Home About us Contact
|
Home About us Contact | ||
|
|
||
Mucosal Morphology (mucosal + morphology)
Selected AbstractsScreening for adult coeliac disease , which serological marker(s) to use?JOURNAL OF INTERNAL MEDICINE, Issue 3 2001C. Lagerqvist Abstract.,Lagerqvist C, Ivarsson A, Juto P, Persson LÅ & Hernell O (Umeå University, Umeå, Sweden). Screening for adult coeliac disease , which serological marker(s) to use? J Intern Med 2001; 250: 241,248. Objective.,To determine which serological marker(s) to use when screening for coeliac disease. Design.,In a population-based cross-sectional study we compared the use of antigliadin antibodies (AGA) of isotypes IgA and IgG, antiendomysial antibodies (AEA) of isotype IgA and antitransglutaminase antibodies (ATGA) of isotype IgA for detecting coeliac disease amongst adults. Setting.,Northern Sweden. Subjects.,A total of 1850 of 2500 (74%) invited adults (aged 25,74 years) who were randomly selected from the population register after stratification for age and sex. Main outcome measures.,The sensitivity, specificity and predictive values of the AGA, ATGA and AEA tests. Results.,Nine cases of biopsy proven, previously undiagnosed coeliac disease were detected by screening. The sensitivity of both ATGA and AEA was 100% whilst AGA IgA and IgG both had a sensitivity of 89%. The AEA test had a specificity of 100% whereas the specificities of the ATGA, AGA IgA and IgG tests were 97, 96 and 78%, respectively. The positive predictive value for the AEA test was 100%, whereas it was considerably lower for the other tests (ATGA > AGA IgA > AGA IgG), with further decreases for all tests when shifting from a clinical to a screening situation. Conclusions.,When screening for coeliac disease we suggest a serial testing approach, i.e. an initial ATGA test and, when positive, followed by an AEA test, provided that IgA deficiency has been excluded. However, assessment of the small intestinal mucosal morphology is still required to ascertain the diagnosis. [source] Clinical trial: gluten microchallenge with wheat-based starch hydrolysates in coeliac disease patients , a randomized, double-blind, placebo-controlled study to evaluate safetyALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 10 2008K. KAUKINEN Summary Background, Wheat-based starch hydrolysates such as glucose syrups, dextrose and maltodextrins are found in more than 50% of European processed food. These products contain low amounts of residual gluten and it has been questioned whether they are safe for coeliac disease patients. Aim, To investigate whether coeliac disease patients can safely consume wheat-based starch hydrolysate products. Methods, This randomized, double-blind, placebo-controlled, prospective follow-up study involved 90 coeliac disease patients in remission randomized to consume glucose syrups, maltodextrins or placebo for 24 weeks. Small bowel mucosal morphology and inflammation, symptoms, coeliac serology and malabsorption laboratory data were evaluated at baseline and at the end of the study. Results, Daily ingestion of wheat-based starch hydrolysates, glucose syrups and maltodextrins, had no deleterious effect on small-bowel mucosal villous architecture or inflammation in coeliac disease patients when compared to the placebo group. Neither were there any significant differences in gastrointestinal symptoms, serology or malabsorption parameters after 24 weeks. Conclusions, Wheat-based starch hydrolysates, glucose syrups and maltodextrins did not have harmful effect on coeliac disease patients. Coeliac patients can thus safely continue to consume these products. [source] Oats in the treatment of childhood coeliac disease: a 2-year controlled trial and a long-term clinical follow-up studyALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 10 2006K. HOLM Summary Background The exclusion of oats from the diet in coeliac disease is controversial. Aim To study the long-term safety of oats in the treatment of children with coeliac disease. Methods Altogether 32 children with coeliac disease were enrolled in a 2-year controlled trial. Twenty-three children in remission were randomized either to oats or gluten challenge; when small bowel histological relapse was evident after gluten challenge, a gluten-free diet including oats was started. Furthermore, nine newly detected coeliac patients adopted an oat-containing gluten-free diet. Small bowel mucosal morphology, CD3+, ,,+ and ,,+ intraepithelial lymphocytes, human leucocyte antigen (HLA) DR expression and coeliac serology were determined. After the trial, the children were allowed to eat oats freely; follow-up was extended up to 7 years. Results In coeliac children in remission, oats had no detrimental effect on intestinal histology or serology during the 2-year trial. In contrast, the gluten-challenge group relapsed after 3,12 months. Complete recovery from the disease was accomplished in all relapsed and newly detected patients on an oat-containing gluten-free diet. After the trial, 86% of the children preferred to consume oats and they all remained in remission. Conclusion In most children with coeliac disease, long-term consumption of oats is well tolerated, and it does not result in small bowel mucosal deterioration or immune activation. [source] Changes of gastric mucosal architecture during long-term omeprazole therapy: results of a randomized clinical trialALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 5 2006L. LUNDELL Summary Background, The impact of long-term acid suppression on the gastric mucosa remains controversial. Aim, To report further observations on an established cohort of patients with gastro-oesophageal reflux disease, after 7 years of follow-up. Methods, Of the original cohort randomized to either antireflux surgery or omeprazole, 117 and 98 patients remained in the medical and surgical arms, respectively. Gastric biopsies were taken at baseline and throughout the study. Results, Fifty-three antireflux surgery and 39 omeprazole-treated patients had Helicobacter pylori infection at randomization. Eighty-three omeprazole-treated and 60 antireflux surgery patients remained H. pylori negative over the 7 years, and no change was observed in mucosal morphology except for a change in endocrine cell population (linear and diffuse hyperplasia, P = 0.03). During the 7-year study many patients, who were initially H. pylori infected, had the infection eradicated leaving only 13 omeprazole and 12 antireflux surgery patients still infected. In these patients, omeprazole induced a deterioration of the mucosal inflammation scores (P = 0.01) with a numerical increase of glandular atrophy. Conclusions, Long-term omeprazole therapy does not alter the exocrine oxyntic mucosal morphology in H. pylori -negative patients, but mucosal endocrine cells appear to be under proliferative stimulation; in H. pylori -positive patients there are changes in mucosal inflammation and atrophy. [source] | ||||||||||