Eur J Nutr. 2021 Jun;60(4):2131-2140. doi: 10.1007/s00394-020-02404-z. Epub 2020 Oct 15.

María Roca ¹, Ester Donat ^2 3, Etna Masip ^2 3, Paula Crespo-Escobar ^2 4, Antonio José Cañada-Martínez ⁵, Begoña Polo ^2 3, Carmen Ribes-Koninckx ^2 3

Author information

• ¹Celiac Disease and Digestive Immunopathology Unit, Instituto de Investigación Sanitaria La Fe, Avda. Fernando Abril Martorell, 106, P.O. Box 46026, Valencia, Spain. maria_roca@iislafe.es.
• ²Celiac Disease and Digestive Immunopathology Unit, Instituto de Investigación Sanitaria La Fe, Avda. Fernando Abril Martorell, 106, P.O. Box 46026, Valencia, Spain.
• ³Pediatric Gastrohepatology Unit, Hospital Universitario y Politécnico La Fe, P.O. Box 46026, Valencia, Spain.
• ⁴Department of Health Science, Universidad Europea Miguel de Cervantes, P.O. Box 47012, Valladolid, Spain.
• ⁵Data Science Unit, Instituto de Investigación Sanitaria La Fe, P.O. Box 46026, Valencia, Spain.

Abstract

Purpose: In celiac disease (CD) there is a need for precise and non-invasive tools to assess dietary compliance to the gluten-free diet (GFD). Our aim is to evaluate the efficacy of the detection of gluten immunogenic peptides (GIP) in feces, to monitor in real life, the adherence to GFD in pediatric patients with CD.

Methods: A cross-sectional, prospective study was conducted. Fecal samples from CD children were analyzed by a rapid immunochromatographic (IC) test and by an ELISA method, both based on the antigliadin 33-mer monoclonal antibody.

Results: Group 1 comprises 43 children on a GFD. According to the food records (FR), 39/43 patients were compliant with the GFD and gluten consumption was recorded in 4. GIP were detected in 15/43 individuals by the ELISA method and also in 7 by IC strips. Group 2: comprise 18 children at CD diagnosis; GIP levels decreased over time (p < 0.001) in a non-linear way (p = 0.028) after starting a GFD and were below the detection limit on the third day in most individuals.

Conclusion: GIP were detected, both by ELISA and by IC strips, in CD patients on a GFD, in which no consumption of gluten had been registered on the FR, confirming GIP detection to be superior to FR discovering involuntary transgressions. Despite a positive correlation between the amount of gluten intake and the concentration of GIP in feces, the interindividual variations observed suggest gastrointestinal factors influencing GIP recovery need to be further investigated.