A57 SUBOPTIMAL FIBRE CONSUMPTION AND ALTERED FIBRE METABOLISM IN CELIAC DISEASE THROUGHOUT THE GASTROINTESTINAL TRACT
Bibliographic record
Abstract
Abstract Background Celiac disease (CeD) is a T-cell mediated enteropathy driven by gluten in people with risk genes HLA-DQ2 or DQ8. Many patients experience symptoms such as constipation and/or persistent mucosal inflammation despite adherence to a gluten-free diet (GFD) and are advised to increase dietary fibre. Preliminary results from gluten-immunized NOD-DQ8 mice revealed that supplemented inulin could improve mucosal healing. However, whether fibre is tolerated and metabolized in CeD is unknown. Aims To investigate whether (1) fibre consumption in untreated and treated CeD compared to healthy volunteers (HV); (2) characterize microbial carbolytic capacity in the duodenum and feces. Methods We conducted an analysis of CeD patients (newly diagnosed and GFD-treated) and HV attending our specialized McMaster adult CeD clinic. To investigate fibre consumption, participants completed a validated food frequency questionnaire (Victoria DQES v2), and the chloroplast trnL-P6 plastid marker was used to analyze the presence and diversity of plant DNA in feces at the time of sample collection (FoodSeq). To characterize fibre metabolism, fecal SCFA were measured using gas chromatography mass-spectrometry, and microbiota composition from duodenal aspirates was investigated by 16S rRNA gene Illumina sequencing of the V3V4 region. In silico predictions of metabolic functions and relative abundances of key enzymes were completed with PICRUSt2. Results Most participants consumed fibre below the minimum recommendation (66% < 25g/day, Health Canada), despite diverse dietary plant consumption. Fibre did not correlate with self-reported gastrointestinal symptoms. Fecal SCFAs were lower in new CeD compared to HV, while GFD was partially rescued (CeD: 2799±927 vs HV: 5199±1616 μg/g, p<0.001; GFD: 4058±1283). Duodenal microbiota composition differed between all groups (Aitchinson Distance β-diversity, p<0.05). Abundance of enzymes related to fibre degradation (α-amylase K07405, fructan β-fructosidase K03332) were decreased in both CeD and GFD groups compared to HV (p<0.001), as was the abundance of several members of the Prevotellaceae family that had the greatest predicted contribution to this function (p<0.05). Conclusions Newly diagnosed CeD patients have inadequate fibre consumption and lower microbial capacity to metabolize fibre in the lower and upper GI tract. Despite patients on GFD having the lowest fibre intake, microbial carbolytic activity was improved. Taken together with unpublished findings of inulin accelerating mucosal healing in mouse models of gluten sensitivity, the data should encourage clinical studies to define the effects of fibre supplementation on symptom management and mucosal healing in CeD during GFD. Funding Agencies CIHRCeliac Canada
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 teacher head, 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".