{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T08:05:11Z","timestamp":1784966711859,"version":"3.55.0"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,11,26]],"date-time":"2019-11-26T00:00:00Z","timestamp":1574726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"This study was funded by\u00a0ImmusanT, Inc"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In patients with coeliac disease, FODMAPs in gluten\u2010containing foods, and participant anticipation of a harmful (\u2018nocebo\u2019) effect, may contribute to acute symptoms after gluten challenge.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To establish acute gluten\u2010specific symptoms linked to immune activation in coeliac disease<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included 36 coeliac disease patients on a gluten\u2010free diet receiving placebo in the RESET CeD trial. Double\u2010blind, bolus vital wheat gluten (~6\u2010g gluten protein) and sham challenges low in FODMAPs were consumed 2 weeks apart. Assessments included daily Coeliac Disease Patient Reported Outcome (CeD PRO) symptom scores (0\u201010), adverse events and serum interleukin\u20102 (baseline and 4\u00a0hours).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median CeD PRO score for nausea increased most (sham: 0 vs gluten: 5.5; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). Apart from tiredness (1 vs 4, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.005) and headache (0 vs 2, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.002), changes in other symptoms were small or absent. Only nausea increased significantly in occurrence with gluten (11% vs 69%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). Without nausea, only tiredness and flatulence were common after gluten. Nausea (6% vs 61%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001; median onset: 1:34\u00a0hours) and vomiting (0% vs 44%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001; 1:51\u00a0hours) were the only adverse events more common with gluten than sham. Interleukin\u20102 was always below the level of quantitation (0.5\u00a0pg\/mL) at baseline, and after sham. Interleukin\u20102 was elevated after gluten in 97% of patients (median fold\u2010change: 20), and correlated with severity of nausea (<jats:italic>r<jats:sub>s<\/jats:sub><\/jats:italic>\u00a0=\u00a0.49, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.0025) and occurrence of vomiting (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.0005).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Nausea and vomiting are relatively specific indicators of acute gluten ingestion, and correlate with immune activation. IBS\u2010like symptoms without nausea are unlikely to indicate recent gluten exposure.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.15551","type":"journal-article","created":{"date-parts":[[2019,11,26]],"date-time":"2019-11-26T12:43:44Z","timestamp":1574772224000},"page":"244-252","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Masked bolus gluten challenge low in FODMAPs implicates nausea and vomiting as key symptoms associated with immune activation in treated coeliac disease"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6042-5102","authenticated-orcid":false,"given":"A. James M.","family":"Daveson","sequence":"first","affiliation":[{"name":"Faculty of Medicine University of Queensland Brisbane Qld Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7687-9654","authenticated-orcid":false,"given":"Jason A.","family":"Tye\u2010Din","sequence":"additional","affiliation":[{"name":"Immunology Division The Walter and Eliza Hall Institute Parkville Vic. Australia"},{"name":"Department of Medical Biology University of Melbourne Parkville Vic. Australia"},{"name":"Department of Gastroenterology The Royal Melbourne Hospital Parkville Vic. Australia"},{"name":"Centre for Food &amp; Allergy Research Murdoch Children's Research Institute Parkville Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0578-1497","authenticated-orcid":false,"given":"Gautam","family":"Goel","sequence":"additional","affiliation":[{"name":"ImmusanT, Inc. Cambridge MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4716-135X","authenticated-orcid":false,"given":"Kaela E.","family":"Goldstein","sequence":"additional","affiliation":[{"name":"ImmusanT, Inc. Cambridge MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly L.","family":"Hand","sequence":"additional","affiliation":[{"name":"ImmusanT, Inc. Cambridge MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin M.","family":"Neff","sequence":"additional","affiliation":[{"name":"ImmusanT, Inc. Cambridge MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie J.","family":"Williams","sequence":"additional","affiliation":[{"name":"ImmusanT, Inc. Cambridge MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9350-0212","authenticated-orcid":false,"given":"Kenneth E.","family":"Truitt","sequence":"additional","affiliation":[{"name":"ImmusanT, Inc. Cambridge MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0764-7267","authenticated-orcid":false,"given":"Robert P.","family":"Anderson","sequence":"additional","affiliation":[{"name":"ImmusanT, Inc. Cambridge MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the RESET CeD Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,11,26]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2009.03992.x"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13988"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2007.03311.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2010.10"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/nqx049"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31796-8"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2013-306578"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2010.04237.x"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2015.156"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2016-312762"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12984"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.aaw7756"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/cei.13369"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.15477"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2008.06.030"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.10.040"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640619874173"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.02.008"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.13698"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1084\/jem.178.1.187"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2012.11.033"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gtc.2005.02.007"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2015-310148"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2016.439"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v25.i11.1409"}],"container-title":["Alimentary Pharmacology &amp; Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fapt.15551","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.15551","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T06:16:02Z","timestamp":1693980962000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apt.15551"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,26]]},"references-count":25,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2020,1]]}},"alternative-id":["10.1111\/apt.15551"],"URL":"https:\/\/doi.org\/10.1111\/apt.15551","archive":["Portico"],"relation":{},"ISSN":["0269-2813","1365-2036"],"issn-type":[{"value":"0269-2813","type":"print"},{"value":"1365-2036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,26]]},"assertion":[{"value":"2019-08-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-10-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-11-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}