RS HETE, the presented correlations show that thromboxane B4 and 16RS-HETE were positively correlated with the body mass and body fat mass of the examined patients. There was a trend in the CYP 450 pathway of decreased 16-RS HETE after GFD. Thromboxane B4 and 16RS-HETE levels before GFD were positively correlated with the body mass and body fat mass of the examined patients. A gluten-free diet in HD does not suppress the synthetic pathways of LOX, COX, or cytochrome P450 (CYP450). The level of adipose tissue has a greater impact on the inflammatory processes in HD than a gluten-free diet. This study does not confirm the suppressive effect of a gluten-free diet on the pro-inflammatory arachidonic acid cascade in any of the three analyzed mediator synthesis LOX, COX, CYP450 pathways. Full article

This study explored the causal and molecular overlap among Crohn’s disease (CD), celiac disease (CeD), and ankylosing spondylitis (AS). Bidirectional Mendelian randomization revealed significant causal associations between each disease pair. Transcriptomic analyses identified three consistently upregulated hub genes—P2RY8, ITGAL, and GPR65—across all conditions, which were validated in independent datasets and inflammatory cell models. Functional enrichment suggested these genes are involved in immune signaling and mucosal inflammation. Regulatory network and molecular docking analyses further highlighted Trichostatin A as a potential therapeutic agent. These findings reveal shared genetic and immune-related mechanisms, offering novel targets for cross-disease treatment strategies. Full article

Celiac disease (CD), a human leukocyte antigen-associated disorder, is caused by gluten sensitivity and is characterized by mucosal alterations in the small intestine. Currently, its diagnosis involves the determination of serological markers. The traditional method for clinically determining these markers is the enzyme-linked immunosorbent assay. However, immunosensors offer sensitivity and facilitate the development of miniaturized and portable analytical systems. This work focuses on developing an amperometric immunosensor for the quantification of IgA antibodies against tissue transglutaminase (IgA anti-TGA) in human serum samples, providing information on a critical biomarker for CD diagnosis. The electrochemical device was designed on a polyimide substrate using a novel solid ink of wax and carbon nanofibers (CNFs). The working electrode microzone was defined by incorporating aminofunctionalized TiO₂ nanoparticles (TiO₂NPs). The interactions and morphology of CNFs/wax and TiO₂NPs/CNFs/wax electrodes were assessed through different characterization techniques. Furthermore, the device was electrochemically characterized, demonstrating that the incorporation of CNFs into the wax matrix significantly enhanced its conductivity and increased the active surface area of the electrode, while TiO₂NPs contributed to the immunoreaction area. The developed device exhibited remarkable sensitivity, selectivity, and reproducibility. These results indicate that the fabricated device is a robust and reliable tool for the precise serological diagnosis of CD. Full article