M. Petrova, A. Ilina, A. Shestopalov, A. Kutsenko, V. Makarova, I. Kuzmina
Significance: The COVID-19 pandemic, declared by WHO on March 11, 2020, has made significant adjustments to the principles of organizing medical care, including treatment, nutrition and care of patients in infectious hospitals. The disease has different clinical courses: from mild asymptomatic to extremely severe, requiring aggressive medical intervention such as organ replacement therapy to replace vital body functions. [1] The spread of viral infection was global, but the pathophysiological aspects of the course of COVID-19 have not been studied enough. The development of ARDS and systemic inflammatory response syndrome as part of the severe course of the disease is accompanied by severe metabolic disorders that require close attention. It is necessary to correct the clinical manifestations of organ dysfunction under severe hypercatabolism. Considerable importance is given to the peculiarities of providing nutritional support to patients using specialized nutritional mixtures to prevent conditions that worsen the prognosis of recovery and survival of patients. [2] The target cells of the virus are angiotensin-converting enzyme receptors of the respiratory, nervous, urinary, cardiovascular systems and organs of the gastrointestinal tract. [3] Consequently, the site of the infection at different organs and systems gives rise to the phenomena of respiratory failure and many heterogeneous clinical manifestations of the disease, which can affect all ties in the pathogenesis of nutritional deficiency. Malnutrition is usually due to the mismatch between the intake and consumption of nutrients, micro-and macroelements. [4] Aim: To systematize ways in which we provide nutritional support based on the prevalent causes of protein-energy malnutrition, taking into account the patient's individual needs and the extent of respiratory support. We analyzed several papers published by foreign colleagues and our own experience in the Department of Anesthesiology and Intensive Care for Patients with a New Coronavirus Infection COVID-19 at the Russian Academy of Sciences Central Clinical Hospital in Moscow in 2020.
{"title":"Diversified nutritional support of patients in severe forms of COVID-19","authors":"M. Petrova, A. Ilina, A. Shestopalov, A. Kutsenko, V. Makarova, I. Kuzmina","doi":"10.17816/clinutr101434","DOIUrl":"https://doi.org/10.17816/clinutr101434","url":null,"abstract":"Significance: The COVID-19 pandemic, declared by WHO on March 11, 2020, has made significant adjustments to the principles of organizing medical care, including treatment, nutrition and care of patients in infectious hospitals. The disease has different clinical courses: from mild asymptomatic to extremely severe, requiring aggressive medical intervention such as organ replacement therapy to replace vital body functions. [1] \u0000The spread of viral infection was global, but the pathophysiological aspects of the course of COVID-19 have not been studied enough. The development of ARDS and systemic inflammatory response syndrome as part of the severe course of the disease is accompanied by severe metabolic disorders that require close attention. It is necessary to correct the clinical manifestations of organ dysfunction under severe hypercatabolism. Considerable importance is given to the peculiarities of providing nutritional support to patients using specialized nutritional mixtures to prevent conditions that worsen the prognosis of recovery and survival of patients. [2] \u0000The target cells of the virus are angiotensin-converting enzyme receptors of the respiratory, nervous, urinary, cardiovascular systems and organs of the gastrointestinal tract. [3] Consequently, the site of the infection at different organs and systems gives rise to the phenomena of respiratory failure and many heterogeneous clinical manifestations of the disease, which can affect all ties in the pathogenesis of nutritional deficiency. Malnutrition is usually due to the mismatch between the intake and consumption of nutrients, micro-and macroelements. [4] \u0000Aim: To systematize ways in which we provide nutritional support based on the prevalent causes of protein-energy malnutrition, taking into account the patient's individual needs and the extent of respiratory support. We analyzed several papers published by foreign colleagues and our own experience in the Department of Anesthesiology and Intensive Care for Patients with a New Coronavirus Infection COVID-19 at the Russian Academy of Sciences Central Clinical Hospital in Moscow in 2020.","PeriodicalId":92235,"journal":{"name":"Journal of clinical nutrition and metabolism","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88049896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dear readers! We are opening a new section of the magazine: "Interviews with leading experts". Today, Doctor of Medical Sciences, Professor Andrey Ustinovich Lekmanov is visiting the editorial office.Andrei Ustinovich Lekmanov is a well-known and respected anesthesiologist-resuscitator in Russia, who devoted his entire practical life to the treatment of children, who stood at the foundations of domestic pediatric anesthesiology and resuscitation. Topic for discussion: "Possibilities and prospects of clinical nutrition in pediatric anesthesiology and resuscitation."
{"title":"Interview with Professor Andrey Ustinovich Lekmanov","authors":"S. Sviridov","doi":"10.17816/clinutr106392","DOIUrl":"https://doi.org/10.17816/clinutr106392","url":null,"abstract":"Dear readers! We are opening a new section of the magazine: \"Interviews with leading experts\". Today, Doctor of Medical Sciences, Professor Andrey Ustinovich Lekmanov is visiting the editorial office.Andrei Ustinovich Lekmanov is a well-known and respected anesthesiologist-resuscitator in Russia, who devoted his entire practical life to the treatment of children, who stood at the foundations of domestic pediatric anesthesiology and resuscitation. Topic for discussion: \"Possibilities and prospects of clinical nutrition in pediatric anesthesiology and resuscitation.\"","PeriodicalId":92235,"journal":{"name":"Journal of clinical nutrition and metabolism","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75350481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. Selective craniocerebral hypothermia (CCН), used in the acute period of brain damage, ensures the development of positive clinical effects (rapid and persistent reduction of neurological deficit, increased consciousness and maintenance of normothermy in feverish patients). The safety and efficacy of CCН in the acute period of cerebrovascular lesions prompted the use of craniocerebral cooling in patients with chronic disorders of consciousness (CDC). For this category of patients, the CCН technique has been developed, which requires careful study including its effect on overall metabolism. Aims. To find out the nature of the metabolic response to CСH procedures in patients in a vegetative state and with a minimal level of consciousness. Materials and Methods. A pilot study was conducted from 03.02.2021 till 12.03.2022. The study included 34 patients who were in a state of CDC after severe brain damage (stroke - 25, brain injury - 5, anoxic brain injuries - 4). Hypothermia was induced using the ATG-01 device, lowering the temperature of the scalp to 4-7 with a cooling procedure lasting for 120 minutes. Indirect calorimetry method was conducted before cooling and after 105 minutes of the CCH session. Statistical analysis was carried out using the program Stat Tech v. 2.6.5 (developer - Stattech LLC, Russia). Results. Craniocerebral cooling provided a decrease in the temperature of the frontal cortex of the large hemispheres already after 30th minute from 36.4 C to 34.9 0.41 C in the left and 34.7 0.47 C in the right hemisphere. By the 120th minute, the temperature in the left hemisphere reached 34.0 0.40 C, in the right 33.3 0.51 C, falling respectively by 2.4 C and 3.1 C. 30 minutes after the completion of CCH, the brain temperature remained lowered by 0.7 Changes in the level of metabolism under the influence of CCН were of a multidirectional nature. In 24 patients (70.59% of patients), the REE [resting energy expenditure] index increased to varying degrees by the end of the cooling procedure, and in 10 participants it decreased. A significant spread of data allowed only a descriptive analysis of the results obtained during a 120-minute CCH session. Conclusions. Chronic disordersofconsciousness are largely associated with severe damage of the cerebral cortex. It can be assumed that in patients who reacted with a decrease in REE to the induction of hypothermia, at least metabolic activity in the intact parts of the cerebral cortex was preserved to a certain extent, which may indicate some level of rehabilitation potential. The lack of expression of the reactions of the general metabolism to craniocerebral cooling may be due to the fact that the severe damage to the cerebral cortex excluded the selectivity of hypothermic exposure.
{"title":"The effect of selective hypothermia of the cerebral cortex on metabolism in patients with prolonged impairment of consciousness.","authors":"O. Shevelev","doi":"10.17816/clinutr105640","DOIUrl":"https://doi.org/10.17816/clinutr105640","url":null,"abstract":"Background. Selective craniocerebral hypothermia (CCН), used in the acute period of brain damage, ensures the development of positive clinical effects (rapid and persistent reduction of neurological deficit, increased consciousness and maintenance of normothermy in feverish patients). \u0000The safety and efficacy of CCН in the acute period of cerebrovascular lesions prompted the use of craniocerebral cooling in patients with chronic disorders of consciousness (CDC). For this category of patients, the CCН technique has been developed, which requires careful study including its effect on overall metabolism. \u0000Aims. To find out the nature of the metabolic response to CСH procedures in patients in a vegetative state and with a minimal level of consciousness. \u0000Materials and Methods. A pilot study was conducted from 03.02.2021 till 12.03.2022. The study included 34 patients who were in a state of CDC after severe brain damage (stroke - 25, brain injury - 5, anoxic brain injuries - 4). Hypothermia was induced using the ATG-01 device, lowering the temperature of the scalp to 4-7 with a cooling procedure lasting for 120 minutes. Indirect calorimetry method was conducted before cooling and after 105 minutes of the CCH session. Statistical analysis was carried out using the program Stat Tech v. 2.6.5 (developer - Stattech LLC, Russia). \u0000Results. Craniocerebral cooling provided a decrease in the temperature of the frontal cortex of the large hemispheres already after 30th minute from 36.4 C to 34.9 0.41 C in the left and 34.7 0.47 C in the right hemisphere. By the 120th minute, the temperature in the left hemisphere reached 34.0 0.40 C, in the right 33.3 0.51 C, falling respectively by 2.4 C and 3.1 C. 30 minutes after the completion of CCH, the brain temperature remained lowered by 0.7 \u0000Changes in the level of metabolism under the influence of CCН were of a multidirectional nature. In 24 patients (70.59% of patients), the REE [resting energy expenditure] index increased to varying degrees by the end of the cooling procedure, and in 10 participants it decreased. \u0000A significant spread of data allowed only a descriptive analysis of the results obtained during a 120-minute CCH session. \u0000Conclusions. Chronic disordersofconsciousness are largely associated with severe damage of the cerebral cortex. It can be assumed that in patients who reacted with a decrease in REE to the induction of hypothermia, at least metabolic activity in the intact parts of the cerebral cortex was preserved to a certain extent, which may indicate some level of rehabilitation potential. The lack of expression of the reactions of the general metabolism to craniocerebral cooling may be due to the fact that the severe damage to the cerebral cortex excluded the selectivity of hypothermic exposure.","PeriodicalId":92235,"journal":{"name":"Journal of clinical nutrition and metabolism","volume":"16 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72775706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. D. Rybakova, A. Miroshnikov, A. Smolensky, A. Meshtel
It is generally accepted that the growth of skeletal muscles and the retention of muscle mass throughout life depends mainly on the amount of protein of animal origin consumed with food. The difference between the effect of animal and plant proteins on muscle mass has recently been studied by many authors, however, when considering this topic, researchers often make gross, in our opinion, mistakes that make it difficult to further study this topic. Is the clear differentiation that has always been made between "animal proteins" and "plant proteins" necessary? Can we say that the differences between protein sources are minimal, and perhaps even non-existent? In this review, we will consider studies on this topic and the effect of protein supplements of various origins and quality and their dosages on muscle mass and strength.
{"title":"A NEW VIEW ON PLANT AND ANIMAL PROTEIN: A LITERATURE REVIEW","authors":"P. D. Rybakova, A. Miroshnikov, A. Smolensky, A. Meshtel","doi":"10.17816/clinutr105296","DOIUrl":"https://doi.org/10.17816/clinutr105296","url":null,"abstract":"It is generally accepted that the growth of skeletal muscles and the retention of muscle mass throughout life depends mainly on the amount of protein of animal origin consumed with food. The difference between the effect of animal and plant proteins on muscle mass has recently been studied by many authors, however, when considering this topic, researchers often make gross, in our opinion, mistakes that make it difficult to further study this topic. \u0000 Is the clear differentiation that has always been made between \"animal proteins\" and \"plant proteins\" necessary? Can we say that the differences between protein sources are minimal, and perhaps even non-existent? In this review, we will consider studies on this topic and the effect of protein supplements of various origins and quality and their dosages on muscle mass and strength.","PeriodicalId":92235,"journal":{"name":"Journal of clinical nutrition and metabolism","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89926717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. R. Gubajdullin, V. Kulakov, A. Yakovleva, M. Petrova, A. Shestopalov
There is ongoing debate about the role of nutrition during critical illness in terms of long-term outcomes. Even taking into account the inability to adequately assess all biological mechanisms associated with nutrition, it should be recognized that the available randomized trials, nutritional support during the early phase of critical illness, when considered in isolation from other treatment, may have very limited long-term functional value. This review focuses on recent clinical studies and evaluating the impact of critical nutrition on long-term physical and functional recovery. Critical survival is becoming an increasingly important subject of attention. Future research on nutritional support should consider specific factors that can provide measurable benefits in terms of both physical and functional recovery. These factors include the development of strategies to ensure adequate nutritional interventions, the provision of nutrition for a period of time in which biologically it is possible to observe differences in the results assessed, and the selection of appropriate methods of assessing the results recorded at clinically significant time points. One of these results is an assessment of muscle mass and function, as well as quality of life. In addition, selection of patients who are most likely to benefit from nutritional interventions and nutritional research after transfer from ICU deserves special attention.
{"title":"THE ROLE OF NUTRITIVE SUPPORT IN THE PHYSICAL AND FUNCTIONAL REHABILITATION OF CRITICAL PATIENTS: OVERVIEW","authors":"R. R. Gubajdullin, V. Kulakov, A. Yakovleva, M. Petrova, A. Shestopalov","doi":"10.17816/clinutr96169","DOIUrl":"https://doi.org/10.17816/clinutr96169","url":null,"abstract":"There is ongoing debate about the role of nutrition during critical illness in terms of long-term outcomes. Even taking into account the inability to adequately assess all biological mechanisms associated with nutrition, it should be recognized that the available randomized trials, nutritional support during the early phase of critical illness, when considered in isolation from other treatment, may have very limited long-term functional value. This review focuses on recent clinical studies and evaluating the impact of critical nutrition on long-term physical and functional recovery. \u0000Critical survival is becoming an increasingly important subject of attention. Future research on nutritional support should consider specific factors that can provide measurable benefits in terms of both physical and functional recovery. These factors include the development of strategies to ensure adequate nutritional interventions, the provision of nutrition for a period of time in which biologically it is possible to observe differences in the results assessed, and the selection of appropriate methods of assessing the results recorded at clinically significant time points. One of these results is an assessment of muscle mass and function, as well as quality of life. In addition, selection of patients who are most likely to benefit from nutritional interventions and nutritional research after transfer from ICU deserves special attention.","PeriodicalId":92235,"journal":{"name":"Journal of clinical nutrition and metabolism","volume":"16 1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83599071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nutritional support for patients in the intensive care unit is an mandatory component of intensive care. Patients of a neurological and neurosurgical profile who are in the intensive care unit are a special group of patients, the treatment of which differs both in the methods of intensive therapy used and in the nutritional support. In recommendations, both on intensive care and nutritional support, there are no clear recommendations for its implementation in this category of patients.
{"title":"Nutritional support for patients in the neurosurgical and neurological ICU: do we need special guidelines?","authors":"K. I. Krylov, S. Sviridov, I. Savin","doi":"10.17816/clinutr105438","DOIUrl":"https://doi.org/10.17816/clinutr105438","url":null,"abstract":"Nutritional support for patients in the intensive care unit is an mandatory component of intensive care. Patients of a neurological and neurosurgical profile who are in the intensive care unit are a special group of patients, the treatment of which differs both in the methods of intensive therapy used and in the nutritional support. In recommendations, both on intensive care and nutritional support, there are no clear recommendations for its implementation in this category of patients.","PeriodicalId":92235,"journal":{"name":"Journal of clinical nutrition and metabolism","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88894492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The development of acute pancreatitis is often accompanied by the development of a systemic inflammatory reaction. Some time ago, the study of the relationship of trace elements, primarily metals, and their relationship with the degree of systemic inflammation was developed.
{"title":"The role of trace elements in acute pancreatitis.","authors":"Vladimir Kotchergin, V. Subbotin, S. Sviridov","doi":"10.17816/clinutr99881","DOIUrl":"https://doi.org/10.17816/clinutr99881","url":null,"abstract":"The development of acute pancreatitis is often accompanied by the development of a systemic inflammatory reaction. Some time ago, the study of the relationship of trace elements, primarily metals, and their relationship with the degree of systemic inflammation was developed.","PeriodicalId":92235,"journal":{"name":"Journal of clinical nutrition and metabolism","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74066986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The use of a specialized product for enteral nutrition of children Nutrigen low-fat showed its safety and good tolerance in pediatric patients treated in the intensive care unit. The optimal composition of the enteral mixture allows it to be used in children with intestinal dysfunction and metabolic disorders as a component of nutritional support and as the only source of nutrition
{"title":"The results of the clinical use of a specialized dietary nutritional product Nutrigen low-fat","authors":"N. Shen","doi":"10.17816/clinutr105275","DOIUrl":"https://doi.org/10.17816/clinutr105275","url":null,"abstract":"The use of a specialized product for enteral nutrition of children Nutrigen low-fat showed its safety and good tolerance in pediatric patients treated in the intensive care unit. The optimal composition of the enteral mixture allows it to be used in children with intestinal dysfunction and metabolic disorders as a component of nutritional support and as the only source of nutrition","PeriodicalId":92235,"journal":{"name":"Journal of clinical nutrition and metabolism","volume":"61 40","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91468171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The development of cachexia is one of the most important factors that can affect both the quality of life of a cancer patient and the effectiveness of treatment. This review presents current ideas about the main causes of malnutrition, pathogenesis and ways of correction during anticancer therapy.
{"title":"Malnutrition in oncology: etiology, pathogenesis, and principles of correction","authors":"D. Tsvetkov","doi":"10.17816/clinutr101663","DOIUrl":"https://doi.org/10.17816/clinutr101663","url":null,"abstract":"The development of cachexia is one of the most important factors that can affect both the quality of life of a cancer patient and the effectiveness of treatment. This review presents current ideas about the main causes of malnutrition, pathogenesis and ways of correction during anticancer therapy.","PeriodicalId":92235,"journal":{"name":"Journal of clinical nutrition and metabolism","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74687247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Historically, the consumption of wheat and other gluten-containing grains became an essential part of the diet of many people around the world. Despite this fact, in recent years gluten-free diet is becoming more and more widespread based on scientific unfounded perception suggesting that gluten is toxic for humans. According to current guidelines only patients diagnosed with celiac disease or wheat allergy are advised to follow a strict gluten-free diet. Another gluten-related disease is called nonceliac gluten sensitivity, which is related with distress after gluten consumption and improvement in the person's internal state after avoidance of gluten. Although important scientific advances have been made in the understanding of the pathologic mechanisms behind nonceliac gluten sensitivity, this disorder still has no generally accepted definition and treatment. In the present review, the modern conception of the immunopathology of gluten-related diseases and overview of the new potential therapies are presented.
{"title":"Topical issues of pathogenesis and diagnosis of gluten-associated diseases: celiac disease, wheat allergy, non-celiac sensitivity to gluten.","authors":"Kaminarskaya Yuliya Kaminarskaya","doi":"10.17816/clinutr90770","DOIUrl":"https://doi.org/10.17816/clinutr90770","url":null,"abstract":"Historically, the consumption of wheat and other gluten-containing grains became an essential part of the diet of many people around the world. Despite this fact, in recent years gluten-free diet is becoming more and more widespread based on scientific unfounded perception suggesting that gluten is toxic for humans. According to current guidelines only patients diagnosed with celiac disease or wheat allergy are advised to follow a strict gluten-free diet. Another gluten-related disease is called nonceliac gluten sensitivity, which is related with distress after gluten consumption and improvement in the person's internal state after avoidance of gluten. Although important scientific advances have been made in the understanding of the pathologic mechanisms behind nonceliac gluten sensitivity, this disorder still has no generally accepted definition and treatment. In the present review, the modern conception of the immunopathology of gluten-related diseases and overview of the new potential therapies are presented.","PeriodicalId":92235,"journal":{"name":"Journal of clinical nutrition and metabolism","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81126151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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