A Call for Research on the Prognostic Role of Follow-Up Histology in Celiac Disease: A Systematic Review
Background: Convincing evidence is lacking on the benefit of follow-up biopsy in celiac disease. Regardless, achieving mucosal recovery (MR) has remained a desirable goal of therapy. We aimed to conduct a systematic review to determine whether MR is a protective factor and persisting villous atrophy...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2019-11-01
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| Series: | Frontiers in Physiology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fphys.2019.01408/full |
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| author | Zsolt Szakács Zsolt Szakács Noémi Gede Zoltán Gyöngyi Margit Solymár Dezső Csupor Bálint Erőss Bálint Erőss Áron Vincze Alexandra Mikó Andrea Vasas László Szapáry László Szapáry Dalma Dobszai Viktória Balikó Roland Hágendorn Péter Hegyi Péter Hegyi Judit Bajor |
| author_facet | Zsolt Szakács Zsolt Szakács Noémi Gede Zoltán Gyöngyi Margit Solymár Dezső Csupor Bálint Erőss Bálint Erőss Áron Vincze Alexandra Mikó Andrea Vasas László Szapáry László Szapáry Dalma Dobszai Viktória Balikó Roland Hágendorn Péter Hegyi Péter Hegyi Judit Bajor |
| author_sort | Zsolt Szakács |
| collection | DOAJ |
| description | Background: Convincing evidence is lacking on the benefit of follow-up biopsy in celiac disease. Regardless, achieving mucosal recovery (MR) has remained a desirable goal of therapy. We aimed to conduct a systematic review to determine whether MR is a protective factor and persisting villous atrophy (PVA) has negative consequences on long-term outcomes of celiac disease.Methods: Seven databases were searched for articles discussing celiac patients subjected to a gluten-free diet who had a follow-up biopsy, and clinical and laboratory characteristics were reported by follow-up histology (MR vs. PVA). Outcomes included clinical symptoms, mortality, malignant tumors, nutritional parameters, and metabolic bone disease. Comparative and descriptive studies were included. Since data proved to be ineligible for meta-analysis, the evidence was synthesized in a systematic review.Results: Altogether, 31 studies were eligible for systematic review. Persisting symptoms were more frequently associated with PVA than with MR, although a lot of symptom-free patients had PVA and a lot of symptomatic patients achieved MR. PVA might be a risk factor of lymphomas, but mortality and the overall rate of malignant tumors seemed independent of follow-up histology. Patients with PVA tended to develop metabolic bone disease more often, although fracture risk remained similar in the groups except in hip fractures of which PVA was a risk factor. Reports on nutritional markers are only anecdotal.Conclusions: The limited evidence calls for high-quality prospective cohort studies to be arranged to clarify the exact role of follow-up histology in celiac disease. |
| first_indexed | 2024-12-13T21:19:54Z |
| format | Article |
| id | doaj.art-70869950a3374633820b7691c888b5bc |
| institution | Directory Open Access Journal |
| issn | 1664-042X |
| language | English |
| last_indexed | 2024-12-13T21:19:54Z |
| publishDate | 2019-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Physiology |
| spelling | doaj.art-70869950a3374633820b7691c888b5bc2022-12-21T23:31:09ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2019-11-011010.3389/fphys.2019.01408466937A Call for Research on the Prognostic Role of Follow-Up Histology in Celiac Disease: A Systematic ReviewZsolt Szakács0Zsolt Szakács1Noémi Gede2Zoltán Gyöngyi3Margit Solymár4Dezső Csupor5Bálint Erőss6Bálint Erőss7Áron Vincze8Alexandra Mikó9Andrea Vasas10László Szapáry11László Szapáry12Dalma Dobszai13Viktória Balikó14Roland Hágendorn15Péter Hegyi16Péter Hegyi17Judit Bajor18Institute for Translational Medicine, Medical School, University of Pécs, Pécs, HungarySzentágothai Research Centre, Medical School, University of Pécs, Pécs, HungaryInstitute for Translational Medicine, Medical School, University of Pécs, Pécs, HungaryDepartment of Public Health Medicine, Medical School, University of Pécs, Pécs, HungaryInstitute for Translational Medicine, Medical School, University of Pécs, Pécs, HungaryDepartment of Pharmacognosy, University of Szeged, Szeged, HungaryInstitute for Translational Medicine, Medical School, University of Pécs, Pécs, HungarySzentágothai Research Centre, Medical School, University of Pécs, Pécs, HungaryDivision of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, HungaryInstitute for Translational Medicine, Medical School, University of Pécs, Pécs, HungaryDepartment of Public Health Medicine, Medical School, University of Pécs, Pécs, HungaryInstitute for Translational Medicine, Medical School, University of Pécs, Pécs, HungaryDepartment of Interventional Cardiology, Heart Institute, University of Pécs, Pécs, HungaryInstitute for Translational Medicine, Medical School, University of Pécs, Pécs, HungaryInstitute for Translational Medicine, Medical School, University of Pécs, Pécs, HungaryDivision of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, HungaryInstitute for Translational Medicine, Medical School, University of Pécs, Pécs, HungarySzentágothai Research Centre, Medical School, University of Pécs, Pécs, HungaryDivision of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, HungaryBackground: Convincing evidence is lacking on the benefit of follow-up biopsy in celiac disease. Regardless, achieving mucosal recovery (MR) has remained a desirable goal of therapy. We aimed to conduct a systematic review to determine whether MR is a protective factor and persisting villous atrophy (PVA) has negative consequences on long-term outcomes of celiac disease.Methods: Seven databases were searched for articles discussing celiac patients subjected to a gluten-free diet who had a follow-up biopsy, and clinical and laboratory characteristics were reported by follow-up histology (MR vs. PVA). Outcomes included clinical symptoms, mortality, malignant tumors, nutritional parameters, and metabolic bone disease. Comparative and descriptive studies were included. Since data proved to be ineligible for meta-analysis, the evidence was synthesized in a systematic review.Results: Altogether, 31 studies were eligible for systematic review. Persisting symptoms were more frequently associated with PVA than with MR, although a lot of symptom-free patients had PVA and a lot of symptomatic patients achieved MR. PVA might be a risk factor of lymphomas, but mortality and the overall rate of malignant tumors seemed independent of follow-up histology. Patients with PVA tended to develop metabolic bone disease more often, although fracture risk remained similar in the groups except in hip fractures of which PVA was a risk factor. Reports on nutritional markers are only anecdotal.Conclusions: The limited evidence calls for high-quality prospective cohort studies to be arranged to clarify the exact role of follow-up histology in celiac disease.https://www.frontiersin.org/article/10.3389/fphys.2019.01408/fullceliac diseasemucosal recoverypersistent villous atrophyfollow-up biopsiesgluten-free diet |
| spellingShingle | Zsolt Szakács Zsolt Szakács Noémi Gede Zoltán Gyöngyi Margit Solymár Dezső Csupor Bálint Erőss Bálint Erőss Áron Vincze Alexandra Mikó Andrea Vasas László Szapáry László Szapáry Dalma Dobszai Viktória Balikó Roland Hágendorn Péter Hegyi Péter Hegyi Judit Bajor A Call for Research on the Prognostic Role of Follow-Up Histology in Celiac Disease: A Systematic Review Frontiers in Physiology celiac disease mucosal recovery persistent villous atrophy follow-up biopsies gluten-free diet |
| title | A Call for Research on the Prognostic Role of Follow-Up Histology in Celiac Disease: A Systematic Review |
| title_full | A Call for Research on the Prognostic Role of Follow-Up Histology in Celiac Disease: A Systematic Review |
| title_fullStr | A Call for Research on the Prognostic Role of Follow-Up Histology in Celiac Disease: A Systematic Review |
| title_full_unstemmed | A Call for Research on the Prognostic Role of Follow-Up Histology in Celiac Disease: A Systematic Review |
| title_short | A Call for Research on the Prognostic Role of Follow-Up Histology in Celiac Disease: A Systematic Review |
| title_sort | call for research on the prognostic role of follow up histology in celiac disease a systematic review |
| topic | celiac disease mucosal recovery persistent villous atrophy follow-up biopsies gluten-free diet |
| url | https://www.frontiersin.org/article/10.3389/fphys.2019.01408/full |
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