Detection of gluten immunogenic peptides in the urine of patients with coeliac disease reveals transgressions in the gluten-free diet and incomplete mucosal healing.
Detection of gluten immunogenic peptides in the urine of patients with coeliac disease reveals transgressions in the gluten-free diet and incomplete mucosal healing.
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DOI：
10.1136/gutjnl-2015-310148
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发表时间：
2017-02
期刊：
影响因子：
24.5
通讯作者：
Sousa C
中科院分区：
文献类型：
--
作者：
Moreno ML;Cebolla Á;Muñoz-Suano A;Carrillo-Carrion C;Comino I;Pizarro Á;León F;Rodríguez-Herrera A;Sousa C
无麸质饮食（GFD）是腹腔疾病（CD）的唯一管理方法。评估GFD依从性的现有方法不足以检测可能导致肠道粘膜损伤的偶尔饮食违规。我们的目的是开发一种方法，以确定谷蛋白摄入量和监测GFD依从性的CD患者，并评估其与粘膜损伤的相关性。收集了76名健康受试者和58名患有CD的患者在不同麸质饮食条件下的尿液样本。使用针对最主要的谷蛋白免疫原性肽（GIP）的高灵敏度和特异性G12单克隆抗体的侧向流试验（LFT）和LFT读数器来定量固相提取的尿液中的GIP。GIP可检测到浓缩尿液中的健康人以前受到GFD早在4-6小时后，单麸质摄入，并保持检测1-2天。 尿液分析显示约50%的患者侵犯了GFD。十二指肠活检分析显示，大多数无绒毛萎缩的CD患者（89%）尿液中未检出GIP，而所有尿液中可定量GIP的患者均显示肠粘膜恢复不完全。GIP在麸质消费后的尿液中被检测到，这使得一种新的非侵入性方法能够监测GFD的依从性和违规行为。该方法灵敏度高、特异性强、操作简便，可用于CD患者的临床监测以及基础和临床研究应用，包括药物开发。NCT02344758。
Gluten-free diet (GFD) is the only management for coeliac disease (CD). Available methods to assess GFD compliance are insufficiently sensitive to detect occasional dietary transgressions that may cause gut mucosal damage. We aimed to develop a method to determine gluten intake and monitor GFD compliance in patients with CD and to evaluate its correlation with mucosal damage. Urine samples of 76 healthy subjects and 58 patients with CD subjected to different gluten dietary conditions were collected. A lateral flow test (LFT) with the highly sensitive and specific G12 monoclonal antibody for the most dominant gluten immunogenic peptides (GIP) and a LFT reader were used to quantify GIP in solid-phase extracted urines. GIP were detectable in concentrated urines from healthy individuals previously subjected to GFD as early as 4–6 h after single gluten intake, and remained detectable for 1–2 days. The urine assay revealed infringement of the GFD in about 50% of the patients. Analysis of duodenal biopsies revealed that most of patients with CD (89%) with no villous atrophy had no detectable GIP in urine, while all patients with quantifiable GIP in urine showed incomplete intestinal mucosa recovery. GIP are detected in urine after gluten consumption, enabling a new and non-invasive method to monitor GFD compliance and transgressions. The method was sensitive, specific and simple enough to be convenient for clinical monitoring of patients with CD as well as for basic and clinical research applications including drug development. NCT02344758.