Negative predictive value of the repeated absence of gluten immunogenic peptides in the urine of treated celiac patients in predicting mucosal healing: new proposals for follow-up in celiac disease

The American Journal of Clinical Nutrition
Ángela Ruiz-CarnicerÁngeles Pizarro

Abstract

The treatment of celiac disease (CD) is a lifelong gluten-free diet (GFD). The current methods for monitoring GFD conformance, such as a dietary questionnaire or serology tests, may be inaccurate in detecting dietary transgressions, and duodenal biopsies are invasive, expensive, and not a routine monitoring technique. Our aim was to determine the clinical usefulness of urine gluten immunogenic peptides (GIP) as a biomarker monitoring GFD adherence in celiac patients and to evaluate the concordance of the results with the degree of mucosal damage. A prospective observational study was conducted involving 22 de novo CD patients, 77 celiac patients consuming a GFD, and 13 nonceliac subjects. On 3 d of the week, urine samples were collected and the GIP concentrations were tested. Simultaneously, anti-tissue transglutaminase antibodies, questionnaire results, clinical manifestations, and histological findings were analyzed. Approximately 24% (18 of 76) of the celiac patients consuming a GFD exhibited Marsh II-III mucosal damage. Among this population, 94% (17 of 18) had detectable urine GIP; however, between 60% and 80% were asymptomatic and exhibited negative serology and appropriate GFD adherence based on the questionnaire. In con...Continue Reading

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Citations

Sep 29, 2020·Critical Reviews in Food Science and Nutrition·Ilkem Demirkesen, Berrin Ozkaya
Feb 5, 2021·Frontiers in Medicine·María de Lourdes MorenoCarolina Sousa
Mar 27, 2021·The American Journal of Gastroenterology·Anupam RejDavid Surendran Sanders
Mar 27, 2021·The American Journal of Gastroenterology·Jocelyn A SilvesterCiaran P Kelly
Jul 3, 2021·Nutrients·Verónica SeguraMaría de Lourdes Moreno

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