title: Are patients with potential celiac disease really potential? The answer of metabonomics.
abstract: Celiac disease (CD) is an autoimmune disorder caused by a permanent sensitivity to gluten in genetically susceptible individuals. Accurate diagnosis of CD at an early stage and its treatment with a gluten-free diet (GFD) are important for optimum treatment and prognosis. Recently, by employing a noninvasive metabonomic approach, we have shown that CD has a well-defined metabonomic signature. Here we address potential CD patients, defined as subjects who do not have, and have never had, a jejunal biopsy consistent with clear CD, and yet have immunological abnormalities similar to those found in celiac patients. Sixty-one overt CD patients at diagnosis, 29 patients with potential CD, and 51 control subjects were examined by (1)H NMR of their serum and urine: out of 29 potential CD patients, 24 were classified as CD and 5 as control subjects. Potential CD largely shares the metabonomic signature of overt CD. Most metabolites found to be significantly different between control and CD subjects were also altered in potential CD. Our results demonstrate that metabolic alterations may precede the development of small intestinal villous atrophy and provide a further rationale for early institution of GFD in patients with potential CD, as recently suggested by prospective clinical studies.
authors.affiliation: Magnetic Resonance Center (CERM), University of Florence, Sesto Fiorentino, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Bernini
authors.forename: Ivano
authors.initials: I
authors.lastname: Bertini
authors.forename: Antonio
authors.initials: A
authors.lastname: Calabrò
authors.forename: Giancarlo
authors.initials: G
authors.lastname: la Marca
authors.forename: Gabriele
authors.initials: G
authors.lastname: Lami
authors.forename: Claudio
authors.initials: C
authors.lastname: Luchinat
authors.forename: Daniela
authors.initials: D
authors.lastname: Renzi
authors.forename: Leonardo
authors.initials: L
authors.lastname: Tenori
mesh_terms: D000328:Adult; D000465:Algorithms; D016022:Case-Control Studies; D002446:Celiac Disease / Q000097:blood / Q000175:diagnosis / Q000378:metabolism* / Q000652:urine; D002956:Citrulline / Q000097:blood; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D008297:Male; D055432:Metabolomics / Q000379:methods*; D008875:Middle Aged; D015233:Models, Statistical; D057054:Molecular Imaging; D019906:Nuclear Magnetic Resonance, Biomolecular; D015203:Reproducibility of Results
chemical_list: D002956:Citrulline