All India Institute of Medical Sciences (AIIMS), New Delhi
PI: Dr Govind Makharia
Activity 1: Characterization of expression of Toll Like Receptors (TLRs) 1 to 9 in Non celiac gluten sensitivity (NCGS) patients, Celiac disease patients (before and 6 months after gluten free diet-GFD) their first degree relatives (FDRs) and controls in small intestinal biopsies using RT-PCR and immunohistochemistry(IHC) (AIIMS/NII)
Progress: In these study 40 celiac disease patients at baseline and 25 patients after six months of GFD, 10 FDRs and 40 controls have been included after meeting inclusion criteria and their samples were collected. Sample processing is under progress. In next review meeting we will discuss the results. As per review meeting, more number of patients will be recruited in the study.
Activity 2: Estimation for gluten intake in patients with celiac disease, their first-degree relatives and controls (AIIMS).
Progress: For the beginning of study, recruitment of patients has been started from celiac clinic, from the department of gastroenterology which is run by Prof. Govind Makharia. Data collection is being done by filling the performa. 80 patients with CeD and their FDRs (100) were interviewed for gluten intake. Patient’s pre-diagnosis and their FDR’s present consumption of gluten containing 54 food items were recorded using a semi-quantitative food frequency questionnaire by a trained dietitian. All the recipes were standardized to calculate the amount of wheat used. Per day consumption of wheat and its products (wheat flour, maida, semolina, vermicelli, breads, pasta, noodles and confectionaries) was calculated based on frequency (range: daily to once/year) and amount of food items consumed. Wheat protein/day was determined from Indian Food Composition Tables (2017) and amount of gluten/day was calculated as amount of wheat protein × 0.80. The gluten intake in patients with CeD, before the diagnosis, is approximately 20 gm/day. Healthy FDRs ingest even higher amount of gluten/day.
Activity 3: Estimation of gluten content in gluten-free labeled food in India (AIIMS).
Progress: 200 food products labeled as gluten free were randomly selected from gluten free shop from New Delhi region of India. Their information are being feeded in excel sheet (like food category, cost, quality of products, ingredient etc) to maintain the variety of products. The food products have been categorized and gluten level (content) from 127 products was quantified by R5 monoclonal antibody by Sandwich ELISA, approved by AOAC & codex alimentarious and results were analyzed. A total of 127 products, labeled as gluten free, were tested by ELISA and it was observed that 113 gluten free food samples were actually gluten free (range of gluten – 1.41-19.5 mg/kg) and 14 samples were not gluten free (range of gluten – 25.7-713.7 mg/kg). 65 non-labeled gluten free samples were also tested, where 61 samples were found to be negative (range of gluten – 1.46-11.36 mg/kg), while 4 samples were positive (range of gluten – 33.9-42 mg/kg).
Activity 4: Evaluation of the diagnostic performance of second-generation serological tests in two different ethnic populations, Indian and Caucasian.
Progress: 100 patients with celiac disease and 80 as disease controls were recruited. Blood samples were collected from them and diagnostic performance of tTG was done by using four different kits. Variation was observed in the performance of different tTG kits used.