Immune Reactivity to a Glb1 Homologue in a Highly Wheat-Sensitive Patient With Type 1 Diabetes and Celiac Disease
Bibliographic record
Abstract
In type 1 diabetes, the environmental factors that induce the patient’s immune system to attack and destroy the insulin-secreting β-cells are not known. There is evidence that some cases of type 1 diabetes could be wheat related (1,2). Exposure to wheat protein was a risk factor for development of type 1 diabetes autoantibodies in high-risk infants (1,2), and as many as 2–8% of type 1 diabetic patients have celiac disease (3), also known as gluten-sensitive enteropathy. Some studies in animals also suggest that wheat could be involved (4–7). Recently, a wheat protein, WP5212, with 80% amino acid homology to wheat storage globulin-1 (Glb1), was identified as the first candidate diabetes-related wheat protein in diabetes-prone rats (5). We report the case of a highly wheat-sensitive patient with type 1 diabetes/celiac disease who displayed strong antibody and T-cell responses to this protein. A 28-year-old Caucasian female, with a 10-year history of type 1 diabetes, presented early in 1999 with diarrhea followed by oral ulcerations and severe lip swelling (Fig. 1 A ). At diagnosis, anti-gliadin IgG, anti-tissue transglutaminase IgA, and endomysial antibodies were present. The diarrhea and lip swelling improved initially with a gluten-free diet, but the symptoms recurred within a few months with worsening of the oral ulcerations, lip swelling, and continued diarrhea. Despite 6 months of a standard gluten-free diet, a duodenal biopsy showed mild villous atrophy. Colonoscopy and small bowel follow-through were normal. Biopsy of the oral lesion showed noncaseating granulomas, which were negative for IgG, IgA, IgM, C3, fibrinogen, and albumin with no histological evidence of eosinophilia. The patient was evaluated by a clinical allergist. Skin prick tests for several foods, including wheat, were all negative, and there was no evidence of IgE-mediated food allergy. In December 2001, the mucosa of her lower lip …
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".