Anna Sapone

Anna Sapone
Massachusetts General Hospital | MGH · Center for Celiac Research and Treatment

About

91
Publications
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Publications

Publications (91)
Article
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Background and aims A wheat-free diet (WFD) represents the elective treatment for Non-celiac Wheat Sensitivity (NCWS) patients. Preliminary reports have shown a possible better tolerability of ancient grains in these subjects. The aim of this observational study was to evaluate the frequency of consumption of ancient grains and its correlation with...
Article
Full-text available
Non-celiac wheat sensitivity (NCWS) is a clinical entity induced by the ingestion of gluten that leads to intestinal and/or extraintestinal symptoms, and is diagnosed when celiac disease and wheat allergy have been ruled out. In addition to gluten, other grains’ components, including amylase trypsin inhibitors (ATIs) and fermentable short-chain car...
Article
Full-text available
Background: Histological changes induced by gluten in the duodenal mucosa of patients with non-coeliac gluten sensitivity (NCGS) are poorly defined. Objectives: To evaluate the structural and inflammatory features of NCGS compared to controls and coeliac disease (CeD) with milder enteropathy (Marsh I-II). Methods: Well-oriented biopsies of 262 cont...
Chapter
While in the past, celiac disease (CD) was considered the only clinical entity caused by the ingestion of gluten-containing grains, now there is evidence that a spectrum of gluten-related disorders, including also wheat allergy and non-celiac gluten (wheat) sensitivity (NCGS/NCWS), exists. The prevalence of gluten-related disorders is rising, and i...
Article
Full-text available
BACKGROUND & AIMS Gluten challenge is used to diagnose celiac disease (CeD) and for clinical research. Sustained gluten exposure reliably induces histological changes but is burdensome. We investigated the relative abilities of multiple biomarkers to assess disease activity induced by two gluten doses, and aimed to identify biomarkers to supplement...
Article
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Background: Celiac disease remains a challenging condition because of a steady increase in knowledge tackling its pathophysiology, diagnosis, management, and possible therapeutic options. Main body: A major milestone in the history of celiac disease was the identification of tissue transglutaminase as the autoantigen, thereby confirming the auto...
Conference Paper
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Introduction Intestinal epithelial cell damages generated by inflammation in coeliac disease (CD) ranges from sub-microscopic to severe architectural distortion. Translation of quantitative morphological changes in intestinal microorgans, like villus/crypt transformation, distribution of inflammatory cells and diagnostic cut offs, is lacking for CD...
Article
Full-text available
Celiac disease (CD) is an immune-mediated disorder triggered by gluten exposure. The contribution of the adaptive immune response to CD pathogenesis has been extensively studied, but the absence of valid experimental models has hampered our understanding of the early steps leading to loss of gluten tolerance. Using intestinal organoids developed fr...
Article
Full-text available
Gluten-related disorders have recently been reclassified with an emerging scientific literature supporting the concept of non-celiac gluten sensitivity (NCGS). New research has specifically addressed prevalence, immune mechanisms, the recognition of non-immunoglobulin E (non-IgE) wheat allergy and overlap of NCGS with irritable bowel syndrome (IBS)...
Article
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Importance The prevalence of gluten-related disorders is rising, and increasing numbers of individuals are empirically trying a gluten-free diet for a variety of signs and symptoms. This review aims to present current evidence regarding screening, diagnosis, and treatment for celiac disease and nonceliac gluten sensitivity. Observations Celiac dis...
Article
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High frequency of gastrointestinal yeast presence in ASD subjects was shown through a simple cultural approach (Candidaspp. in 57.5 % of ASDs and no controls); the identification of aggressive form (pseudo-hyphae presenting) of Candidaspp. at light microscope means that adhesion to intestinal mucosa is facilitated. Dysbiosis appears sustained by lo...
Article
Celiac disease (CD) is an autoimmune enteropathy triggered by gluten and characterized by a strong Th1/Th17 immune response in the small intestine. Treg cells are CD4(+) CD25(++) FOXP3(+) cells that regulate the immune response. Conversely to its counterpart, FOXP3 full length (FL), the alternatively spliced isoform FOXP3 Δ2 cannot properly down-re...
Article
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The association of autoimmune type 1 diabetes mellitus and celiac disease in children and adolescents has been known for a long time. This critical review of the literature should encourage readers to reassess many of the recent concepts on celiac disease screening accepted for the general population but that must be carefully evaluated before they...
Article
Full-text available
Background Autism spectrum disorders (ASD) are complex conditions whose pathogenesis may be attributed to gene–environment interactions. There are no definitive mechanisms explaining how environmental triggers can lead to ASD although the involvement of inflammation and immunity has been suggested. Inappropriate antigen trafficking through an impai...
Article
Full-text available
Non-celiac gluten sensitivity (NCGS) is the term used to describe individuals complaining of intestinal and extra-intestinal symptoms related to gluten ingestion and rapidly improving after its withdrawal, and in which both celiac disease (CD) and wheat allergy (WA) were properly ruled out. The prevalence of this condition remains unknown and a lot...
Article
Full-text available
Background: In celiac disease (CD), intestinal epithelium damage occurs secondary to an immune insult and is characterized by blunting of the villi and crypt hyperplasia. Similarities between Hedgehog (Hh)/BMP4 downregulation, as reported in a mouse model, and CD histopathology, suggest mechanistic involvement of Hh/BMP4/WNT pathways in proliferat...
Data
Model of intestinal crypt signaling between intestinal stem cell and stem cell niche. (A) At the homeostasis IHH is released by the mature epithelium and received by stromal cells that under IHH stimulus secrete BMP4. It is hypothesized that BMP4 gradient originating from stromal cells along the crypt villus axis opposes to WNT to restrain intestin...
Data
GREM2 Gene expression in HC and A-CD whole biopsies. Total RNA from HC (N = 10) and A-CD (N = 10) biopsies were evaluated by qRT-PCR. GREM2 gene was found significantly upregulated in A-CD biopsies. (*) P < .05. (PDF)
Data
In situ hybridization of LGR5 transcripts in HC and A-CD intestinal crypts. LGR5 positive cells can be distinguished in high and low based on staining intensity. LGR5high labels the CBCs (Crypt Base Columnar Cells) (black arrow), whereas LGR5low identify immature proliferating (TA) progenitor cells. A significant increase of LGR5low positive cells...
Data
Volcano plot representing 80 stem cell related genes expression profile in celiac crypts. Samples from healthy (N = 5) and CD (N = 5) crypts were obtained by laser capture microscopy. Gene expression with a 2.5 fold of downregulation is represented with green dots and 2.5 upregulation is represented with red dot. Dots above the blue line represents...
Article
Full-text available
During the past decade there has been an impressive increase in popularity of the gluten-free diet (GFD)—now the most trendy alimentary habit in the United States and other countries. According to recent surveys, as many as 100 million Americans will consume gluten-free products within a year. Operating under the concept that the GFD benefits only...
Chapter
Full-text available
Intestinal permeability alterations have been demonstrated in autistic children and their first-degree relatives by means of the lactulose/mannitol permeability test. Permeability tests, even if influenced by many interfering factors, give a good global figure of the state of health of intestinal barrier. If one or more components of the complex st...
Article
Full-text available
Non Celiac Gluten sensitivity (NCGS) was originally described in the 1980s and recently a "re-discovered" disorder characterized by intestinal and extra-intestinal symptoms related to the ingestion of gluten-containing food, in subjects that are not affected with either celiac disease (CD) or wheat allergy (WA). Although NCGS frequency is still unc...
Data
Supplementary material includes a table reporting normal values age-based of the investigated total and specific IgE, total IgA and IgG.
Article
Full-text available
Autistic disorders (ADs) are heterogeneous neurodevelopmental disorders arised by the interaction of genes and environmental factors. Dysfunctions in social interaction and communication skills, repetitive and stereotypic verbal and non-verbal behaviours are common features of ADs. There are no defined mechanisms of pathogenesis, rendering curative...
Article
Full-text available
Purpose: Immune system of some autistic patients could be abnormally triggered by gluten/casein assumption. The prevalence of antibodies to gliadin and milk proteins in autistic children with paired/impaired intestinal permeability and under dietary regimen either regular or restricted is reported. Methods: 162 ASDs and 44 healthy children were...
Article
Purpose. Immune system of some autistic patients could be abnormally triggered by gluten/casein assumption. The prevalence of antibodies to gliadin and milk proteins in autistic children with paired/impaired intestinal permeability and under dietary regimen either regular or restricted is reported. Methods. 162 ASDs and 44 healthy children were inv...
Article
Full-text available
Autism and autism spectrum disorders (ASDs) are heterogeneous neurodevelopmental disorders. They are enigmatic conditions that have their origins in the interaction of genes and environmental factors. ASDs are characterized by dysfunctions in social interaction and communication skills, in addition to repetitive and stereotypic verbal and nonverbal...
Article
Full-text available
A decade ago celiac disease was considered extremely rare outside Europe and, therefore, was almost completely ignored by health care professionals. In only 10 years, key milestones have moved celiac disease from obscurity into the popular spotlight worldwide. Now we are observing another interesting phenomenon that is generating great confusion am...
Article
Full-text available
Autism and autism spectrum disorders (ASDs) are heterogeneous complex neuro-developmental disorders characterized by dysfunctions in social interaction and communication skills. Their pathogenesis has been linked to interactions between genes and environmental factors. Consistent with the evidence of certain similarities between immune cells and ne...
Article
Full-text available
Celiac disease (CD) is an autoimmune enteropathy triggered by the ingestion of gluten. Gluten-sensitive individuals (GS) cannot tolerate gluten and may develop gastrointestinal symptoms similar to those in CD, but the overall clinical picture is generally less severe and is not accompanied by the concurrence of tissue transglutaminase autoantibodie...
Article
Full-text available
Intestinal permeability (IPT) was investigated in patients with autism as well as in their first-degree relatives to investigate leaky gut hypothesis. Faecal calprotectin (FC) was also measured in patients with autism, either with or without gastrointestinal symptoms, and in their first-degree relatives. IPT results, assessed by means of the lactul...
Article
Full-text available
The immune-mediated enteropathy, celiac disease (CD), and gluten sensitivity (GS) are two distinct clinical conditions that are both triggered by the ingestion of wheat gliadin. CD, but not GS, is associated with and possibly mediated by an autoimmune process. Recent studies show that gliadin may induce the activation of IL-17-producing T cells and...
Article
Alteration in intestinal permeability may be an important factor in the pathogenesis of both the progression of some chronic liver diseases and the onset of some complications in patients with liver cirrhosis. To investigate the relationships between intestinal permeability, portal hypertension, alcohol use, plasma levels of pro-inflammatory cytoki...
Article
Full-text available
Autoimmune diseases are characterized by tissue damage and loss of function due to an immune response that is directed against specific organs. This review is focused on celiac disease (CD), an autoimmune enteropathy, and type 1 diabetes (T1D), a hyperglycosaemia caused by a destructive autoimmune process targeting the insulin-producing pancreatic...
Article
Full-text available
Zonulin, a protein that modulates intestinal permeability, is upregulated in several autoimmune diseases and is involved in the pathogenesis of autoimmune diabetes in the BB/Wor animal model of the disease. To verify the association between serum zonulin levels and in vivo intestinal permeability in patients with type 1 diabetes, both parameters we...
Article
Full-text available
Little is known about the interaction of gliadin with intestinal epithelial cells and the mechanism(s) through which gliadin crosses the intestinal epithelial barrier. We investigated whether gliadin has any immediate effect on zonulin release and signaling. Both ex vivo human small intestines and intestinal cell monolayers were exposed to gliadin,...