Taavela, Juha
https://orcid.org/0000-0003-3948-9555
Mayo Clinic
Central Finland Health Care District
Citations 2
Gluten Induces Subtle Histological Changes in Duodenal Mucosa of Patients with Non-Coeliac Gluten Sensitivity: A Multicentre Study
Rostami, Kamran , Ensarı, Arzu , Marsh, Michael N. , Villanacci, Vincenzo , Aghdaei, Hamid Asadzadeh , Bai, Julio C. , Bassotti, Gabrio , Becheanu, Gabriel , Bell, Phoenix , Bella, Camillo Di, Bozzola, Anna, Cadei, Moris, Casella, Giovanni , Ciacci, Carolina , Ciobanu, Delia , Danciu, Mihai , Das, Prasenjit , Drage, Michael G. , Elli, Luca , Fasano, Alessio , Florena, Ada Maria , Fusco, Nicola , Guandalini, Stefano , Hayman, David T. S. , Ishaq, Sauid , Jericho, Hilary , Johncilla, Melanie , Johnson, Matt, Kaukinen, Katri , Levene, Adam, Liptrot, Sarah, Lu, Laura , Makharia, Govind , Mathews, Sherly, Mazzarella, Giuseppe , Maxim, Roxana, Myint, Khun La Win, Shalmani, Hamid Mohaghegh , Moradi, Afshin , Mulder, Chris J. , Ray, Ronnie, Ricci, Chiara , Rostami‐Nejad, Mohammad , Sapone, Anna, Sanders, David S. , Taavela, Juha , Volta, Umberto , Walker, Marjorie M. , Carroccio, Antonio , Asadzadeh Aghdaei, Hamid , Bassotti, Gabrio , Bell, Phoenix , Casella, Giovanni , Ciacci, Carolina , Apostol Ciobanu, Delia Gabriela , Danciu, Mihai , Das, Prasenjit , Elli, Luca , Fasano, Alessio , Fusco, Nicola , Guandalini, Stefano , Hagen, Catherine E. , Hayman, David T S , Makharia, Govind K , Mazzarella, Giuseppe , Mohaghegh-Shalmani, Hamid , Ricci, Chiara , Rostami-Nejad, Mohammad , Taavela, Juha , Volta, Umberto , Walker, Marjorie , Drage, Michael G , Srivastava, Amitabh , Catassi, Carlo , Cross, Simon S. , SORDO, Rachele DEL , Going, James J. , Derakhshan, Mohammad Hossein
Nutrients | June 16, 2022 | Volume: 14 | Issue: 12 | Pages: 2487
Background: Histological changes induced by gluten in the duodenal mucosa of patients with non-coeliac gluten sensitivity (NCGS) are poorly defined. Objectives: To evaluate the structural and inflammatory features of NCGS compared to controls and coeliac disease (CeD) with milder enteropathy (Marsh I-II). Methods: Well-oriented biopsies of 262 control cases with normal gastroscopy and histologic findings, 261 CeD, and 175 NCGS biopsies from 9 contributing countries were examined. Villus height (VH, in μm), crypt depth (CrD, in μm), villus-to-crypt ratios (VCR), IELs (intraepithelial lymphocytes/100 enterocytes), and other relevant histological, serologic, and demographic parameters were quantified. Results: The median VH in NCGS was significantly shorter (600, IQR: 400–705) than controls (900, IQR: 667–1112) (p < 0.001). NCGS patients with Marsh I-II had similar VH and VCR to CeD [465 µm (IQR: 390–620) vs. 427 µm (IQR: 348–569, p = 0·176)]. The VCR in NCGS with Marsh 0 was lower than controls (p < 0.001). The median IEL in NCGS with Marsh 0 was higher than controls (23.0 vs. 13.7, p < 0.001). To distinguish Marsh 0 NCGS from controls, an IEL cut-off of 14 showed 79% sensitivity and 55% specificity. IEL densities in Marsh I-II NCGS and CeD groups were similar. Conclusion: NCGS duodenal mucosa exhibits distinctive changes consistent with an intestinal response to luminal antigens, even at the Marsh 0 stage of villus architecture.
Outcome measures in coeliac disease trials: the Tampere recommendations
Ludvigsson, Jonas F. , Ciacci, Carolina , Green, Peter H.R., Kaukinen, Katri , Korponay‐Szabó, Ilma R. , Kurppa, Kalle , Lundin, Knut Erik Aslaksen, Mäki, Markku , Popp, Alina , Reilly, Norelle R., Rodríguez‐Herrera, Alfonso , Sanders, David S. , Schuppan, Detlef, Sleet, Sarah, Voorhees, Kristin, Walker, Marjorie M. , Leffler, Daniel A. , Ciacci, Carolina , Green, Peter H.R. , Murray, Joseph A. , Taavela, Juha
Gut | February 13, 2018 | Volume: 67 | Issue: 8 | Pages: 1410-1424
Objective A gluten-free diet is the only treatment option of coeliac disease, but recently an increasing number of trials have begun to explore alternative treatment strategies. We aimed to review the literature on coeliac disease therapeutic trials and issue recommendations for outcome measures. Design Based on a literature review of 10 062 references, we (17 researchers and 2 patient representatives from 10 countries) reviewed the use and suitability of both clinical and non-clinical outcome measures. We then made expert-based recommendations for use of these outcomes in coeliac disease trials and identified areas where research is needed. Results We comment on the use of histology, serology, clinical outcome assessment (including patient-reported outcomes), quality of life and immunological tools including gluten immunogenic peptides for trials in coeliac disease. Conclusion Careful evaluation and reporting of outcome measures will increase transparency and comparability of coeliac disease therapeutic trials, and will benefit patients, healthcare and the pharmaceutical industry.