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  4. The combined metabolome and metagenomics approach in coeliac disease; to understand why some patients with coeliac disease don’t feel better despite being on a gluten-free diet

The combined metabolome and metagenomics approach in coeliac disease; to understand why some patients with coeliac disease don’t feel better despite being on a gluten-free diet

Principal Investigator: Dr Ramesh Arasaradnam

Institution: Clinical Sciences Research Institute, University Hospital Coventry & Warwickshire and University of Warwick

Research classification: Management of disease

Project start & duration: February 2016 (22 months)

Grant awarded: £50k

Some people with coeliac disease continue to experience symptoms despite being on a gluten-free diet. In many cases the problem is thought to be ongoing gluten ingestion, but researchers at the University of Warwickshire are more persuaded that it is actually an individual’s gut bacteria that may be causing this.

Emerging studies show that children with coeliac disease have a different gut bacterial profile compared to those without coeliac disease but further work is required to understand more in adults.

This project proposes that an individual’s gut bacteria may predispose them to lack of symptom improvement when they’re following a gluten-free diet. If this is the case, then there may be potential to make modifications with the use of probiotics.

To explore the theory, researchers will look at a group of people newly diagnosed with coeliac disease before they start treatment and then again, six months after starting a gluten-free diet. Participants in the study will be asked to complete a questionnaire, to determine their response to the gluten-free diet, and to provide blood, urine and faecal samples.

Genetic material recovered from faecal samples will be analysed (metagenomics) to identify the bacterial profile. Chemicals produced by bacteria will also be studied (metabolomics).

It is hoped that this project will identify what constitutes a good bacterial profile for people with coeliac disease and provide some explanation for why some people continue to experience symptoms while following a gluten-free diet.

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