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1. ESPGHAN position paper on management and follow-up of children and adolescents with celiac disease

Author

Mearin, M.L., Agardh, D., Antunes, H., Al-Toma, A., Auricchio, R., Castillejo, G., Catassi, C., Ciacci, C., Discepolo, V., Dolinsek, J., Donat, E., Gillett, P., Guandalini, S., DMSc, S.H.M., Md, S.K., Koltai, T., Korponay-Szabo, I.R., Kurppa, K., Lionetti, E., Marild, K., Ojinaga, E.M., Meijer, C., Monachesi, C., Polanco, I., Popp, A., Roca, M., Rodriguez-Herrera, A., Shamir, R., Stordal, K., Troncone, R., Valitutti, F., Vreugdenhil, A., Wessels, M., Whiting, P., ESPGHAN Special Interest Grp Celia, Kindergeneeskunde, MUMC+: MA Medische Staf Kindergeneeskunde (9), RS: NUTRIM - R1 - Obesity, diabetes and cardiovascular health, Mearin, Maria Luisa, Agardh, Daniel, Antunes, Henedina, Al-Toma, Abdul, Auricchio, Renata, Castillejo, Gemma, Catassi, Carlo, Ciacci, Carolina, Discepolo, Valentina, Dolinsek, Jernej, Donat, Ester, Gillett, Peter, Guandalini, Steffano, Husby Md DMSc, Steffen, Koletzko Md, Sibylle, Koltai, Tunde, Korponay-Szabó, Ilma Rita, Kurppa, Kalle, Lionetti, Elena, Mårild, Karl, Martinez Ojinaga, Eva, Meijer, Caroline, Monachesi, Chiara, Polanco, Isabel, Popp, Alina, Roca, Maria, Rodriguez-Herrera, Alfonso, Shamir, Raanan, Stordal, Ketil, Troncone, Riccardo, Valitutti, Francesco, Vreugdenhil, Anita, Wessels, Margreet, and Whiting, Penny

Subjects
MUCOSAL RECOVERY, Adolescent, Glutens, LARAZOTIDE ACETATE, position paper European Society of Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN), Gastroenterology, EUROPEAN-SOCIETY, Diet, Gluten-Free, DOUBLE-BLIND, children and adolescents, QUALITY-OF-LIFE, HEPATITIS-B-VACCINE, THYROID-DISEASE, Pediatrics, Perinatology and Child Health, Quality of Life, follow-up, Humans, IMMUNE-RESPONSE, children and adolescent, BONE-MINERAL DENSITY, Child, GLUTEN-FREE DIET, celiac disease, Follow-Up Studies
Abstract

There is a need for consensus on the recommendations for follow-up of children and adolescents with celiac disease. Objectives: To gather the current evidence and to offer recommendations for follow-up and management. Methods: The Special Interest Group on Celiac Diseases of the European Society of Paediatric Gastroenterology Hepatology and Nutrition formulated ten questions considered to be essential for follow-up care. A literature search (January 2010-March 2020) was performed in PubMed or Medline. Relevant publications were identified and potentially eligible studies were assessed. Statements and recommendations were developed and discussed by all coauthors. Recommendations were voted upon: joint agreement was set as at least 85%. Results: Publications (n = 2775) were identified and 164 were included. Using evidence or expert opinion, 37 recommendations were formulated on: The need to perform follow-up, its frequency and what should be assessed, how to assess adherence to the gluten-free diet, when to expect catch-up growth, how to treat anemia, how to approach persistent high serum levels of antibodies against tissue-transglutaminase, the indication to perform biopsies, assessment of quality of life, management of children with unclear diagnosis for which a gluten-challenge is indicated, children with associated type 1 diabetes or IgA deficiency, cases of potential celiac disease, which professionals should perform follow-up, how to improve the communication to patients and their parents/caregivers and transition from pediatric to adult health care. Conclusions: We offer recommendations to improve follow-up of children and adolescents with celiac disease and highlight gaps that should be investigated to further improve management.

Published
2022

2. Co-adjuvant effects of retinoic acid and IL-15 induce inflammatory immunity to dietary antigens

Author

DePaolo, R.W., Abadie, V., Tang, F., Fehlner-Peach, H., Hall, J.A., Wang, W., Marietta, E.V., Kasarda, D.D., Waldmann, T.A., Murray, J.A., Semrad, C., Kupfer, S.S., Belkaid, Y., Guandalini, S., and Jabri, B.

Subjects
Tretinoin -- Health aspects -- Physiological aspects, Immune response -- Research, Antigens -- Health aspects -- Physiological aspects, Environmental issues, Science and technology, Zoology and wildlife conservation
Abstract

Under physiological conditions the gut-associated lymphoid tissues not only prevent the induction of a local inflammatory immune response, but also induce systemic tolerance to fed antigens (1,2). A notable exception is coeliac disease, where genetically susceptible individuals expressing human leukocyte antigen (HLA) HLA-DQ2 or HLA-DQ8 molecules develop inflammatory T-cell and antibody responses against dietary gluten, a protein present in wheat (3). The mechanisms underlying this dysregulated mucosal immune response to a soluble antigen have not been identified. Retinoic acid, a metabolite of vitamin A, has been shown to have a critical role in the induction of intestinal regulatory responses (4-6). Here we find in mice that in conjunction with IL-15, a cytokine greatly upregulated in the gut of coeliac disease patients (3,7), retinoic acid rapidly activates dendritic cells to induce JNK (also known as MAPK8) phosphorylation and release the proinflammatory cytokines IL-12p70 and IL-23. As a result, in a stressed intestinal environment, retinoic acid acted as an adjuvant that promoted rather than prevented inflammatory cellular and humoral responses to fed antigen. Altogether, these findings reveal an unexpected role for retinoic acid and IL-15 in the abrogation of tolerance to dietary antigens., Induction of regulatory intestinal responses to oral antigens prevents the subsequent development of systemic T-helper type-1 ([T.sub.H]1) responses to those antigens, a phenomenon referred to as oral tolerance (2). An [...]

Published
2011
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4. Intractable diarrhoea in infancy in the 1990s: A survey in Italy

Author

Ventura, Alessandro, Dragovich, Dana, Ansaldi, N., Balli, F., Banchini, G., Bascietto, F., Bianchi, C., Bonamico, M., Calvani, M., Cataldo, F., Catassi, C., Light, C., Ciampolini, M., Dore, A., DeSeta, L., Faraguha, D., Ferrari, R., Fontana, M., Giunta, A. M., Guandalini, S., Guarino, A., Iacono, G., Lambertini, A., Lazzari, R., Mastella, G., Miano, A., Patanè, R., Pesce, F., Roggero, P., Rutigliano, V., Scotta, S., Tedesch, A., Troncone, R., Ugazio, A., and Zancan, L.

Published
1995
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14. Early Nutrition: Impact on Short- and Long-Term Health : 68th Nestlé Nutrition Institute Workshop, Pediatric Program, Washington, DC, October 2010

Author

van Goudoever, H., Guandalini, S., Kleinman, R.E, van Goudoever, H., Guandalini, S., and Kleinman, R.E

Subjects
Infants--Nutrition, Pregnancy, Children--Nutrition, Pregnancy--Nutritional aspects, Food habits, Newborn infants, Newborn infants--Nutrition--Congresses, Infants--Nutrition--Congresses, Medicine, Preventive--Congresses, Children, Children--Nutrition--Psychological aspects--Congresses, Human beings
Abstract

In this book, a selected group of international experts review nutritional practices and feeding behaviors in infancy and early childhood. They present the latest knowledge on feeding practices during the period considered and their effect on growth, development, and immediate and long-term health. One of the main topics discussed involves feeding practices in the newborn critical care unit, concentrating on the use of human donor milk and probiotics in the diet of premature and ill newborns. Another point of focus is the causes and the effect of an insufficient intake of selected micronutrients, such as iron and zinc, which is highly prevalent particularly in the developing world. Besides, this publication contains information on the influence of early feeding habits on the later development of a number of health-related issues such as food allergies, later food preferences and eating habits, obesity, bone development, the risk of developing celiac disease in genetically predisposed children. This volume provides essential reading for pediatricians, clinical investigators and health workers interested in the effects of early nutrition on health.

Published
2011

16. Contributors

Author

Abruzzo, A., Alahmadi, A., Arthur, J.C., Bakker, G.J., Bercik, P., Bertelsen, R.J., Britton, R.A., Burton, J.P., Carr, J.S., Carroll, I.M., Chanyi, R.M., Chibbar, R., Cifone, M.G., Cinque, B., Ciorba, M.A., Combs, M., Comelli, E.M., Darby, T.M., Dieleman, L.A., Ding, N.S., Donelli, G., Doron, S., Ellermann, M., Eloit, M., Fine, S., Floch, M.H., Floch, N., Fodor, A.A., Freitas, M., Gorbach, S., Green, P.H.R., Guandalini, S., Guslandi, M., Hart, A., Hickman, R.A., Hod, K., Holmes, E., Jenkins, D.J.A., Jensen, E.T., Jones, R.M., Kelly, C.R., Kendall, C.W.C., Khan, A., Krishnareddy, S., Kroeker, K.I., La Torre, C., Lecuit, M., Lombardi, F., Lu, C., Madsen, K., Magro, F., Mastromarino, P., McFarland, L.V., Mitmesser, S., Neish, A.S., Neto, A.G., Nieuwdorp, M., Noronha, J.C., Nossa, C., Nowak-Wegrzyn, A., Palumbo, P., Park, H., Pei, Z., Philip, V., Pitchumoni, C.S., Punzalan, C., Qamar, A., Quigley, E.M.M., Ringel, Y., Ringel-Kulka, T., Sansotta, N., Sarafian, M.H., Sarkar, A., Schultz, M., Sievenpiper, J.L., Szajewska, H., Treisman, G.J., van den Rest, M.E., Vitali, B., Vuotto, C., Walker, W.A., and Wong, J.M.W.

Published
2017
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19. Constipation and encopresis in childhood

Author

Taminiau, J. A. J. M., Benninga, M. A., Guandalini, S., Paediatric Gastroenterology, and Amsterdam Gastroenterology Endocrinology Metabolism

Published
2004

21. Rationale for Early Feeding in Childhood Gastroenteritis

Author

Isolauri, E., Walker-Smith, J. A., Banchini, G., Van Caillie-Bertrand, M., Dias, J. A., Guandalini, S., Hoekstra, J. H., Juntunen M., Kolaček, S., Marx, D., Mičetić-Turk, D., Razenberg, H., Szajewska, M. C. A. C., Taminiau, J., Weizman, Z., Zanacca, C., and Zetterstr, R.

Subjects
Diarrhea, medicine.medical_specialty, Pediatrics, Time Factors, Dehydration, business.industry, Gastroenterology, food and beverages, Early feeding, Gastroenteritis, Eating, El Niño, oral rehydration solution, acute diarrhea, dietary-management, clinical-trials, infants, multicenter, children, milk, recommendations, permeability, Food, Rehydration Solutions, Internal medicine, Pediatrics, Perinatology and Child Health, medicine, Fluid Therapy, Humans, Child, Food Deprivation, business
Abstract

Historical review of the treatment of children with gastroenteritis makes interesting reading and suggests that until the 1930s children with diarrhea were not routinely starved. An 1893 Vade Mecum states, “diet should be given sparingly, consisting of non-irritating articles— gruel, rice, arrowroot, Neave's food prepared with extra quantity of milk, old rice well cooked with milk. Best diet is milk-and-limewater, iced if feverish” (1). This practice changed in 1926 when Powers (2) described the major procedures in the treatment of “intestinal intoxication” as fluid administration, blood transfusion, withholding food for a period of time, and feeding at the end of the period of starvation in gradually increasing amounts. Therapeutic starvation became the established practice in addition to intravenous fluid therapy

Published
2001

22. Practical guidelines for the management of gastroenteritis in children

Author

Sandhu, B. K., Isolauri, E., Walker-Smith, J. A., Banchini, G., Van Caillie-Bertrand, M., Dias, J. A., Guandalini, S., Hoekstra, J. H., Juntunen, M., Kolaček, Sanja, Marx, D., Micetic-Turk, D., Razenberg, M. C. A. C., Szajewska, H., Taminiau, J., Weizman, Z., Zanacca, C., Zetterström, R., Abu-Zibari, M., Agnarsson, U., Arato, A., Chouraqui, J. P., Hadjiminas, J., Hauer, A. C., Kherbheudlidze, M., Kolsrud, E., Kon, I., Kuchtova, N., Molla, M., Marginean, O., Marsba-Ebela, A., Nousia-Arvanitabis, S., Paerregaard, A., Persson, G., Sharif, F., Tamm, E., Ugonis, V., and Vubavic, T.

Subjects
pediatric gastroenteritis
Abstract

Substantial scientific evidence and consequent general agreement now exists among pediatric gastroenterologists that optimal management of mildly to moderately dehydrated children in Europe should consist of the following “ Six Pillars of Good Practice” : Use of oral rehydration solution (ORS) to correct estimated dehydration in 3 to 4 hours (i.e., fast rehydration) (1– 5). Use of hypoosmolar solution (60 mmol/L sodium, 74– 111 mmol/L glucose) (6– 12). Continuation of breast-feeding throughout (13). Early refeeding, i.e., resumption of normal diet (without restriction of lactose intake) after 4 hours rehydration (1– 5, 14– 26). Prevention of further dehydration by supplementing maintenance fluids with ORS (10 mmol/kg/watery stool (1– 4). No unnecessary medication (27– 28).

Published
2001

23. Guidelines prepared by the ESPGAN Working Group on Acute Diarrhoea. Recommendations for feeding in childhood gastroenteritis. European Society of Pediatric Gastroenterology and Nutrition

Author

Walker-Smith, J. A., Sandhu, B. K., Isolauri, E., Banchini, G., van Caillie-Bertrand, M., Dias, J. A., Fasano, A., Guandalini, S., Hoekstra, J. H., Juntunen, M., Kolacek, S., Marx, D., Micetic-Turk, D., Razenberg, M. C., Szajewska, H., Taminiau, J., Weizman, Z., Zanacca, C., Zetterström, R., and Other departments

Published
1997

28. Treatment and prevention of travellers' diarrhoea

Author

Farthing, M. J. G., Du Pont, H. L., Guandalini, S., Keusch, G. T., Steffen, R., University of Zurich, and Farthing, M J G

Subjects
610 Medicine & health, 2715 Gastroenterology, 10060 Epidemiology, Biostatistics and Prevention Institute (EBPI)
Published
1992

43. Pathogenesis of postantibiotic diarrhoea caused by Clostridium difficile: an in vitro study in the rabbit intestine.

Author

Guandalini, S, Fasano, A, Migliavacca, M, Verga, M C, Mastrantonio Gianfrilli, P, Ferrara, A, Alessio, M, Malamisura, B, Galati, P, and Pantosti, A

Abstract

To elucidate the pathophysiological changes leading to postantibiotic diarrhoea caused by Clostridium difficile and its cytotoxin, oral ampicillin was given to rabbits, and jejunal, ileal, and caecal segments of those that developed diarrhoea were investigated in vitro. The rabbits that, in response to treatment, harboured Clostridium difficile in their colonic lumen were studied, and the results expressed according to the presence or absence of Clostridium difficile and/or its cytotoxin. Thus, we refer to either CD+ or CD- segments. The influx of glucose, phenylalanine, glycylphenylalanine, and lysine across the brush border of jejunum and ileum of CD+ segments was severely impaired, while only slightly blunted in CD-. No significant change was detected in the influx of glutamic acid in the jejunum of all treated animals and in the CD- ilea. Morphologic damage in ileum and caecum of CD+ was also more evident than in CD-. Transepithelial ion transport across short circuited ileal mucosa (CD+ and CD-) revealed secretory changes in Cl net transport that were more marked in CD-. We conclude that: (1) Clostridium difficile may also colonise the upper intestinal tract, where it induces morphological and functional damage, severely impairing nutrient absorption; and (2) the ileum contributes to the diarrhoea caused by CD even when the micro-organism is confined to the more distal gut by showing moderate impairment of nutrient absorption and marked electrolyte secretion. [ABSTRACT FROM PUBLISHER]

Published
1988

44. Unconjugated bilirubin and the bile from light exposed Gunn rats inhibit intestinal water and electrolyte absorption.

Author

Guandalini, S, Fasano, A, Albini, F, Marchesano, G, Nocerino, A, De Curtis, M, Rubaltelli, F F, Pettenazzo, A, and Rubino, A

Abstract

Jaundiced babies undergoing phototherapy often develop diarrhoea. The cause of it is still uncertain. Increasing evidence supports a role of a secretory mechanism for the diarrhoea. We therefore studied the effects of bile from congenitally jaundiced rats undergoing phototherapy and of unconjugated bilirubin on rat small intestine in vivo and in vitro. Results suggest that: (1) the bile from homozygous Gunn rats under phototherapy has an anti-absorptive effect when tested in the perfused jejunum of normal Wistar rats; (2) unconjugated bilirubin has a dose dependent secretory effect on the intestinal transport of water and electrolytes, when tested in the same system. Alteration of cyclic AMP or cyclic GMP, known intracellular mediators of secretion, was not observed. We conclude that free bilirubin is an intestinal secretagogue acting by an as yet unknown mechanism, that may mediate the secretory type of diarrhoea in jaundiced neonates undergoing phototherapy. [ABSTRACT FROM PUBLISHER]

Published
1988

47. Etiology and risk factors of severe and protracted diarrhea.

Author

Guarino, Alfredo, Spagnuolo, Maria Immacolata, Russo, Stefania, Albano, Fabio, Guandalini, Stefano, Capano, Guglielmo, Cucchiara, Salvatore, Vairano, Paola, Liguori, Roberto, Casola, Antonella, Rubino, Armido, Guarino, A, Spagnuolo, M I, Russo, S, Albano, F, Guandalini, S, Capano, G, Cucchiara, S, Vairano, P, and Liguori, R

Published
1995

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