Background: Potential celiac disease (CD) is a condition characterized by positivity of CD serology (anti-endomysial antibodies EMA and anti-transglutaminases IgA anti-TG2) in the absence of intestinal mucosa damage. Aim of the study vas to verify the clinical, serological and genetic characteristics of potential CD population in the nationwide territory and particularly what is the nutritional management of these patients in different CD centers. Methods: The study included 300 children with potential CD fulfilling the inclusion criteria from 10 different Italian CD centers (with median follow-up of 2 years). During the follow-up auxological parameters, presence of symptoms, antibody titers, diet (with or without gluten) were evaluated periodically. Every 2 years a biopsy was performed to check the status of the duodenal mucosa. Data were collected using a specific form. Results: At the time of diagnosis, 33% of patients were asymptomatic (15.3% were first degree of CD patients). In the symptomatic group (67%) the most frequent symptoms were abdominal pain (18.3%) and weight loss (16.3%). The mean values of anti-TG2 was 37.6 U/ml. Duodenal biopsies at first evaluation showed normal mucosal architecture in 52.5% and evidence of inflammatory infiltration in 47.2%. At the end of follow-up (range 2–5 years), 73% was still on a diet containing gluten, while 17% started a gluten-free diet for symptoms and 8% for villous atrophy development. Conclusion: This observational study has confirmed that potential celiac disease remains quite a problem common to all CD Italian Centers. There were no substantial differences in the characteristics and management of patients from different centers. Gluten-free diet is prescribed only in 25% of patients.

Tauro-conjugated BA, which are predominant during development, are more polar and more resistant to passive intestinal absorption than G-conjugated. To further elucidate the possible impact of postnatal BA conjugation pattern on the dynamic of enterohepatic circulation, we have studied 16 premature formula-fed infants (29-36 gw): at the age of 2 weeks, they were randomly assigned to receive an adapted formula(F)with or without T (25μmol/dl). Before and after 4 weeks of this diet, fasting serum levels of cholic (CA) and chenodeoxycholic (CDCA) acids were determined by competitive solid phase enzyme immunoassay, after TLC separation of the G and T conjugated forms. The predominance of G-conjugates (mainly of CA)in serum of prematures, contrasts with the reported excess of T-conjugated BA in their duodenal fluid and may be due to later appearance of the active ileal transport system, for which T-conjugates are almost exclusively dependent to be absorbed. T-feeding produced a slight change in the relative proportion of G and T conjugates in serum, which seems limited to CA, in agreement with the “in vitro” observation of higher synthesis of conjugates for CA than CDCA. The sensible decrease of serum CA levels after T supplementation may be related to the inability of prematures to absorb increased amounts of tauro-CA, while extensive passive absorption would permit conservation of the more hydrophobic CDCA.

Journal of Pediatric Gastroenterology and NutritionVolume 7, Issue 2 p. 309-309 Selected Reviews: PDF Only COMPARISON OF FOUR PANCREATIC EXTRACTS IN CYSTIC FIBROSIS Carla Colombo, Carla Colombo Department of Pediatrics, University of Milan, Milan, ItalySearch for more papers by this author Carla Colombo, Carla Colombo Department of Pediatrics, University of Milan, Milan, ItalySearch for more papers by this author First published: 01 March 1988 https://doi.org/10.1002/j.1536-4801.1988.tb09535.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume7, Issue2March 1988Pages 309-309 RelatedInformation

Previous studies of the bile acid composition of meconium and bile obtained in the first few days of life indicate that, compared to the adult, there are significant differences in the hepatic synthesis of bile acids. Analysis of human fetal gallbladder bile provides a more direct assessment of primary hepatic synthesis in utero, but only limited studies have been described. Using HPLC, GLC and mass speetrometry the bile acid composition was determined for fetal gallbladder bile obtained after legal abortion between the 14th and 20th weeks of gestation. Chenodeoxycholic and cholic acids were the major bile acids identified however the profiles were characterized by an array of metabolites not normally found in adult bile. Hyocholic acid levels often exceeded those of cholic acid indicating C-6 hydroxylation to be a major pathway for bile acid synthesis in early life. Bile acid concentrations were relatively low before week 17 of gestation but showed a significant surge thereafter, increasing by >10 fold by week 20. The ratio of chenodeoxycholic:cholic acid in bile was constant (0.85) over this period and much lower than for newborn bile and adult bile indicating an immaturity in hepatic 12α-hydroxylase in early development. These observations demonstrate that more than 50% of the bile acids are accounted for by atypical bile acids and that the profile resembles that found in adults with cholestasis. This may in part account for the physiologic cholestasis of the newborn.

ABSTRACT: Using analytical techniques, which included capillary column gas-liquid chromatography and mass spectrometry, detailed bile acid profiles were obtained for 24 fetal bile samples collected after legal abortions were performed between the 14th and 20th wk of gestation. Qualitatively, the bile acid profiles of all fetal bile samples were similar. The predominant bile acids identified were chenodeoxycholic and cholic acid. The presence of small but variable amounts of deoxycholic acid and traces of lithocholic acid suggested placental transfer of these bile acids from the maternal circulation. 3β-Hydroxy-5-cholenoic acid was detected at higher levels than lithocholic acid. A conspicuous feature of the profiles was the presence of bile acids with hydroxyl groups at positions C-1 and C-6, and one other nuclear position of unknown origin, indicating fetal hepatic synthesis via pathways different from those normally seen in the adult. Quantitatively total biliary bile acid concentrations were extremely low (<0.05 mM) before wk 17 of gestation, but thereafter concentrations markedly increased reflecting a possible surge in bile acid synthesis; however, the ratio of cholic:chenodeoxycholic acids remained relatively constant over this period (mean ± SD = 0.85 ± 0.36) and different from that reported for the healthy newborn (ca. 2.5) and adult (ca. 1.6). These data indicate an immaturity in hepatic 12α-hydroxylation of bile acids during early development and may explain why other pathways, in particular 1β and 6α-hydroxylation, are activated at this stage of life.