Seven recent developments in celiac disease research

This month new FDA standards for the labeling of gluten-free food products went into effect, assuring people with celiac disease that “foods labeled ‘gluten-free’ meet a clear standard established and enforced by the FDA” for the first time in the US. In light of this improvement to the celiac treatment landscape, here are seven highlights of celiac disease research presented recently on Healio.com/Gastroenterology.

1. Serological markers identified mucosal healing in children with celiac disease on gluten-free diet

Winita Hardikar

A study performed by Winita Hardikar, FRACP, PhD, department of gastroenterology, Royal Children's Hospital, Melbourne, and colleagues showed that tTG and DGP antibodies effectively identified mucosal recovery in children with celiac disease on a gluten-free diet.

These findings call “into question the need for routine repeat endoscopic biopsy in the setting of clinical remission and normal serologic values,” the researchers wrote. Read more

2. Mothers with celiac disease showed no major increased risk for pregnancy complications

In a study conducted by Alyshah A. Sultan, PhD, division of epidemiology and public health, University of Nottingham, and colleagues, estimates of pregnancy complications and adverse birth outcomes showed no increased risk in women with celiac disease.

“Most women with [celiac disease] diagnosed either before or after pregnancy will have a pregnancy and delivery that is not complicated by an adverse event,” Sultan said. Read more

Alyshah A. Sultan

3. Increased risk for malignant cancer was observed after 5 years of celiac disease diagnosis

Researchers from Finland calculated standardized incidence ratios (SIRs) for malignancies in patients with celiac disease. Although no overall increased risk was observed, there was an increase 5 or more years after celiac disease was diagnosed.

“We conclude that the overall incidence of malignancy among clinically diagnosed celiac patients was not increased, although an increased SIR for malignancy was seen after 5 years from the diagnosis,” the researchers wrote. Read more

4. Children of parents with celiac disease had an increased but minor risk for congenital malformation

Jonas F. Ludvigsson

Jonas F. Ludvigsson, MD, PhD, department of pediatrics, Örebro University Hospital, Sweden, and colleagues compared parents and children with and without a parental diagnosis of celiac disease and found only a slightly increased risk for congenital malformation.

“There is no reason to screen for [celiac disease] in pregnant women in order to prevent [congenital malformation].” Read more

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5. Children with HLA haplotype DR3-DQ2 had high risk for celiac disease

Daniel Agardh

In the TEDDY study, Daniel Agardh, MD, PhD, department of pediatrics, Skåne University Hospital, Sweden, and colleagues evaluated children from birth to 15 years of age, and found that HLA-DR3-DQ2/DR3-DQ2 genotype was the major risk factor for early celiac disease.

“This study may guide clinicians who follow [celiac disease] patients on how HLA and other established risk factors may be used when estimating the risk for developing [celiac disease] during childhood,” Agardh said. Read more

6. Simplified serological panel predicted celiac disease before biopsy

In a retrospective analysis conducted by researchers at the Rotherham NHS Foundation Trust in the United Kingdom, results from a serological screening panel that tested immunoglobulin A anti-tissue transglutaminase (tTG) correlated strongly with positive celiac disease histology.

The researchers recommended that their algorithm for testing tTG at presentation of symptoms is “a pragmatic method to detect most [celiac disease] while minimizing the risk of missing the diagnosis in a few [cases].” Read more

7. Gluten-free diet improved mild cognitive impairment associated with celiac disease

Researchers from Australia conducted a longitudinal pilot study and found that celiac disease-related mild cognitive impairment improved concomitantly with mucosal healing in newly diagnosed patients who adhered to a gluten-free diet.

“These results support patient reports of ‘brain fog’ … [and] introduce the possibility that cognitive tests have the potential to provide a noninvasive, cost-efficient marker of intestinal healing.” Read more