Moreno María de Lourdes, Sánchez-Muñoz Diego, Sanders David, Rodríguez-Herrera Alfonso, Sousa Carolina
Departamento de Microbiología y Parasitología, Facultad de Farmacia, Universidad de Sevilla, Sevilla, Spain.
Área de Digestivo y Endoscopias, Hospital Sagrado Corazón, Sevilla, Spain.
Front Med (Lausanne). 2021 Jan 18;7:601854. doi: 10.3389/fmed.2020.601854. eCollection 2020.
Refractory celiac disease (RCD) involves T-lymphocyte activation despite supposed absence of gluten exposure. Assessing dietary adherence is the cornerstone of RCD diagnosis, but available diagnostic tools fail to monitor gluten-free diet (GFD). A recently acknowledged GFD biomarker is gluten immunogenic peptides (GIP) in urine. This study assessed urine GIP to verify whether RCD patients could be reclassified as "exposed to gluten." Three out of four RCD patients had at least two positive-GIP urine samples in a follow-up of 3 months, demonstrating gluten exposure. Urine GIP may enable the accurate RCD verification and decrease overuse of immunosuppressants, increasing cost effectiveness.
难治性乳糜泻（RCD）尽管假定没有接触麸质，但仍涉及T淋巴细胞活化。评估饮食依从性是RCD诊断的基石，但现有的诊断工具无法监测无麸质饮食（GFD）。一种最近被认可的GFD生物标志物是尿液中的麸质免疫原性肽（GIP）。本研究评估了尿液GIP，以验证RCD患者是否可重新归类为“接触过麸质”。在3个月的随访中，四分之三的RCD患者至少有两份GIP尿液样本呈阳性，表明存在麸质接触。尿液GIP可能有助于准确的RCD验证，并减少免疫抑制剂的过度使用，提高成本效益。
