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Objective. Less severe histological changes have sometimes been reported in the terminal ileum (TI) of coeliac patients. The aim of this work was to assess whether magnified ileoscopy and the corresponding biopsy could be used when diagnosing coeliac disease (CD). This would be of clinical value in coeliac patients who show predominant abdominal symptoms and who undergo colonoscopy with ileoscopy as first clinical examination. Material and methods. All patients underwent conventional and magnified ileoscopy, along with histological examination of macroscopic mucosal abnormalities, if present. Patients whose ileoscopy with biopsy suggested CD underwent a blood test for quantitative determination of anti-transglutaminase antibodies and upper gastrointestinal endoscopy with corresponding duodenal biopsy. Results. Out of 143 patients enrolled, 21 had a TI mucosal lesion, and 10 of these showed villous atrophy at ileoscopy only after magnification. Six showed a count of intra-epithelial lymphocytes (IELs) >25/100 enterocytes and upper intestinal lesions, confirming the diagnosis of CD. Finally, of four patients diagnosed with Crohn's disease, TI mucosal aftoid lesions were seen in two only in magnified view. Conclusions. Magnified ileoscopy reliably recognizes the presence of mucosal villous subtotal or total atrophy at TI. This finding, even if not specific to CD, can address the diagnosis of CD. Magnification in the course of ileoscopy could also be useful in the diagnosis of Crohn's disease. [ABSTRACT FROM AUTHOR]

Background and Aim: In the present paper, the toxicity of prolamines derived from three cereals with a different genome was investigated in human colon cancer Caco-2/TC7 and human myelogenous leukemia K562(S) cells. The purpose of this study was to investigate if species from ancient wheat could be considered as healthy food crops devoid or poor in cytotoxic prolamines for celiac disease. Methods: Cytotoxicity was measured in terms of inhibition of cell growth, activation of apoptosis, release of nitric oxide (NO), detection of tissue transglutaminase (TG II) and alteration of transepithelial electrical resistance (TEER) on Caco-2/Tc7 and K562 (S) cell agglutination. Peptic-tryptic (PT) digest from bread wheat ( T. aestivum S. Pastore) was used as a positive control. Results: PT digests of prolamins from spelt wheat ( T. aestivum ssp. spelta) were found to exert toxic effects on Caco-2/TC7 cells and to agglutinate K562(S) cells. Increased amounts of NO and TG II expression were observed in Caco-2/TC7 cells exposed to 1 mg/mL of spelt prolamins, suggesting that spelt wheat can induce cellular mechanisms implicated in the pathogenesis of celiac disease. By contrast, the PT digests from monoccum wheat ( Triticum monococcum) and farro wheat ( T. turgidum ssp. dicoccum) did not exhibit any negative effects on Caco-2/TC7 and K562(S) cells. Conclusions: The results have shown a constant and significant toxic effect of spelt wheat which is not shared by the two other ancient cereals. Future studies on celiac intestinal organ cultures are needed to increase the prospects of breeding programs aimed at developing wheat cultivars potentially tolerated by most celiac patients. [ABSTRACT FROM AUTHOR]

Background: The association between coeliac disease (CD) and neoplasms has been long established, but few data are available about the risk factors. The aim of this paper is to estimate the risk of developing a neoplasm among non diagnosed coeliac patients and to evaluate if this risk correlates with the age of patients at diagnosis of coeliac disease. Methods: The study population consists of patients (n = 1968) diagnosed with CD at 20 Italian gastroenterology referral Centers between 1st January 1982 and 31st March 2005. Results: The SIR for all cancers resulted to be 1.3; 95% CI = 1.0—1.7 p < 0.001. The specific SIRs for non Hodgkin lymphoma was 4.7; 95% CI = 2.9—7.3 p < 0.001, for the small bowel carcinoma 25; 95% CI = 8.5—51.4 p < 0.001, for non Hodgkin lymphoma 10; 95% CI = 2.7—25 p = 0.01, finally for the stomach carcinoma 3; 95% CI = 1.3—4.9 p < 0.08. The mean age at diagnosis of CD of patients that developed sooner or later a neoplasm was 47,6 ± 10.2 years versus 28.6 ± 18.2 years of patients who did not. Conclusion: Coeliac patients have an increased risk of developing cancer in relation to the age of diagnosis of CD. This risk results higher for malignancies of the gastro-intestinal sites. An accurate screening for tumors should be performed in patients diagnosed with CD in adulthood and in advancing age. [ABSTRACT FROM AUTHOR]

Presents several letters to the editor. Discussion on the risk of gastrointestinal non-Hodgkin's lymphoma at diagnosis of celiac disease; Discussion on the predictors of short-term outcome of spontaneous bacterial peritonitis in Turkish cirrhotic patients; Analysis of the care rate of high dose omeprazole and amoxicillin therapy for treatment resistant helicobacter pylori infection.

Abstract: Caco-2 human intestinal cell line was exposed, both separately and simultaneously, to gliadin pepsin-tryptic digest and MP-chitosan. MP-Chitosan was able to depress the gliadin toxicity, and to lower caspase-3 activation and apoptosis, nitric oxide production, and lactate dehydrogenase release by the cells, whilst improving the cell viability. The interaction between MP-chitosan and mannose-receptor might account for some of these effects. [Copyright &y& Elsevier]

Abstract: Celiac disease (CD) is characterized by a permanent intolerance to wheat gliadin and related proteins in genetically susceptible individuals. It is generally considered that CD is an immuno-mediated multifactorial disease, but a direct cytotoxic activity of gliadin-derived peptides (GL-PT) on intestinal mucosa cannot be excluded. Many efforts have been done to identify possible antagonists of this direct toxicity and several studies indicated that mannan and oligomers of N-acetylglucosamine, [N,N′-diacetylchitobiose (GLcNAc)2 and N,N′,N″;-triacetylchitotriose (GLcNAc)3], could be very promising candidates. In the present study we investigated the ability of mannan, (GLcNAc)2 and (GLcNAc)3 to interfere with some toxic effects exerted by GL-PT, as cell growth and viability impairment, increased intestinal permeability and cellular inflammation, on a clone of the human intestinal Caco-2 cell line, Caco-2/TC7, expressing a more homogeneous population than the parental one. Our present results demonstrate that mannan, among the three molecules investigated, is the most suitable to counteract the adverse effects induced by GL-PT on Caco-2/TC7 cells, for all the parameters considered in this study. [Copyright &y& Elsevier]