Detection of gluten immunogenic peptides in the urine of patients with coeliac disease reveals transgressions in the gluten-free diet and incomplete mucosal healing
ObjectiveGluten-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...
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| Veröffentlicht in: | Gut 2017-02, Vol.66 (2), p.250-257 |
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| creator | Moreno, María de Lourdes Cebolla, Ángel Muñoz-Suano, Alba Carrillo-Carrion, Carolina Comino, Isabel Pizarro, Ángeles León, Francisco Rodríguez-Herrera, Alfonso Sousa, Carolina |
| description | ObjectiveGluten-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.DesignUrine 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.ResultsGIP 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.ConclusionGIP 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.Trial registration numberNCT02344758. |
| doi_str_mv | 10.1136/gutjnl-2015-310148 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5284479</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1859486863</sourcerecordid><originalsourceid>FETCH-LOGICAL-b501t-bbc1f614610653a3b8caa92be9f623ac1fb3c6992f6b92d4c1bdcdf0890a1c5c3</originalsourceid><addsrcrecordid>eNqNkruO1DAUhiMEYoeFF6BAlmhoAr7EHrtBQstVWokGast2TjIeJXawnV3xPjwoHmUZAdVWLs73_-fiv2meE_yaECbejGs5hqmlmPCWEUw6-aDZkU7IllEpHzY7jMm-5ftOXTRPcj5ijKVU5HFzQYXAshN41_x6DwVc8TGgOKBxWgsE5Od5DXGE4B1aYCm-h4x8QOUAaE0-wIldTPEQSka3vhyQizB541DvM5gMKMENmCmjkkzIY4Kca4uzydanHRJAVUBBJvS15uK8THUeNK8uZjOhQ_XwYXzaPBqqGTy7ey-b7x8_fLv63F5__fTl6t11azkmpbXWkUHUAxAsODPMSmeMohbUICgztWiZE0rRQVhF-84R27t-wFJhQxx37LJ5u_kuq52hd3W9ZCa9JD-b9FNH4_W_leAPeow3mlPZdXtVDV7dGaT4Y4Vc9Oyzg2kyAeKaNZFcdVJIwe6B1k9iHaWyoi__Q49xTaFeolKCccExx5WiG-VSzDnBcJ6bYH3Ki97yok950VtequjF3xufJX8CUoF2A-x8vI_hb3-_0Mk</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1863565050</pqid></control><display><type>article</type><title>Detection of gluten immunogenic peptides in the urine of patients with coeliac disease reveals transgressions in the gluten-free diet and incomplete mucosal healing</title><source>MEDLINE</source><source>PubMed Central</source><creator>Moreno, María de Lourdes ; Cebolla, Ángel ; Muñoz-Suano, Alba ; Carrillo-Carrion, Carolina ; Comino, Isabel ; Pizarro, Ángeles ; León, Francisco ; Rodríguez-Herrera, Alfonso ; Sousa, Carolina</creator><creatorcontrib>Moreno, María de Lourdes ; Cebolla, Ángel ; Muñoz-Suano, Alba ; Carrillo-Carrion, Carolina ; Comino, Isabel ; Pizarro, Ángeles ; León, Francisco ; Rodríguez-Herrera, Alfonso ; Sousa, Carolina</creatorcontrib><description>ObjectiveGluten-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.DesignUrine 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.ResultsGIP 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.ConclusionGIP 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.Trial registration numberNCT02344758.</description><identifier>ISSN: 0017-5749</identifier><identifier>EISSN: 1468-3288</identifier><identifier>DOI: 10.1136/gutjnl-2015-310148</identifier><identifier>PMID: 26608460</identifier><identifier>CODEN: GUTTAK</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Adolescent ; Adult ; Antibodies, Monoclonal ; Biopsy ; Case-Control Studies ; Celiac disease ; Celiac Disease - diet therapy ; Celiac Disease - pathology ; Celiac Disease - urine ; Child ; Child, Preschool ; Chromatography, Affinity ; Coeliac Disease ; Compliance ; Diet ; Diet Records ; Diet, Gluten-Free ; Duodenum - pathology ; Female ; Gliadin - immunology ; Gluten ; Glutens - immunology ; Glutens - metabolism ; GTP-Binding Proteins - immunology ; Humans ; Immunoglobulin A - blood ; Male ; Middle Aged ; Patient Compliance ; Peptides ; Peptides - immunology ; Peptides - urine ; Sensitivity and Specificity ; Transglutaminases - immunology ; Urine ; Young Adult</subject><ispartof>Gut, 2017-02, Vol.66 (2), p.250-257</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.</rights><rights>Copyright: 2017 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b501t-bbc1f614610653a3b8caa92be9f623ac1fb3c6992f6b92d4c1bdcdf0890a1c5c3</citedby><cites>FETCH-LOGICAL-b501t-bbc1f614610653a3b8caa92be9f623ac1fb3c6992f6b92d4c1bdcdf0890a1c5c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5284479/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5284479/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,882,27905,27906,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26608460$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Moreno, María de Lourdes</creatorcontrib><creatorcontrib>Cebolla, Ángel</creatorcontrib><creatorcontrib>Muñoz-Suano, Alba</creatorcontrib><creatorcontrib>Carrillo-Carrion, Carolina</creatorcontrib><creatorcontrib>Comino, Isabel</creatorcontrib><creatorcontrib>Pizarro, Ángeles</creatorcontrib><creatorcontrib>León, Francisco</creatorcontrib><creatorcontrib>Rodríguez-Herrera, Alfonso</creatorcontrib><creatorcontrib>Sousa, Carolina</creatorcontrib><title>Detection of gluten immunogenic peptides in the urine of patients with coeliac disease reveals transgressions in the gluten-free diet and incomplete mucosal healing</title><title>Gut</title><addtitle>Gut</addtitle><description>ObjectiveGluten-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.DesignUrine 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.ResultsGIP 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.ConclusionGIP 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.Trial registration numberNCT02344758.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Antibodies, Monoclonal</subject><subject>Biopsy</subject><subject>Case-Control Studies</subject><subject>Celiac disease</subject><subject>Celiac Disease - diet therapy</subject><subject>Celiac Disease - pathology</subject><subject>Celiac Disease - urine</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Chromatography, Affinity</subject><subject>Coeliac Disease</subject><subject>Compliance</subject><subject>Diet</subject><subject>Diet Records</subject><subject>Diet, Gluten-Free</subject><subject>Duodenum - pathology</subject><subject>Female</subject><subject>Gliadin - immunology</subject><subject>Gluten</subject><subject>Glutens - immunology</subject><subject>Glutens - metabolism</subject><subject>GTP-Binding Proteins - immunology</subject><subject>Humans</subject><subject>Immunoglobulin A - blood</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patient Compliance</subject><subject>Peptides</subject><subject>Peptides - immunology</subject><subject>Peptides - urine</subject><subject>Sensitivity and Specificity</subject><subject>Transglutaminases - immunology</subject><subject>Urine</subject><subject>Young Adult</subject><issn>0017-5749</issn><issn>1468-3288</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ACMMV</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkruO1DAUhiMEYoeFF6BAlmhoAr7EHrtBQstVWokGast2TjIeJXawnV3xPjwoHmUZAdVWLs73_-fiv2meE_yaECbejGs5hqmlmPCWEUw6-aDZkU7IllEpHzY7jMm-5ftOXTRPcj5ijKVU5HFzQYXAshN41_x6DwVc8TGgOKBxWgsE5Od5DXGE4B1aYCm-h4x8QOUAaE0-wIldTPEQSka3vhyQizB541DvM5gMKMENmCmjkkzIY4Kca4uzydanHRJAVUBBJvS15uK8THUeNK8uZjOhQ_XwYXzaPBqqGTy7ey-b7x8_fLv63F5__fTl6t11azkmpbXWkUHUAxAsODPMSmeMohbUICgztWiZE0rRQVhF-84R27t-wFJhQxx37LJ5u_kuq52hd3W9ZCa9JD-b9FNH4_W_leAPeow3mlPZdXtVDV7dGaT4Y4Vc9Oyzg2kyAeKaNZFcdVJIwe6B1k9iHaWyoi__Q49xTaFeolKCccExx5WiG-VSzDnBcJ6bYH3Ki97yok950VtequjF3xufJX8CUoF2A-x8vI_hb3-_0Mk</recordid><startdate>20170201</startdate><enddate>20170201</enddate><creator>Moreno, María de Lourdes</creator><creator>Cebolla, Ángel</creator><creator>Muñoz-Suano, Alba</creator><creator>Carrillo-Carrion, Carolina</creator><creator>Comino, Isabel</creator><creator>Pizarro, Ángeles</creator><creator>León, Francisco</creator><creator>Rodríguez-Herrera, Alfonso</creator><creator>Sousa, Carolina</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>9YT</scope><scope>ACMMV</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>7T5</scope><scope>H94</scope><scope>5PM</scope></search><sort><creationdate>20170201</creationdate><title>Detection of gluten immunogenic peptides in the urine of patients with coeliac disease reveals transgressions in the gluten-free diet and incomplete mucosal healing</title><author>Moreno, María de Lourdes ; Cebolla, Ángel ; Muñoz-Suano, Alba ; Carrillo-Carrion, Carolina ; Comino, Isabel ; Pizarro, Ángeles ; León, Francisco ; Rodríguez-Herrera, Alfonso ; Sousa, Carolina</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b501t-bbc1f614610653a3b8caa92be9f623ac1fb3c6992f6b92d4c1bdcdf0890a1c5c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Antibodies, Monoclonal</topic><topic>Biopsy</topic><topic>Case-Control Studies</topic><topic>Celiac disease</topic><topic>Celiac Disease - diet therapy</topic><topic>Celiac Disease - pathology</topic><topic>Celiac Disease - urine</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Chromatography, Affinity</topic><topic>Coeliac Disease</topic><topic>Compliance</topic><topic>Diet</topic><topic>Diet Records</topic><topic>Diet, Gluten-Free</topic><topic>Duodenum - pathology</topic><topic>Female</topic><topic>Gliadin - immunology</topic><topic>Gluten</topic><topic>Glutens - immunology</topic><topic>Glutens - metabolism</topic><topic>GTP-Binding Proteins - immunology</topic><topic>Humans</topic><topic>Immunoglobulin A - blood</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patient Compliance</topic><topic>Peptides</topic><topic>Peptides - immunology</topic><topic>Peptides - urine</topic><topic>Sensitivity and Specificity</topic><topic>Transglutaminases - immunology</topic><topic>Urine</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Moreno, María de Lourdes</creatorcontrib><creatorcontrib>Cebolla, Ángel</creatorcontrib><creatorcontrib>Muñoz-Suano, Alba</creatorcontrib><creatorcontrib>Carrillo-Carrion, Carolina</creatorcontrib><creatorcontrib>Comino, Isabel</creatorcontrib><creatorcontrib>Pizarro, Ángeles</creatorcontrib><creatorcontrib>León, Francisco</creatorcontrib><creatorcontrib>Rodríguez-Herrera, Alfonso</creatorcontrib><creatorcontrib>Sousa, Carolina</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Gut</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Moreno, María de Lourdes</au><au>Cebolla, Ángel</au><au>Muñoz-Suano, Alba</au><au>Carrillo-Carrion, Carolina</au><au>Comino, Isabel</au><au>Pizarro, Ángeles</au><au>León, Francisco</au><au>Rodríguez-Herrera, Alfonso</au><au>Sousa, Carolina</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Detection of gluten immunogenic peptides in the urine of patients with coeliac disease reveals transgressions in the gluten-free diet and incomplete mucosal healing</atitle><jtitle>Gut</jtitle><addtitle>Gut</addtitle><date>2017-02-01</date><risdate>2017</risdate><volume>66</volume><issue>2</issue><spage>250</spage><epage>257</epage><pages>250-257</pages><issn>0017-5749</issn><eissn>1468-3288</eissn><coden>GUTTAK</coden><abstract>ObjectiveGluten-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.DesignUrine 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.ResultsGIP 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.ConclusionGIP 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.Trial registration numberNCT02344758.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>26608460</pmid><doi>10.1136/gutjnl-2015-310148</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Antibodies, Monoclonal Biopsy Case-Control Studies Celiac disease Celiac Disease - diet therapy Celiac Disease - pathology Celiac Disease - urine Child Child, Preschool Chromatography, Affinity Coeliac Disease Compliance Diet Diet Records Diet, Gluten-Free Duodenum - pathology Female Gliadin - immunology Gluten Glutens - immunology Glutens - metabolism GTP-Binding Proteins - immunology Humans Immunoglobulin A - blood Male Middle Aged Patient Compliance Peptides Peptides - immunology Peptides - urine Sensitivity and Specificity Transglutaminases - immunology Urine Young Adult |
| title | 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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