101

Multi-Threat Mass Spectrometer Detector

T. Chamberlain, K. Hanold, M. Hanning-Lee, Y. Liu, J. Syage, K. Linker, C. Rhykerd, and R. Bouchier

Proc. of the ICAO Workshop, (DERA, UK, 2000)

102

M.D. Evans, K.A. Hanold, and J.A. Syage

Proc. of 1st Joint Conf. Point Det. for CB Defense, (2000)

A high-speed detection system for chemical and biological threat identification is presented, utilizing innovations in mass spectrometry. The design combines a photoionization source with a hybrid quadrupole ion trap and time-of-flight mass analyzer (QitTof). Photoionization offers broad detection efficiency, minimal ion fragmentation, and low interference from background compounds. The compact, automated system supports real-time early warning, point-of-entry screening, and emergency response applications.

103

J. A. Syage, M. D. Evans, and K. A. Hanold

Amer. Lab 32, 24 (2000). [invited paper]

A compact, nonlaser photoionization mass spectrometry (PI MS) source achieves near-universal, soft ionization with minimal fragmentation by utilizing energy levels that selectively ignore common air and solvent interferents. This capability facilitates the accurate, real-time analysis of complex mixtures, yielding significant performance advantages for high-speed applications such as chemical threat detection and combinatorial drug discovery.

104

J.A. Syage, M.A. Hanning-Lee, and K.A. Hanold

Field Anal. Chem. & Tech., 4, 204-215 (2000). [invited paper]

A 30-pound portable chemical analysis system was developed with performance comparable to benchtop instruments by integrating a novel atmospheric photoionization source with a quadrupole ion-trap, time-of-flight mass spectrometer (QitTof). The design incorporates low-power electronics, rapid ion sampling (1–10 s), and compact data acquisition via a notebook-based system. Capable of detecting trace compounds such as phosphonates and aromatics at sub-ppb and picogram levels, the system supports applications in treaty compliance, defense, and hazardous material response.

105a

J.A. Syage and M.D. Evans

Spectroscopy 16, 14 (2001) and reprinted in PharmaGenomics, 1, 30 (2001)

Photoionization mass spectrometry (PI-MS) offers rapid, high-throughput molecular analysis ideal for pharmaceutical research. By enabling efficient ionization with minimal fragmentation, PI-MS supports fast screening of combinatorial libraries and enhances productivity in drug discovery. The technique bridges the gap between high sensitivity and speed, providing a versatile alternative to traditional ionization methods for lead identification and optimization.

105b

J.A. Syage and M.D. Evans

Spectroscopy 16, 14 (2001) and reprinted in PharmaGenomics, 1, 30 (2001)

Photoionization mass spectrometry (PI-MS) offers rapid, high-throughput molecular analysis ideal for pharmaceutical research. By enabling efficient ionization with minimal fragmentation, PI-MS supports fast screening of combinatorial libraries and enhances productivity in drug discovery. The technique bridges the gap between high sensitivity and speed, providing a versatile alternative to traditional ionization methods for lead identification and optimization.

106

J.A. Syage, B.J. Nies, M.D. Evans, and K.A. Hanold

J. Am. Soc. Mass Spectrom. 12, 648 (2001). [invited paper]

Development of a compact gas chromatograph coupled with a time-of-flight mass spectrometer (GC/TOFMS) is described for field-deployable chemical analysis. The system aims to meet laboratory-level performance while minimizing size, power, and cost. Utilizing a quadrupole ion trap TOF configuration (QitTof), it enables rapid, real-time detection of hazardous or biological agents and supports mobile monitoring applications. Recent improvements demonstrate accurate recording of fast GC transients in a 30-lb portable format.

107

J.A. Syage, K.A. Hanold, and M.A. Hanning-Lee

Proc. INMM – 42nd Annual Meeting, (2001)

A personnel screening system for detecting explosives integrates a novel sample collection portal from Sandia National Laboratories with a high-throughput mass spectrometer developed by Syagen Technology. Designed for airports and other high-security environments, the system emphasizes automation, accuracy, and speed while minimizing false positives. It offers an alternative to ion mobility spectrometry, leveraging mass spectrometry’s superior selectivity and adaptability for trace explosive detection in real-time screening.

108

J.A. Syage, B.J. Nies, M.D. Evans, A.P. Snyder, W.M. Maswadeh, and A. Tripathi

Proc. of 2nd Joint Conf. Point Det. for CB Defense, (2004)

A chemical/biological (CB) monitoring system was developed using a pyrolysis/gas chromatography interface coupled with a photoionization mass spectrometer (PI-QitTof MS). The instrument enables rapid, high-sensitivity detection of biological agents through distinctive spectral patterns while minimizing fragmentation. Tests on surrogate samples demonstrated clear differentiation between most biological entities via GC time-axis separation and selected ion monitoring, with detection limits near 1 ACPLA and strong reproducibility across runs.

109

K.A. Hanold, S.M. Fischer, P.H. Cormia, C.E. Miller, and J.A. Syage

Anal Chem. 76, 2842-2851 (2004)

Performance characteristics of atmospheric pressure photoionization (APPI) for liquid chromatography/mass spectrometry are evaluated and compared with APCI and ESI. Direct APPI achieves sensitivity comparable to APCI but with broader compound compatibility and reduced ion suppression, especially at low flow rates. The technique offers improved ionization for nonpolar and thermally stable compounds, making it a versatile alternative for LC/MS applications and expanding the range of analytes accessible to atmospheric ionization methods.

110

J.A. Syage, K.A. Hanold, T.C. Lynn, J.A. Horner, and R.A. Thakur

J. Chromatog. A. 1050, 137-49 (2004)

Results are presented on combining atmospheric pressure photoionization (APPI) with atmospheric pressure chemical ionization (APCI) and electrospray ionization (ESI) to broaden analyte coverage. Three configurations were examined: individual use, simultaneous dual-ionizer operation, and rapid mode switching during a chromatographic run. Dual-source operation produced minimal signal enhancement but provided flexibility for compound-specific ionization behavior. ESI/APPI combinations revealed notable signal suppression effects, attributed to ion–molecule interactions between sources. The dual-source design enables positive and negative ion operation, extending analytical versatility for complex chemical analyses.

111

J.A. Syage

J. Am. Soc. Mass Spectrom., 15, 1521-1533 (2004)

The mechanism of protonated molecule formation ([M + H]+) during direct photoionization is analyzed through comparative studies across solvents and vapor-phase environments. The process involves photoionization of M followed by hydrogen abstraction from a protic solvent (S). Evidence includes selective MH+ formation in protic but not aprotic solvents, equilibrium oscillations between MH+ and M+, and correlation between their ratios and reaction length. Thermodynamic modeling suggests that while hydrogen abstraction is endothermic, equilibrium strongly favors MH+ due to minimal reverse reaction rates, explaining observed ion distributions.

112

J. Wu, J. Greenlee, and J.A. Syage

J. AWWA 96(12), 44-47 (2004)

A photoionization mass spectrometry (PI/MS) system was developed for early detection of chemical warfare agents and related compounds in drinking water. The method enables rapid, automated, and sensitive screening across diverse contaminants with low false-positive and false-negative rates. The city of Houston implemented this PI/MS technology to enhance water security, using it for both distribution and raw water analysis. Its high-throughput capability allows identification of chemical agents, pesticides, and decomposition products at subacute levels, supporting real-time threat monitoring and public safety applications.

113

J. Calles, R. Gottler, M. Evans, and J.A. Syage

J. AWWA 97(1), 62-73 (2005)

A photoionization and quadrupole ion trap, time-of-flight mass spectrometry (PI/QitTof MS) system was developed for rapid early-warning detection of chemical threats in drinking water. The analyzer provides high-speed, high-throughput molecular identification of chemical warfare agents and related compounds at subacute concentrations, requiring no sample preparation and a 45-second analysis cycle. Municipalities such as Phoenix, Arizona, have adopted this technology to strengthen public water safety and emergency preparedness against potential contamination or terrorist threats.

114

Guarding Drinking Water Against Chemical Weapons Attack

J. A. Syage

Water & Wastes Digest, 45(1), 22 (2005)

115

S.-S. Cai and J.A. Syage

Anal. Chem., 76, 1191-99 (2006)

Quantitative analysis of lipids was compared using APPI, APCI, and ESI ionization methods coupled with LC/MS. APPI provided the lowest detection limits, strongest signal intensities, and broadest linear range, outperforming APCI and ESI by 2–4 times in sensitivity. While APCI and ESI rely heavily on mobile phase modifiers, APPI maintained superior signal quality without them. The technique proved especially effective for complex lipid mixtures such as fish oils, offering enhanced analyte response and improved analytical precision for diverse lipid classes.

116

S.-S. Cai and J.A. Syage

J. Chromatogr. A, 1110, 15-26 (2006)

Parameters for analyzing fatty acid esters and acylglycerol lipids using APPI-MS were optimized and compared with APCI. Sensitivity depended strongly on solvent composition and probe temperature, with normal-phase solvents and higher probe temperatures yielding superior ionization and peak shape. Hexane and isooctane produced the best signal-to-noise ratios, especially for EPA methyl ester. APPI demonstrated linear response across four to five decades, clean spectra, and reproducible signals for custom lipid standards and fish oils, achieving detection limits down to 12 pg for EPA methyl ester.

117

J.A. Syage, S.-S. Cai, J. Li, and M.D. Evans

Anal. Chem, 78, 2967-76 (2006)

Photoionization mass spectrometry (PI-MS) enables rapid, high-sensitivity detection of chemical warfare agents and related compounds in water without sample preparation. The system identifies CW agents such as VX, GA, GB, GD, GF, HD, HN1, and HN3 at subnanogram concentrations within a ~45-second analysis cycle. Using 1-μL injections, detection limits of 1–3 ng/mL and 2 pg were achieved with linearity across 3–4 decades. The technique’s precision and speed make it suitable for real-time early warning and environmental monitoring applications.

118

J.A. Syage and K.A. Hanold

Trace Chemical Sensing of Explosives, Edited by Ronald L. Woodfin, Wiley, New York, 2007, Chap. 11, p. 219

This chapter reviews the use of mass spectrometry (MS) as a technology for explosives trace detection (ETD) in security screening applications. It contrasts MS with ion mobility spectrometry (IMS), highlighting MS’s superior sensitivity, specificity, and lower false-positive and false-negative rates. The discussion covers operational criteria such as speed, accuracy, and automation, emphasizing the need for reliable, high-throughput screening systems for airports and other high-security venues as threats evolve.

119

L.C. Short, S.-S. Cai, and J.A. Syage

J. Am. Soc. Mass Spectrom. 18, 589-599 (2007)

Atmospheric pressure photoionization (APPI) was evaluated for detecting polyaromatic hydrocarbons using different VUV lamps (Xe, Kr, Ar) and mobile phases representative of reversed-phase LC conditions. Results showed that solvent photo-ion chemistry significantly influences signal intensity and ionization pathways. Methanol-based solvents and Ar lamps produced stronger signals and higher signal-to-noise ratios, while acetonitrile-based systems limited ionization due to strong clustering effects. Findings clarify how solvent and photon source selection optimize APPI sensitivity for nonpolar analytes.

120

S.-S. Cai, K.A. Hanold, and J.A. Syage

Anal. Chem. 79, 2491-98 (2007)

Atmospheric pressure photoionization (APPI) and chemical ionization (APCI) were compared for normal-phase LC/MS chiral analysis of pharmaceuticals using a ChiralPak AD-H column. APPI produced stronger, more reproducible signals with lower ion suppression, achieving up to 530× higher sensitivity than APCI depending on analyte and method. Detection limits (S/N = 3) ranged from 7–132 pg for various enantiomers. APPI required fewer dopants and avoided safety issues associated with APCI corona discharge, making it a superior technique for chiral separations under flammable mobile-phase conditions.

121

L.C. Short, K.A. Hanold, S.-S. Cai, and J.A. Syage

Rapid Commun. Mass Spectrom. 21, 1561-66 (2007)

A dual-source ionization system combining electrospray ionization (ESI) and atmospheric pressure photoionization (APPI) was developed for analyzing both polar and nonpolar compounds under low-flow LC/MS conditions. The source transitions between direct photoionization and photo-induced chemical ionization depending on temperature and solvent composition. Using Kr and Ar lamps, optimal performance was achieved for different analyte types, with the Ar lamp enhancing solvent-driven ionization at low temperatures. Tests on 12 analytes demonstrated superior performance compared to standard ESI, particularly for unstable compounds such as flurbi­profen.

122

S.-S. Cai, L.C. Short, J.A. Syage, M. Potvin, and J.M. Curtis

J. Chromatogr. A 1173, 88-97 (2007)

The study evaluates LC–APPI–MS performance for triacylglycerol lipid analysis using six binary non-aqueous mobile phases. Sensitivity was highly dependent on solvent composition, with MeOH/iPrOH yielding the best signal without dopants due to self-doping effects. Dopants enhanced sensitivity variably across other solvent systems, and photo-induced chemical ionization effects were shown to influence ion response. Overall, APPI provided strong sensitivity and consistent detection across all mobile phases, confirming LC–APPI–MS as a robust approach for neutral lipid analysis under non-aqueous conditions.

123

L.C. Short and J.A. Syage

Rapid Commun. Mass Spectrom. 22, 541-48 (2008)

A multimode electrospray ionization/atmospheric pressure photoionization (ESI/APPI) system—termed ESPI—was developed for liquid chromatography/mass spectrometry (LC/MS) to analyze both polar and nonpolar components in mixed-polarity samples. The method enables simultaneous detection of free, bound, and complexed species, such as pharmaceuticals with cyclodextrin. ESPI improves bound-complex detection and performance at low solvent flow rates compared to standard ESI or ESCI. Results show that low-substitution cyclodextrins preferentially bind low-polarity compounds, establishing ESPI as a versatile approach for studying biologically relevant binding equilibria.

124

J.A. Syage, L.C. Short, and S.-S. Cai

LCGC North America, 26, 2-7 (2008)

This article reviews the emergence of atmospheric pressure photoionization (APPI) as a complementary and potentially superior ionization method for LC–MS compared with electrospray ionization (ESI) and atmospheric pressure chemical ionization (APCI). APPI expands the range of detectable compounds, offering advantages in ionization efficiency, sensitivity, and applicability for both polar and nonpolar analytes. The authors argue that APPI, especially in combination with ESI, provides the broadest analytical versatility and may eventually serve as a replacement for APCI in routine small-molecule analysis.

125

J.A. Syage and K.A. Hanold

Current Trends in Mass Spectrometry, 20-25 (July 2009)

This article examines the application of mass spectrometry (MS) in homeland security for detecting concealed explosives. It compares MS-based trace detection with ion mobility spectrometry (IMS), highlighting improvements in analytical precision, detection capability, and reliability. The discussion focuses on Syagen Technology’s development of a mass spectrometer–based personnel screening portal for airports and transportation hubs, capable of rapid, noninvasive explosive detection. The authors emphasize MS’s potential to enhance security screening efficiency and expand forensic and field detection applications.

126

S.-S. Cai, J.A. Syage, K.A. Hanold, and M.P. Balogh

Anal. Chem. 81, 2123-2128 (2009)

Ultra-performance LC–APPI–MS/MS was applied to the analysis of the U.S. EPA’s 16 priority polycyclic aromatic hydrocarbons (PAHs), achieving separation of all analytes within 3.5 minutes using a Waters Acquity-TQ system with a Syagen PhotoMate APPI source. The method produced low detection limits with chloro­benzene dopant and demonstrated linear dynamic ranges spanning 3–4 orders of magnitude. Compared to standard EPA GC/MS procedures, the technique improved sample throughput by at least tenfold while maintaining high chromatographic resolution and sensitivity for both low- and high-molecular-weight PAHs.

127

S.-S. Cai, J. Stevens, and J.A. Syage

J. Chromatogr A, 1227, 138-144 (2012)

An ultra-high performance LC–APPI–MS method was developed for quantifying the 16 U.S. EPA priority PAHs in oyster tissue following the Gulf of Mexico oil spill. Using an Agilent 1290 UHPLC coupled with a 6410A triple quadrupole MS and a Syagen PhotoMate APPI source, the method achieved rapid 4.5-minute runs with excellent chromatographic resolution and low detection limits. Calibration covered 3.6–5.1 orders of magnitude, and method detection limits reached sub-ng/g levels—up to five times lower than FDA thresholds for concern—demonstrating the technique’s high sensitivity, precision, and robustness for environmental biomonitoring.

128

K. Jorabchi, K.A. Hanold, and J.A. Syage

Anal Bioanal Chem. 405(22): 7011-8 (2013)

This study enhances direct analysis in real time (DART) mass spectrometry by integrating atmospheric pressure photoionization (APPI) downstream of the desorption region. The combined DART–APPI method yields radical molecular ions from nonpolar compounds not observed with DART alone and achieves 3–5× higher sensitivity for positive ions. Comparable improvements are seen in negative mode when using helium or nitrogen as desorption gases. The hybrid interface broadens the detectable molecular range and improves in-field analytical performance through efficient desorption–ionization coupling.

129

S. Klee, V. Derpmann, W. Wißdorf, S. Klopotowski, H. Kersten, K.J. Brockmann, T. Benter, S. Albrecht, A.P. Bruins, F. Dousty, T. Kauppila, R. Kostiainen, R. O’Brien, D.B. Robb, and J.A. Syage

J. Am. Soc. Mass Spectrom., 25, 1310-21 (2014)

This work reexamines the central role of cluster ions in atmospheric pressure ionization (API) mechanisms, emphasizing their ubiquity and significance in charge transport and ion chemistry. The paper explores how cluster formation, reagent ion chemistry, and the thermal or energetic history of ions affect ionization efficiency and analyte fragmentation. It highlights the dynamic equilibrium between thermodynamic and kinetic control of ion populations entering the analyzer region, providing a framework for understanding variability in API performance across techniques such as APCI and APPI.

130

J.A. Syage and K. Jorabchi

Chap. 5 from the book “Ambient Ionization Mass Spectrometry,” edited by R. B. Cody and M. A. Domin, Royal Society of Chemistry Publishing, Cambridge (2014)

This chapter discusses the evolution of ambient ionization techniques, focusing on atmospheric-pressure photoionization (APPI) coupled with thermal desorption. The method enables direct sampling of analytes without the need for vacuum interfaces or carrier gases, offering a robust and straightforward approach for field and security applications. APPI is highlighted for its ability to ionize a wide range of compounds, including explosives and narcotics, under ambient conditions. The authors trace the method’s development from early photoionization techniques to its modern integration with mass spectrometry, emphasizing its sensitivity, simplicity, and operational flexibility.

131

T.J. Kauppila, J.A. Syage, and T. Benter

Mass Spectrom. Rev. 36, 423-449 (2017)

This review surveys the progress in atmospheric pressure photoionization (APPI) and its applications from 2009 to 2014. It focuses on practical aspects of APPI operation, including ion source design, dopant use, and its integration with gas chromatography–mass spectrometry (GC–MS), liquid chromatography–mass spectrometry (LC–MS), and ambient MS. The authors discuss instrument configurations, mechanisms of photoionization, and developments in vacuum ultraviolet (VUV) lamp technology that enhance sensitivity and ionization range. APPI’s capability to ionize both polar and nonpolar compounds is emphasized, making it a versatile complement to APCI and ESI in analytical mass spectrometry.

132

J.A. Syage, J.A. Murray, P.H.R. Green, and C. Khosla

Dig. Dis. & Sci., 62, 2428-2432 (2017)

This clinical study examined the efficacy of latiglutenase, an orally administered mixture of gluten-specific proteases, in seropositive celiac disease patients adhering to a gluten-free diet (GFD). While prior trials did not demonstrate histologic improvement, this post hoc analysis found significant reductions in symptom severity and frequency among seropositive participants. Over 12 weeks of treatment, those receiving the highest latiglutenase dose showed 58% and 44% reductions in abdominal pain and bloating, respectively, compared to placebo. The findings suggest latiglutenase may provide symptomatic relief for celiac patients experiencing persistent symptoms despite strict adherence to a GFD.

133

J.A. Syage

Reminiscences of Ahmed H. Zewail: Photons, Electrons and What Else? Edited by A. Abderrazzak, World Scientific, Singapore, Chap 5., pp. 31-37 (2018). [invited chapter]

Jack A. Syage reflects on his postdoctoral experience with Ahmed Zewail, recalling a pivotal conversation that inspired him to think deeply about his purpose as a scientist. The piece is a brief, personal tribute to mentorship and intellectual growth.

134

J.A. Syage, C.P. Kelly, M.A. Dickason, Á. Cebolla Ramírez, F. León, R. Domínguez, and J.A. Sealey-Voyksner

Am. J. Clin. Nutr. 107, 201-207 (2018)

This study analyzed data from clinical trials to estimate how much gluten celiac disease patients unintentionally consume while following a gluten-free diet. Results showed that many patients still ingest enough gluten, often over 100 mg per day, to trigger symptoms and intestinal damage.

135

J.A. Syage, P.H.R. Green, C. Khosla, D.C. Adelman, J.A. Sealey-Voyksner, and J.A. Murray

GastroHep, 1, 293-301 (2019)

This clinical analysis found that seropositive celiac disease patients on a gluten-free diet experienced significant, dose-dependent reductions in symptoms such as abdominal pain, bloating, and fatigue when treated with latiglutenase. Quality of life measures also improved, suggesting the enzyme may benefit symptomatic patients despite adherence to a gluten-free diet.

136

J.A. Syage

Orange County Business Journal, p. 41 (May 11, 2020)

Syage analyzes COVID-19 death rates and trends to propose a data-driven approach for reopening Orange County. He argues that, based on relatively low case and death counts compared to hotspots like New York and New Jersey, OC could begin easing restrictions cautiously around mid-May 2020, provided strict phased monitoring is maintained to prevent resurgence.

137

J.A. Syage

MedRxiv DOI: 10.1101/2020.05.16.20104430. (2020)

This paper presents a simple real-time model for forecasting COVID-19 deaths, active cases, and new infections using Gaussian-based statistical methods. The model produces stable, comparable results to the UW IHME model but with less variability, offering a practical tool for guiding social easing decisions during pandemics.

138

J.A. Syage

MedRxiv DOI: 10.1101/2020.06.21.20136937 (2020)

This paper refines Syage’s earlier asymmetric Gaussian model by integrating SEIR-like dynamics to better capture changing transmission rates from social distancing and easing. The hybrid model produces forecasts comparable to the UW IHME model while maintaining simpler equations and adaptability to real-time behavioral shifts during the COVID-19 pandemic.

139

J.A. Syage and P.T. Lavin

Int. J. Celiac Dis.8, 85-89 (2020)

The study models the relationship between accidental gluten ingestion and symptom severity in celiac patients on a gluten-free diet. Using clinical trial data, the authors estimate that even small amounts of gluten correlate with significant symptoms, suggesting that episodic gluten exposure is a key driver of ongoing distress in celiac disease patients.

140

J.A. Syage

Medium, Nov. 24 (2020)

An examination warning that COVID-19 deaths in the U.S. are accelerating again, with states lacking restrictions facing far worse outbreaks. Citing IHME forecasts, it argues that universal mask mandates could prevent tens of thousands of deaths and criticizes political divisions for worsening outcomes, comparing daily death tolls to multiple plane crashes or major historical tragedies.

141

J.A. Syage

Orange County Business Journal, p. 35 (February 1, 2021)

Syage examines how COVID-19’s impact in California has disproportionately affected minority communities—especially African Americans and Hispanics—due to occupational exposure and unequal healthcare access. He calls for addressing these disparities while criticizing both pandemic denialism and the inadequate clarity of public health communication.

142

T.J. Kauppila and J.A. Syage

Photoionization and Photo‐Induced Processes in Mass Spectrometry: Fundamentals and Applications, Edited by R. Zimmerman and L. Hanley, Wiley-VCH, Weinheim, Chap 8, pp. 267-303 (2021)

This chapter reviews atmospheric and low-pressure photoionization (APPI and LPPI) techniques in liquid chromatography–mass spectrometry. It highlights APPI’s strengths—broad compound ionization range, low ion suppression, wide dynamic range, and minimal background noise—making it a powerful alternative to electrospray and chemical ionization for analyzing low-polarity compounds.

143

J.A. Syage

Orange County Business Journal, p. 53 (February 21, 2022)

Comparison of the COVID-19 pandemic progression to the 1918 Spanish flu, noting that the Omicron wave may signal a transition to endemic circulation as cases surged but mortality and hospitalization rates declined.

144

J.A. Murray, J.A. Syage, et al.

Gastroenterol, 163, 1510-1521 (2022)

This phase 2 trial found that latiglutenase (IMGX003) protected intestinal mucosa and reduced symptom severity in celiac disease patients undergoing a controlled gluten challenge, showing significant improvements in histology and symptom scores compared to placebo.

145

J. A. Syage, A. Ramos, V. Loskutov, A. Norum, A. Bledsoe, R. S. Choung, M. Dickason, J. Sealey-Voyksner, and J. Murray

Nutrients, 15, 5083 (2023)

This study examined how celiac disease patients’ antibody levels respond to gluten exposure, showing that substantial gluten intake is needed to trigger measurable serologic changes and that assay thresholds may need adjustment for better diagnostic accuracy.

146a

J. A. Syage, M. Mäki, D. A. Leffler, J. A. Silvester, J. A. Sealey-Voyksner, T.-T. Wu, and J. A. Murray

Clin Gastro & Hep, 22, 1238-1244 (2024)

The study introduces the VCIEL composite histologic scale, which combines villus height-to-crypt depth and intraepithelial lymphocyte measurements to provide improved precision and statistical significance in assessing mucosal injury in celiac disease compared with either measure alone.

146b

D. Schuppan, K. Rostami

Clin Gastro & Hep, 22, 1238-1244 (2024)

This editorial discusses advancements in quantifying mucosal damage in celiac disease, highlighting Syage et al.’s VCIEL scoring system, which combines villus height-to-crypt depth and intraepithelial lymphocyte counts to improve accuracy and reproducibility in evaluating histological response and treatment efficacy