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Elli L.,Gastroenterology Unit | Elli L.,Center for Prevention and Diagnosis of Celiac Disease | Bardella M.T.,Center for Prevention and Diagnosis of Celiac Disease | Bardella M.T.,University of Milan | And 4 more authors.
Acta Gastro-Enterologica Belgica | Year: 2010

Amyloidosis, a potentially fatal disease, is characterized by an abnormal deposition of autologous proteins. Heart, liver, kidneys, lung, thyroid, skin and the gastrointestinal tract can be involved; in this last case mucosal alterations or disturbances of the motility leading to pseudo-obstruction, bleeding, diarrhea and malabsorption can be present. However, the data concerning the possible gastrointestinal presentations of amyloidosis are scanty and heterogeneous. We report the case of a patient presenting severe gastrointestinal symptoms caused by a megaduodenum. The patient was thoroughly investigated and lesions appeared limited to the upper gastrointestinal tract in the absence of a systemic disorder. However, at follow up the patient developed cardiac dilatation and bioptic samples revealed the presence of amyloidosis.

Massironi S.,Gastroenterology Unit | Rossi R.E.,Gastroenterology Unit | Rossi R.E.,University of Milan | Fraquelli M.,Gastroenterology Unit | And 11 more authors.
Scandinavian Journal of Gastroenterology | Year: 2012

Background: Liver involvement in celiac disease (CD) is clinically relevant and could require specific treatment in addition to gluten-free diet (GFD). Transient elastography (TE), a noninvasive tool for assessing liver stiffness (LS), has widely been reported as an accurate surrogate marker of liver fibrosis. Aims: To prospectively identify celiac patients with liver involvement by TE and to assess the effect of GFD. Material and methods: Ninety-five histologically confirmed CD patients (24 newly diagnosed) were consecutively evaluated by TE and compared with 146 patients with chronic hepatitis C (HCV) and 54 healthy subjects. Results: LS ranged between 2.8 and 6.7 kPa (median 4.9) in healthy subjects, defining 6.9 kPa as the upper reference limit (2 SD above the mean levels). TE was above 6.9 kPa in 10 (10.5%) CD patients. Median TE values resulted significantly higher in CD patients with hypertransaminasemia than those without [6.1 vs. 4.2 kPa (p < 0.01)]. Among the 24 newly diagnosed patients with CD, median TE values declined from 4.4 to 4 kPa, after 6 months of GFD, resulting below 6.9 kPa in 100% of the patients. Conclusions: A subset of CD patients with hypertransaminasemia showed liver involvement by TE. Accordingly, based on its accuracy in predicting liver fibrosis, TE could be used to identify those CD patients suitable for liver biopsy. © 2012 Informa Healthcare.

Mazzeo T.,University of Parma | Roncoroni L.,Center for Prevention and Diagnosis of Celiac Disease | Roncoroni L.,University of Milan | Lombardo V.,University of Milan | And 9 more authors.
Journal of the Academy of Nutrition and Dietetics | Year: 2016

Background: To date, it is unclear whether individuals with celiac disease following a gluten-free (GF) diet for several years have adequate intake of all recommended nutrients. Lack of a food frequency questionnaire (FFQ) for individuals with celiac disease could be partly responsible for this still-debated issue. Objective: The aim of the study is to evaluate the performance of a modified European Prospective Investigation into Cancer and Nutrition (EPIC) FFQ in estimating nutrient and food intake in a celiac population. Design: In a cross-sectional study, the dietary habits of individuals with celiac disease were reported using a modified Italian EPIC FFQ and were compared to a 7-day weighed food record as a reference method. Participants/setting: A total of 200 individuals with histologically confirmed celiac disease were enrolled in the study between October 2012 and August 2014 at the Center for Prevention and Diagnosis of Celiac Disease (Milan, Italy). Main outcome measures: Nutrient and food category intake were calculated by 7-day weighed food record using an Italian food database integrated with the nutrient composition of 60 GF foods and the modified EPIC FFQ, in which 24 foods were substituted with GF foods comparable for energy and carbohydrate content. Statistical analyses performed: An evaluation of the modified FFQ compared to 7-day weighed food record in assessing the reported intake of nutrient and food groups was conducted using Spearman's correlation coefficients and weighted κ. Results: One hundred individuals completed the study. The Spearman's correlation coefficients of FFQ and 7-day weighed food record ranged from .13 to .73 for nutrients and from .23 to .75 for food groups. A moderate agreement, which was defined as a weighted κ value of .40 to .60, was obtained for 30% of the analyzed nutrients, and 40% of the nutrients showed values between .30 and .40. The weighted κ exceeded .40 for 60% of the 15 analyzed food groups. Conclusions: The modified EPIC FFQ demonstrated moderate congruence with a weighed food record in ranking individuals by dietary intakes, particularly food groups. © 2016 Academy of Nutrition and Dietetics.

Roncoroni L.,Center for Prevention and Diagnosis of Celiac Disease | Roncoroni L.,University of Milan | Elli L.,Center for Prevention and Diagnosis of Celiac Disease | Bardella M.T.,Center for Prevention and Diagnosis of Celiac Disease | And 8 more authors.
Cancer Investigation | Year: 2010

The aim of the study was to investigate whether changes in the pattern of gene copy number and cell cycle were present passing from the two- to the three-dimensional cell culture system. We used three human colon adenocarcinoma cell lines grown two- and three-dimensionally. We analyzed morphology, karyotype, chromosomal gain and losses, and cell cycle. In three-dimensional cell cultures the growth is delayed and arrested in G1 phase without specific rearrangements in the three-dimensional cultures compared to the two-dimensional cultures. These data suggest that the differences between the two- and three-dimensional cell culture systems do not involve chromosomal rearrangements.

Elli L.,Center for Prevention and Diagnosis of Celiac Disease | Roncoroni L.,Center for Prevention and Diagnosis of Celiac Disease | Roncoroni L.,University of Milan | Bardella M.T.,Center for Prevention and Diagnosis of Celiac Disease | And 6 more authors.
Digestive Diseases and Sciences | Year: 2011

Background: Uncomplicated diverticular disease is a common condition in patients older than 50 years. Symptoms are aspecific and overlapping with those of irritable bowel syndrome. Nowadays, patients are often treated with antinflammatory drugs (5-aminosalicilic acid). Aim: Our purpose was to evaluate the presence of inflammation in the colonic mucosa of patients with symptomatic uncomplicated diverticular disease compared with subjects without diverticula. Methods: Endoscopic biopsies of colon from 10 patients with symptomatic uncomplicated diverticular disease and 10 from subjects without diverticula (controls) were taken. Specimens were homogenised and IL2, IL4, IL5, IL8, IL10, IL12p70, IL13, IFN gamma, TNF alfa (searchlight multiplex technique), TGF beta, transglutaminase type 2 and caspase 9 were measured. Histochemistry for transglutaminase type 2 and TUNEL were performed on the histological sections, in addition to morphologic evaluation, as markers of tissue remodelling and apoptosis. For statistical analysis Student's t test and Spearman correlation test were used. Results: No histological differences were detected between the patients with an uncomplicated diverticular disease and controls. Mean values of mucosal cytokines and of the other tested parameters did not show statistically significant differences between patients with uncomplicated diverticular disease and controls. Conclusions: Even if based on a small number of patients, the study demonstrates the absence of inflammation in the mucosa of subjects affected by uncomplicated diverticular disease. © 2011 Springer Science+Business Media, LLC.

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