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de Carvalho JF, Lerner A, Benzvi C. Foot reflexology in autoimmune diseases: Effectiveness and mechanisms. World J Clin Cases 2025; 13:97403. [PMID: 40051795 PMCID: PMC11612686 DOI: 10.12998/wjcc.v13.i7.97403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 10/21/2024] [Accepted: 11/14/2024] [Indexed: 11/25/2024] Open
Abstract
Foot reflexology (FR) is a Chinese-originated and non-invasive complementary therapy increasingly used by functional, alternative and para-medical professionals. Enhance attempts are made to study FR in non-functional organic conditions. The present invited Editorial discusses the application of FR in autoimmune diseases (AD), highlighting a few successful studies demonstrating symptomatic relief and objective improvements. Despite promising results, the FR domain remains under-investigated and an urgent need to confirm and understand the effect of FR in chronic diseases, including AD, is highly recommended.
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Affiliation(s)
- Jozélio Freire de Carvalho
- Núcleo de Pesquisa em Doenças Crônicas não Transmissíveis, Federal University of Bahia, Salvador 40231-300, Bahia, Brazil
| | - Aaron Lerner
- Department of Research, Chaim Sheba Medical Center, The Zabludowicz Research Center for Autoimmune Diseases, Ramat Gan 52621, Israel
| | - Carina Benzvi
- Department of Research, Chaim Sheba Medical Center, The Zabludowicz Research Center for Autoimmune Diseases, Ramat Gan 52621, Israel
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Guerrero Aznar MD, Villanueva Guerrero MD, Beltrán García M, Hernández Cruz B. Specific Composition Diets and Improvement of Symptoms of Immune-Mediated Inflammatory Diseases in Adulthood-Could the Comparison Between Diets Be Improved? Nutrients 2025; 17:493. [PMID: 39940351 PMCID: PMC11819864 DOI: 10.3390/nu17030493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2024] [Revised: 01/24/2025] [Accepted: 01/26/2025] [Indexed: 02/16/2025] Open
Abstract
Diet is considered a possible cofactor, which affects the immune system and potentially causes dysregulation of intestinal homeostasis and inflammation. This study aimed to review the quality of evidence on the effects of specific diet composition on symptoms of immune-mediated inflammatory diseases (IMIDs), including rheumatoid arthritis (RA), spondyloarthritis, multiple sclerosis (MS), inflammatory bowel disease (IBD) [remission maintenance of Crohn's disease and ulcerative colitis], psoriasis and psoriatic arthritis in adult patients. We conducted a review of meta-analyses and Cochrane systematic reviews using PubMed and EMBASE, from inception to September 2024, and Google Scholar. The methodological quality of the meta-analyses was assessed using the AMSTAR 2 rating system. Three Cochrane systematic reviews and eight meta-analyses were evaluated. Some specific composition diets have been shown to reduce the symptoms of RA, IBD, and MS and improve activity parameters in IBD and RA, with critically low or low levels of evidence. The reduction in inflammatory biomarker levels is unclear. This review summarizes the global evidence for specific dietary interventions, mostly with anti-inflammatory properties due to their components, to improve IMID symptoms, clarifying the weaknesses of clinical trials and dietary meta-analyses with critically low or low levels of evidence; and shows the need to use indices such as the Dietary Inflammatory Index, which allows diets to be classified by their pro-inflammatory or anti-inflammatory food content, to better compare diet groups in clinical trials. The difficulty of obtaining high-level evidence from dietary studies is apparent and may delay the application of the results. Clinicians should be aware of the role of diets with anti-inflammatory properties as a complement to pharmacological treatments in IMIDs.
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Affiliation(s)
- M. Dolores Guerrero Aznar
- Pharmacy Health Management Unit, Virgen Macarena University Hospital, 41009 Seville, Spain; (M.D.V.G.); (M.B.G.)
| | | | - Margarita Beltrán García
- Pharmacy Health Management Unit, Virgen Macarena University Hospital, 41009 Seville, Spain; (M.D.V.G.); (M.B.G.)
| | - Blanca Hernández Cruz
- Rheumatology Health Management Unit, Virgen Macarena University Hospital, 41009 Seville, Spain;
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Laganà M, Piticchio T, Alibrandi A, Le Moli R, Pallotti F, Campennì A, Cannavò S, Frasca F, Ruggeri RM. Effects of Dietary Habits on Markers of Oxidative Stress in Subjects with Hashimoto's Thyroiditis: Comparison Between the Mediterranean Diet and a Gluten-Free Diet. Nutrients 2025; 17:363. [PMID: 39861493 PMCID: PMC11768057 DOI: 10.3390/nu17020363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2024] [Revised: 01/16/2025] [Accepted: 01/17/2025] [Indexed: 01/27/2025] Open
Abstract
BACKGROUND The Mediterranean diet (MedD) exerts anti-inflammatory and anti-oxidant effects that are beneficial in autoimmune thyroid diseases (ATD). Recently, a gluten-free diet (GFD) has been proposed for non-celiac patients with Hashimoto's thyroiditis (HT), but its usefulness is under debate. The present pilot study evaluates the effects of these two dietary regimes, with a focus on redox homeostasis, in HT. PATIENTS AND METHODS 45 euthyroid HT patients (30 F; median age 42 years) were randomly assigned to different dietary regimes: MedD (n = 15), GFD (n = 15) and free diet (FD, n = 15). Thyroid function tests, autoantibodies, and oxidative stress markers (Advanced glycation end products, AGEs; glutathione peroxidase (GPx), thioredoxin reductase (TRxR), and total plasma antioxidant activity (TEAA) were measured at baseline and after 12 weeks. RESULTS In the MedD group, significantly lower values of AGEs and higher values of GPX, TRX and TEAA with anti-oxidant action were detected (p < 0.05) at 12 weeks compared to baseline, and compared to the GFD and FD groups, in which the oxidative stress parameters did not change significantly (p > 0.05). No significant differences in serum levels of TSH, FT4, Ab-Tg, Ab-TPO compared to baseline were found in any group. CONCLUSIONS This pilot study confirms the protective effect of the MedD against oxidative stress, while a GFD does not significantly influence markers of oxidative stress and/or thyroid autoimmunity/function parameters.
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Affiliation(s)
- Martina Laganà
- Endocrine Unit, Department of Human Pathology of Adulthood and Childhood DETEV, University of Messina, 98125 Messina, Italy; (M.L.); (S.C.)
| | - Tommaso Piticchio
- Department of Medicine and Surgery, University of Enna “Kore”, 94100 Enna, Italy; (T.P.); (R.L.M.); (F.P.)
| | - Angela Alibrandi
- Unit of Statistical and Mathematical Sciences, Department of Economics, University of Messina, 98125 Messina, Italy;
| | - Rosario Le Moli
- Department of Medicine and Surgery, University of Enna “Kore”, 94100 Enna, Italy; (T.P.); (R.L.M.); (F.P.)
| | - Francesco Pallotti
- Department of Medicine and Surgery, University of Enna “Kore”, 94100 Enna, Italy; (T.P.); (R.L.M.); (F.P.)
| | - Alfredo Campennì
- Unit of Nuclear Medicine, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, 98125 Messina, Italy;
| | - Salvatore Cannavò
- Endocrine Unit, Department of Human Pathology of Adulthood and Childhood DETEV, University of Messina, 98125 Messina, Italy; (M.L.); (S.C.)
| | - Francesco Frasca
- Endocrinology Section, Department of Clinical and Experimental Medicine, Garibaldi Nesima Hospital, University of Catania, 95124 Catania, Italy;
| | - Rosaria Maddalena Ruggeri
- Endocrine Unit, Department of Human Pathology of Adulthood and Childhood DETEV, University of Messina, 98125 Messina, Italy; (M.L.); (S.C.)
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Szczuko M, Kacprzak J, Przybylska A, Szczuko U, Pobłocki J, Syrenicz A, Drozd A. The Influence of an Anti-Inflammatory Gluten-Free Diet with EPA and DHA on the Involvement of Maresin and Resolvins in Hashimoto's Disease. Int J Mol Sci 2024; 25:11692. [PMID: 39519244 PMCID: PMC11546266 DOI: 10.3390/ijms252111692] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2024] [Revised: 10/25/2024] [Accepted: 10/30/2024] [Indexed: 11/16/2024] Open
Abstract
The potential modulation of thyroid inflammatory conditions via a gluten-free diet has been suggested after establishing a link between Hashimoto's thyroiditis (HT) and celiac disease. However, the majority of targeted studies in this field do not support the general recommendation of prescribing a gluten-free diet (GFD) for all HT patients. This study aims to analyze data regarding the impact of a GFD supplemented with eicosapentaenoic (EPA) and docosahexaenoic acid (DHA), along with vegetables, on the course of inflammation involving long-chain fatty acid mediators. The study cohort consisted of 39 Caucasian female patients with autoimmune HT. Metabolite separations were performed using a liquid chromatograph with a DAD detector. Absorption peaks were read at 210 nm for resolvin E1, protectin DX, and maresin 1 and at 302 nm for resolvin D1. The introduction of a gluten-free diet completed with omega-3, including EPA and DHA, may contribute to a reduction in the inflammatory state in HT patients. This effect is supported by the elevation in the levels of anti-inflammatory mediators derived from long-chain fatty acids with anti-inflammatory properties but not by eliminating gluten. Significant statistical changes in the levels of all derivatives were observed before and after the implementation of the diet. It is worth noting that this effect was not observed in anti-TPO and anti-TG levels. The induction of anti-inflammatory changes can be achieved by supplementing the diet with EPA, DHA and vegetables with increased anti-inflammatory potential.
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Affiliation(s)
- Małgorzata Szczuko
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University, 71-460 Szczecin, Poland (A.P.); (A.D.)
- Department of Human Nutrition and Bromatology, Pomeranian Medical University, 71-210 Szczecin, Poland
| | - Julia Kacprzak
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University, 71-460 Szczecin, Poland (A.P.); (A.D.)
| | - Aleksandra Przybylska
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University, 71-460 Szczecin, Poland (A.P.); (A.D.)
| | - Urszula Szczuko
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University, 71-460 Szczecin, Poland (A.P.); (A.D.)
| | - Jakub Pobłocki
- Department of Endocrinology, Metabolic Diseases and Internal Diseases, Pomeranian Medical University, 70-252 Szczecin, Poland; (J.P.); (A.S.)
| | - Anhelli Syrenicz
- Department of Endocrinology, Metabolic Diseases and Internal Diseases, Pomeranian Medical University, 70-252 Szczecin, Poland; (J.P.); (A.S.)
| | - Arleta Drozd
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University, 71-460 Szczecin, Poland (A.P.); (A.D.)
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de la Fuente-Munoz E, Fernández-Arquero M, Subbhi-Issa N, Guevara-Hoyer K, Suárez LP, Laborda RG, Sánchez M, Ochoa-Grullón J, Guzmán-Fulgencio M, Villegas Á, Mansilla MD, Pérez N, Cornudella RS, Gastañaga-Holguera T, Urrutia MC, García IC, Sánchez-Ramón S. Recurrent reproductive failure and celiac genetic susceptibility, a leading role of gluten. Front Immunol 2024; 15:1451552. [PMID: 39512358 PMCID: PMC11540631 DOI: 10.3389/fimmu.2024.1451552] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Accepted: 10/03/2024] [Indexed: 11/15/2024] Open
Abstract
Introduction The prevalence of gluten-related disorders, mainly celiac disease (CD) and non-celiac gluten sensitivity (NCGS), varies between 0.6% and 13% in the general population. There is controversial evidence regarding the association of both CD and NCGS with extra-digestive manifestations, including recurrent reproductive failure (RRF), which may have clinical implications. Objective To study the prevalence of HLA susceptibility alleles for CD/NCGS in a cohort of female patients with RRF from a single reference center and to evaluate the effect of a gluten-free diet on reproductive success. Material and methods A retrospective study was conducted on 173 patients with RRF, consecutively attended at the Reproductive Immunology Unit of San Carlos University Clinical Hospital in Madrid. We collected and analyzed the clinical, analytical, and immunological profiles of RRF patients who presented HLA alleles associated with CD and NCGS (HLA DQ2.2, DQ2.5, DQ8, and DQ7.5). Results We observed a significantly higher prevalence of HLA alleles associated with CD and NCGS in our RRF cohort compared to the prevalence in the general population (69% vs. 35%-40%, p<0.0001). Only 2.3% of patients met the criteria for a CD diagnosis. In our RRF cohort, HLA-genetic susceptibility for CD/NCGS (HLA-risk group) was associated with a significantly higher rate of hypothyroidism compared to patients without these alleles (HLA-negative group) (48.7% vs. 26.92%, p=0.03). Patients with HLA-genetic susceptibility for CD/NCGS and thyroid disease had a significantly higher success rate in the subsequent pregnancy after management (55% vs. 30%, p=0.002). Two factors were found to be significant in this group: a gluten-free diet (p=0.019) and the use of levothyroxine (p=0.042). Conclusions In our cohort of RRF patients, we observed a significantly higher prevalence of HLA susceptibility genes for CD/NCGS compared to the general population, also associated with a higher incidence of thyroid alterations. A gluten-free diet and the use of levothyroxine in cases of thyroid pathology had significant beneficial effects on pregnancy outcomes. We suggest that HLA typing for CD/NCGS and a gluten-free diet, in the presence of risk alleles, can improve pregnancy outcomes in RRF patients.
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Affiliation(s)
- Eduardo de la Fuente-Munoz
- Department of Clinical Immunology, Instituto de Medicina de Laboratorio (IML) and Fundación para la Investigación Biomédica del Hospital Clínico San Carlos (IDISCC), Hospital Universitario Clínico San Carlos, Madrid, Spain
- Department of Immunology, Ophthalmology and Otorhinolaryngology (ENT), School of Medicine, Universidad Complutense, Madrid, Spain
| | - Miguel Fernández-Arquero
- Department of Clinical Immunology, Instituto de Medicina de Laboratorio (IML) and Fundación para la Investigación Biomédica del Hospital Clínico San Carlos (IDISCC), Hospital Universitario Clínico San Carlos, Madrid, Spain
- Department of Immunology, Ophthalmology and Otorhinolaryngology (ENT), School of Medicine, Universidad Complutense, Madrid, Spain
| | - Nabil Subbhi-Issa
- Department of Clinical Immunology, Instituto de Medicina de Laboratorio (IML) and Fundación para la Investigación Biomédica del Hospital Clínico San Carlos (IDISCC), Hospital Universitario Clínico San Carlos, Madrid, Spain
- Department of Immunology, Ophthalmology and Otorhinolaryngology (ENT), School of Medicine, Universidad Complutense, Madrid, Spain
| | - Kissy Guevara-Hoyer
- Department of Clinical Immunology, Instituto de Medicina de Laboratorio (IML) and Fundación para la Investigación Biomédica del Hospital Clínico San Carlos (IDISCC), Hospital Universitario Clínico San Carlos, Madrid, Spain
- Department of Immunology, Ophthalmology and Otorhinolaryngology (ENT), School of Medicine, Universidad Complutense, Madrid, Spain
- Cancer Immunomonitoring and Immune-mediated Diseases Research Unit, Instituto de Investigación Sanitaria San Carlos (Fundación para la Investigación Biomédica del Hospital Clínico San Carlos (IDISCC)), Department of Clinical Immunology, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Lydia Pilar Suárez
- Department of Obstetrics and Gynecology, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Raquel Gil Laborda
- Department of Clinical Immunology, Instituto de Medicina de Laboratorio (IML) and Fundación para la Investigación Biomédica del Hospital Clínico San Carlos (IDISCC), Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Marina Sánchez
- Department of Immunology, Ophthalmology and Otorhinolaryngology (ENT), School of Medicine, Universidad Complutense, Madrid, Spain
| | - Juliana Ochoa-Grullón
- Department of Clinical Immunology, Instituto de Medicina de Laboratorio (IML) and Fundación para la Investigación Biomédica del Hospital Clínico San Carlos (IDISCC), Hospital Universitario Clínico San Carlos, Madrid, Spain
- Department of Immunology, Ophthalmology and Otorhinolaryngology (ENT), School of Medicine, Universidad Complutense, Madrid, Spain
| | - María Guzmán-Fulgencio
- Department of Clinical Immunology, Instituto de Medicina de Laboratorio (IML) and Fundación para la Investigación Biomédica del Hospital Clínico San Carlos (IDISCC), Hospital Universitario Clínico San Carlos, Madrid, Spain
- Department of Immunology, Ophthalmology and Otorhinolaryngology (ENT), School of Medicine, Universidad Complutense, Madrid, Spain
| | - Ángela Villegas
- Department of Clinical Immunology, Instituto de Medicina de Laboratorio (IML) and Fundación para la Investigación Biomédica del Hospital Clínico San Carlos (IDISCC), Hospital Universitario Clínico San Carlos, Madrid, Spain
- Department of Immunology, Ophthalmology and Otorhinolaryngology (ENT), School of Medicine, Universidad Complutense, Madrid, Spain
| | - María Dolores Mansilla
- Department of Clinical Immunology, Instituto de Medicina de Laboratorio (IML) and Fundación para la Investigación Biomédica del Hospital Clínico San Carlos (IDISCC), Hospital Universitario Clínico San Carlos, Madrid, Spain
- Department of Immunology, Ophthalmology and Otorhinolaryngology (ENT), School of Medicine, Universidad Complutense, Madrid, Spain
| | - Noelia Pérez
- Department of Obstetrics and Gynecology, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | | | | | - Marta Calvo Urrutia
- Department of Obstetrics and Gynecology, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Ignacio Cristóbal García
- Department of Obstetrics and Gynecology, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Silvia Sánchez-Ramón
- Department of Clinical Immunology, Instituto de Medicina de Laboratorio (IML) and Fundación para la Investigación Biomédica del Hospital Clínico San Carlos (IDISCC), Hospital Universitario Clínico San Carlos, Madrid, Spain
- Department of Immunology, Ophthalmology and Otorhinolaryngology (ENT), School of Medicine, Universidad Complutense, Madrid, Spain
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Kotak PS, Kadam A, Acharya S, Kumar S, Varma A. Beyond the Thyroid: A Narrative Review of Extra-thyroidal Manifestations in Hashimoto's Disease. Cureus 2024; 16:e71126. [PMID: 39525250 PMCID: PMC11544504 DOI: 10.7759/cureus.71126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2024] [Accepted: 10/08/2024] [Indexed: 11/16/2024] Open
Abstract
Hashimoto's disease, the most common cause of hypothyroidism in iodine-sufficient regions, is traditionally viewed as a thyroid-specific autoimmune disorder. However, emerging evidence indicates that Hashimoto's disease has far-reaching systemic effects, manifesting in multiple organ systems beyond the thyroid gland. This comprehensive review aims to elucidate the extra-thyroidal manifestations of Hashimoto's disease, highlighting their pathophysiology, clinical presentation, and management strategies. The review explores neurological, cardiovascular, dermatological, gastrointestinal, musculoskeletal, and hematological manifestations, which can significantly impact the quality of life and complicate the clinical course of the disease. Neurological symptoms such as cognitive impairment, depression, and peripheral neuropathy, as well as cardiovascular complications like dyslipidemia and atherosclerosis, are increasingly recognized as significant concerns in patients with Hashimoto's disease. Additionally, autoimmune skin disorders, gastrointestinal motility issues, and musculoskeletal pain are discussed in the context of their connection to thyroid dysfunction. The review emphasizes the importance of recognizing these systemic manifestations for comprehensive patient management and suggests that a holistic approach, rather than focusing solely on thyroid hormone replacement, is essential. This review aims to improve diagnostic accuracy, treatment outcomes, and overall patient care by broadening the understanding of Hashimoto's disease to include its extra-thyroidal effects. Further research is encouraged to explore novel therapeutic approaches targeting the autoimmune mechanisms underlying these systemic manifestations.
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Affiliation(s)
- Palash S Kotak
- Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Medical Research, Wardha, IND
| | - Abhinav Kadam
- Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Medical Research, Wardha, IND
| | - Sourya Acharya
- Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Medical Research, Wardha, IND
| | - Sunil Kumar
- Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Medical Research, Wardha, IND
| | - Anuj Varma
- Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Medical Research, Wardha, IND
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Haimi M, Lerner A. Utilizing Telemedicine Applications in Celiac Disease and Other Gluten-Free-Diet-Dependent Conditions: Insights from the COVID-19 Pandemic. Healthcare (Basel) 2024; 12:1132. [PMID: 38891207 PMCID: PMC11171739 DOI: 10.3390/healthcare12111132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 05/28/2024] [Accepted: 05/29/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Globally, approximately 1.4% of people have celiac disease (CD), induced by gluten sensitivity. If left untreated, it causes small intestinal inflammation and villous atrophy, which can result in failure to thrive, anemia, osteoporosis, malabsorption, and even malignancy. The only treatment option available is a gluten-free diet (GFD). Few studies have looked at the role and perception of telehealth in relation to CD and selective nutrition both before and after the COVID-19 pandemic. AIM Our goal was to screen and investigate the research conducted both before and after the COVID-19 pandemic concerning the utilization of telehealth applications and solutions in CD and other GFD-dependent circumstances. METHODS We employed a narrative review approach to explore articles that were published in scholarly journals or organizations between the years 2000 and 2024. Only English-language publications were included. PubMed and Google Scholar searches were mainly conducted using the following keywords: telemedicine, telehealth, telecare, eHealth, m-health, COVID-19, SARS-CoV-2, celiac disease, and gluten-free diet (GFD). Manual searches of the references in the acquired literature were also carried out, along with the authors' own personal contributions of their knowledge and proficiency in this field. RESULTS Only a few studies conducted prior to the COVID-19 outbreak examined the viewpoints and experiences of adult patients with CD with relation to in-person clinic visits, as well as other options such as telehealth. The majority of patients believed that phone consultations were appropriate and beneficial. Video conferencing and telemedicine became more popular during the COVID-19 pandemic, demonstrating the effectiveness of using these technologies for CD on a global basis. In recent years, urine assays for gluten identification have become accessible for use at home. These tests could be helpful for CD monitoring with telemedicine assistance. CONCLUSIONS The extended knowledge gathered from the COVID-19 pandemic is expected to complement pre-COVID-19 data supporting the usefulness of telemedicine even after the emergent pandemic, encouraging its wider adoption in standard clinical practice. The monitoring and follow-up of CD patients and other GFD-dependent conditions can greatly benefit from telemedicine.
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Affiliation(s)
- Motti Haimi
- Health Systems Management Department, The Max Stern Yezreel Valley College, Yezreel Valley 1930600, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3109601, Israel
| | - Aaron Lerner
- Chaim Sheba Medical Center, The Zabludowicz Research Center for Autoimmune Diseases, Ramat Gan 5266202, Israel;
- Research Department, Ariel University, Ariel 407000, Israel
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Lerner A, Benzvi C, Vojdani A. Cross-reactivity and sequence similarity between microbial transglutaminase and human tissue antigens. Sci Rep 2023; 13:17526. [PMID: 37845267 PMCID: PMC10579360 DOI: 10.1038/s41598-023-44452-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 10/09/2023] [Indexed: 10/18/2023] Open
Abstract
Microbial transglutaminase (mTG) is a bacterial survival factor, frequently used as a food additive to glue processed nutrients. As a result, new immunogenic epitopes are generated that might drive autoimmunity. Presently, its contribution to autoimmunity through epitope similarity and cross-reactivity was investigated. Emboss Matcher was used to perform sequence alignment between mTG and various antigens implicated in many autoimmune diseases. Monoclonal and polyclonal antibodies made specifically against mTG were applied to 77 different human tissue antigens using ELISA. Six antigens were detected to share significant homology with mTG immunogenic sequences, representing major targets of common autoimmune conditions. Polyclonal antibody to mTG reacted significantly with 17 out of 77 tissue antigens. This reaction was most pronounced with mitochondrial M2, ANA, and extractable nuclear antigens. The results indicate that sequence similarity and cross-reactivity between mTG and various tissue antigens are possible, supporting the relationship between mTG and the development of autoimmune disorders 150W.
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Affiliation(s)
- Aaron Lerner
- Chaim Sheba Medical Center, The Zabludowicz Research Center for Autoimmune Diseases, Tel Hashomer, Israel.
- Ariel University, Ariel, Israel.
| | - Carina Benzvi
- Chaim Sheba Medical Center, The Zabludowicz Research Center for Autoimmune Diseases, Tel Hashomer, Israel
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Mahroum N, Elsalti A, Alwani A, Seida I, Alrais M, Seida R, Esirgun SN, Abali T, Kiyak Z, Zoubi M, Shoenfeld Y. The mosaic of autoimmunity - Finally discussing in person. The 13 th international congress on autoimmunity 2022 (AUTO13) Athens. Autoimmun Rev 2022; 21:103166. [PMID: 35932955 PMCID: PMC9349027 DOI: 10.1016/j.autrev.2022.103166] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 07/31/2022] [Indexed: 11/29/2022]
Abstract
While autoimmunity is a branch of medicine linked to every single organ system via direct and indirect pathways, meeting in person to discuss autoimmunity during the 13th international congress on autoimmunity (AUTO13) with participants from all over the world had a very good reason. The mechanisms involved in autoimmune diseases are of extreme importance and in fact critical in understanding the course of diseases as well as selecting proper therapies. COVID-19 has served as a great example of how autoimmunity is deeply involved in the disease and directly correlated to severity, morbidity, and mortality. For instance, initially the term cytokine storm dominated, then COVID-19 was addressed as the new member of the hyperferritinemic syndrome, and also the use of immunosuppressants in patients with COVID-19 throughout the pandemic, all shed light on the fundamental role of autoimmunity. Unsurprisingly, SARS-CoV-2 was called the “autoimmune virus” during AUTO13. Subsequently, the correlation between autoimmunity and COVID-19 vaccines and post-COVID, all were discussed from different autoimmune aspects during the congress. In addition, updates on the mechanisms of diseases, autoantibodies, novel diagnostics and therapies in regard to autoimmune diseases such as antiphospholipid syndrome, systemic lupus erythematosus, systemic sclerosis and others, were discussed in dedicated sessions. Due to the magnificence of the topics discussed, we aimed to bring in our article hereby, the pearls of AUTO13 in terms of updates, new aspects of autoimmunity, and interesting findings. While more than 500 abstract were presented, concluding all the topics was not in reach, hence major findings were summarized.
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Affiliation(s)
- Naim Mahroum
- International School of Medicine, Istanbul Medipol University, Istanbul, Turkey.
| | - Abdulrahman Elsalti
- International School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Abdulkarim Alwani
- International School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Isa Seida
- International School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Mahmoud Alrais
- International School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Ravend Seida
- International School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Sevval Nil Esirgun
- International School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Tunahan Abali
- International School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Zeynep Kiyak
- International School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Majdi Zoubi
- Department of Internal Medicine B, HaEmek Medical Center, Afula, Israel, Affiliated to Technion, Faculty of Medicine, Haifa, Israel
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What about TSH and Anti-Thyroid Antibodies in Patients with Autoimmune Thyroiditis and Celiac Disease Using a Gluten-Free Diet? A Systematic Review. Nutrients 2022; 14:nu14081681. [PMID: 35458242 PMCID: PMC9028602 DOI: 10.3390/nu14081681] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/08/2022] [Accepted: 04/16/2022] [Indexed: 12/05/2022] Open
Abstract
The prevalence of celiac disease (CD) in patients with chronic autoimmune thyroiditis (CAIT) is estimated to be between 2 and 7.8%. A gluten-free diet (GFD) in patients with CD is suggested to have a beneficial effect on CAIT. Thus, the present systematic review was undertaken to achieve more robust evidence about the change in thyroid stimulating hormone (TSH) and thyroid-specific antibodies (T-Ab) levels obtained in CD patients following a GFD. A specific search strategy was planned. The last search was performed on March 2022. The following data were mainly searched for in order to be extracted: sample size, mean and/or median with standard deviation (SD), and error (SE), individually, of thyroid hormones and T-Ab at baseline and after GFD, and the duration of the study. The initial search retrieved 297 records and 6 articles met the inclusion criteria. In total, 50 patients with both CD and CAIT and 45 controls were reported. The effects of a GFD on the thyroid hormonal and immunological profile could be extracted only in a part of the studies. Two studies were case reports. A low risk of bias was observed. These findings advise further studies, ideally randomized, in order to better investigate the potential relationship between GFD and thyroid homeostasis. The level of evidence is not still sufficient to recommend GFD to patients with CAIT.
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Could I-FABP Be an Early Marker of Celiac Disease in Children with Type 1 Diabetes? Retrospective Study from the Tertiary Reference Centre. Nutrients 2022; 14:nu14030414. [PMID: 35276772 PMCID: PMC8840733 DOI: 10.3390/nu14030414] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/09/2022] [Accepted: 01/16/2022] [Indexed: 02/05/2023] Open
Abstract
Patients with type 1 diabetes (T1D) are at higher risk of celiac disease (CD). Recently, intestinal fatty acid binding protein (I-FABP) has been shown to be a serological biomarker of impaired intestinal barrier in CD. Thus, the aim of this study was to verify whether I-FABP could be an early marker of CD in pediatric T1D patients. I-FABP was measured in sera of patients with T1D (n = 156), active CD (n = 38), T1D with active CD (T1D-CD, n= 51), and age-matched healthy children (n = 55). Additionally, I-FABP was determined in T1D patients with negative CD serology at least one year before CD diagnosis (T1D-CD-1, n = 22), in CD patients on a gluten-free diet (CD-GFD, n = 36), and T1D-CD patients on GFD (T1D-CD-GFD, n = 39). Sera were tested using immunoenzymatic assay. Significantly increased levels of I-FABP were found in the T1D, active CD, and T1D-CD groups (1153 ± 665, 1104 ± 916, and 1208 ± 878, respectively) in comparison to healthy with controls (485 ± 416, p < 0.05). GFD induced a significant decrease in I-FABP levels in CD and T1D-CD groups (510 ± 492 and 548 ± 439, respectively). Interestingly, in T1D-CD-1 and T1D, I-FABP levels were comparable (833 ± 369 vs. 1153 ± 665), and significantly increased in relation to healthy controls and T1D-CD values on GFD. The results indicate that the epithelial barrier is disrupted in T1D patients independently of CD development; therefore, I-FABP cannot serve as an early marker of CD in T1D patients. Although GFD can improve epithelial recovery, the question remains as to whether GFD could exert beneficial effects on the intestinal barrier in early stages of T1D.
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12
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Knippenberg A, Robinson GA, Wincup C, Ciurtin C, Jury EC, Kalea AZ. Plant-based dietary changes may improve symptoms in patients with systemic lupus erythematosus. Lupus 2022; 31:65-76. [PMID: 34978516 PMCID: PMC8793314 DOI: 10.1177/09612033211063795] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Previous studies have reported that patients affected by systemic lupus erythematosus (SLE) are interested in using diet to treat fatigue, cardiovascular disease and other symptoms. However, to date, there is insufficient information regarding the ways for patients to modify their diet to improve SLE symptoms. We investigated the relationship between the eating patterns of SLE patients and their self-reported disease symptoms and general aspects of health. METHODS A UK-based, online survey was developed, in which patients with SLE were asked about their attitudes and experiences regarding their SLE symptoms and diet. RESULTS The majority (>80%) of respondents that undertook new eating patterns with increased vegetable intake and/or decreased intake of processed food, sugar, gluten, dairy and carbohydrates reported benefiting from their dietary change. Symptom severity ratings after these dietary changes were significantly lower than before (21.3% decrease, p<0.0001). The greatest decreases in symptom severity were provided by low/no dairy (27.1% decrease), low/no processed foods (26.6% decrease) and vegan (26% decrease) eating patterns (p<0.0001). Weight loss, fatigue, joint/muscle pain and mood were the most cited symptoms that improved with dietary change. CONCLUSION SLE patients who changed their eating patterns to incorporate more plant-based foods while limiting processed foods and animal products reported improvements in their disease symptoms. Thus, our findings show promises in using nutrition interventions for the management of SLE symptoms, setting the scene for future clinical trials in this area. Randomised studies are needed to further test whether certain dietary changes are effective for improving specific symptoms of SLE.
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Affiliation(s)
| | - George A Robinson
- Centre for Rheumatology Research, Division of Medicine, University College London, London, UK
- Centre for Adolescent Rheumatology Versus Arthritis, Division of Medicine, University College London, London, UK
| | - Chris Wincup
- Centre for Rheumatology Research, Division of Medicine, University College London, London, UK
| | - Coziana Ciurtin
- Centre for Adolescent Rheumatology Versus Arthritis, Division of Medicine, University College London, London, UK
| | - Elizabeth C Jury
- Centre for Rheumatology Research, Division of Medicine, University College London, London, UK
| | - Anastasia Z Kalea
- Division of Medicine, University College London, London, UK
- Institute of Cardiovascular Science, University College London, London, UK
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Taniguchi K, Ikeda Y, Nagase N, Tsuji A, Kitagishi Y, Matsuda S. Implications of Gut-Brain axis in the pathogenesis of Psychiatric disorders. AIMS BIOENGINEERING 2021. [DOI: 10.3934/bioeng.2021021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
<abstract>
<p>Psychiatric disorders may extremely impair the quality of life with patients and are important reasons of social disability. Several data have shown that psychiatric disorders are associated with an altered composition of gut microbiota. Dietary intake could determine the microbiota, which contribute to produce various metabolites of fermentation such as short chain fatty acids. Some of the metabolites could result in epigenetic alterations leading to the disease susceptibility. Epigenetic dysfunction is in fact implicated in various psychiatric and neurologic disorders. For example, it has been shown that neuroepigenetic dysregulation occurs in psychiatric disorders including schizophrenia. Several studies have demonstrated that the intestinal microbiome may influence the function of central nervous system. Furthermore, it has been proved that the alterations in the gut microbiota-composition might affect in the bidirectional communication between gut and brain. Similarly, evidences demonstrating the association between psychiatric disorders and the gut microbiota have come from preclinical studies. It is clear that an intricate symbiotic relationship might exist between host and microbe, although the practical significance of the gut microbiota has not yet to be determined. In this review, we have summarized the function of gut microbiota in main psychiatric disorders with respect to the mental health. In addition, we would like to discuss the potential mechanisms of the disorders for the practical diagnosis and future treatment by using bioengineering of microbiota and their metabolites.</p>
</abstract>
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