Search Results (206)

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

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

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

Hydrated cassava starch is widely consumed for its convenience and to appeal to health-conscious individuals, including those with celiac disease, due to its gluten-free nature. However, potential gluten contamination during processing and the lack of specific regulations underscores the need for careful monitoring to ensure safety. Thus, this study aimed to evaluate the presence of gluten in different commercially available hydrated cassava starches and to partially characterize them regarding their physicochemical properties. Thirty-five samples of hydrated cassava starch from local markets in various regions of Brazil were analyzed. The samples underwent partial physicochemical characterization, including pH, moisture content, and particle size distribution. Additionally, gluten presence was assessed using a rapid detection kit. The hydrated cassava starch samples showed a wide pH range (3.4–4.6) and high moisture content (36.0–41.4%), indicating high perishability. Granulometry varied significantly, with samples above 39% moisture forming larger particles which result in irregular texture and inconsistency in tapioca production. Gluten contamination found in 5.71% of the 35 samples presents a risk to gluten-sensitive individuals, underscoring the urgent need for industry and regulatory agencies to implement routine gluten screening. Full article

The increasing use of assisted reproductive technologies (ARTs) globally, such as intracytoplasmic sperm injection (ICSI) and in vitro fertilization (IVF), has highlighted the pressing need to determine the modifiable factors affecting the success of implantation and the outcomes of early pregnancy. Scientific interest in the role of nutrition in fertility is growing, but outside of celiac disease, little is known about gluten, a dietary protein with immunogenic and inflammatory properties. With an emphasis on ART results, this narrative review summarizes the most recent data regarding the possible effects of gluten consumption on reproductive health, focusing primarily on individuals with celiac disease (CD) and non-celiac gluten sensitivity (NCGS). In addition to discussing potential molecular processes connecting gluten-induced inflammation, increased gut permeability, autoimmune, and decreased endometrial receptivity, we further explore the documented link between CD and infertility and investigate new information on NCGS. These findings are tentative and based on scant low-quality evidence, although some case reports and small clinical studies have indicated that avoiding gluten may help some people undergoing ART, especially those with immune-mediated diseases or infertility that cannot be explained. There is currently no robust prospective evidence confirming that gluten restriction improves infertility outcomes. Therefore, before gluten elimination is advised in this situation, more carefully planned extensive research is required to generate reliable scientific proof. Beyond traditional celiac disease, we suggest that gluten sensitivity might be an underappreciated factor in ART failure that merits more research. A gluten-free diet may serve as a low-risk supplementary option for appropriately selected patients, pending the results of more extensive controlled studies. Full article

The human gut microbiome is intricately linked to systemic and organ-specific immune responses and is highly responsive to dietary modulation. As metagenomic techniques enable in-depth study of an ever-growing number of gut microbial species, it has become increasingly feasible to decipher the specific functions of the gut microbiome and how they may be modulated by diet. Diet exerts both supportive and selective pressures on the gut microbiome by regulating a multitude of factors, including energy density, macronutrient and micronutrient content, and circadian rhythm. The microbiome, in turn, contributes to local and systemic immune responses by providing colonization resistance against pathogens, shaping immune cell activity and differentiation, and facilitating the production of bioactive metabolites. Emerging research has strengthened the connections between the gut microbiome and cardiometabolic disorders (e.g., cardiovascular disease, obesity, type-2 diabetes), autoimmune conditions (e.g., type-1 diabetes, rheumatoid arthritis, celiac disease), respiratory disease, chronic kidney and liver disease, inflammatory bowel disease, and neurological disorders (e.g., Alzheimer’s, Parkinson’s disease, depressive disorders). Here, we outline ways in which dietary factors impact host response in diseases through alterations of gut microbiome functionality and composition. Consideration of diet-mediated microbial effects within the context of the diseases discussed highlights the potential of microbiome-targeted treatment strategies as alternative or adjunct therapies to improve patient outcomes. Full article

Intestinal microbiota and the host’s immune system form a symbiotic alliance that sustains normal development and function in the human gut. Changes such as dietary habits among societies in developed countries have led to the development of unbalanced microbial populations in the gut, likely contributing to the dramatic increase in inflammatory diseases in the last few decades. Recent advances in DNA sequencing technologies have tremendously helped to characterize the microbiome associated with disease, both in identifying global alterations and discovering specific biomarkers that potentially contribute to disease pathogenesis, as evidenced by animal studies. Beyond bacterial alterations, non-bacterial components such as fungi, viruses, and microbial metabolites have been implicated in these diseases, influencing immune responses and gut homeostasis. Multi-omics approaches integrating metagenomics, metabolomics, and transcriptomics offer a more comprehensive understanding of the microbiome’s role in disease pathogenesis, paving the way for innovative diagnostic and therapeutic strategies. Unraveling the metagenomic profiles associated with disease may facilitate earlier diagnosis and intervention, as well as the development of more personalized and effective therapeutic strategies. This review synthesizes recent and relevant microbiome research studies aimed at characterizing the microbial signatures associated with inflammatory bowel disease, colorectal cancer, and celiac disease. Full article

This review is dedicated to exploring recent advancements in the study of amaranth grain and presents research primarily on Amaranthus species such as Amaranthus cruentus, Amaranthus hypochondriacus, and Amaranthus caudatus, and to a lesser extent Amaranthus hybridus, Amaranthus mantegazzianus, Amaranthus muricatus, Amaranthus tuberculatus, Amaranthus viridis, Amaranthus spinosus, and Amaranthus tenuifoliu. Amaranth (Amaranthus spp.) is a promising, high-yield pseudocereal crop with significant commercial potential for developing functional food products. It contains a wide range of bioactive compounds, including squalene, tocopherols, phenolic compounds, phytates, and vitamins, which possess important physiological properties. Amaranth grain is characterized by high levels of starch, proteins, minerals, and dietary fiber. Moreover, amaranth proteins are distinguished by a balanced amino acid composition and exhibit greater resistance to external factors compared to animal-derived proteins. Grains of amaranth are free of gliadin, making it a valuable nutritional source for individuals with celiac disease, an immune-mediated disorder. Unlike traditional cereals, where prolamins and glutelins dominate the protein composition, the proteins of pseudocereals like amaranth primarily consist of albumins and globulins. The processing methods of amaranth grain influence their quantitative and qualitative composition, often significantly improving their physicochemical, antioxidant, functional, and rheological properties. This work provides a detailed analysis of amaranth’s chemical composition and bioactive components, along with its evaluation of therapeutic and preventive properties. Amaranth protein fractions (albumin, globulin, and glutelin) and squalene exhibit increased antioxidant activity, contributing to notable resistance to radiation and X-ray exposure. Bioactive compounds such as phytol, α-tocopherol, and a lunasin-like peptide (AhLun) with potential anticancer properties have also been identified in amaranth. Furthermore, six bioactive peptides were isolated and identified from amaranth, which, according to predictive models, demonstrate a high capacity to inhibit angiotensin-converting enzyme (ACE) activity, suggesting potential hypotensive effects. Certain amaranth peptides are considered promising functional food ingredients for the prevention and comprehensive treatment of conditions such as diabetes, inflammatory bowel diseases, hypercholesterolemia, cardiovascular diseases, and obesity. Amaranthus spp. and its processed products hold significant interest for the development of innovative food products, contributing to the expansion of their range and enhancement of nutritional value. Full article

Introduction: Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by social communication difficulties and repetitive behaviors. Emerging evidence suggests a potential link between ASD and celiac disease (CD), possibly mediated by immune dysregulation and nutrient deficiencies. This study explores the shared biological pathways between ASD and CD using an in silico approach. Methods: Gene–disease associations for ASD and CD were retrieved from DisGeNET using MedGen Concept IDs (C1510586 and C0007570, respectively). An over-representation analysis (ORA) was conducted using GeneTrail 3.2 to identify significantly enriched biological pathways, which were then compared for overlap. A false discovery rate (FDR) < 0.05 was considered statistically significant. Results: The gene–disease association analysis identified 536 ASD-related genes and 52 CD-related genes. The ORA revealed several shared biological pathways, including immune pathways, cellular metabolism, and micronutrient processing (e.g., folate, selenium, vitamin A). These findings suggest immune dysfunction and nutrient malabsorption as potential mechanistic links between ASD and CD. Conclusions: The observed pathway overlap supports the hypothesis that immune dysregulation and metabolic disturbances contribute to both ASD and CD. Nutrient deficiencies, driven by CD-associated malabsorption, may exacerbate ASD symptoms. Additionally, sensory processing abnormalities in ASD could impact dietary choices, complicating gluten-free diet adherence. Future studies should validate these findings in clinical cohorts and explore dietary interventions, such as targeted supplementation, to mitigate ASD symptoms in individuals with CD. Full article

Background: Gluten-related disorders, particularly celiac disease, are triggered in susceptible individuals by the toxic effects of gluten, the major storage protein of wheat grains. This toxicity can be reduced by wheat glutenases. Members of the papain-like cysteine protease family, which can act in the human gastrointestinal tract, are promising candidates for the enzymatic treatment of celiac disease. Methods: Two wheat proteases were selected using AlphaFold2, produced in recombinant forms, and characterized. Their glutenase potentials under acidic or slightly acidic conditions were evaluated and compared with the properties of the previously characterized wheat glutenase Triticain-α. Results: All enzymes tested, Ta-P7, Ta-V6, and Triticain-α, were able to hydrolyze the model substrate (α-gliadin-derived epitope) in the pH range of 3.6–7.5. Nevertheless, Triticain-α performs the most efficient hydrolysis of the peptide substrate under the conditions of the gastrointestinal tract, according to its kinetic characteristics. In the wheat gluten degradation experiment at pH 4.6 and 37 °C, both Ta-P7 and Triticain-α cleaved the mixture almost completely within 5 min. In addition, Triticain-α and Ta-P7 significantly reduced the levels of toxic peptides compared to both intact gluten and gluten treated with pepsin-trypsin digestion as tested by the Ridascreen Gliadin Kit. Conclusions: Novel wheat proteases under investigation possess the expected glutenase activity to varying degrees; however, Triticain-α is a primary candidate for potential use in the enzymatic therapy of gluten-related disorders. Full article

Pediatric gastroenterology is entering a pivotal phase marked by significant challenges and emerging opportunities in treating conditions like celiac disease (CeD), eosinophilic esophagitis (EoE), inflammatory bowel disease (IBD), and autoimmune hepatitis (AIH) pose significant clinical hurdles, but new therapeutic avenues are emerging. Advances in precision medicine, particularly proteomics, are reshaping care by tailoring treatments to individual patient characteristics. For CeD, therapies like gluten-degrading enzymes (latiglutenase, Kuma030) and zonulin inhibitors (larazotide acetate) show promise, though clinical outcomes are inconsistent. Immunotherapy and microbiota modulation, including probiotics and fecal microbiota transplantation (FMT), are also under exploration, with potential benefits in symptom management. Transglutaminase 2 inhibitors like ZED-1227 could help prevent gluten-induced damage. Monoclonal antibodies targeting immune pathways, such as AMG 714 and larazotide acetate, require further validation in pediatric populations. In EoE, biologics like dupilumab, cendakimab, dectrekumab (IL-13 inhibitors), and mepolizumab, reslizumab, and benralizumab (IL-5/IL-5R inhibitors) show varying efficacy, while thymic stromal lymphopoietin (TSLP) inhibitors like tezepelumab are also being investigated. These therapies require more pediatric-specific research to optimize their use. For IBD, biologics like vedolizumab, ustekinumab, and risankizumab, as well as small molecules like tofacitinib, etrasimod, and upadacitinib, are emerging treatments. New medications for individuals with refractory or steroid-dependent AIH have been explored. Personalized therapy, integrating precision medicine, therapeutic drug monitoring, and lifestyle changes, is increasingly guiding pediatric IBD management. This narrative review explores recent breakthroughs in treating CeD, EoE, IBD, and AIH, with a focus on pediatric studies when available, and discusses the growing role of proteomics in advancing personalized gastroenterological care. Full article

The contribution of genetics to the development of gut-related autoimmune diseases such as celiac disease (CeD) and inflammatory bowel diseases (IBDs) is well-established, especially in immune cells, but pinpointing the significance of genetic variants to other cell types is more elusive. Increasing evidence indicates that intestinal epithelial cells are active players in modulating the immune response, suggesting that genetic variants affecting these cells could change cell behavior during disease. Moreover, fine-mapping genetic variants and causal genes to relevant cell types can help to identify drug targets and develop personalized targeted therapies. In this context, we reviewed the functions of genes in disease-associated loci shared by CeD and IBD that are expressed in epithelial cells and explored their potential impacts. Full article

Celiac disease (CD) is an immune-mediated enteropathy of the small intestine triggered by gluten ingestion. Although the small bowel is the main organ affected, peripheral blood cell alterations have also been described in CD. We aimed to investigate immunological cell patterns in the blood of treated CD patients and in response to a 3-day gluten challenge (GC). Blood samples were collected from 10 patients with CD and 8 healthy controls on a gluten-free diet at baseline and 6 days after initiating the GC. All the samples were analyzed by spectral flow cytometry using a 34-marker panel. We found that patients with CD displayed a lower proportion of memory B cells compared to healthy controls, both at baseline and post-GC. Additionally, we observed the previously reported activated gut-homing CD4⁺, CD8⁺, and TCRγδ⁺ T lymphocytes on day 6 post-GC, and found the CD8⁺ subpopulation to be the most readily identifiable by flow cytometry. Importantly, the CCR9 marker proved effective in enhancing the selection of these gluten-responsive T cells, offering the potential for increased diagnostic accuracy. Spectral flow cytometry involves a complex data analysis, but it offers valuable insights into previously unexplored immunological responses and enables in-depth cell characterization. Full article

Background: This study aimed to assess the safety and efficacy of gemcitabine plus S-1-based chemoradiotherapy (GS-CRT) among patients with locally advanced pancreatic ductal adenocarcinoma (PDAC), especially among those with unresectable locally advanced (UR-LA) cases. Methods: A total of 351 consecutive PDAC patients were enrolled and prognostic predictors of disease-specific survival (DSS) were identified. Results: The treatment completion rate was 98.9% and Grade 3 or higher adverse events occurred in 181 cases (51.6%). Among 319 re-evaluated patients, pancreatectomy was performed in 184 (57.7%). Based on resectability, the 5-year DSS rates for the entire cohort were 39.6% (R), 43.8% (BR-PV), 21.2% (BR-A) and 13.3% (UR-LA), while the predictors of DSS were performance status (PS), hemoglobin (Hb) level, celiac artery (CA) involvement of ≥180 degrees and JPS 8th T category. In the resected cases, the predictors of DSS were preoperative PS, preoperative CA19-9 level, preoperative JPS-T factor, degree of histological response and adjuvant chemotherapy. In UR-LA resected patients, preoperative prognostic nutritional index (PNI), absence of pathological venous invasion and adjuvant chemotherapy were predictors of DSS. Conclusions: Even though Grade 3 or higher adverse events were encountered in about half of the cases, they were uneventfully managed. Therefore, GS-CRT is safe and highly tolerable with potential to improve patients‘ prognosis. Preoperative PS, CA19-9 levels and histological response are important prognostic factors, as well as adjuvant therapy. In UR-LA patients, prognostic nutritional index (PNI) and adjuvant chemotherapy were important for curative intent surgery. Full article

Background/Objectives: Thalassemia, a hereditary blood disorder, leads to reduced hemoglobin levels, impairing oxygen transport and negatively impacting patient health. Recent research suggests a possible association between thalassemia and gastrointestinal (GI) symptoms, such as abdominal pain, diarrhea, and GI bleeding, potentially due to immune compromise and iron overload. This systematic review aims to explore the prevalence and underlying factors of GI pathologies in thalassemia patients, excluding treatment-related effects and iron overload. Methods: A comprehensive search following the PRISMA guidelines was conducted to identify the prevalence and causes of GI disorders in thalassemia patients. Studies assessing non-treatment-related GI symptoms and their links to thalassemia were analyzed. After screening 1902 studies, 13 were included to investigate gastrointestinal manifestations in thalassemia patients. Results: Evidence indicates potential associations between thalassemia and GI disorders, including malabsorption, inflammatory bowel disease, Heliobacter pylori (H. pylori) infection, and celiac disease. Findings highlight immune compromise and iron dysregulation as possible contributing factors. Conclusions: This review highlights the importance of further research into the GI manifestations of thalassemia to enable early detection and improve patient health outcomes and quality of life. Addressing this gap may provide insights into better clinical management strategies for thalassemia patients. Full article