Evidence map›Paper›PMID 37952751›Full record

ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2024

A Composite Morphometric Duodenal Biopsy Mucosal Scale for Celiac Disease Encompassing Both Morphology and Inflammation.

Jack A Syage, Markku Mäki, Daniel A Leffler, Jocelyn A Silvester, Jennifer A Sealey-Voyksner, Tsung-Teh Wu, Joseph A Murray

Open access · bronzeAbstract readEvaluation Study
In one paragraph

Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.2field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 8 citations in OpenAlex.

  1. Gut microbes · 2026
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 4 countries.

Jack A SyageImmunogenX, Inc, Newport Beach, California. Electronic address: jsyage@immuongenx.com.
Markku MäkiFaculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Daniel A LefflerCeliac Disease Research Program, Harvard Medical School, Boston, Massachusetts.
Jocelyn A SilvesterCeliac Disease Research Program, Harvard Medical School, Boston, Massachusetts.
Jennifer A Sealey-VoyksnerImmunogenX, Inc, Newport Beach, California.
Tsung-Teh WuMayo Clinic, Rochester, Minnesota.
Joseph A MurrayMayo Clinic, Rochester, Minnesota.
National Institutes of Health · USHarvard University · USImmunogenics (United States) · USTampere University · FI

Funding

Mechanisms and Markers of Small Intestinal Epithelial Injury and Villous AtrophyK23DK119584 · NIDDK · BOSTON CHILDREN'S HOSPITAL · PI SILVESTER, JOCELYN ANNE · 2019 to 2023
$971k
NIDDK NIH HHS K23 DK119584
6 · The paper itself

Abstract

BACKGROUND &

aimsVillus height to crypt depth ratio (Vh:Cd) and intraepithelial lymphocytes (IEL) are key measures of histology of the small intestine in celiac disease. Although the field of celiac disease has advanced, there remains no broadly accepted measure of mucosal injury. We assessed whether a composite Vh:Cd and IEL scale (VCIEL) can improve accuracy and statistical precision for assessing histology, compared with individual measures.

methodsThe formulation of the VCIEL composite histologic scale was based on combining the Vh:Cd and IEL measurements for individual patients with equal weighting, by converting each scale to a fraction of their standard deviation and summing the results. The VCIEL formula was applied to several clinical trials and the results for Vh:Cd and IEL were compared with those for VCIEL with regards to clinical significance (effect size) and statistical significance.

resultsFor the ALV003-1021 trial, we observed an effect size and P value (analysis of covariance) of 1.37 and 0.038 for ΔVh:Cd, 1.17 and 0.005 for ΔIEL, and 1.86 and 0.004 for ΔVCIEL. For the similar gluten-challenge IMGX003-NCCIH-1721 trial, the corresponding results were 0.76 and 0.057 for ΔVh:Cd, 0.98 and 0.018 for ΔIEL, and 1.14 and 0.007 for ΔVCIEL. Similar improvements with the use of VCIEL over individual Vh:Cd and IEL measures were observed for other studies, including a nontherapeutic gluten challenge study.

conclusionsThe composite VCIEL scale combining Vh:Cd and IEL values seems to improve accuracy and statistical precision compared with either component alone.

Indexed as

Celiac DiseaseDuodenumIntestinal MucosaBiopsyHistocytochemistryHumansCeliac DiseaseInflammationMorphologyMucosal ScaleSmall Intestinal Histology

Identifiers

PMID37952751
PMCPMC12213069
OpenAlexW4388599894

What OpenQuestion holds

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LicenceTDM
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.