In the Journals

Altered microbiota linked to GI symptoms in celiac patients on strict diet

Abnormal intestinal microbiota was associated with gastrointestinal symptoms that persisted in patients with celiac disease despite adhering to a long-term gluten-free diet, according to new research data.

Researchers from Finland identified 177 patients with celiac disease at the Tampere University Hospital and University of Tampere, who underwent clinical examination, dietary assessment, gastrointestinal endoscopy with duodenal biopsy, and celiac disease serology analysis. Of the remaining patients who were on a strict gluten-free diet for several years and had normalized small bowel mucosa and negative celiac autoantibodies, those with the highest (n=18) and lowest (n=18) Gastrointestinal Symptom Rating Scale scores were identified for 16S rRNA gene pyrosequencing to analyze their duodenal microbiota.

Results showed that patients with persistent symptoms had different duodenal microbiota composition compared with patients who did not have symptoms, with reduced microbial richness (analysis based on genera, P=.05; based on operational taxonomic units, P=.007), higher abundance of Proteobacteria (40% vs. 21%; P=.04) and lower abundance of Bacteroidetes (15% vs. 25%; P=.01) and Firmicutes (33% vs. 46%; P=.05).

“Our results showed that celiac disease patients suffering from persistent symptoms on [gluten-free diet] had altered Proteobacteria-rich duodenal microbiota and reduced richness of bacteria, indicating intestinal dysbiosis,” the researchers concluded. “We propose that this altered microbiota is associated with persistent symptoms in celiac patients with strict [gluten-free diet] and small bowel mucosal recovery. Further studies are warranted to confirm our results and possibly to find applications for alleviating the symptoms of this specific patient subgroup by intestinal microbiota modulation.”

Disclosure: The researchers report no relevant financial disclosures.

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