M. R. Dessi

Delayed diagnosis of coeliac disease increases cancer risk.

BackgroundThe 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.MethodsThe study population consists of patients (n = 1968) diagnosed with CD at 20 Italian gastroenterology referral Centers between 1st January 1982 and 31st March 2005.ResultsThe 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.ConclusionCoeliac 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.

Effect of a gluten-free diet on the risk of enteropathy-associated T-cell lymphoma in celiac disease.

Patients with celiac disease have an increased rate of enteropathy-associated T-cell lymphoma, but conflicting data are available about the protective role of a gluten-free diet with regard to the development of this malignancy. We followed 1,757 celiac patients for a total period of 31,801 person-years, collecting data about the frequency of gluten intake and the incidence of the enteropathy-associated T-cell lymphoma. Out of the nine celiac patients who developed an intestinal lymphoma [standard morbidity ratio of 6.42 (95% CIxa0=xa02.9–12.2; Pxa0<xa00.001)], only two kept a strict gluten-free diet after the diagnosis of celiac diasese and developed the malignancy after the peridiagnosis period of 3xa0years, dropping therefore the standard morbidity ratio to 0.22 (95%CIxa0=xa00.02–0.88; Pxa0<xa00.001). The risk of developing an intestinal lymphoma for the celiac patients that used to have dietary gluten was significant (X2xa0=xa04.8 Pxa0=xa00.01). These results show that a strict gluten-free diet is protective towards the development of enteropathy-associated T-cell lymphoma.

Environmental factors of celiac disease: Cytotoxicity of hulled wheat species Triticum monococcum, T. turgidum ssp. dicoccum and T. aestivum ssp. spelta

Background and Aim:u2002 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.

In vitro tests indicate that certain varieties of oats may be harmful to patients with coeliac disease

Background:u2002 The presence of oats in gluten‐free diet is controversial. The aim of this work is to evaluate if different varieties of oats exert different toxicity in coeliac disease.

Separation of coeliac-active peptides from bread wheat with the aid of methylpyrrolidinone chitosan

Abstract Gliadin-derived peptides from haxaploid wheat, known to be toxic for in-vitro cultured small-intestinal mucosa from coeliac patients, are very active in agglutinating K562(S) cells. Chromatographic data obtained with the use of methylpyrrolidinone chitosan coupled to Sepharose-6B indicate that a minor (1·3%) fraction of the peptides binds very strongly to the support at nearly neutral pH values, and can be eluted at pH 2·85. This fraction is the one responsible for the agglutination of K562(S) cells, being one-hundred times more active than the digest from which it has been separated.