Celiac Disease
Conditions
Brief summary
Increased intestinal permeability can represent compromise of the epithelium's integrity and is thought to be the primary mechanism in patients who develop Celiac Disease (CeD) and non-celiac gluten sensitivity when gluten peptides cross the barrier and trigger an immune response. In this study, the investigators propose to use a novel, minimally invasive technology to detect mucosal damage (i.e. barrier dysfunction) in the duodenal epithelium. The primary aim of this study is to identify if there is a difference in duodenal mucosal impedance between CeD and control patients.
Interventions
DIAGNOSTIC_TESTMucosal Impedance Catheter
During routine endoscopy, consented study participants will have a mucosal impedance catheter sensor positioned along the mucosal wall to measure resistance across the mucosa. The study procedure will add approximately 1-2 minutes of anesthesia time for each participant.
DIAGNOSTIC_TESTBlood sample
At time of endoscopy, subjects with initial positive CeD serology will have a blood sample taken for any missing CeD serologies and intestinal fatty acid-binding protein (IFABP). This will be done at time of IV initiation as to avoid any additional venipuncture.
Sponsors
Vanderbilt University Medical Center
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
* scheduled for endoscopy as part of routine care with or without suspected Celiac Disease based upon at least 1 positive serologic marker of CeD * consuming gluten at time of endoscopy
Exclusion criteria
* Already on a gluten free diet or unwilling to undergo a gluten challenge * Undergoing upper endoscopy for an urgent indication such as unstable gastrointestinal bleed or food impaction * Patients with inflammatory bowel disease * Patients on blood thinners other than aspirin at time of endoscopy * Patient unable to give informed consent * Patient less than 18 years old
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| mucosal impedance values | Values will be obtained at conclusion of esophagogastroduodenoscopy (EGD), an expected average of 6 minutes | Identify if there is a difference in duodenal mucosal impedance between CeD and control patients |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Marsh Score | 1 week | Correlate measures of duodenal impedance with standardized pathology scores in CeD (Marsh Score) |
| IFABP | 1 week | Identify whether there is a difference in IFABP in patients with normal and abnormal mucosal impedance |
Countries
United States
Outcome results
None listed