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Título: | Clinical utility of urinary gluten immunogenic peptides in the follow-up of patients with coeliac disease |
Autor: | Garzón-Benavides, Marta CSIC ORCID; Ruiz-Carnicer, Ángela; Segura, Verónica; Fombuena, Blanca CSIC; García-Fernández, Francisco José CSIC; Sobrino-Rodríguez, Salvador; Gómez Izquierdo, Lourdes; Montes-Cano, Marco-Antonio CSIC; Millán Domínguez, Raquel CSIC; Rico, María Carmen CSIC; González-Naranjo, Carmen; Bozada-García, Juan M.; Coronel Rodríguez, Cristóbal; Espín, Beatriz; Díaz, Jacobo; Comino, Isabel; Argüelles Arias, Federico; Cebolla, Ángel; Romero-Gómez, Manuel CSIC ORCID CVN; Rodríguez-Herrera, Alfonso; Sousa, Carolina; Pizarro, Ángeles CSIC | Palabras clave: | Urine Coeliac disease Duodenal mucosal damage Gluten immunogenic peptides Gluten-free diet |
Fecha de publicación: | may-2023 | Editor: | John Wiley & Sons | Citación: | Alimentary Pharmacology and Therapeutics 57(9): 993-1003 (2023) | Resumen: | [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. |
Versión del editor: | https://doi.org/10.1111/apt.17417 | URI: | http://hdl.handle.net/10261/334070 | DOI: | 10.1111/apt.17417 | ISSN: | 0269-2813 | E-ISSN: | 1365-2036 |
Aparece en las colecciones: | (IBIS) Artículos |
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coeliac-disease.pdf | 4,81 MB | Adobe PDF | Visualizar/Abrir |
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