Hello Dr Ray

I was interested in your question and was looking forward to reading what other RG members wrote, but as no-one has responded yet, I was wondering if you had seen the last three paragraphs (particularly) of this paper (that you are probably already familiar with) for interest rather than for answers:

Ramakrishna, B. S. (2011). Celiac disease: can we avert the impending epidemic in India?. The Indian journal of medical research, 133(1), 5.

https://www.researchgate.net/publication/49836391_Celiac_disease_Can_we_avert_the_impending_epidemic_in_India

I was interested in your paper:' Inflammatory bowel disease in India - Past, present and future'

I see that Dr Ramakrishna has co-authored quite a few of the references that you have used for your paper and is carrying out a lot of work in this field.

I hope there will be further responses.

Very best wishes,

Mary 

Article Celiac disease: Can we avert the impending epidemic in India?

Hi Mary thanks for sharing this interesting article.

I would agree with Gautam that diet and also also stress can have a major role in the increase of IBD in India

Thanks Mary Wilson for your interest. Of course the wheat factor is well known as also the timing of its introduction in diet. There are dynamic changes in the microbiome as an infant grows up and recent research focus on this aspect in celiac pathogenesis. With rampant use of antibiotics in India beginning in childhood and the variegated food fads of modern children, it will be interesting to see whether these influences outcome in celiac disease.

The most probable reason is a better knowledge of doctors of these diseases in awareness and investigations received from different parts of the world

Hi, Murtaza  and Dr.Rodrigo,

I agree that these factors also play their part to some extent.

These papers that may be of interest to you. The rise of obesity and the use of anti-biotics and proton-pump inhibitors have greatly reduced the diversity of the microbiome. The use of emulsifiers in the food supply compromises the gut barrier. 

https://www.karger.com/Article/FullText/440991

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4368562/pdf/pone.0121776.pdf

Hello. very interesting and challenging topic

Some additional publications on emulsifiers (polysorbate 80) disrupting intestinal barrier mechanisms

1. Lerner A, Matthias T. Comment to Nature publication, e- publication   2015;519  

2. Chassaing B et al. Dietary emulsifiers impact the mouse gut microbiota promoting colitis and metabolic syndrome. Nature. 2015;519:92-96. (e-correspondance)

3. Lerner A, Matthias T. Multiple food additives enhance human chronic diseases. SOJ Microbiology&Infectious Dis. 2016;4:1-2.

4. Singh RK et al. SOJ Microbiology&Infectious Diseases. 2016;4(1).

Cani PD et al. Keeping gut lining at bay: impact of emulsifiers. Trend in Endocrinol and metabolism. 2015;26; No 6.

Dr. Lerner,

Thank you for those articles. I did a quick search on P-80 and could only find one paper with estimates of the quantity of P-80 in the diet in EU countries. The total P-80 exposure from diet surveys according to FACET exceeds the acceptable diet intake for children. This does not account for the use in medications and dietary supplements. 

Vin K, Connolly A, McCaffrey T, et al. Estimation of the dietary intake of 13 priority additives in France, Italy, the UK and Ireland as part of the FACET project. Food additives & contaminants Part A, Chemistry, analysis, control, exposure & risk assessment. 2013;30(12):2050-2080.

Hi, Patricia,

Real food for thought. Though reduced bacterial diversity has been well demonstrated in IBD, whether the same works in celiac remains to be seen. Of course there is altered gut barrier in both.

Thanks Patricia

Very valuable information. As you know Emulsifiers are only part of the problematic processed food additives. Sugar, Salt, gluten, organic acids, microbial transglutaminase, nano particles are some more:

Lerner A, Matthias T. Changes in intestinal tight junction permeability associated with industrial food additives explain the rising incidence of autoimmune disease. Autoimmun Rev. 2015;14:479-89  

Lerner A, Matthias T. Possible association between celiac disease and bacterial transglutaminase in food processing: a hypothesis. Nutr Rev. 2015;73:544-552.

Matthias T, Jeremias P, Neidhöfer S, Lerner A. The industrial food additive microbial transglutaminase, mimics the tissue transglutaminase and is immunogenic in celiac disease patients. Autoimmun Rev, 2016;15:1111-1119.

Lerner A, Matthias T. Don’t forget the exogenous microbial transglutaminases: it is immunogenic and potentially pathogenic. Biophysics, 2016;3:529-535

Lerner A, Matthias T. Are Microbial Enzymes Used Safe in the Processed Food Industries? Food and Bioprocess Technology, 2016;9: 2125-2126, DOI:10.1007/s11947-016-1795-x.

 .

Its interesting to know that food additives and enzymes can alter the intestinal tight junctions so such foods can make latent celiac overt indirectly.

Latest research suggest involvement of intestinal microbiome in pathogenesis of celiac disease also like IBD.

Microorganisms in the Pathogenesis and Management of Celiac Disease (CeD)

January 2023. DOI: 10.1007/978-981-19-4800-8_15

In book: Role of Microorganisms in Pathogenesis and Management of Autoimmune Diseases. A.Singh, V.Midha, A.Sood