Salivary diagnosis for celiac disease
Jiménez Wolf, Andrés
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Celiac disease is a gluten-sensitive enteropathy, characterized by an inflammatory reaction in the small intestine triggered by gluten proteins. Clinical consequences include malabsorption of nutrients due to the loss of absorptive villi and crypt hyperplasia. Certain similarities are found between the primary structures of gluten and salivary proline-rich proteins. These structural similarities can give an interesting perspective to the manner salivary proteins can be regarded in the celiac disease mechanism. Salivary proteome analyses have revealed a great potential for the diagnosis of systemic diseases. The concept of saliva as a diagnostic fluid is alluring because it is easily collected in a non-invasive manner, and the number of potential applications is rapidly increasing. The main focus of our study is to compare saliva composition, with emphasis on proline-rich proteins, in samples collected from healthy and celiac patients. A multisite clinical study was initiated, in collaboration with the Department of Medicine and Division of Gastroenterology at Beth Israel Deaconess Medical Center Boston, MA. Healthy and celiac patients are being recruited, consented, and asked to fill out three questionnaires probing oral health, overall gastrointestinal health and symptoms characteristic of celiac disease. From all participating subjects 10 ml of stimulated whole saliva and parotid saliva were being collected as well as two buccal epithelial swab samples. Salivary flow rate was monitored throughout the collection. Collected whole saliva samples were aliquoted, centrifuged and separated into supernatant and pellet fractions. So far samples from 42 subjects have been collected and processed: 19 from celiac disease patients (CD), 6 from refractory celiac disease patients (RCD), 6 from gastrointestinally symptomatic patients (GI), and and 11 from healthy control subjects (HC). Subjects also completed a series of gastrointestinal and oral health questionnaires, that revealed certain trends indicating that RCD patients tend to have significantly stronger symptomatic manifestations than subjects from the other groups, followed by CD and GI. Oral health questionnaires showed that subjects from all groups maintained, on average, good oral hygiene habits. Statistical analysis of flow rate distribution data showed no significant difference in saliva flow between sample groups. Future biological analysis will include proteome composition determination by SDS-PAGE and RP-HPLC, enzyme activity analysis, salivary microbiome analysis, and exon sequencing of mammalian genes of interest.
PLEASE NOTE: This work is protected by copyright. Downloading is restricted to the BU community: please click Download and log in with a valid BU account to access. If you are the author of this work and would like to make it publicly available, please contact firstname.lastname@example.org.Thesis (MSD) --Boston University, Henry M. Goldman School of Dental Medicine, 2014 (Department of Periodontology and Oral Biology)xi, 66 leavesIncludes bibliography: leaves 56-64.
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