P519 - EVALUATION OF ADHERENCE TO THE GLUTEN-FREE DIET IN CELIAC PATIENTS: THE INNOVATIVE DETECTION OF GLUTEN IMMUNOGENIC PEPTIDES (GIPS) COMPARED TO TRADITIONAL METHODS

P519

EVALUATION OF ADHERENCE TO THE GLUTEN-FREE DIET IN CELIAC PATIENTS: THE INNOVATIVE DETECTION OF GLUTEN IMMUNOGENIC PEPTIDES (GIPS) COMPARED TO TRADITIONAL METHODS

V. Lombardo 1, A. Scricciolo1,*, L. Roncoroni 1,2, L. Scaramella1,3, A. Costantino 1,4, M. Topa1,3, B. Rota1, M. Vecchi 3,5, L. Elli1,3

1Gastroenterology and Endoscopy Unit; Center for Prevention and Diagnosis of Celiac Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 2Department of Biomedical, Surgical and Dental Sciences, University of Milan, 3Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 4Department of Pathophysiology and Transplantation, University of Milan, 5Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy

 

Rationale: Celiac disease (CD) is an immune-mediated disorder triggered by gluten ingestion, managed exclusively through a lifelong gluten-free diet (GFD). However, adherence to the GFD is often inconsistent. Traditional indirect monitoring methods have limitations, suggesting the development of direct techniques such as detecting gluten immunogenic peptides (GIP) in urine and stool to assess gluten intake accurately.

This study aimed to evaluate GFD adherence in CD patients by comparing fecal GIP detection with traditional follow-up methods and serological markers. 

Methods: 30 CD patients with borderline or positive anti-tTG antibody levels during annual check-ups were enrolled. Adherence was assessed using validated questionnaires (Biagi score and Celiac Disease Adherence Test - CDAT) and gastrointestinal symptoms were evaluated using the CeD-GSRS (Gastrointestinal Symptom Rating Scale). Patients were stratified by serological results and fecal GIP levels.

Results: Results showed no statistically significant correlation between anti-tTG antibodies and fecal GIP levels. However, the absence of detectable gluten in stool samples from patients with positive antibody results, highlighted discrepancies between the two methods. The average Biagi score (3.3 ± 0.5) indicated optimal GFD adherence, with higher scores suggesting stricter adherence among women and patients with negative fecal GIP results (p = 0.07). The Biagi questionnaire proved to be more effective than the CDAT. Additionally, the CeD-GSRS questionnaire confirmed the predictive role of GIP as a symptom-related marker.

Conclusion: This observational study highlights the potential of fecal GIP quantification as a precise tool to monitor GFD adherence in CD patients.

Disclosure of Interest: None declared