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May 07, 2022
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Celiac Disease Awareness Month: disease management, dietary care, quality of life and more

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May is Celiac Disease Awareness Month, and the Celiac Disease Foundation — along with those in the celiac community — have dedicated the month to raising awareness and funds for critical disease research and advocacy efforts.

Celiac disease is a chronic, autoimmune digestive condition that damages small intestinal villi and interferes with the absorption of nutrients. It affects 1% of the U.S. population and, if left untreated, can cause debilitating complications, including intestinal cancer, diabetes, malnutrition, infertility and even death.

Celiac Awareness Month

While much is known about the development of the disease and its effect on the body, questions remain about screening, diagnosis and patient care.

In support of Celiac Disease Awareness Month, Healio has compiled eight recent reports that include updates on dietary care, disease management strategies, patient quality of life and more.

Microbiome status unrelated to current celiac disease activity, severity

Pre-existing fecal microbiome diversity was unaffected by gluten challenge in patients with celiac disease and nonceliac gluten sensitivity, according to data published in Clinical and Translational Gastroenterology.

“Investigations of celiac disease (CD) have posited a role of the gut microbiome in multiple aspects of disease development and progression,” Yael R. Nobel, MD, a gastroenterology and hepatology fellow at Columbia University Irving Medical Center in New York City, and colleagues wrote. “Certain taxa, including Bifidobacterium and Clostridial species such as Faecalibacterium prausnitzii, have decreased abundance in patients with active CD or treated CD compared with controls.” Read more.

Low FODMAP diet improves gastrointestinal symptoms in patients with celiac disease

A short-term, moderately low FODMAP diet, in addition to a strict gluten-free diet, significantly reduced gastrointestinal symptoms and improved disease-specific health in celiac patients, according to a study.

“There are no recommendations or guidelines for patients with [celiac disease (CeD)] in remission with ongoing symptoms, but dietary interventions, in addition to a gluten-free diet, could be a treatment option for persistent IBS-like symptoms in CeD,” Frida van Megen, a doctoral research fellow at the department of clinical services at Oslo University Hospital Rikshospitalet in Norway, and colleagues wrote in Clinical Gastroenterology and Hepatology. Read more.

Group-based education improves symptom management, quality of life in celiac disease

A group-based education program improved gastrointestinal symptoms and quality of life among patients with celiac disease, according to research published in BMC Gastroenterology.

“Complete elimination of gluten from the diet is the only available treatment [for celiac disease]. Non-adherence to a gluten-free diet (GFD) leads to a reduction in quality of life and worsening of symptoms. However, strict compliance to this diet can be difficult,” Zahra Akbari Namvar, of the Tabriz University of Medical Sciences, and colleagues wrote. “Individual education provided by an expert dietitian is usual care of these patients. ... Group-based education is another method of nutrition education. This method provides more detailed information and support from other patients who experience the same condition and promotes discussions about patients’ problems.” Read more.

Entering the ‘age of enlightenment’ with a new generation of celiac disease leaders

I’ve been engaged in celiac disease for more than 30 years, and for a long time it was what I call an orphaned disease, with less than a handful of expatriate academics exhibiting any interest in it.

The irony is that in the ’60s there was great interest in celiac disease in academic gastroenterology, with GI giants publishing on celiac before it went out into the wilderness. A renaissance of interest was born in the ’90s and grew into what I call the “age of enlightenment,” where celiac disease is not only considered a major disease within GI but also an excellent example of an autoimmune disease. It is garnering a lot more attention as a model disease in which we can manipulate the immune system. Read more.

In silico models may identify biomarkers of celiac disease

The use of in silico models is an effective method for identifying biomarkers of celiac disease, according to a presentation at the North American Society for Pediatric Gastroenterology, Hepatology & Nutrition Annual Meeting.

“We have found that metabolic modeling can provide a functional link to RNA-seq data,” Isabelle Aldridge, an undergraduate research assistant at the University of Virginia’s Gastroenterology Data Science Lab in Charlottesville, said during the presentation. “We have demonstrated the value of this in silico method in identifying disease biomarkers and druggable targets which will bring us closer to celiac disease precision medicine.” Read more.

Management of patients with celiac disease is ‘a marathon not a sprint’

If left untreated, celiac disease can cause a plethora of complications, including malnutrition, bone weakening, infertility and miscarriage, nervous system problems and more.

“It’s a really fascinating disease because it’s one of the few diseases that can be treated by strictly removing a particular type of food from the diet,” Lisa M. Fahey, MD, attending physician and co-director of the Celiac Center at the Children’s Hospital of Philadelphia, said. Read more.

VIDEO: Brain fog, neurocognitive symptoms highly frequent in celiac disease

In this video exclusive, Alice Bast and Jessica Edwards George, PhD, discuss how brain fog and other neurocognitive symptoms affect patients with celiac disease.

“Brain fog isn’t given as much attention from researchers as GI symptoms,” said Bast, CEO of Beyond Celiac, which collaborated with researchers from Northeastern University to help fund a survey of 1,400 patients with celiac disease or non-celiac gluten sensitivity. Read more.

ZED1227 prevents increased mucosal injury in celiac disease

Transglutaminase 2 inhibitor ZED1227 reduced intestinal mucosal injury among patients with celiac disease, according to research published in The New England Journal of Medicine.

“The only available treatment for celiac disease is lifelong adherence to a strict gluten-free diet, a diet that is difficult to maintain. ... Moreover, many patients with celiac disease report having persistent symptoms despite adherence to the gluten-free diet. Thus, there is an unmet medical need for an effective treatment adjunct to a strict gluten-free diet,” Detlef Schuppan, MD, PhD, of Johannes Gutenberg University, and colleagues wrote. “ZED1227 inhibits transglutaminase 2 with high specificity and prevents the formation of deamidated gluten and, putatively, the initial steps of gluten-induced T-cell activation. Our phase 1 clinical studies ... did not show drug-related adverse effects or signs of drug toxicity.” Read more.