Evaluation of a Single Determination of Gluten Immunogenic Peptides in Urine from Unaware Celiac Patients to Monitor Gluten-Free Diet Adherence
Articolo
Data di Pubblicazione:
2023
Citazione:
Evaluation of a Single Determination of Gluten Immunogenic Peptides in Urine from Unaware Celiac Patients to Monitor Gluten-Free Diet Adherence / V. Lombardo, A. Scricciolo, A. Costantino, L. Elli, G. Legnani, Á. Cebolla, L. Doneda, F. Mascaretti, M. Vecchi, L. Roncoroni. - In: NUTRIENTS. - ISSN 2072-6643. - 15:5(2023), pp. 1259.1-1259.10. [10.3390/nu15051259]
Abstract:
Introduction and aim: Usually, adherence to the gluten-free diet (GFD) in celiac patients is
indirectly assessed through serological analysis, questionnaires, or invasive methods such as intestinal
biopsy. The detection of gluten immunogenic peptides in urine (urinary gluten immunogenic
peptides—uGIP) is a novel technique that directly evaluates the ingestion of gluten. The aim of
this study was to evaluate the clinical efficacy of uGIP in the follow-up of celiac disease (CD).
Methods: From April 2019 to February 2020, CD patients reporting complete adherence to the GFD
were prospectively enrolled but were unaware of the reason for the tests. Urinary GIP, the celiac
dietary adherence test (CDAT), symptomatic visual analog scales (VAS), and tissue transglutaminase
antibodies (tTGA) titres were evaluated. Duodenal histology and capsule endoscopy (CE) were
performed when indicated. Results: A total of 280 patients were enrolled. Thirty-two (11.4%) had
a positive uGIP test (uGIP+). uGIP+ patients did not show significant differences in demographic
parameters, CDAT, or VAS scores. The tTGA+ titre was not related to the positivity of uGIP (14.4%
vs. 10.9% in patients with tTGA+ and tTGA−). Regarding histology, 66.7% of the GIP+ patients had
atrophy compared to 32.7% of the GIP patients (p-value 0.01). However, the presence of atrophy
did not correlate with tTGA. Mucosal atrophy was detected in 29 (47.5%) out of 61 patients by CE.
With this method, no noticeable dependence on uGIP results (24 GIP− vs. 5 GIP+) was observed.
Conclusions: The single uGIP test was positive in 11% of CD cases referring a correct GFD adherence.
Furthermore, uGIP results significantly correlated with the duodenal biopsy, formerly considered the
gold standard for assessing CD activity.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
celiac disease; gluten immunogenic peptides; gluten-free diet; gluten-free diet monitoring; urinary gluten detect
Elenco autori:
V. Lombardo, A. Scricciolo, A. Costantino, L. Elli, G. Legnani, Á. Cebolla, L. Doneda, F. Mascaretti, M. Vecchi, L. Roncoroni
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