Valkeakoski

Researchers are conducting a prospective cohort study to improve diagnosis and treatment evaluation of small-bowel diseases, focusing on celiac disease and refractory small-bowel injury. The study aims to establish reliable histological reference values for normal small-bowel tissue, enhance diagnostic accuracy, and develop detailed molecular profiles using advanced analysis techniques. It addresses challenges in current histological evaluations, which show variability and diagnostic errors. The study collects duodenal biopsies from three groups: healthy controls undergoing clinically indicated gastroscopy, patients referred for initial celiac disease diagnosis, and patients with small-bowel mucosal injury not responding to a gluten-free diet. Biopsies are examined through standard pathology and advanced methods including digital morphometry, AI-based image analysis, RNA sequencing, and intestinal organoid cultures to study disease progression and treatment response. Participants undergo routine clinical assessments, and research biopsies are processed at Tampere University Celiac Disease Research Center with pseudonymization. The study monitors outcomes such as villus-to-crypt ratio changes and transcriptomic profiles via RNA sequencing through December 31, 2025. All data will be securely stored for 15 years, supporting long-term analysis of histological and molecular markers in small-bowel diseases.