A gluten metabolism study in healthy individuals shows the presence of faecal glutenasic activity.

PURPOSE: To study the gluten metabolism in healthy individuals and its effect over the intestinal microbial activity. METHODS: The faeces of eleven healthy subjects were analysed under 4 diet regimens: their normal gluten diet, a strict gluten-free diet (GFD), a GFD with a supplemental intake of 9 g gluten/day and a GFD with a supplemental intake of 30 g gluten/day. Gluten content, faecal tryptic activity (FTA), short-chain fatty acids (SCFAs) and faecal glutenasic activity (FGA) were analysed in faecal samples. RESULTS: Faecal gluten contents, FTA, SCFAs and FGA varied significantly with different levels of gluten intake in the diet. When high gluten doses (30 g/day) were administered in the diet, SCFA concentrations (70.5 mmoles/kg faeces) were significantly different from those from the GFD period (33.8 mmoles/kg faeces) of the experiment. However, the FTA showed significant differences between the GFD (34 units) and the normal gluten-containing diet (60 units) and also between the GFD and the GFD + 30 g of gluten/day (67 units). When gluten was present in the diet, gluten was detected in the faeces, showing that at least a portion of the gluten ingested is eliminated in the large intestine, providing a substrate for intestinal microbial proteases. We have also shown the presence of faecal glutenasic activity that increased proportionally with the gluten intake in the diet, showing an enzymatic activity of 993 units in DSG, 2,063 units in DSG + 9 g and 6,090 units in DSG + 30 g. CONCLUSIONS: The activity of the intestinal microbiota is modified by gluten intake in the diet. The incorporation of gluten in the diet increases the activity of a gluten proteolytic activity in the faeces.

Differences of small intestinal bacteria populations in adults and children with/without celiac disease: effect of age, gluten diet, and disease.

BACKGROUND: Scientific evidence has revealed microecological changes in the intestinal tract of celiac infants. The objective of this work is the study of bacterial differences in the upper small intestine in both adults (healthy, untreated celiac disease [CD], and CD treated with a gluten-free diet) and children (healthy and untreated CD). METHODS: Intestinal bacterial communities were identified by 16S rRNA gene sequencing of DNA extracted from duodenal biopsies. RESULTS: Analysis of the sequences from adults and children showed that this niche was colonized by bacteria affiliated mainly with three phyla: Firmicutes, Proteobacteria, and Bacteroidetes. In total, 89 different genera were identified in adults and 46 in children. Bacterial richness was significantly lower in the children than in the adults. A global principal component analysis of the bacterial communities of both healthy and untreated CD patient groups (including both children and adults) revealed a strong effect of age in principal component 1--clustering all adults and children separately--and a possible effect of the disease in adults with untreated patients clustering separately. CONCLUSIONS: There are bacterial differences in the upper small intestine between untreated children CD patients and untreated CD adults due to age. There are bacterial differences in the upper small bacteria microbiota between treated and untreated CD adults due to treatment with a gluten-free diet.

Manifestaciones gastrointestinales en pacientes con inmunodeficiencias primarias que cursan con déficit de anticuerpos / Gastrointestinal manifestations in patients with primary immunodeficiencies causing antibody deficiency

Introducción. Las inmunodeficiencias primarias pueden presentar manifestaciones digestivas aún no bien definidas. Objetivo. Analizar la patología digestiva que se asocia a las inmunodeficiencias primarias. Material y métodos. Estudio retrospectivo que incluyó a los pacientes diagnosticados de deficiencias primarias de anticuerpos en un hospital de tercer nivel. Fueron divididos en 2 grupos: déficit aislado de IgA (Def-IgA) y síndrome de inmunodeficiencia común variable (SICV). Se analizaron el momento de presentación y tipo de sintomatología digestiva. Resultados. Se recogieron 57 pacientes: 20 con SICV (35%) y 37 con Def-IgA (65%). El diagnóstico fue realizado en edad pediátrica en 17 casos, de los cuales 13 cursaban con Def-IgA. El diagnóstico de inmunodeficiencia fue previo a las manifestaciones digestivas en el 84% de los casos. La clínica digestiva se presentaba en un 74% de los pacientes, la diarrea fue el síntoma más frecuente. La patología se confirmó en el 46% de los casos principalmente mediante endoscopia. La enfermedad celiaca-like, gastritis crónica atrófica, colitis ulcerosa-like y enfermedad de Crohn fueron más comunes en el SICV. Mientras que en el Def-IgA predominaron la gastritis crónica con Helicobacter positivo. La edad media fue significativamente mayor (36 vs. 24 años, p=0,02) y el título de IgA menor (17 vs. 34UI/ml; p=0,008) en los pacientes que presentaban patología digestiva asociada. Conclusiones. Los síntomas digestivos son frecuentes y se llega al diagnóstico en la mitad de los pacientes con inmunodeficiencias primarias mediante estudio endoscópico. La colitis ulcerosa, Crohn y celiaca-like son entidades atípicas y propias del SICV (AU)

ObjectiveTo analyze gastrointestinal manifestations associated with primary immunodeficiencies. Material and methods. We performed a retrospective study that included patients diagnosed with primary antibody deficiencies in a third-level hospital. The patients were divided into two groups: isolated IgA deficiency and common variable immunodeficiency syndrome (CVIS). The timing of presentation and type of gastrointestinal symptoms were analyzed. Results. There were 57 patients: 20 with CVIS (35%) and 37 with isolated IgA deficiency (65%). Diagnosis was made in the pediatric age in 17 patients, of whom 13 had isolated IgA deficiency. In 84% of the patients, diagnosis of immunodeficiency was made before the development of gastrointestinal manifestations. Digestive symptoms were found in 74% of the patients, the most frequent being diarrhea. In 46% of the patients, digestive disease was confirmed, mainly through endoscopy. Celiac-like lesions, chronic atrophic gastritis, ulcerative colitis-like disease and Crohn's disease were more common in CVIS. In isolated IgA deficiency, Helicobacter pylori-positive chronic gastritis predominated. Mean age was significantly higher (36 vs. 24 years, p=0.02) and IgA titer significantly lower (17 vs. 34UI/ml; p=0.008) in patients with associated gastrointestinal disease. Conclusions. Gastrointestinal symptoms are frequent and lead to endoscopic diagnosis in half of patients with primary immunodeficiencies. Ulcerative colitis, and celiac- and Crohn's-like disease are atypical entities that occur in CVIS (AU)