Small- bowel mucosal changes and antibody responses after low- and moderate-dose gluten challenge in celiac disease

BMC Gastroenterology

Research Article

Katri Kaukinen¹  Marja-Leena Lähdeaho²  Kaija Laurila²  Markku Mäki²  Heini Huhtala³ 

[1] Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital and School of Medicine, University of Tampere, Tampere, Finland;Paediatric Research Centre and School of Medicine, University of Tampere and Tampere University Hospital, Tampere, Finland;School of Health Sciences, University of Tampere, Finland;

关键词: Celiac Disease;    Villous Atrophy;    Celiac Disease Patient;    Celiac Patient;    Crypt Hyperplasia;   

DOI  :  10.1186/1471-230X-11-129

 received in 2011-08-10, accepted in 2011-11-24,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundDue to the restrictive nature of a gluten-free diet, celiac patients are looking for alternative therapies. While drug-development programs include gluten challenges, knowledge regarding the duration of gluten challenge and gluten dosage is insufficient.We challenged adult celiac patients with gluten with a view to assessing the amount needed to cause some small-bowel mucosal deterioration.MethodsTwenty-five celiac disease adults were challenged with low (1-3 g) or moderate (3-5g) doses of gluten daily for 12 weeks. Symptoms, small-bowel morphology, densities of CD3+ intraepithelial lymphocytes (IELs) and celiac serology were determined.ResultsBoth moderate and low amounts of gluten induced small-bowel morphological damage in 67% of celiac patients. Moderate gluten doses also triggered mucosal inflammation and more gastrointestinal symptoms leading to premature withdrawals in seven cases. In 22% of those who developed significant small- intestinal damage, symptoms remained absent. Celiac antibodies seroconverted in 43% of the patients.ConclusionsLow amounts of gluten can also cause significant mucosal deterioration in the majority of the patients. As there are always some celiac disease patients who will not respond within these conditions, sample sizes must be sufficiently large to attain to statistical power in analysis.

【 授权许可】

Unknown   
© Lähdeaho et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.