Cenni Sabrina, Casertano Marianna, D'Addio Elisabetta, Pacella Daniela, Tolone Carlo, Martinelli Massimo, Staiano Annamaria, Miele Erasmo, Strisciuglio Caterina
Department of Experimental Medicine, University of Campania 'Luigi Vanvitelli', Naples, Italy.
Department of Woman, Child and General and Specialist Surgery, University of Campania 'Luigi Vanvitelli', Naples, Italy.
Acta Paediatr. 2025 Jun 20. doi: 10.1111/apa.70187.
Determination of faecal gluten immunogenic peptides (f-GIP) has recently been proposed as new noninvasive method to detect gluten intake in celiac disease (CD). Our aim was to evaluate the use of f-GIP for the adherence to gluten-free diet (GFD) and to compare this new marker with traditional methods.
We enrolled both newly diagnosed cases and children in follow-up with CD. Adherence to the GFD was assessed using the Biagi score, IgA anti-transglutaminase (tTG IgA) and f-GIP.
Seventy-one CD children, 40.8% new diagnosis and 59.2% in follow-up, were enrolled. Significant differences were found in the levels of faecal GIP between new diagnosis and follow up (median 185.7 ng/mL, IQR 67.8-318.8 ng/mL and 16.6 ng/mL, IQR 6.9-61 ng/mL respectively, p < 0.001). A significant direct correlation was found between faecal GIP and tTG IgA in the total cohort of enrolled patients (r = 0.5, p < 0.001). In the follow up group, 21.4% tested positive for GIP and, of these GIP + patients, 78% had a high Biagi score.
Our data shows that faecal GIP offers a precise assessment of even occasional exposure to gluten and suggests it might represent a less invasive instrument to check dietary adherence compared to traditional methods.
粪便麸质免疫原性肽（f-GIP）的测定最近被提议作为检测乳糜泻（CD）患者麸质摄入量的一种新的非侵入性方法。我们的目的是评估f-GIP在无麸质饮食（GFD）依从性方面的应用，并将这一新指标与传统方法进行比较。
我们纳入了新诊断的病例以及处于随访期的CD患儿。使用比亚吉评分、抗转谷氨酰胺酶IgA（tTG IgA）和f-GIP来评估对GFD的依从性。
共纳入71名CD患儿，其中新诊断病例占40.8%，随访病例占59.2%。新诊断病例与随访病例的粪便GIP水平存在显著差异（中位数分别为185.7 ng/mL，四分位间距为67.8 - 318.8 ng/mL和16.6 ng/mL，四分位间距为6.9 - 61 ng/mL，p < 0.001）。在所有纳入患者的队列中，粪便GIP与tTG IgA之间存在显著的正相关（r = 0.5，p < 0.001）。在随访组中，21.4%的患者GIP检测呈阳性，在这些GIP阳性患者中，78%的比亚吉评分较高。
我们的数据表明，粪便GIP即使对偶尔摄入麸质的情况也能提供精确评估，并表明与传统方法相比，它可能是一种检查饮食依从性的侵入性较小的手段。
