Reviewer's report
Title:Small-bowel mucosal changes and antibody responses after low- and
moderate-dose gluten challenge in celiac disease
Version: 1Date:23 September 2011
Reviewer: Umberto UV Volta
Reviewer's report:
The present paper investigates small bowel mucosal changes and antibody
responses after low- and moderate-dose gluten challenge in celiac disease
patients. Both moderate and low amounts of gluten induced small bowel
morphological damage in 67% of celiac patients. Antibody seroconversion was
observed in 43% of celiac patients studied. This study confirms that low amounts
of gluten can cause significant mucosal deterioration in the majority of celiac
patients and that celiac disease requires a strict compliance with gluten-free diet.
This is an interesting study with solid conclusions in line with the results obtained.
I have only some minor observations:
1) Results section, page 12 : The Authors state that all the 3 antibodies studied
(TG2, EmA and DGP) showed the same antibody titers during gluten challenge.
It would be interesting to know which of the 3 antibodies appeared first after
gluten challenge.
2) Results section, page 12: Small-bowel mucosal TG2-targeted autoantibody
deposits are regarded as a predictor of celiac disease development being found
before the appearance of serum TG2 antibodies. Therefore, it sounds strange
that they become positive after serum TG2 appearance and the Authors should
provide their interpretation for this atypical behavior.
3) Discussion, page 15: The Authors state that celiac serology is not always a
reliable means of assessing gluten-induced harm. We agree with this assertion,
but it would be interesting to evaluate whether the recently introduced test, DGP,
provides some advantage in comparison with TG2 antibodies in this respect.
4) Results, page 10: patients studied were 25, but at 11 line 26 patients are
reported : “moderate IgA-deposits were seen in two and faint in four patients. In
the remaining 20….” Check please this point.
Level of interest: An article of outstanding merit and interest in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Reviewer's report
Title:Small-bowel mucosal changes and antibody responses after low- and
moderate-dose gluten challenge in celiac disease
Version: 1Date:23 September 2011
Reviewer: Umberto UV Volta
Reviewer's report:
The present paper investigates small bowel mucosal changes and antibody
responses after low- and moderate-dose gluten challenge in celiac disease
patients. Both moderate and low amounts of gluten induced small bowel
morphological damage in 67% of celiac patients. Antibody seroconversion was
observed in 43% of celiac patients studied. This study confirms that low amounts
of gluten can cause significant mucosal deterioration in the majority of celiac
patients and that celiac disease requires a strict compliance with gluten-free diet.
This is an interesting study with solid conclusions in line with the results obtained.
I have only some minor observations:
1) Results section, page 12 : The Authors state that all the 3 antibodies studied
(TG2, EmA and DGP) showed the same antibody titers during gluten challenge.
It would be interesting to know which of the 3 antibodies appeared first after
gluten challenge.
2) Results section, page 12: Small-bowel mucosal TG2-targeted autoantibody
deposits are regarded as a predictor of celiac disease development being found
before the appearance of serum TG2 antibodies. Therefore, it sounds strange
that they become positive after serum TG2 appearance and the Authors should
provide their interpretation for this atypical behavior.
3) Discussion, page 15: The Authors state that celiac serology is not always a
reliable means of assessing gluten-induced harm. We agree with this assertion,
but it would be interesting to evaluate whether the recently introduced test, DGP,
provides some advantage in comparison with TG2 antibodies in this respect.
4) Results, page 10: patients studied were 25, but at 11 line 26 patients are
reported : “moderate IgA-deposits were seen in two and faint in four patients. In
the remaining 20….” Check please this point.
Level of interest: An article of outstanding merit and interest in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Please review this paper.
user
Reviewer's report
Title:Small-bowel mucosal changes and antibody responses after low- and
moderate-dose gluten challenge in celiac disease
Version: 1Date:23 September 2011
Reviewer: Umberto UV Volta
Reviewer's report:
The present paper investigates small bowel mucosal changes and antibody
responses after low- and moderate-dose gluten challenge in celiac disease
patients. Both moderate and low amounts of gluten induced small bowel
morphological damage in 67% of celiac patients. Antibody seroconversion was
observed in 43% of celiac patients studied. This study confirms that low amounts
of gluten can cause significant mucosal deterioration in the majority of celiac
patients and that celiac disease requires a strict compliance with gluten-free diet.
This is an interesting study with solid conclusions in line with the results obtained.
I have only some minor observations:
1) Results section, page 12 : The Authors state that all the 3 antibodies studied
(TG2, EmA and DGP) showed the same antibody titers during gluten challenge.
It would be interesting to know which of the 3 antibodies appeared first after
gluten challenge.
2) Results section, page 12: Small-bowel mucosal TG2-targeted autoantibody
deposits are regarded as a predictor of celiac disease development being found
before the appearance of serum TG2 antibodies. Therefore, it sounds strange
that they become positive after serum TG2 appearance and the Authors should
provide their interpretation for this atypical behavior.
3) Discussion, page 15: The Authors state that celiac serology is not always a
reliable means of assessing gluten-induced harm. We agree with this assertion,
but it would be interesting to evaluate whether the recently introduced test, DGP,
provides some advantage in comparison with TG2 antibodies in this respect.
4) Results, page 10: patients studied were 25, but at 11 line 26 patients are
reported : “moderate IgA-deposits were seen in two and faint in four patients. In
the remaining 20….” Check please this point.
Level of interest: An article of outstanding merit and interest in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
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