Trial Outcomes & Findings for Serum Markers in Gluten Challenge (NCT NCT00931892)

NCT ID: NCT00931892

Last Updated: 2021-06-04

Results Overview

Histological evaluation of duodenal biopsy samples to evaluate crypt depth to villous height ratio. On the best oriented section of each biopsy fragment, villous height to crypt depth (Vh:Cd) ratio was determined by measuring the mean height /mean depth of adjacent villi/proliferative crypt zones at magnification 100x. Evaluations were considered discrepant Vh:Cd differed by more than 0.5. Overall, there was excellent concordance with the evaluations of the 165 biopsy fragments determined to be optimal for evaluation. The Vh:Cd ratios on individual biopsies from a single averaged to produce a representative Vh:Cd ratio for each endoscopy. Normal Vh:Cd ratio was regarded as 3:1 or greater. Adelman DC, Murray J, Wu TT, Mäki M, Green PH, Kelly CP. Measuring Change In Small Intestinal Histology In Patients With Celiac Disease. Am J Gastroenterol. 2018 Mar;113(3):339-347. doi: 10.1038/ajg.2017.480. Epub 2018 Feb 20. Review. PubMed PMID: 29460921.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

21 participants

Primary outcome timeframe

Screening (Day -7 to -14), Day 3, Day 14

Results posted on

2021-06-04

Participant Flow

21 patients were enrolled in the study. 1 patient was found to be negative for DQ2 and DQ8, therefore did not have Celiac disease. This patient was excluded from the study. Therefore, for the study we had a total of 20 participants.

Participant milestones

Participant milestones
Measure
Low Gluten Group
Subjects will eat 3g of gluten per day Gluten: 3g
High Gluten Group
Subjects will eat 10g of gluten per day Gluten: 10g
Completed Gluten Challenge
STARTED
10
10
Completed Gluten Challenge
COMPLETED
10
10
Completed Gluten Challenge
NOT COMPLETED
0
0
Completed Endoscopies
STARTED
10
10
Completed Endoscopies
First Endoscopy
10
10
Completed Endoscopies
Second Endoscopy
10
10
Completed Endoscopies
Third Endoscopy
10
9
Completed Endoscopies
COMPLETED
10
9
Completed Endoscopies
NOT COMPLETED
0
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Low Gluten Group
Subjects will eat 3g of gluten per day Gluten: 3g
High Gluten Group
Subjects will eat 10g of gluten per day Gluten: 10g
Completed Endoscopies
Patient did not complete third endoscopy due to discomfort
0
1

Baseline Characteristics

Serum Markers in Gluten Challenge

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Low Gluten Group
n=10 Participants
Participants meeting inclusion criteria were randomized into the low gluten group. These participants ate two slices of wheat bread per day (3 g of gluten). Bread was procured from a standard source and gluten dose tested using the RIDASCREEN Gliadin R5 antibody ELISA. The study included a 14-day run-in period followed by a 14 day gluten challenge and a final visit 14 days post-gluten challenge. Other than the dispensed bread, subjects were instructed to remain on their gluten-free diet throughout the duration of the study. Gluten: 3g
High Gluten Group
n=10 Participants
Participants meeting inclusion criteria were randomized into the low gluten group. These participants ate five slices of wheat bread per day (10 g of gluten). Bread was procured from a standard source and gluten dose tested using the RIDASCREEN Gliadin R5 antibody ELISA. The study included a 14-day run-in period followed by a 14 day gluten challenge and a final visit 14 days post-gluten challenge. Other than the dispensed bread, subjects were instructed to remain on their gluten-free diet throughout the duration of the study. Gluten: 10g
Total
n=20 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
10 Participants
n=5 Participants
10 Participants
n=7 Participants
20 Participants
n=5 Participants
Age, Categorical
>=65 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Continuous
48.8 years
STANDARD_DEVIATION 13.0 • n=5 Participants
38.8 years
STANDARD_DEVIATION 13.1 • n=7 Participants
43.3 years
STANDARD_DEVIATION 13.7 • n=5 Participants
Sex: Female, Male
Female
10 Participants
n=5 Participants
9 Participants
n=7 Participants
19 Participants
n=5 Participants
Sex: Female, Male
Male
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
10 Participants
n=5 Participants
10 Participants
n=7 Participants
20 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
White
9 Participants
n=5 Participants
10 Participants
n=7 Participants
19 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Region of Enrollment
United States
10 participants
n=5 Participants
10 participants
n=7 Participants
20 participants
n=5 Participants
Age at Celiac Diagnosis
45.4 years
STANDARD_DEVIATION 13.9 • n=5 Participants
31.0 years
STANDARD_DEVIATION 11.7 • n=7 Participants
35.7 years
STANDARD_DEVIATION 14.4 • n=5 Participants
Months since Celiac Disease diagnosis
42.3 months
STANDARD_DEVIATION 21.3 • n=5 Participants
92.5 months
STANDARD_DEVIATION 49.1 • n=7 Participants
62.3 months
STANDARD_DEVIATION 87.1 • n=5 Participants
Laboratory Characteristics
HLA DQ2
4 Participants
n=5 Participants
6 Participants
n=7 Participants
10 Participants
n=5 Participants
Laboratory Characteristics
HLA DQ8
3 Participants
n=5 Participants
3 Participants
n=7 Participants
6 Participants
n=5 Participants
Laboratory Characteristics
HLA DQ2 + DQ 8
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
Laboratory Characteristics
HLA A1 * 05 alone
2 Participants
n=5 Participants
0 Participants
n=7 Participants
2 Participants
n=5 Participants
Villous height to crypt depth ratio
2.05 unitless
STANDARD_DEVIATION 0.80 • n=5 Participants
4.33 unitless
STANDARD_DEVIATION 6.69 • n=7 Participants
2.21 unitless
STANDARD_DEVIATION 0.8 • n=5 Participants
Mean number of Intraepithelial lymphocytes
37.10 unitless
STANDARD_DEVIATION 13.66 • n=5 Participants
28.4 unitless
STANDARD_DEVIATION 13.3 • n=7 Participants
32.59 unitless
STANDARD_DEVIATION 15.1 • n=5 Participants
Baseline tissue transglutaminase (tTG)
13.76 units
STANDARD_DEVIATION 8.30 • n=5 Participants
8.27 units
STANDARD_DEVIATION 5.70 • n=7 Participants
11.00 units
STANDARD_DEVIATION 7.50 • n=5 Participants
Baseline Deamidated gliadin peptide (DGP)
6.70 units
STANDARD_DEVIATION 2.59 • n=5 Participants
14.04 units
STANDARD_DEVIATION 26.49 • n=7 Participants
10.90 units
STANDARD_DEVIATION 19.60 • n=5 Participants
Baseline Celiac Dietary Adherence test (CDAT)
11.33 scores on a scale
STANDARD_DEVIATION 3.2 • n=5 Participants
11.40 scores on a scale
STANDARD_DEVIATION 2.9 • n=7 Participants
11.37 scores on a scale
STANDARD_DEVIATION 2.9 • n=5 Participants
Baseline Celiac Symptom Index (CSI)
28.50 scores on a scale
STANDARD_DEVIATION 5.78 • n=5 Participants
22.50 scores on a scale
STANDARD_DEVIATION 4.99 • n=7 Participants
25.26 scores on a scale
STANDARD_DEVIATION 5.90 • n=5 Participants
Baseline Gastrointestinal Symptom Rating Scale (GSRS)
22.88 scores on a scale
STANDARD_DEVIATION 9.58 • n=5 Participants
19.20 scores on a scale
STANDARD_DEVIATION 3.26 • n=7 Participants
20.32 scores on a scale
STANDARD_DEVIATION 5.10 • n=5 Participants
Baseline Quality of Life Visual Analog Scale (VAS)
80.00 scores on a scale
STANDARD_DEVIATION 13.10 • n=5 Participants
84.40 scores on a scale
STANDARD_DEVIATION 12.10 • n=7 Participants
82.20 scores on a scale
STANDARD_DEVIATION 12.50 • n=5 Participants

PRIMARY outcome

Timeframe: Screening (Day -7 to -14), Day 3, Day 14

Population: Subjects with biopsy proven celiac disease in remission were enrolled. For Day 3, 17 subjects had evaluable pathology biopsies. On Day 14, 19 participants had evaluable pathology biopsies.

Histological evaluation of duodenal biopsy samples to evaluate crypt depth to villous height ratio. On the best oriented section of each biopsy fragment, villous height to crypt depth (Vh:Cd) ratio was determined by measuring the mean height /mean depth of adjacent villi/proliferative crypt zones at magnification 100x. Evaluations were considered discrepant Vh:Cd differed by more than 0.5. Overall, there was excellent concordance with the evaluations of the 165 biopsy fragments determined to be optimal for evaluation. The Vh:Cd ratios on individual biopsies from a single averaged to produce a representative Vh:Cd ratio for each endoscopy. Normal Vh:Cd ratio was regarded as 3:1 or greater. Adelman DC, Murray J, Wu TT, Mäki M, Green PH, Kelly CP. Measuring Change In Small Intestinal Histology In Patients With Celiac Disease. Am J Gastroenterol. 2018 Mar;113(3):339-347. doi: 10.1038/ajg.2017.480. Epub 2018 Feb 20. Review. PubMed PMID: 29460921.

Outcome measures

Outcome measures
Measure
Baseline (Day -14) Low Gluten Group
n=10 Participants
Villous height to crypt depth ratio in low gluten group In the low gluten group, subjects consumed 3 grams of gluten per day
Baseline (Day -14) High Gluten Group
n=10 Participants
Villous height to crypt depth ratio in high gluten group In the high gluten group, subjects consumed 10 grams of gluten per day.
Day 3 Low Gluten Group
n=8 Participants
Villous height to crypt depth ratio in low gluten group In the low gluten group, subjects consumed 3 grams of gluten per day.
Day 3 High Gluten Group
n=9 Participants
Villous height to crypt depth ratio in high gluten group In the high gluten group, subjects consumed 10 grams of gluten per day.
Day 14 Low Gluten Group
n=10 Participants
Villous height to crypt depth ratio in low gluten group In the low gluten group, subjects consumed 3 grams of gluten per day
Day 14 High Gluten Group
n=9 Participants
Villous height to crypt depth ratio in high gluten group. In the high gluten group subjects consume 10 grams of gluten per day.
Day 7 Low Gluten Dose Group
Subjects in the low gluten dose group consumed 3 grams of gluten per day.
Day 7 High Gluten Dose Group
Subjects in the high gluten dose group consumed 10 grams of gluten per day.
Day 14 Low Gluten Dose Group
Subjects in the low gluten dose group consumed 3 grams of gluten per day.
Day 14 High Gluten Dose Group
Subjects in the high gluten dose group consumed 10 grams of gluten per day.
Day 28 Low Gluten Dose Group
Subjects in the low gluten dose group consumed 3 grams of gluten per day.
Day 28 High Gluten Dose Group
Subjects in the high gluten dose group consumed 10 grams of gluten per day.
Crypt Depth to Villous Height Ratio
2.05 ratio
Standard Deviation 0.80
4.33 ratio
Standard Deviation 6.69
1.19 ratio
Standard Deviation 0.67
2.02 ratio
Standard Deviation 0.99
0.98 ratio
Standard Deviation 0.85
1.26 ratio
Standard Deviation 1.08

SECONDARY outcome

Timeframe: Screening (Day -7 to -14), Day 3, Day 14

Population: Subjects with biopsy proven celiac disease in remission were enrolled. For Day 3, 17 subjects had evaluable pathology biopsies. On Day 14, 19 participants had evaluable pathology biopsies.

On the best oriented section of each biopsy fragment , the number of intraepithelial lymphocytes (IEL count) per 100 enterocytes was recorded at magnification 400x. IEL counts were considered discrepant if a difference of \>10 IELs existed between counts. Overall, there was excellent concordance with the evaluations of the 165 biopsy fragments determined to be optimal for evaluation. The IEL counts on individual biopsies from a single endoscopy were averaged to produce a representative IEL count for each endoscopy. Adelman DC, Murray J, Wu TT, Mäki M, Green PH, Kelly CP. Measuring Change In Small Intestinal Histology In Patients With Celiac Disease. Am J Gastroenterol. 2018 Mar;113(3):339-347. doi: 10.1038/ajg.2017.480. Epub 2018 Feb 20. Review. PubMed PMID: 29460921.

Outcome measures

Outcome measures
Measure
Baseline (Day -14) Low Gluten Group
n=10 Participants
Villous height to crypt depth ratio in low gluten group In the low gluten group, subjects consumed 3 grams of gluten per day
Baseline (Day -14) High Gluten Group
n=10 Participants
Villous height to crypt depth ratio in high gluten group In the high gluten group, subjects consumed 10 grams of gluten per day.
Day 3 Low Gluten Group
n=8 Participants
Villous height to crypt depth ratio in low gluten group In the low gluten group, subjects consumed 3 grams of gluten per day.
Day 3 High Gluten Group
n=9 Participants
Villous height to crypt depth ratio in high gluten group In the high gluten group, subjects consumed 10 grams of gluten per day.
Day 14 Low Gluten Group
n=10 Participants
Villous height to crypt depth ratio in low gluten group In the low gluten group, subjects consumed 3 grams of gluten per day
Day 14 High Gluten Group
n=9 Participants
Villous height to crypt depth ratio in high gluten group. In the high gluten group subjects consume 10 grams of gluten per day.
Day 7 Low Gluten Dose Group
Subjects in the low gluten dose group consumed 3 grams of gluten per day.
Day 7 High Gluten Dose Group
Subjects in the high gluten dose group consumed 10 grams of gluten per day.
Day 14 Low Gluten Dose Group
Subjects in the low gluten dose group consumed 3 grams of gluten per day.
Day 14 High Gluten Dose Group
Subjects in the high gluten dose group consumed 10 grams of gluten per day.
Day 28 Low Gluten Dose Group
Subjects in the low gluten dose group consumed 3 grams of gluten per day.
Day 28 High Gluten Dose Group
Subjects in the high gluten dose group consumed 10 grams of gluten per day.
Count of Intraepithelial Lymphocytes Per 100 Enterocytes in Duodenal Biopsy Samples
37.08 Count of Lymphocytes Per 100 Enterocytes
Standard Deviation 13.66
28.91 Count of Lymphocytes Per 100 Enterocytes
Standard Deviation 15.81
44.89 Count of Lymphocytes Per 100 Enterocytes
Standard Deviation 20.49
30.68 Count of Lymphocytes Per 100 Enterocytes
Standard Deviation 18.09
47.95 Count of Lymphocytes Per 100 Enterocytes
Standard Deviation 14.30
52.36 Count of Lymphocytes Per 100 Enterocytes
Standard Deviation 28.52

SECONDARY outcome

Timeframe: Screening (Day -7 to -14), Day 0, Day 3, Day 7, Day 14, Day 28

Population: Subjects with biopsy proven celiac disease in remission were enrolled. Measures of intestinal permeability (urinary lactulose to mannitol ratio) (LAMA) . Four participants were unable to tolerate LAMA testing due to gastrointestinal symptoms.

LAMA evaluation has been reported to be an accurate measure of small intestinal mucosal permeability though assessment of differential absorption of lactulose and mannitol. For LAMA testing, a solution containing 7.5 g lactulose and 2 g mannitol in 100 mL of water was ingested by the participants in the evening after visit 1 and in the evening before each other study visit. The participants were asked to fast for at least 4 h and to void completely before drinking the sugar solution, then fast overnight and collect all overnight and morning urine. Urine sample analyzed for lactulose and mannitol using standardized methodology by liquid chromatography-tandem mass spectrometry.

Outcome measures

Outcome measures
Measure
Baseline (Day -14) Low Gluten Group
n=8 Participants
Villous height to crypt depth ratio in low gluten group In the low gluten group, subjects consumed 3 grams of gluten per day
Baseline (Day -14) High Gluten Group
n=8 Participants
Villous height to crypt depth ratio in high gluten group In the high gluten group, subjects consumed 10 grams of gluten per day.
Day 3 Low Gluten Group
n=8 Participants
Villous height to crypt depth ratio in low gluten group In the low gluten group, subjects consumed 3 grams of gluten per day.
Day 3 High Gluten Group
n=8 Participants
Villous height to crypt depth ratio in high gluten group In the high gluten group, subjects consumed 10 grams of gluten per day.
Day 14 Low Gluten Group
n=8 Participants
Villous height to crypt depth ratio in low gluten group In the low gluten group, subjects consumed 3 grams of gluten per day
Day 14 High Gluten Group
n=7 Participants
Villous height to crypt depth ratio in high gluten group. In the high gluten group subjects consume 10 grams of gluten per day.
Day 7 Low Gluten Dose Group
n=8 Participants
Subjects in the low gluten dose group consumed 3 grams of gluten per day.
Day 7 High Gluten Dose Group
n=7 Participants
Subjects in the high gluten dose group consumed 10 grams of gluten per day.
Day 14 Low Gluten Dose Group
n=8 Participants
Subjects in the low gluten dose group consumed 3 grams of gluten per day.
Day 14 High Gluten Dose Group
n=6 Participants
Subjects in the high gluten dose group consumed 10 grams of gluten per day.
Day 28 Low Gluten Dose Group
n=8 Participants
Subjects in the low gluten dose group consumed 3 grams of gluten per day.
Day 28 High Gluten Dose Group
n=7 Participants
Subjects in the high gluten dose group consumed 10 grams of gluten per day.
Measures of Intestinal Permeability (Urinary Lactulose to Mannitol Ratio)
0.23 ratio
Standard Deviation 0.17
0.24 ratio
Standard Deviation 0.25
0.65 ratio
Standard Deviation 1.15
0.17 ratio
Standard Deviation 0.15
0.25 ratio
Standard Deviation 0.15
0.44 ratio
Standard Deviation 0.60
0.45 ratio
Standard Deviation 0.71
0.29 ratio
Standard Deviation 0.28
0.89 ratio
Standard Deviation 1.53
0.59 ratio
Standard Deviation 0.52
0.29 ratio
Standard Deviation 0.24
0.57 ratio
Standard Deviation 0.82

SECONDARY outcome

Timeframe: Screening (Day -7 to -14), Day 0, Day 3, Day 7, Day 14, Day 28

Population: Subjects with biopsy proven celiac disease in remission were enrolled.

IgA anti-human tissue transglutaminase assay (Inova Diagnostics, Inc., San Diego, USA): negative \<20, borderline 20-30, positive \>30. IgA/IgG anti- DGP assay : NEGATIVE \<20, BORDERLINE 20-30, POSITIVE \>30 METHOD IS INOVA ANTI-DEAMIDATED GLIADIN PEPTIDE IGA/IGG.

Outcome measures

Outcome measures
Measure
Baseline (Day -14) Low Gluten Group
n=10 Participants
Villous height to crypt depth ratio in low gluten group In the low gluten group, subjects consumed 3 grams of gluten per day
Baseline (Day -14) High Gluten Group
n=10 Participants
Villous height to crypt depth ratio in high gluten group In the high gluten group, subjects consumed 10 grams of gluten per day.
Day 3 Low Gluten Group
n=10 Participants
Villous height to crypt depth ratio in low gluten group In the low gluten group, subjects consumed 3 grams of gluten per day.
Day 3 High Gluten Group
n=10 Participants
Villous height to crypt depth ratio in high gluten group In the high gluten group, subjects consumed 10 grams of gluten per day.
Day 14 Low Gluten Group
n=10 Participants
Villous height to crypt depth ratio in low gluten group In the low gluten group, subjects consumed 3 grams of gluten per day
Day 14 High Gluten Group
n=10 Participants
Villous height to crypt depth ratio in high gluten group. In the high gluten group subjects consume 10 grams of gluten per day.
Day 7 Low Gluten Dose Group
n=10 Participants
Subjects in the low gluten dose group consumed 3 grams of gluten per day.
Day 7 High Gluten Dose Group
n=10 Participants
Subjects in the high gluten dose group consumed 10 grams of gluten per day.
Day 14 Low Gluten Dose Group
n=10 Participants
Subjects in the low gluten dose group consumed 3 grams of gluten per day.
Day 14 High Gluten Dose Group
n=10 Participants
Subjects in the high gluten dose group consumed 10 grams of gluten per day.
Day 28 Low Gluten Dose Group
n=10 Participants
Subjects in the low gluten dose group consumed 3 grams of gluten per day.
Day 28 High Gluten Dose Group
n=10 Participants
Subjects in the high gluten dose group consumed 10 grams of gluten per day.
Measures of Immune Activation
IgA anti-tTG
6.70 units on a scale
Standard Deviation 2.60
10.34 units on a scale
Standard Deviation 5.75
13.76 units on a scale
Standard Deviation 10.88
11.50 units on a scale
Standard Deviation 6.63
11.84 units on a scale
Standard Deviation 9.50
10.34 units on a scale
Standard Deviation 5.75
13.77 units on a scale
Standard Deviation 10.90
11.50 units on a scale
Standard Deviation 6.63
12.63 units on a scale
Standard Deviation 8.73
15.16 units on a scale
Standard Deviation 10.30
37.81 units on a scale
Standard Deviation 45.07
43.20 units on a scale
Standard Deviation 53.77
Measures of Immune Activation
IgA/IgG anti- DGP
6.70 units on a scale
Standard Deviation 2.60
14.04 units on a scale
Standard Deviation 26.49
7.83 units on a scale
Standard Deviation 2.54
14.69 units on a scale
Standard Deviation 27.01
12.95 units on a scale
Standard Deviation 8.26
14.04 units on a scale
Standard Deviation 26.49
7.83 units on a scale
Standard Deviation 2.54
14.69 units on a scale
Standard Deviation 27.01
17.81 units on a scale
Standard Deviation 22.97
22.74 units on a scale
Standard Deviation 29.31
45.42 units on a scale
Standard Deviation 62.56
41.95 units on a scale
Standard Deviation 33.91

SECONDARY outcome

Timeframe: Screening (Day -7 to -14), Day 3, Day 14

Population: All 20 subjects were included for the tTG and DGP analysis. For Day 28 High Gluten Challenge Dose Group, 1 participant had both a tTG and DGP \>20 which is why the count is greater than the number analyzed.

Proportion of participants responding to a gluten challenge. Tissue transglutaminase (tTG) scoring: NEGATIVE \<20, BORDERLINE 20-30, POSITIVE \>30. Deamidated gliadin peptide (DGP) scoring: NEGATIVE \<20, BORDERLINE 20-30, POSITIVE \>30 METHOD IS INOVA ANTI-DEAMIDATED GLIADIN PEPTIDE IGA/IGG.

Outcome measures

Outcome measures
Measure
Baseline (Day -14) Low Gluten Group
n=10 Participants
Villous height to crypt depth ratio in low gluten group In the low gluten group, subjects consumed 3 grams of gluten per day
Baseline (Day -14) High Gluten Group
n=10 Participants
Villous height to crypt depth ratio in high gluten group In the high gluten group, subjects consumed 10 grams of gluten per day.
Day 3 Low Gluten Group
n=10 Participants
Villous height to crypt depth ratio in low gluten group In the low gluten group, subjects consumed 3 grams of gluten per day.
Day 3 High Gluten Group
n=10 Participants
Villous height to crypt depth ratio in high gluten group In the high gluten group, subjects consumed 10 grams of gluten per day.
Day 14 Low Gluten Group
n=20 Participants
Villous height to crypt depth ratio in low gluten group In the low gluten group, subjects consumed 3 grams of gluten per day
Day 14 High Gluten Group
n=20 Participants
Villous height to crypt depth ratio in high gluten group. In the high gluten group subjects consume 10 grams of gluten per day.
Day 7 Low Gluten Dose Group
Subjects in the low gluten dose group consumed 3 grams of gluten per day.
Day 7 High Gluten Dose Group
Subjects in the high gluten dose group consumed 10 grams of gluten per day.
Day 14 Low Gluten Dose Group
Subjects in the low gluten dose group consumed 3 grams of gluten per day.
Day 14 High Gluten Dose Group
Subjects in the high gluten dose group consumed 10 grams of gluten per day.
Day 28 Low Gluten Dose Group
Subjects in the low gluten dose group consumed 3 grams of gluten per day.
Day 28 High Gluten Dose Group
Subjects in the high gluten dose group consumed 10 grams of gluten per day.
Assessment of Protein Expression in Intestinal Biopsies
tTG > 20
3 Participants
2 Participants
5 Participants
6 Participants
8 Participants
8 Participants
Assessment of Protein Expression in Intestinal Biopsies
DGP > 20
2 Participants
4 Participants
4 Participants
5 Participants
6 Participants
9 Participants
Assessment of Protein Expression in Intestinal Biopsies
tTG > 20 or DGP > 20
5 Participants
6 Participants
9 Participants
10 Participants
14 Participants
17 Participants

SECONDARY outcome

Timeframe: Screening (Day -7 to -14), Day 0, Day 3, Day 7, Day 14, Day 28

Population: Subjects with biopsy proven celiac disease in remission were enrolled. On Day -14, one subject in the high gluten dose group missed the CSI. On Day 7 one subject in the high gluten dose group missed the CSI. On Day 14 one subject in the high gluten dose group missed the CSI. On Day 28, one subject in the high gluten dose group and one subject in the low gluten dose missed the CSI.

CSI (Celiac Symptom Index) scores range from 7-80. Higher scores indicate greater degree of symptoms CSI: Leffler DA, Dennis M, Edwards George J, Jamma S, Cook EF, Schuppan D, Kelly CP. A validated disease-specific symptom index for adults with celiac disease. Clin Gastroenterol Hepatol. 2009;7:1328-34. PubMed PMID: 19665584.

Outcome measures

Outcome measures
Measure
Baseline (Day -14) Low Gluten Group
n=10 Participants
Villous height to crypt depth ratio in low gluten group In the low gluten group, subjects consumed 3 grams of gluten per day
Baseline (Day -14) High Gluten Group
n=9 Participants
Villous height to crypt depth ratio in high gluten group In the high gluten group, subjects consumed 10 grams of gluten per day.
Day 3 Low Gluten Group
n=10 Participants
Villous height to crypt depth ratio in low gluten group In the low gluten group, subjects consumed 3 grams of gluten per day.
Day 3 High Gluten Group
n=10 Participants
Villous height to crypt depth ratio in high gluten group In the high gluten group, subjects consumed 10 grams of gluten per day.
Day 14 Low Gluten Group
n=10 Participants
Villous height to crypt depth ratio in low gluten group In the low gluten group, subjects consumed 3 grams of gluten per day
Day 14 High Gluten Group
n=10 Participants
Villous height to crypt depth ratio in high gluten group. In the high gluten group subjects consume 10 grams of gluten per day.
Day 7 Low Gluten Dose Group
n=10 Participants
Subjects in the low gluten dose group consumed 3 grams of gluten per day.
Day 7 High Gluten Dose Group
n=9 Participants
Subjects in the high gluten dose group consumed 10 grams of gluten per day.
Day 14 Low Gluten Dose Group
n=10 Participants
Subjects in the low gluten dose group consumed 3 grams of gluten per day.
Day 14 High Gluten Dose Group
n=9 Participants
Subjects in the high gluten dose group consumed 10 grams of gluten per day.
Day 28 Low Gluten Dose Group
n=9 Participants
Subjects in the low gluten dose group consumed 3 grams of gluten per day.
Day 28 High Gluten Dose Group
n=9 Participants
Subjects in the high gluten dose group consumed 10 grams of gluten per day.
Symptomatic Response to Gluten Exposure Determined by Celiac Symptom Index Questionnaire
28.5 score on a scale
Standard Deviation 5.78
22.5 score on a scale
Standard Deviation 4.99
28.44 score on a scale
Standard Deviation 6.44
23.00 score on a scale
Standard Deviation 5.29
30.33 score on a scale
Standard Deviation 7.81
27.54 score on a scale
Standard Deviation 10.27
31.11 score on a scale
Standard Deviation 7.90
28.80 score on a scale
Standard Deviation 13.36
31.38 score on a scale
Standard Deviation 11.40
31.00 score on a scale
Standard Deviation 12.70
26.88 score on a scale
Standard Deviation 7.70
23.90 score on a scale
Standard Deviation 6.740

SECONDARY outcome

Timeframe: Screening (Day -7 to -14), Day 3, Day 14

Population: Only 19 subjects were evaluated for Marsh scores because one patient had a single endoscopy which did not produce evaluable samples.

Proportion of participants responding to a gluten challenge. Tissue transglutaminase (tTG) scoring: NEGATIVE \<20, BORDERLINE 20-30, POSITIVE \>30. Deamidated gliadin peptide (DGP) scoring: NEGATIVE \<20, BORDERLINE 20-30, POSITIVE \>30 METHOD IS INOVA ANTI-DEAMIDATED GLIADIN PEPTIDE IGA/IGG.

Outcome measures

Outcome measures
Measure
Baseline (Day -14) Low Gluten Group
n=10 Participants
Villous height to crypt depth ratio in low gluten group In the low gluten group, subjects consumed 3 grams of gluten per day
Baseline (Day -14) High Gluten Group
n=9 Participants
Villous height to crypt depth ratio in high gluten group In the high gluten group, subjects consumed 10 grams of gluten per day.
Day 3 Low Gluten Group
n=10 Participants
Villous height to crypt depth ratio in low gluten group In the low gluten group, subjects consumed 3 grams of gluten per day.
Day 3 High Gluten Group
n=9 Participants
Villous height to crypt depth ratio in high gluten group In the high gluten group, subjects consumed 10 grams of gluten per day.
Day 14 Low Gluten Group
n=20 Participants
Villous height to crypt depth ratio in low gluten group In the low gluten group, subjects consumed 3 grams of gluten per day
Day 14 High Gluten Group
n=19 Participants
Villous height to crypt depth ratio in high gluten group. In the high gluten group subjects consume 10 grams of gluten per day.
Day 7 Low Gluten Dose Group
Subjects in the low gluten dose group consumed 3 grams of gluten per day.
Day 7 High Gluten Dose Group
Subjects in the high gluten dose group consumed 10 grams of gluten per day.
Day 14 Low Gluten Dose Group
Subjects in the low gluten dose group consumed 3 grams of gluten per day.
Day 14 High Gluten Dose Group
Subjects in the high gluten dose group consumed 10 grams of gluten per day.
Day 28 Low Gluten Dose Group
Subjects in the low gluten dose group consumed 3 grams of gluten per day.
Day 28 High Gluten Dose Group
Subjects in the high gluten dose group consumed 10 grams of gluten per day.
Assessment of Protein Expression in Intestinal Biopsies Using Marsh Scores
Marsh III
5 Participants
8 Participants
0 Participants
0 Participants
5 Participants
8 Participants
Assessment of Protein Expression in Intestinal Biopsies Using Marsh Scores
Marsh III or tTG >20
8 Participants
9 Participants
5 Participants
6 Participants
13 Participants
16 Participants
Assessment of Protein Expression in Intestinal Biopsies Using Marsh Scores
Marsh III or DGP > 20
7 Participants
9 Participants
4 Participants
5 Participants
11 Participants
17 Participants
Assessment of Protein Expression in Intestinal Biopsies Using Marsh Scores
Marsh III or DGP > 20 or tTG > 20
10 Participants
9 Participants
9 Participants
9 Participants
19 Participants
19 Participants

SECONDARY outcome

Timeframe: Screening (Day -7 to -14), Day 0, Day 3, Day 7, Day 14, Day 28

Population: Subjects with biopsy proven celiac disease in remission were enrolled. On Day -14, one subject in the high gluten group missed completing the GSRS. On Day 0, two subjects (one in the low gluten group and one subject in the high gluten group) missed completing the GSRS. On Day 7, one subject in the high gluten group missed completing the GSRS. On Day 14, one subject in the high gluten group missed completing the GSRS. On Day 28, one subject in the high gluten group missed completing the GSRS.

Measure Description: GSRS (Gastrointestinal Symptom Rating Scale) scores range 15-105 with higher scores indicating greater degree of symptoms GSRS: Svedlund J, Sjödin I, Dotevall G. GSRS--a clinical rating scale for gastrointestinal symptoms in patients with irritable bowel syndrome and peptic ulcer disease. Dig Dis Sci. 1988;33(2):129-134. doi:10.1007/BF01535722

Outcome measures

Outcome measures
Measure
Baseline (Day -14) Low Gluten Group
n=10 Participants
Villous height to crypt depth ratio in low gluten group In the low gluten group, subjects consumed 3 grams of gluten per day
Baseline (Day -14) High Gluten Group
n=9 Participants
Villous height to crypt depth ratio in high gluten group In the high gluten group, subjects consumed 10 grams of gluten per day.
Day 3 Low Gluten Group
n=9 Participants
Villous height to crypt depth ratio in low gluten group In the low gluten group, subjects consumed 3 grams of gluten per day.
Day 3 High Gluten Group
n=9 Participants
Villous height to crypt depth ratio in high gluten group In the high gluten group, subjects consumed 10 grams of gluten per day.
Day 14 Low Gluten Group
n=10 Participants
Villous height to crypt depth ratio in low gluten group In the low gluten group, subjects consumed 3 grams of gluten per day
Day 14 High Gluten Group
n=10 Participants
Villous height to crypt depth ratio in high gluten group. In the high gluten group subjects consume 10 grams of gluten per day.
Day 7 Low Gluten Dose Group
n=10 Participants
Subjects in the low gluten dose group consumed 3 grams of gluten per day.
Day 7 High Gluten Dose Group
n=9 Participants
Subjects in the high gluten dose group consumed 10 grams of gluten per day.
Day 14 Low Gluten Dose Group
n=10 Participants
Subjects in the low gluten dose group consumed 3 grams of gluten per day.
Day 14 High Gluten Dose Group
n=9 Participants
Subjects in the high gluten dose group consumed 10 grams of gluten per day.
Day 28 Low Gluten Dose Group
n=10 Participants
Subjects in the low gluten dose group consumed 3 grams of gluten per day.
Day 28 High Gluten Dose Group
n=9 Participants
Subjects in the high gluten dose group consumed 10 grams of gluten per day.
Symptomatic Response to Gluten Exposure Determined by Gastrointestinal Symptom Rating Scale
21.63 score on a scale
Standard Deviation 7.05
19.20 score on a scale
Standard Deviation 3.26
22.88 score on a scale
Standard Deviation 9.58
18.40 score on a scale
Standard Deviation 3.06
30.22 score on a scale
Standard Deviation 11.63
26.45 score on a scale
Standard Deviation 13.18
28.22 score on a scale
Standard Deviation 9.87
27.30 score on a scale
Standard Deviation 14.94
31.00 score on a scale
Standard Deviation 13.71
31.00 score on a scale
Standard Deviation 17.09
23.89 score on a scale
Standard Deviation 11.59
19.40 score on a scale
Standard Deviation 4.33

Adverse Events

Low Gluten Group

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

High Gluten Group

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Low Gluten Group
n=10 participants at risk
Subjects will eat 3g of gluten per day Gluten: 3g
High Gluten Group
n=10 participants at risk
Subjects will eat 10g of gluten per day Gluten: 10g
Gastrointestinal disorders
Nausea and vomiting
10.0%
1/10 • Number of events 1 • 4 weeks after participant received first dose
0.00%
0/10 • 4 weeks after participant received first dose

Additional Information

Dr. Ciaran Kelly

Beth Israel Deaconess Medical Center

Phone: 617-667-1272

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place