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News

Intestinal permeability is more precise in monitoring celiac patients

Doctors find that intestinal permeability offers more precise information than antigliadin antibody test for monitoring celiac patients, reported in April's Digestive Diseases and Sciences.

News image

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Celiac disease causes chronic inflammation of the intestinal mucosa and reduces surface absorption.

After the withdrawal of gluten from the diet, there are clinical and histologic improvements.

The intestinal permeability test and serologic tests are useful for confirming the diagnosis and monitoring patients.

Antigliadin antibody remained positive in 41% of celiac patients
Digestive Diseases and Sciences

Dr Eduardo Garcia Vilela and colleagues from Brazil compared the antigliadin antibody test with the intestinal permeability test for celiac patients on a gluten-free diet.

The team of doctors assessed 22 celiac patients who were antigliadin immunoglobulin A-positive before treatment.

After 12 months on a gluten-free diet, antigliadin antibody testing was repeated and the intestinal permeability test was performed.

A control group was composed of 11 healthy individuals.

The doctors found that antigliadin antibody remained positive in 41% of celiac patients.

The team observed that the mean urinary lactulose excretion was 10%.

The mean value of mannitol was 10%, and the lactulose/mannitol ratio was just over 1.

The doctors found that in the subgroup in which antigliadin became negative, the value for lactulose was 4%, and 11% for mannitol.

The lactulose/mannitol ratio was 0.4 in this subgroup.

The urinary lactulose excretion and the lactulose/mannitol ratio was less in the control group compared with the 2 celiac groups.

The doctors noted that urinary mannitol excretion was greater in the control group compared with the celiac groups.

The team suggested persistent lesions in mucosa of both subgroups, although to a lesser degree for those that became antigliadin antibody negative.

Dr Vilela's team concluded, “Intestinal permeability allows a more precise clinical physiopathologic correlation than antigliadin, and offers more information for the monitoring of these patients.”

Dig Dis Sci 2007: 52(5): 1304-09
24 April 2007

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