Clinical Utility of Urinary Gluten Immunogenic Peptides in the Follow-up of Patients with Coeliac Disease

Background: Gluten-free diet (GFD) is the only treatment for patients with coeliac disease (CD). and its compliance should be monitored to avoid cumulative damage. Aims: To analyse gluten exposures of coeliac patients on GFD for at least 24 months using different monitoring tools and its impact on d...

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Autores: Garzón Benavides, Marta, Ruiz Carnicer, Ángela, Segura Montero, Verónica, Fombuena, Blanca, García-Fernández, Francisco-José, Comino Montilla, Isabel María, Argüelles Arias, Federico, Romero Gómez, Manuel, Sousa Martín, Carolina, Pizarro Moreno, Ángeles
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Universidad de Sevilla (US)
Repositorio:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:idus.us.es:11441/149019
Acceso en línea:https://hdl.handle.net/11441/149019
https://doi.org/10.1111/apt.17417
Access Level:acceso abierto
Palabra clave:Coeliac disease
Duodenal mucosal damage
Gluten immunogenic peptides
Gluten-free diet
Urine
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spelling Clinical Utility of Urinary Gluten Immunogenic Peptides in the Follow-up of Patients with Coeliac DiseaseGarzón Benavides, MartaRuiz Carnicer, ÁngelaSegura Montero, VerónicaFombuena, BlancaGarcía-Fernández, Francisco-JoséComino Montilla, Isabel MaríaArgüelles Arias, FedericoRomero Gómez, ManuelSousa Martín, CarolinaPizarro Moreno, ÁngelesCoeliac diseaseDuodenal mucosal damageGluten immunogenic peptidesGluten-free dietUrineBackground: Gluten-free diet (GFD) is the only treatment for patients with coeliac disease (CD). and its compliance should be monitored to avoid cumulative damage. Aims: To analyse gluten exposures of coeliac patients on GFD for at least 24 months using different monitoring tools and its impact on duodenal histology at 12-month follow-up and evaluate the interval of determination of urinary gluten immunogenic peptides (u-GIP) for the monitoring of GFD adherence. Methods: Ninety-four patients with CD on a GFD for at least 24 months were prospectively included. Symptoms, serology, CDAT questionnaire, and u-GIP (three samples/visit) were analysed at inclusion, 3, 6, and 12 months. Duodenal biopsy was performed at inclusion and 12 months. Results: At inclusion, 25.8% presented duodenal mucosal damage; at 12 months, this percentage reduced by half. This histological improvement was indicated by a reduction in u-GIP but did not correlate with the remaining tools. The determination of u-GIP detected a higher number of transgressions than serology, regardless of histological evolution type. The presence of >4 u-GIP-positive samples out of 12 collected during 12 months predicted histological lesion with a specificity of 93%. Most patients (94%) with negative u-GIP in ≥2 follow-up visits showed the absence of histological lesions (p < 0.05). Conclusion: This study suggests that the frequency of recurrent gluten exposures, according to serial determination of u-GIP, could be related to the persistence of villous atrophy and that a more regular follow-up every 6 months, instead of annually, provides more useful data about the adequate adherence to GFD and mucosal healing.Junta de Andalucía PI- 0427-2017, PI- 0053-2018Wiley-BlackwellMicrobiología y ParasitologíaMedicinaJunta de Andalucía2023info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/11441/149019https://doi.org/10.1111/apt.17417reponame:idUS. Depósito de Investigación de la Universidad de Sevillainstname:Universidad de Sevilla (US)InglésAlimentary Pharmacology and Therapeutics, 57 (9), 993-1003.PI- 0427-2017PI- 0053-2018https://dx.doi.org/10.1111/apt.17417info:eu-repo/semantics/openAccessoai:idus.us.es:11441/1490192026-06-17T12:51:07Z
dc.title.none.fl_str_mv Clinical Utility of Urinary Gluten Immunogenic Peptides in the Follow-up of Patients with Coeliac Disease
title Clinical Utility of Urinary Gluten Immunogenic Peptides in the Follow-up of Patients with Coeliac Disease
spellingShingle Clinical Utility of Urinary Gluten Immunogenic Peptides in the Follow-up of Patients with Coeliac Disease
Garzón Benavides, Marta
Coeliac disease
Duodenal mucosal damage
Gluten immunogenic peptides
Gluten-free diet
Urine
title_short Clinical Utility of Urinary Gluten Immunogenic Peptides in the Follow-up of Patients with Coeliac Disease
title_full Clinical Utility of Urinary Gluten Immunogenic Peptides in the Follow-up of Patients with Coeliac Disease
title_fullStr Clinical Utility of Urinary Gluten Immunogenic Peptides in the Follow-up of Patients with Coeliac Disease
title_full_unstemmed Clinical Utility of Urinary Gluten Immunogenic Peptides in the Follow-up of Patients with Coeliac Disease
title_sort Clinical Utility of Urinary Gluten Immunogenic Peptides in the Follow-up of Patients with Coeliac Disease
dc.creator.none.fl_str_mv Garzón Benavides, Marta
Ruiz Carnicer, Ángela
Segura Montero, Verónica
Fombuena, Blanca
García-Fernández, Francisco-José
Comino Montilla, Isabel María
Argüelles Arias, Federico
Romero Gómez, Manuel
Sousa Martín, Carolina
Pizarro Moreno, Ángeles
author Garzón Benavides, Marta
author_facet Garzón Benavides, Marta
Ruiz Carnicer, Ángela
Segura Montero, Verónica
Fombuena, Blanca
García-Fernández, Francisco-José
Comino Montilla, Isabel María
Argüelles Arias, Federico
Romero Gómez, Manuel
Sousa Martín, Carolina
Pizarro Moreno, Ángeles
author_role author
author2 Ruiz Carnicer, Ángela
Segura Montero, Verónica
Fombuena, Blanca
García-Fernández, Francisco-José
Comino Montilla, Isabel María
Argüelles Arias, Federico
Romero Gómez, Manuel
Sousa Martín, Carolina
Pizarro Moreno, Ángeles
author2_role author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Microbiología y Parasitología
Medicina
Junta de Andalucía
dc.subject.none.fl_str_mv Coeliac disease
Duodenal mucosal damage
Gluten immunogenic peptides
Gluten-free diet
Urine
topic Coeliac disease
Duodenal mucosal damage
Gluten immunogenic peptides
Gluten-free diet
Urine
description Background: Gluten-free diet (GFD) is the only treatment for patients with coeliac disease (CD). and its compliance should be monitored to avoid cumulative damage. Aims: To analyse gluten exposures of coeliac patients on GFD for at least 24 months using different monitoring tools and its impact on duodenal histology at 12-month follow-up and evaluate the interval of determination of urinary gluten immunogenic peptides (u-GIP) for the monitoring of GFD adherence. Methods: Ninety-four patients with CD on a GFD for at least 24 months were prospectively included. Symptoms, serology, CDAT questionnaire, and u-GIP (three samples/visit) were analysed at inclusion, 3, 6, and 12 months. Duodenal biopsy was performed at inclusion and 12 months. Results: At inclusion, 25.8% presented duodenal mucosal damage; at 12 months, this percentage reduced by half. This histological improvement was indicated by a reduction in u-GIP but did not correlate with the remaining tools. The determination of u-GIP detected a higher number of transgressions than serology, regardless of histological evolution type. The presence of >4 u-GIP-positive samples out of 12 collected during 12 months predicted histological lesion with a specificity of 93%. Most patients (94%) with negative u-GIP in ≥2 follow-up visits showed the absence of histological lesions (p < 0.05). Conclusion: This study suggests that the frequency of recurrent gluten exposures, according to serial determination of u-GIP, could be related to the persistence of villous atrophy and that a more regular follow-up every 6 months, instead of annually, provides more useful data about the adequate adherence to GFD and mucosal healing.
publishDate 2023
dc.date.none.fl_str_mv 2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/11441/149019
https://doi.org/10.1111/apt.17417
url https://hdl.handle.net/11441/149019
https://doi.org/10.1111/apt.17417
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Alimentary Pharmacology and Therapeutics, 57 (9), 993-1003.
PI- 0427-2017
PI- 0053-2018
https://dx.doi.org/10.1111/apt.17417
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Wiley-Blackwell
publisher.none.fl_str_mv Wiley-Blackwell
dc.source.none.fl_str_mv reponame:idUS. Depósito de Investigación de la Universidad de Sevilla
instname:Universidad de Sevilla (US)
instname_str Universidad de Sevilla (US)
reponame_str idUS. Depósito de Investigación de la Universidad de Sevilla
collection idUS. Depósito de Investigación de la Universidad de Sevilla
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,300724

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