Celiac disease is attributable to autoimmune diseases, where treatment is based on absolute respect for gluten-free diet. As the gluten used widely in all areas of food production, strict adherence to a gluten-free diet really can be difficult for people with celiac disease. Products suitable also for those suffering from the disease are usually expensive. Finally, patients that undergo exclusively on a gluten-free diet are robbing the important nutritional components. Therefore, interest in this type of products innovation enhance as to the nutritional, technological, as well as organoleptic properties. The aim of this final thesis was to draw up literature review of the celiac disease and gluten allergen, or his particular part of gliadin. In the experimental part, attention was focused on the first hydrolytic cleavage of starch, the substrate was sterilized wheat flour and water, where is incorporated spiral just gluten. The best ability of degrading the starch grains, the combination of enzymes and MT3K and GLUAMK concentration of 0, 1% over 4 hours of action, as indicated by a reduction in the starch content of the original amount of 72,65 % at a concentration of 29,00 %. The next item of work distribution used different proteases, to reduce the amount of gliadin to below 20 ppm per kilogram of final product. Low levels investigated allergen (10,79 ppm/kg) recorded by the enzyme combination exoprotease Flavourzyme (0,1 %) and endoprotease Neutral Protease (0,1 %) at 7 hours hydrolytic action. The conclusion of the thesis was prepared several alternatives gluten-free breads and through sensory evaluation assessed the characteristics of color, aroma and taste to predict the location of the products on the commercial market.

Gluten sensitive entheropathy - celiac disease is a lifelong, genetically predisposed, immunologically mediated susceptibility to dietary wheat gluten, most frequently demonstrated by small-bowel damage and malabsorption syndrome. Strict adherence to gluten-free diet is the sole rational therapy of the disease. One of the possible therapeutic strategy for the treating of celiac disease is to utilize the synthetic polymer P(HEMA-co-SS). This polymer is capable specifically bound gliadin in gastrointestinal tract and by this way to neutralize the damaging effect of this alimentary protein on mucosa of small intestine in celiac patients. The in vitro study on human PBMC and specimens of small intestinal biopsies of celiac patients in our laboratory demonstrated that putative therapeutic ability of P(HEMA-co-SS) is substantially influenced by degree of proteolytic processing of gliadin and P(HEMA- co-SS) and also by different timing of per os administration of both components in organism. Another putative adjuvant therapy of celiac disease is employing of the beneficial probiotic bacterial strains. Our experiments were based on the findings of Prof. Y Sánz and her group demonstrating the significant differences in the composition of bacterial microflora in patients with active form of celiac disease,...

This diploma thesis deals with the issue of celiac disease with a focus on the importance of micronutrients in treatment and clinical monitoring of patients with celiac disease. The thesis is divided into two parts, theoretical and practical. The theoretical part is divided into two chapters. The first chapter deals with celiac disease in general - history, epidemiology, pathogenesis, clinical classification, clinical manifestations, diagnostics and complications of celiac disease. Procedures for clinical monitoring of patients with celiac disease are also discussed. Last but not least, cereal proteins are analysed with a focus on gluten and its importance in the pathogenesis of celiac disease. The second chapter describes gluten-free diet as the only available possibility how to treat celiac disease. Furthermore, the pitfalls of the gluten-free diet and its possible nutritional imbalances associated with a gluten-free diet. The issue of gluten-free products is discussed, both in terms of legislation and in terms of selecting suitable foods. The possibilities of supplementation of micronutrients in celiac and other investigated possibilities of treatment of celiac disease outside the gluten-free diet are also mentioned. The practical part of this diploma thesis has two main goals. The first goal is...

Purpose: The aim of this study was to determine whether glycemic control is different between subjects who screened negative for Celiac Disease (CD) compared to subjects who screened positive for CD among subjects with autoimmune insulin-dependent diabetes. Also, this study investigated if the presence of specific beta cell autoantibodies, GAD65, Islet cell antibodies or both, could predict the risk for positive CD screening. METHODS/PROCEDURES: A retrospective cohort study of an existing clinical care data was obtained from the Clinical Data Warehouse (CDW) in Boston Medical Center (BMC) for the period between January 2000 and November 2015. The exposed cohort included those who screened positive for CD, while the non-exposed cohort included subjects who screened negative for CD. The following data was collected and included in the analysis: demographic variables, A1C levels, Diabetic Ketoacidosis (DKA) events, diabetes-associated antibodies, CD screening tests, and CD biopsy results. Longitudinal data for each subject was obtained from the CDW. RESULTS: The prevalence of potential CD in this study was 8.8%, while the prevalence of biopsy confirmed CD was 4.4%. Mean A1C level for subjects who screened negative for TTG was 8.9% (CI 8.3 - 9.6), while mean A1C levels for subjects who screened positive for TTG was 7.9% (CI 6.8 - 9.0) after adjusting for confounders using the mixed-effect model. This difference was not statistically significant. Moreover, diabetes-associated antibodies did not predict the risk for positive TTG screening. CONCLUSION: The glycemic control for subjects who screened negative for CD was found to be similar to subjects who screened positive for CD. However, further studies with higher power and larger sample size are needed to confirm the findings of this study. / 2017-11-03T00:00:00Z

Celiac disease is characterized by an allergic reaction to gluten that causes inflammation of the small intestine and can lead to malabsorption and malnutrition. Glutenree products are being developed that meet dietary needs of individuals with celiac disease. However, these products often lack whole grains and fiber. Fortification of glutenree products with flax can increase nutritional value and alleviate inflammation. Sensory analysis (N=152) was conducted to evaluate the acceptability of glutenree muffins with moderate (3.8%) and high (7.4%) amounts of added flax. Results indicated that consumers preferred (p<0.05) the muffin without flax or the highlax muffin more than the muffin with the moderatelax treatment. The highlax and control treatments were rated 6.7, between like slightly and moderately like; the muffins from the moderatelax treatment were rated 6.4 on a nine-point hedonic scale. Producers of glutenree products could potentially formulate muffins that include flax and are acceptable to consumers.

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Introduction Several studies have found celiac disease may be associated with a variety of cardiac manifestations. Atrial fibrillation (AF) is one of the most common arrhythmias that can cause significant morbidity. However, the risk of atrial fibrillation in patients with celiac disease according to epidemiological studies remains unclear. The aim of this meta-analysis study is to assess the risk of atrial fibrillation in patients diagnosed with celiac disease compared to controls. Methods A systematic literature review was conducted in MEDLINE, EMBASE, Cochrane databases from inception through December 2017 to identify studies that evaluated the risk of atrial fibrillation in patients with celiac disease. We included randomized controlled trial, cross sectional and cohort studies that reported the odds ratio, relative risk, hazard ratio, and standardized incidence ratio comparing the risk of developing atrial fibrillation among patients with celiac disease, versus patients without celiac disease as control. The Newcastle-Ottawa scale was used to determine the quality of the studies. Effect estimates from individual studies were extracted and combined using random-effect, generic inverse variance method of DerSimonian and Laird. Results Celiac disease is an autoimmune condition. This inflammatory state predisposes patients to develop AF. After a review of the literature, four observational studies with a total of 64,397 participants were enrolled. The association between celiac disease and increased risk of atrial fibrillation was significant, with a pooled OR of 1.38 (95% CI: 1.01-1.88). No publication bias as assessed by the funnel plots and Egger's regression asymmetry test with p = 0.54. However, the heterogeneity of the included studies was high (I2 = 96). Conclusion A significant association between celiac disease and risk of atrial fibrillation was reported in this study. There is a 38% increased risk of atrial fibrillation. Additional studies are needed to clarify the mechanistic link between atrial fibrillation and celiac disease. Some of the limitations of this study are that all were observational studies, some were medical registry-based and there was high heterogeneity between studies.

Diss. (sammanfattning) Umeå : Umeå universitet, 2009. / Härtill 4 uppsatser.

INTRODUÇÃO: A Doença Celíaca pode ser definida como uma intolerância permanente ao glúten e proteínas relacionadas, em indivíduos geneticamente susceptíveis, com lesão não específica, porém característica da mucosa do intestino delgado e que apresenta melhora clínica e histológica com a dieta específica. A recente disponibilidade de testes sorológicos que demonstram alta sensibilidade e especificidade permitiu perceber que a Doença Celíaca evidencia-se mais prevalente do que antes imaginado. A utilização do anticorpo antiendomísio IgA (AAE) e do anticorpo anti-transglutaminase tecidual IgA(tTG) viabilizou a realização de estudos de prevalência em doadores de sangue. O objetivo geral dessa pesquisa visa estimar a prevalência da Doença Celíaca em adultos na cidade de São Paulo, através da investigação de marcadores sorológicos em doadores voluntários em banco de sangue. São Paulo representa uma das maiores metrópoles do mundo e a maior cidade do Brasil, sendo um centro urbano com grande variabilidade étnica e um importante pólo de migração interna, aumentando ainda mais a miscigenação da sua população, o que constitui uma fonte de estudo importante para a previsão de prevalência da doença celíaca em nosso país. O objetivo específico propõe correlacionar essa prevalência com a raça/cor dos doadores de sangue, visto que mantidos os fatores genéticos e ambientais, a prevalência da doença celíaca parece ser a mesma, independentemente da região de residência. METODOLOGIA: Aplicação de questionário demográfico, investigação de sintomas e inquérito sobre ancestralidade, aplicados aos doadores, em um total de 4000 voluntários. Foi realizado em toda a amostra o teste sorológico antitransglutaminase IgA, bem como o teste sorológico com anticorpos IgA antiendomísio. Como o padrão ouro na análise da Doença Celíaca ainda é a biópsia do intestino delgado, o diagnóstico foi confirmado com a realização de endoscopia digestiva alta, com biópsia de duodeno e avaliação dos fragmentos com base nos critérios de Marsh modificado por Oberhuber. RESULTADOS: A idade média dos doadores foi de 31 anos, com 1817 do gênero feminino e 2183 masculino. Quanto à ancestralidade, 29% referiram ascendência européia. Dos 4000 testes, houve concordância dos exames em 11 casos, além de 10 com tTG positivo mas sem correlação com AAE e 3 casos apresentando AAE positivo isoladamente. No exame histopatológico, houve confirmação diagnóstica com achados de atrofia de vilos em 14 casos. CONCLUSÃO: Na cidade de São Paulo a prevalência da Doença Celíaca em doadores de sangue comprovada por biópsia é de no mínimo 1:286, semelhante aos de países europeus e Estados Unidos / BACKGROUND: Celiac disease is a permanent enteropathy caused by the ingestion of gluten and leads to an immunologically mediated inflammation of the small intestine mucosa. The prevalence of celiac disease varies among different nations and ethnic backgrounds, and its diversity is determined by genetic and environmental factors. More recently, several serological population screenings have shown that the prevalence of the disease is more common than previously imagined. Sao Paulo city is one of the biggest cities in the world, with a large population and with an important history of migratory flow from other countries, mainly European ones, and from other Brazilian cities, also with an important miscegenation. Since Sao Paulo city can be thought as a reflection of ethnic and social characters of the Brazilian population, we have decided to study the prevalence of celiac disease in Sao Paulo city. The aim of the present study was to assess the prevalence of unrecognized adult celiac disease in Sao Paulo and correlate it with further information about ancestry of the population studied. METHODS: We have measured the prevalence of celiac disease by means of a survey of serum markers (IgA transglutaminase antibody-guinea pig and IgA endomysium antibody-human umbilical cord) in 4,000 volunteers donors in the central Blood Bank in Sao Paulo, Pro-Sangue Foundation. The antibody-positive subjects were asked to undergo small-bowel biopsy. RESULTS: There were 1817 female and 2183 male with mean age of 31 years. In the ancestry evaluation of the 4,000 volunteers, we had 68% subjects with Brazilian origin and the remaining from other countries, mainly Italy, Portugal, Spain, and Germany. Of the 4,000 subjects, twenty-four subjects had positive tests, with results of the two antibody tests concordant or not. Ten subjects were positive for IgA-class tissue transglutaminase only. Most donors diagnosed with celiac disease were asymptomatic and when symptomatic the most common symptoms were flatulence and constipation. So far, in 21 positive patients, duodenal biopsies were performed and in 14 patients the diagnosis of celiac disease was confirmed (Marsh criteria modified for Oberhuber). CONCLUSION: Among apparently healthy blood donors, the prevalence of celiac disease is at least 1: 286 donors, similar to that seen in the United States and Europe