Real-world Gluten Exposure in Patients With Celiac Disease on Gluten-Free Diets, Determined From Gliadin Immunogenic Peptides in Urine and Fecal Samples.

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It is not clear how often patients who are on gluten-free diets (GFDs) for treatment celiac disease are still exposed to gluten. We studied levels of gluten immunogenic peptides (GIP) in fecal and urine samples, collected over 4 weeks, from patients with celiac disease following a long-term GFD.We performed a prospective study of 53 adults with celiac disease who had been on a GFD for more than 2 years (median duration, 8 years; interquartile range, 5-12 years) in Argentina. At baseline, symptoms were assessed by the celiac symptom index questionnaire. Patients collected stool each Friday and Saturday and urine samples each Sunday for 4 weeks. We used a commercial ELISA to measure GIP in stool and point-of-care tests to measure GIP in urine samples.Overall, 159 of 420 stool and urine samples (37.9%) were positive for GIP; 88.7% of patients had at least 1 fecal or urine sample that was positive for GIP (median, 3 excretions). On weekends (urine samples), 69.8% of patients excreted GIP at least once, compared with 62.3% during weekdays (stool). The number of patients with a sample that was positive for GIP increased over the 4-week study period (urine samples in week 1 vs week 4, P


Click here to read the full article @ Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

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