#05: A/Professor Jason Tye-Din - Coeliac Disease unpacked: Diagnosis, treatment and emerging approaches

We very excited about the episode today!We are joined by A/Professor Jason Tye-Din - a leading expert in coeliac disease and immune-mediated gut disorders. He is Coeliac labratory head at the Walter and Eliza Hall Institute of Medical Research, a Mathison Centenary Fellow at the University of Melbourne, and consultant Gastroenterologist at the Royal Melbourne Hospital. His work focuses on the immunology of coeliac disease, novel diagnostic approaches, and developing non-dietary treatments. He is also one of the smartest (and nicest) clinicians that we have had the privilege  of working with. Joining Jason on the podcast today is Dr Cynthia Kanagasundaram. Cynthia is a UK trained Consultant Gastroenterologist with a vast experience in all things gastroenterology. She prides herself on innovation and has developed a novel GUT HUT service which slashed waiting times and improved patient care. She is embarking on a new stage of her career exploring novel diagnostics, techniques and treatments in Coeliac disease in the Tye-Din lab at the WEHI with A/Prof Jason Tye-Din as her supervisor.Today we delve into the complexities of coeliac disease. We cover the diagnosis, dietary management, refractory celiac disease, models of care and future of coeliac.The International Celiac Disease Symposium (ICDS 2026) will be held in Melbourne Australia 17-20 November 2026. Details at https://www.icds2026.orgChapters00:20 Introduction with Jon and James04:42 Introduction to A/Prof Tye-Din and Dr Kanagasundaram06:42 Understanding Coeliac Disease: Diagnosis and Patient Education09:17 Dietary Considerations: Foods to Avoid and Oats Discussion12:44 Biopsy Guidelines and Diagnostic Approaches16:44 Revisiting Biopsy Techniques and Clinical Observations19:40 Mucosal Healing and Follow-Up Practices22:35 Refractory Coeliac Disease: Definitions and Management26:48 Treatment Strategies for Refractory Coeliac Disease31:14 Understanding Treatment Targets in Coeliac Disease32:16 Maintenance Treatment for Refractory Coeliac Disease33:13 Exploring Alternative Treatment Options34:12 Balancing Treatment Risks and Benefits34:59 Advancements in Histology and Scoring Systems37:05 Future Directions in Coeliac Disease Research39:01 Innovations in Diagnosis and Screening41:01 The Role of Gluten Challenges in Diagnosis43:14 Understanding the Causes of Coeliac Disease45:14 Patient Management and Follow-Up Care48:12 Vaccination and Hyposplenism56:13 Opportunities for Research and CollaborationLinks to papers mentionedIron deficiency.(Link)2020 ESPGHAN Guidelines for diagnosing Coeliac Disease Clinical and Immunologic Features of Ultra-Short Celiac Disease.  (Link)A prospective, double-blind, placebo-controlled trial to establish a safe gluten threshold for patients with celiac disease.(Link)Diagnostic outcomes after gluten challenge in adult patients with unconfirmed coeliac disease already on a gluten-free diet: A 20-year retrospective cohort study.(Link)AGA Clinical Practice Update on Management of Refractory Celiac Disease: Expert Review.  (Link)Open-Capsule Budesonide for Refractory Celiac Disease. (Link)Budesonide Induces Favourable Histologic and Symptomatic Recovery in Patients with Non-responsive and Refractory Coeliac Disease When Given in an Open Capsule Format.  (Link)Stool Gluten Peptide Detection Is Superior to Urinary Analysis, Coeliac Serology, Dietary Adherence Scores and Symptoms in the Detection of Intermittent Gluten Exposure in Coeliac Disease: A Randomised, Placebo-Controlled, Low-Dose Gluten Challenge Study.  https://doi.org/10.3390/nu16020279Impaired IgM Memory B Cell Function Is Common in Coeliac Disease but Conjugate Pneumococcal Vaccination Induces Robust Protective Immunity.  (Link)