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  1. Article ; Online: Gluten-Free Diet and Other Celiac Disease Therapies: Current Understanding and Emerging Strategies.

    Mazzola, Anna Maria / Zammarchi, Irene / Valerii, Maria Chiara / Spisni, Enzo / Saracino, Ilaria Maria / Lanzarotto, Francesco / Ricci, Chiara

    Nutrients

    2024  Volume 16, Issue 7

    Abstract: A lifelong gluten-free diet (GFD) is the only treatment for celiac disease and other gluten-related disorders. Nevertheless, strict adherence to the GFD is often challenging due to concerns about social isolation, risk of gluten contaminations, high cost, ...

    Abstract A lifelong gluten-free diet (GFD) is the only treatment for celiac disease and other gluten-related disorders. Nevertheless, strict adherence to the GFD is often challenging due to concerns about social isolation, risk of gluten contaminations, high cost, poor quality and the taste of gluten-free products. Moreover, although the GFD is effective in achieving mucosal healing, it may lead to dietary imbalances due to nutrient deficiencies over a long period of time. To overcome these issues, several gluten-free wheat flours have been developed to create products that closely resemble their gluten-containing counterparts. Furthermore, given the critical importance of adhering to the GFD, it becomes essential to promote adherence and monitor possible voluntary or involuntary transgressions. Various methods, including clinical assessment, questionnaires, serology for celiac disease, duodenal biopsies and the detection of Gluten Immunogenic Peptides (GIPs) are employed for this purpose, but none are considered entirely satisfactory. Since adherence to the GFD poses challenges, alternative therapies should be implemented in the coming years to improve treatment efficacy and the quality of life of patients with celiac disease. The aim of this narrative review is to explore current knowledge of the GFD and investigate its future perspectives, focusing on technology advancements, follow-up strategies and insights into a rapidly changing future.
    MeSH term(s) Humans ; Diet, Gluten-Free ; Celiac Disease ; Quality of Life ; Glutens/adverse effects ; Biopsy
    Chemical Substances Glutens (8002-80-0)
    Language English
    Publishing date 2024-03-29
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2518386-2
    ISSN 2072-6643 ; 2072-6643
    ISSN (online) 2072-6643
    ISSN 2072-6643
    DOI 10.3390/nu16071006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Effect of Tofacitinib on One-Year Colectomy Risk in Anti-TNF Refractory Ulcerative Colitis: A Prospective Multicenter Italian Study.

    Carvalhas Gabrielli, Anna Maria / Ferretti, Francesca / Monico, Camilla Maria / Tombetti, Enrico / Maconi, Giovanni / Romeo, Samanta / Piazza O Sed, Nicole / Caprioli, Flavio / Mazzola, Anna Maria / Alicante, Saverio / Bertè, Roberto / Lolli, Elisabetta / Scribano, Maria Lia / Buscarini, Elisabetta / Ricci, Chiara / Carmagnola, Stefania / Ardizzone, Sandro / Cannatelli, Rosanna

    Digestive diseases and sciences

    2024  Volume 69, Issue 5, Page(s) 1785–1792

    Abstract: Background: Tofacitinib is an oral Janus kinase inhibitor recently approved to induce and maintain remission in ulcerative colitis (UC).: Aims: Considering the number of anti-TNF non-responders, this study aims to assess the effectiveness and safety ... ...

    Abstract Background: Tofacitinib is an oral Janus kinase inhibitor recently approved to induce and maintain remission in ulcerative colitis (UC).
    Aims: Considering the number of anti-TNF non-responders, this study aims to assess the effectiveness and safety of tofacitinib in a cohort of multi-failure patients with moderate-to-severe UC at 52 weeks.
    Methods: From January 2021 to March 2023, we performed a prospective multicenter study observing adult patients with moderate-to-severe UC starting tofacitinib after an anti-TNF failure for a 52-week-long period. Effectiveness and safety were assessed in terms of colectomy rate, clinical remission and response, endoscopic remission, steroid-free clinical remission, and rate of adverse events.
    Results: We included 58 patients with UC with an age of 42 ± 14.4 years, 59% males, 96.6% left-sided or pancolitis, who were failure to a single (65.5%) or more than one anti-TNF (34.5%). Only 6 (10.3%) patients underwent colectomy. Colectomy was clinically associated with the necessity and the number of extra cycles of tofacitinib 10 mg bid at W8 (p = 0.023) and W24 (p = 0.004), and with a higher partial Mayo score at W8 (p = 0.025). At W52, clinical remission, clinical response, and steroid-free clinical remission were 53.4%, 43.1%, and 48.3%, respectively. Of 22 performed colonoscopies at W52, 11 (50%) showed endoscopic remission. Adverse events occurred in 14 (24.1%) patients, but only 2 (3.4%) led to tofacitinib discontinuation.
    Conclusions: In a real-life setting of patients with anti-TNF refractory UC, tofacitinib has proved to be effective in preventing colectomy and inducing clinical and endoscopic remission at 52 weeks with a good safety profile.
    MeSH term(s) Humans ; Colitis, Ulcerative/surgery ; Colitis, Ulcerative/drug therapy ; Pyrimidines/therapeutic use ; Male ; Female ; Colectomy/adverse effects ; Piperidines/therapeutic use ; Piperidines/adverse effects ; Piperidines/administration & dosage ; Adult ; Middle Aged ; Prospective Studies ; Italy/epidemiology ; Tumor Necrosis Factor Inhibitors/therapeutic use ; Tumor Necrosis Factor Inhibitors/adverse effects ; Janus Kinase Inhibitors/therapeutic use ; Janus Kinase Inhibitors/adverse effects ; Remission Induction ; Treatment Outcome ; Protein Kinase Inhibitors/therapeutic use ; Protein Kinase Inhibitors/adverse effects
    Chemical Substances tofacitinib
    Language English
    Publishing date 2024-03-26
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Observational Study
    ZDB-ID 304250-9
    ISSN 1573-2568 ; 0163-2116
    ISSN (online) 1573-2568
    ISSN 0163-2116
    DOI 10.1007/s10620-024-08394-w
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Autoimmune polyglandular syndrome type 4: experience from a single reference center.

    Gatta, Elisa / Anelli, Valentina / Cimino, Elena / Di Lodovico, Elena / Piovani, Elda / Zammarchi, Irene / Gozzoli, Giorgia / Maltese, Virginia / Cavadini, Maria / Agosti, Barbara / Delbarba, Andrea / Pirola, Ilenia / Girelli, Angela / Buoso, Caterina / Bambini, Francesca / Alfieri, Daniele / Bremi, Walter / Facondo, Paolo / Lupo, Roberto /
    Bezzi, Francesco / Fredi, Micaela / Mazzola, Anna Maria / Gandossi, Elena / Saullo, Maura / Marini, Fiorella / Licini, Massimo / Pezzaioli, Letizia Chiara / Pini, Laura / Franceschini, Franco / Ricci, Chiara / Cappelli, Carlo

    Frontiers in endocrinology

    2023  Volume 14, Page(s) 1236878

    Abstract: Purpose: To characterize patients with APS type 4 among those affected by APS diagnosed and monitored at our local Reference Center for Autoimmune Polyglandular Syndromes.: Methods: Monocentric observational retrospective study enrolling patients ... ...

    Abstract Purpose: To characterize patients with APS type 4 among those affected by APS diagnosed and monitored at our local Reference Center for Autoimmune Polyglandular Syndromes.
    Methods: Monocentric observational retrospective study enrolling patients affected by APS diagnosed and monitored in a Reference Center. Clinical records were retrieved and analyzed.
    Results: 111 subjects (51 males) were affected by APS type 4, mean age at the onset was 23.1 ± 15.1 years. In 15 patients the diagnosis of APS was performed during the first clinical evaluation, in the other 96 after a latency of 11 years (range 1-46). The most frequent diseases were type I diabetes mellitus and celiac disease, equally distributed among sexes.
    Conclusions: The prevalence of APS type 4 is 9:100,000 people. Type I diabetes mellitus was the leading indicator of APS type 4 in 78% subjects and in 9% permitted the diagnosis occurring as second manifestation of the syndrome. Our data, showing that 50% of patients developed APS type 4 within the first ten years, don't suggest any particular follow-up time and, more importantly, don't specify any particular disease. It is important to emphasize that 5% of women developed premature ovarian failure.
    MeSH term(s) Adolescent ; Adult ; Child ; Female ; Humans ; Male ; Young Adult ; Celiac Disease/complications ; Celiac Disease/diagnosis ; Celiac Disease/epidemiology ; Diabetes Mellitus, Type 1/epidemiology ; Polyendocrinopathies, Autoimmune/diagnosis ; Polyendocrinopathies, Autoimmune/epidemiology ; Primary Ovarian Insufficiency ; Retrospective Studies ; Syndrome
    Language English
    Publishing date 2023-10-23
    Publishing country Switzerland
    Document type Journal Article ; Observational Study
    ZDB-ID 2592084-4
    ISSN 1664-2392
    ISSN 1664-2392
    DOI 10.3389/fendo.2023.1236878
    Database MEDical Literature Analysis and Retrieval System OnLINE

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