The gut‐bone axis in coeliac disease : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Nutritional Science at Massey University, Manawatū, New Zealand

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dc.confidentialEmbargo : Noen_US
dc.contributor.advisorKruger, Marlena
dc.contributor.authorSchraders, Katie Elizabeth Coad Pedley
dc.date.accessioned2023-03-06T20:41:34Z
dc.date.accessioned2023-04-05T03:56:27Z
dc.date.available2023-03-06T20:41:34Z
dc.date.available2023-04-05T03:56:27Z
dc.date.issued2022
dc.description.abstractCoeliac Disease (CD) is a lifelong autoimmune disease, highly prevalent in New Zealand, triggered by ingestion of gluten in genetically susceptible individuals. It leads to villous atrophy and nutrient malabsorption which often compromises bone mineral density (BMD). Although a gluten‐free diet (GFD) usually improves symptoms, BMD is often not fully resolved. Persistent low BMD may be due to ongoing gut inflammation and malabsorption, or the uncoupling of bone formation and resorption. Previous research indicates that individuals with CD and low BMD may have altered bone signalling pathways, particularly in the expression of receptor activator of NF‐κβ ligand (RANKL) and osteoprotegerin. RANKL is implicated in both the initiation of the immune response and persistent low BMD because it has a role in bone resorption, via the differentiation of osteoclasts, and a possible role in translocating gluten across the gut, via the expression of microfold cells. The objective of this PhD was to examine underlying mechanisms underpinning low BMD in individuals with CD using a small intestinal organoid model which allows for investigation of otherwise inaccessible gut cells and signalling pathways implicated in the gut‐bone axis. A further study, Close to the Bone, investigated BMD in premenopausal women with CD compared to healthy controls. A third online A Gut Feeling study investigated dietary advice that individuals consuming a GFD in New Zealand receive, focusing on bone health. Although the organoid research was interrupted due to the SARS‐CoV‐2 pandemic, the model was established using murine tissue and future research opportunities were identified. The results of the Close to the Bone study demonstrated no differences in BMD between the coeliac group and healthy controls but identified further research into bone density in people with CD in New Zealand was warranted. This study raised concerns about iodine intake and status in people with CD. The A Gut Feeling study found inconsistencies in advice given to individuals diagnosed with CD. The research identified that the organoid model offers potential for future study of the gut‐bone axis and that individuals with CD are at risk of nutritional deficiencies but often are not advised well or referred for a bonescan.en_US
dc.identifier.urihttp://hdl.handle.net/10179/18147
dc.publisherMassey Universityen_US
dc.rightsThe Authoren_US
dc.subjectCeliac diseaseen
dc.subjectBonesen
dc.subjectGastrointestinal systemen
dc.subjectDiseasesen
dc.subject.anzsrc321004 Nutritional scienceen
dc.titleThe gut‐bone axis in coeliac disease : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Nutritional Science at Massey University, Manawatū, New Zealanden_US
dc.typeThesisen_US
massey.contributor.authorSchraders, Katie Elizabeth Coad Pedleyen_US
thesis.degree.disciplineNurtritional Scienceen_US
thesis.degree.grantorMassey Universityen_US
thesis.degree.levelDoctoralen_US
thesis.degree.nameDoctoral Philosophyen_US
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