Symptomatic suspected gluten exposure is common among patients with coeliac disease on a gluten-free diet.

Science.gov (United States)

Silvester, J A; Graff, L A; Rigaux, L; Walker, J R; Duerksen, D R

2016-09-01

A gluten-free diet is the only recommended treatment for coeliac disease. To determine the prevalence and characteristics of reactions to gluten among persons with coeliac disease on a gluten-free diet. Adults with biopsy proven, newly diagnosed coeliac disease were prospectively enrolled. A survey related to diet adherence and reactions to gluten was completed at study entry and 6 months. The Coeliac Symptom Index, Coeliac Diet Assessment Tool (CDAT) and Gluten-Free Eating Assessment Tool (GF-EAT) were used to measure coeliac disease symptoms and gluten-free diet adherence. Of the 105 participants, 91% reported gluten exposure gluten was reported by 66%. Gluten consumption was unsuspected until a reaction occurred (63%) or resulted from problems ordering in a restaurant (29%). The amount of gluten consumed ranged from cross-contact (30%) to a major ingredient (10%). Median time to symptom onset was 1 h (range 10 min to 48 h), and median symptom duration was 24 h (range 1 h to 8 days). Common symptoms included abdominal pain (80%), diarrhoea (52%), fatigue (33%), headache (30%) and irritability (29%). Reactions to suspected gluten exposure are common among patients with coeliac disease on a gluten-free diet. Eating at restaurants and other peoples' homes remain a risk for unintentional gluten exposure. When following individuals with coeliac disease, clinicians should include questions regarding reactions to gluten as part of their assessment of gluten-free diet adherence. © 2016 John Wiley & Sons Ltd.

Prevalence of Self-Reported Gluten-Related Disorders and Adherence to a Gluten-Free Diet in Salvadoran Adult Population.

Science.gov (United States)

Ontiveros, Noé; Rodríguez-Bellegarrigue, Cecilia Ivonne; Galicia-Rodríguez, Gerardo; Vergara-Jiménez, Marcela de Jesús; Zepeda-Gómez, Elia María; Arámburo-Galvez, Jesús Gilberto; Gracia-Valenzuela, Martina Hilda; Cabrera-Chávez, Francisco

2018-04-18

Gluten-related disorders are not considered of relevance at public health level in Central America. The prevalence of gluten-related disorders, and adherence to a gluten-free diet, remain unknown in the Central American region. We conducted a cross-sectional survey of the Central American population from San Salvador, El Salvador, to estimate the prevalence rates of self-reported gluten-related disorders and adherence to a gluten-free diet. 1326 individuals were surveyed. Self-reported prevalence rates were (95% Confidence Interval): gluten sensitivity 3.1% (2.3–4.2); physician-diagnosed celiac disease 0.15% (0.04–0.5); wheat allergy 0.75% (0.4–1.3); non-celiac gluten sensitivity 0.98% (0.5–1.6). The prevalence rate of adherence to a gluten-free diet was 7.0% (5.7–8.5). Seven self-reported physician diagnosed gluten-sensitive cases informed the co-existence of non-celiac gluten sensitivity with celiac disease and/or wheat allergy. Among the non-self-reported gluten sensitivity individuals following a gluten-free diet, 50% reported that they were seeing a health professional for gluten-free dietary advice. Gluten sensitivity is commonly reported in Salvadoran population, but some health professionals acknowledge the coexistence of wheat allergy, celiac disease, and non-celiac gluten sensitivity. Among studies at population level, the prevalence of adherence to a gluten-free diet in Salvadoran population is the highest reported until now. However, just a few of the gluten-free diet followers were doing it for health-related benefits; the others reported weight control and the perception that the diet is healthier as the main motivation for adopting such a diet.

In search of tetraploid wheat accessions reduced in celiac disease-related gluten epitopes

NARCIS (Netherlands)

Broeck, van den H.C.; Hongbing, C.; Lacaze, X.; Dusautoir, J.C.; Gilissen, L.J.W.J.; Smulders, J.M.; Meer, van der I.M.

2010-01-01

Tetraploid wheat (durum wheat) is mainly used for the preparation of pasta. As a result of breeding, thousands of tetraploid wheat varieties exist, but also tetraploid landraces are still maintained and used for local food preparations. Gluten proteins present in wheat can induce celiac disease, a

Celiac disease and non-celiac gluten sensitivity

Science.gov (United States)

Lebwohl, Benjamin; Ludvigsson, Jonas F

2015-01-01

Celiac disease is a multisystem immune based disorder that is triggered by the ingestion of gluten in genetically susceptible individuals. The prevalence of celiac disease has risen in recent decades and is currently about 1% in most Western populations. The reason for this rise is unknown, although environmental factors related to the hygiene hypothesis are suspected. The pathophysiology of celiac disease involves both the innate and adaptive immune response to dietary gluten. Clinical features are diverse and include gastrointestinal symptoms, metabolic bone disease, infertility, and many other manifestations. Although a gluten-free diet is effective in most patients, this diet can be burdensome and can limit quality of life; consequently, non-dietary therapies are at various stages of development. This review also covers non-celiac gluten sensitivity. The pathophysiology of this clinical phenotype is poorly understood, but it is a cause of increasing interest in gluten-free diets in the general population. PMID:26438584

Prevalence of Self-Reported Gluten-Related Disorders and Adherence to a Gluten-Free Diet in Salvadoran Adult Population

Directory of Open Access Journals (Sweden)

Noé Ontiveros

2018-04-01

Full Text Available Gluten-related disorders are not considered of relevance at public health level in Central America. The prevalence of gluten-related disorders, and adherence to a gluten-free diet, remain unknown in the Central American region. We conducted a cross-sectional survey of the Central American population from San Salvador, El Salvador, to estimate the prevalence rates of self-reported gluten-related disorders and adherence to a gluten-free diet. 1326 individuals were surveyed. Self-reported prevalence rates were (95% Confidence Interval: gluten sensitivity 3.1% (2.3–4.2; physician-diagnosed celiac disease 0.15% (0.04–0.5; wheat allergy 0.75% (0.4–1.3; non-celiac gluten sensitivity 0.98% (0.5–1.6. The prevalence rate of adherence to a gluten-free diet was 7.0% (5.7–8.5. Seven self-reported physician diagnosed gluten-sensitive cases informed the co-existence of non-celiac gluten sensitivity with celiac disease and/or wheat allergy. Among the non-self-reported gluten sensitivity individuals following a gluten-free diet, 50% reported that they were seeing a health professional for gluten-free dietary advice. Gluten sensitivity is commonly reported in Salvadoran population, but some health professionals acknowledge the coexistence of wheat allergy, celiac disease, and non-celiac gluten sensitivity. Among studies at population level, the prevalence of adherence to a gluten-free diet in Salvadoran population is the highest reported until now. However, just a few of the gluten-free diet followers were doing it for health-related benefits; the others reported weight control and the perception that the diet is healthier as the main motivation for adopting such a diet.

Treatment of celiac disease: from gluten-free diet to novel therapies.

Science.gov (United States)

Francavilla, R; Cristofori, F; Stella, M; Borrelli, G; Naspi, G; Castellaneta, S

2014-10-01

Gluten-free diet (GFD) is the cornerstone treatment for celiac disease (CD). This diet excludes the protein gluten a protein forum in in grains such as wheat, barley, rye and triticale. Gluten causes small intestines inflammation in patients with CD and eating a GFD helps these patients in controlling signs and symptoms and prevent complications. Following a GFD may be frustrating, however, it is important to know that plenty of foods are naturally gluten-free and nowadays is relatively easy to find substitutes for gluten-containing foods. Certain grains, such as oats, are generally safe but can be contaminated with wheat during growing and processing stages of production. For this reason, it is generally recommended avoiding oats unless they are specifically labelled gluten-free. Other products that may contain gluten include food additives, such as malt flavouring, modified food starch and some supplement and/or vitamins that use gluten as a binding agent. Cross-contamination occurs when gluten-free foods come into contact with foods that contain gluten. It can happen during the manufacturing process or if the same equipment is used to make a variety of products. Cross-contamination can also occur at home if foods are prepared on common surfaces or with utensils that have not been cleaned after being used to prepare gluten-containing foods (using a toaster for gluten-free and regular bread). Although safe and effective, the GFD is not ideal: it is expensive, of limited nutritional value, and not readily available in many countries. Consequently, a need exists for novel, non-dietary therapies for celiac disease. Advances in understanding the immunopathogenesis of CD have suggested several types of therapeutic strategies alternative to the GFD. Some of these strategies attempt to decrease the immunogenicity of gluten-containing grains by manipulating the grain itself or by using oral enzymes to break down immunogenic peptides that normally remain intact during

Is gluten a cause of gastrointestinal symptoms in people without celiac disease?

Science.gov (United States)

Biesiekierski, Jessica R; Muir, Jane G; Gibson, Peter R

2013-12-01

The avoidance of wheat- and gluten-containing products is a worldwide phenomenon. While celiac disease is a well-established entity, the evidence base for gluten as a trigger of symptoms in patients without celiac disease (so-called 'non-celiac gluten sensitivity' or NCGS) is limited. The problems lie in the complexity of wheat and the ability of its carbohydrate as well as protein components to trigger gastrointestinal symptoms, the potentially false assumption that response to a gluten-free diet equates to an effect of gluten withdrawal, and diagnostic criteria for coeliac disease. Recent randomized controlled re-challenge trials have suggested that gluten may worsen gastrointestinal symptoms, but failed to confirm patients with self-perceived NCGS have specific gluten sensitivity. Furthermore, mechanisms by which gluten triggers symptoms have yet to be identified. This review discusses the most recent scientific evidence and our current understanding of NCGS.

HLA-DQ-Gluten Tetramer Blood Test Accurately Identifies Patients With and Without Celiac Disease in Absence of Gluten Consumption.

Science.gov (United States)

Sarna, Vikas K; Lundin, Knut E A; Mørkrid, Lars; Qiao, Shuo-Wang; Sollid, Ludvig M; Christophersen, Asbjørn

2018-03-01

Celiac disease is characterized by HLA-DQ2/8-restricted responses of CD4+ T cells to cereal gluten proteins. A diagnosis of celiac disease based on serologic and histologic evidence requires patients to be on gluten-containing diets. The growing number of individuals adhering to a gluten-free diet (GFD) without exclusion of celiac disease complicates its detection. HLA-DQ-gluten tetramers can be used to detect gluten-specific T cells in blood of patients with celiac disease, even if they are on a GFD. We investigated whether an HLA-DQ-gluten tetramer-based assay accurately identifies patients with celiac disease. We produced HLA-DQ-gluten tetramers and added them to peripheral blood mononuclear cells isolated from 143 HLA-DQ2.5 + subjects (62 subjects with celiac disease on a GFD, 19 subjects without celiac disease on a GFD [due to self-reported gluten sensitivity], 10 subjects with celiac disease on a gluten-containing diet, and 52 presumed healthy individuals [controls]). T cells that bound HLA-DQ-gluten tetramers were quantified by flow cytometry. Laboratory tests and flow cytometry gating analyses were performed by researchers blinded to sample type, except for samples from subjects with celiac disease on a gluten-containing diet. Test precision analyses were performed using samples from 10 subjects. For the HLA-DQ-gluten tetramer-based assay, we combined flow-cytometry variables in a multiple regression model that identified individuals with celiac disease on a GFD with an area under the receiver operating characteristic curve value of 0.96 (95% confidence interval [CI] 0.89-1.00) vs subjects without celiac disease on a GFD. The assay detected individuals with celiac disease on a gluten-containing diet vs controls with an area under the receiver operating characteristic curve value of 0.95 (95% CI 0.90-1.00). Optimized cutoff values identified subjects with celiac disease on a GFD with 97% sensitivity (95% CI 0.92-1.00) and 95% specificity (95% CI 0

Self-Reported Prevalence of Gluten-Related Disorders and Adherence to Gluten-Free Diet in Colombian Adult Population

Directory of Open Access Journals (Sweden)

Francisco Cabrera-Chávez

2016-01-01

Full Text Available Background. Celiac disease seems to be rare in Colombians, but there are currently no data about the prevalence rates of symptomatic adverse reactions to gluten or adherence to gluten-free diet (GFD in this population. Aim. to evaluate the self-reported prevalence rates of adverse reactions to gluten, adherence to GFD, and gluten-related disorders at population level in Colombia. Methods. A self-administered questionnaire-based cross-sectional study was conducted in a population from Northwest Colombia. Results. The estimated prevalence rates were (95% CI 7.9% (6.5–9.6 and 5.3% (4.1–6.7 for adverse and recurrent adverse reactions to wheat/gluten, respectively, adherence to GFD 5.9% (4.7–7.4, wheat allergy 0.74% (0.3–1.4, and nonceliac gluten sensitivity 4.5% (3.5–5.8. There were no self-reported cases of celiac disease. Prevalence of self-reported physician-diagnosis of gluten-related disorders was 0.41% (0.17–0.96. Most respondents reported adherence to GFD without a physician-diagnosis of gluten-related disorders (97.2%. The proportion of gluten avoiders was 17.2% (15.2–19.5. Most of them did not report recurrent adverse reactions to wheat/gluten (87.0%. Conclusions. Nonceliac gluten sensitivity is rarely formally diagnosed in Colombia, but this population has the highest prevalence rate of adherence to GFD reported to date. Consequently, most respondents were avoiding wheat- and/or gluten-based products for reasons other than health-related symptoms.

Adverse effects of gluten ingestion and advantages of gluten withdrawal in nonceliac autoimmune disease.

Science.gov (United States)

Lerner, Aaron; Shoenfeld, Yehuda; Matthias, Torsten

2017-12-01

In light of the coincident surge in overall gluten intake and the incidence of autoimmune diseases, the possible biological adverse effects of gluten were explored. PubMed, MEDLINE, and the Cochrane Library databases were screened for reports published between 1964 and 2016 regarding the adverse effects of gluten as well as the effects of a gluten-free diet on autoimmune diseases. In vitro and in vivo studies describing gluten intake in animal models or cell lines and gluten-free diets in human autoimmune diseases were reviewed. Multiple detrimental aspects of gluten affect human health, including gluten-dependent digestive and extradigestive manifestations mediated by potentially immunological or toxic reactions that induce gastrointestinal inadequacy. Gluten affects the microbiome and increases intestinal permeability. It boosts oxidative stress and affects epigenetic behavior. It is also immunogenic, cytotoxic, and proinflammatory. Gluten intake increases apoptosis and decreases cell viability and differentiation. In certain nonceliac autoimmune diseases, gluten-free diets may help curtail the adverse effects of gluten. Additional in vivo studies are needed to unravel the puzzle of gluten effects in humans and to explore the potential beneficial effects of gluten-free diets in autoimmune diseases. © The Author(s) 2017. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Cereal-Based Gluten-Free Food: How to Reconcile Nutritional and Technological Properties of Wheat Proteins with Safety for Celiac Disease Patients

Directory of Open Access Journals (Sweden)

Carmela Lamacchia

2014-01-01

Full Text Available The gluten-free diet is, to date, the only efficacious treatment for patients with Celiac Disease. In recent years, the impressive rise of Celiac Disease incidence, dramatically prompted changes in the dietary habit of an increasingly large population, with a rise in demand of gluten-free products. The formulation of gluten-free bakery products presents a formidable challenge to cereal technologists. As wheat gluten contributes to the formation of a strong protein network, that confers visco-elasticity to the dough and allows the wheat flour to be processed into a wide range of products, the preparation of cereal-based gluten-free products is a process somehow difficult process. This review focuses on nutritional and technological quality of products made with gluten-free cereals available on the market. The possibility of using flour from naturally low toxic ancient wheat species or detoxified wheat for the diet of celiacs is also discussed.

Gluten-free diet may improve obstructive sleep apnea-related symptoms in children with celiac disease.

Science.gov (United States)

Yerushalmy-Feler, Anat; Tauman, Riva; Derowe, Ari; Averbuch, Eran; Ben-Tov, Amir; Weintraub, Yael; Weiner, Dror; Amir, Achiya; Moran-Lev, Hadar; Cohen, Shlomi

2018-02-07

Enlarged tonsils and adenoids are the major etiology of obstructive sleep apnea (OSA) in children. Lymphatic hyperplasia is common to both OSA and celiac disease. We aimed to investigate the effect of a gluten-free diet on OSA symptoms in children with celiac disease. Children with celiac disease aged 2-18 years were prospectively recruited before the initiation of a gluten-free diet. Children with negative celiac serology who underwent gastrointestinal endoscopies for other indications served as controls. All participants completed a validated OSA-related symptoms questionnaire and the pediatric sleep questionnaire (PSQ) at baseline and 6 months later. Thirty-four children with celiac disease (mean age 6.6 ± 3.5 years) and 24 controls (mean age 7.3 ± 4.6 years, P = 0.5) were recruited. There were no significant differences in gender, body mass index or season at recruitment between the two groups. The rate of positive PSQ scores was higher (more OSA-related symptoms) in the control group compared to the celiac group, both at recruitment and at the 6-month follow-up (33.3% vs. 11.8%, P = 0.046, and 16.7% vs. 0, P = 0.014, respectively). PSQ scores improved significantly in both groups at the 6-month follow-up (P celiac group compared to controls (0.1 ± 0.09 vs.0.06 ± 0.06, respectively, P = 0.04). Children with celiac disease had fewer OSA-related symptoms than controls, but the degree of improvement following the initiation of a gluten-free diet was significantly higher. These findings suggest that a gluten-free diet may improve OSA-related symptoms in children with celiac disease.

Going Gluten-Free: Life with Celiac Disease

Science.gov (United States)

... diagnose it. Diagnosis can often be difficult, as celiac disease symptoms are often similar to those of other conditions. ... of Diabetes and Digestive and Kidney Diseases (NIDDK) Celiac Disease or Gluten Sensitivity? Some of the symptoms of gluten sensitivity (also known as gluten intolerance) ...

Health Benefits and Adverse Effects of a Gluten-Free Diet in Non-Celiac Disease Patients.

Science.gov (United States)

Niland, Benjamin; Cash, Brooks D

2018-02-01

Gluten-related diseases such as celiac disease and gluten ataxia are rare conditions, affecting less than 1% of the population in the United States. Despite the rarity of these diseases, there have been significant increases in the adoption of a gluten-free lifestyle and the consumption of gluten-free foods in the United States over the last 3 decades. More than $15.5 billion were spent on retail sales of gluten-free foods in 2016. The gluten-free diet is driven by multiple factors, including social and traditional media coverage, aggressive consumer-directed marketing by manufacturers and retail outlets, and reports in the medical literature and mainstream press of the clinical benefits of gluten avoidance. Individuals may restrict gluten from their diets for a variety of reasons, such as improvement of gastrointestinal and nongastrointestinal symptoms, as well as a perception that gluten is potentially harmful and, thus, restriction represents a healthy lifestyle. Emerging evidence shows that gluten avoidance may be beneficial for some patients with gastrointestinal symptoms, such as those commonly encountered with irritable bowel syndrome. However, high-quality evidence supporting gluten avoidance for physical symptoms or diseases other than those specifically known to be caused by immune-mediated responses to gluten is neither robust nor convincing. In fact, gluten avoidance may be associated with adverse effects in patients without proven gluten-related diseases. This article provides insight regarding gluten avoidance patterns and effects on patients without gluten-related diseases, and highlights concerns surrounding gluten avoidance in the absence of a gluten-mediated immunologic disease.

Difficulties related to compliance with gluten-free diet by patients with coeliac disease living in Upper Silesia

Directory of Open Access Journals (Sweden)

Magdalena Ferster

2015-12-01

Full Text Available Compliance with gluten-free diet is the basic method for controlling coeliac disease in patients regardless of their age. It may be, however, challenging to follow in daily life. The prevalence of the disease (approx. 1% of European population is affected makes it an important public health problem. Aim of the study: Investigating the difficulties and obstacles related to compliance with gluten-free diet by children and adult patients living in Upper Silesia region. Material and method: The study included 30 mothers of children with coeliac disease (Group I and 30 adult coeliac disease patients (Group II. The patients kept a gluten-free diet. Data were obtained in an anonymous survey drawn up for the purpose of this study, conducted in 2010. Results: The respondents reported a very limited access to gluten-free meals in mass-catering establishments (76.7% of the participants in Group II, and 70% children at nurseries, kindergartens and schools, lack of adequate food product labelling (93% in both groups, difficulties experienced in social life (60% in Group II, difficulties experienced when travelling within Poland (76.7% in Group II and abroad (83.3% in Group II, and no existing reimbursement plan for the high diet costs (16.7% in Group I vs. 26.7% in Group II. Conclusions: 1 The necessity of compliance with gluten-free diet causes a lot of difficulties in everyday life to patients with coeliac disease and parents of children suffering from coeliac disease. Proper treatment requires their identification by the attending physician. 2 Improved food labelling as regards gluten content as well as inclusion of gluten-free meals in the menu of food-serving establishments will contribute to improved quality of life of children and adults suffering from coeliac disease. 3 Associations of patients on a gluten-free diet should continue their efforts to have high costs of this diet refunded.

[Irritable bowel syndrome, celiac disease and gluten].

Science.gov (United States)

Mearin, Fermín; Montoro, Miguel

2014-08-04

For many years irritable bowel syndrome (IBS) and celiac disease (CD) have been considered 2 completely separate entities, with CD being clearly related to a permanent gluten intolerance and IBS having no relation with gluten ingestion. However IBS and CD symptoms may be indistinguishable, especially when diarrhea, bloating or abdominal pain predominate. In the last decade several studies have shown that the separation between CD and IBS is not so clear. Thus, some patients who have been diagnosed of IBS suffer in fact from CD. In addition, it seems that there is a group of patients who, without having CD, suffer gluten intolerance that cause them digestive symptoms similar to those of IBS. Gluten sensitivity is defined as the spectrum of morphological, immunological and functional abnormalities that respond to a gluten-free diet. This concept includes histological, immunological and clinical manifestations in the absence of evident morphological abnormalities. Therefore, it is mandatory to establish in a scientific way in which patients a gluten-free diet will be beneficial as well as when this is not justified. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Non-celiac gluten sensitivity: people without celiac disease avoiding gluten-is it due to histamine intolerance?

Science.gov (United States)

Schnedl, Wolfgang J; Lackner, Sonja; Enko, Dietmar; Schenk, Michael; Mangge, Harald; Holasek, Sandra J

2018-04-01

Food intolerance/malabsorption is caused by food ingredients, carbohydrates (mainly lactose and fructose), proteins (gluten), and biogenic amines (histamine) which cause nonspecific gastrointestinal and extra-intestinal symptoms. Here we focus on possible etiologic factors of intolerance/malabsorption especially in people with non-celiac gluten sensitivity (NCGS) or the so-called people without celiac disease avoiding gluten (PWCDAG) and histamine intolerance. Recognizing the recently described symptoms of NCGS (PWCDAG) we review correlations and parallels to histamine intolerance (HIT). We show that intestinal and extra-intestinal NCGS (PWCDAG) symptoms are very similar to those which can be found in histamine intolerance. After a detailed diagnostic workup for all possible etiologic factors in every patient, a targeted dietary intervention for single or possibly combined intolerance/malabsorption might be more effective than a short-term diet low in fermentable oligo-, di- and monosaccharides and polyols (FODMAP) or the untargeted uncritical use of gluten-free diets.

Efficient degradation of gluten by a prolyl endoprotease in a gastrointestinal model: Implications for coeliac disease

NARCIS (Netherlands)

Mitea, C.; Havenaar, R.; Wouter Drijfhout, J.; Edens, L.; Dekking, L.; Koning, F.; Dekking, E.H.A.

2008-01-01

Background: Coeliac disease is caused by an immune response to gluten. As gluten proteins are proline rich they are resistant to enzymatic digestion in the gastrointestinal tract, a property that probably contributes to the immunogenic nature of gluten. Aims: This study determined the efficiency of

Spectrum of gluten-related disorders: consensus on new nomenclature and classification

Directory of Open Access Journals (Sweden)

Sapone Anna

2012-02-01

Full Text Available Abstract A decade ago celiac disease was considered extremely rare outside Europe and, therefore, was almost completely ignored by health care professionals. In only 10 years, key milestones have moved celiac disease from obscurity into the popular spotlight worldwide. Now we are observing another interesting phenomenon that is generating great confusion among health care professionals. The number of individuals embracing a gluten-free diet (GFD appears much higher than the projected number of celiac disease patients, fueling a global market of gluten-free products approaching $2.5 billion (US in global sales in 2010. This trend is supported by the notion that, along with celiac disease, other conditions related to the ingestion of gluten have emerged as health care concerns. This review will summarize our current knowledge about the three main forms of gluten reactions: allergic (wheat allergy, autoimmune (celiac disease, dermatitis herpetiformis and gluten ataxia and possibly immune-mediated (gluten sensitivity, and also outline pathogenic, clinical and epidemiological differences and propose new nomenclature and classifications.

Targeted liquid chromatography tandem mass spectrometry to quantitate wheat gluten using well-defined reference proteins

Science.gov (United States)

Schalk, Kathrin; Koehler, Peter

2018-01-01

Celiac disease (CD) is an inflammatory disorder of the upper small intestine caused by the ingestion of storage proteins (prolamins and glutelins) from wheat, barley, rye, and, in rare cases, oats. CD patients need to follow a gluten-free diet by consuming gluten-free products with gluten contents of less than 20 mg/kg. Currently, the recommended method for the quantitative determination of gluten is an enzyme-linked immunosorbent assay (ELISA) based on the R5 monoclonal antibody. Because the R5 ELISA mostly detects the prolamin fraction of gluten, a new independent method is required to detect prolamins as well as glutelins. This paper presents the development of a method to quantitate 16 wheat marker peptides derived from all wheat gluten protein types by liquid chromatography tandem mass spectrometry (LC-MS/MS) in the multiple reaction monitoring mode. The quantitation of each marker peptide in the chymotryptic digest of a defined amount of the respective reference wheat protein type resulted in peptide-specific yields. This enabled the conversion of peptide into protein type concentrations. Gluten contents were expressed as sum of all determined protein type concentrations. This new method was applied to quantitate gluten in wheat starches and compared to R5 ELISA and gel-permeation high-performance liquid chromatography with fluorescence detection (GP-HPLC-FLD), which resulted in a strong correlation between LC-MS/MS and the other two methods. PMID:29425234

Targeted liquid chromatography tandem mass spectrometry to quantitate wheat gluten using well-defined reference proteins.

Directory of Open Access Journals (Sweden)

Kathrin Schalk

Full Text Available Celiac disease (CD is an inflammatory disorder of the upper small intestine caused by the ingestion of storage proteins (prolamins and glutelins from wheat, barley, rye, and, in rare cases, oats. CD patients need to follow a gluten-free diet by consuming gluten-free products with gluten contents of less than 20 mg/kg. Currently, the recommended method for the quantitative determination of gluten is an enzyme-linked immunosorbent assay (ELISA based on the R5 monoclonal antibody. Because the R5 ELISA mostly detects the prolamin fraction of gluten, a new independent method is required to detect prolamins as well as glutelins. This paper presents the development of a method to quantitate 16 wheat marker peptides derived from all wheat gluten protein types by liquid chromatography tandem mass spectrometry (LC-MS/MS in the multiple reaction monitoring mode. The quantitation of each marker peptide in the chymotryptic digest of a defined amount of the respective reference wheat protein type resulted in peptide-specific yields. This enabled the conversion of peptide into protein type concentrations. Gluten contents were expressed as sum of all determined protein type concentrations. This new method was applied to quantitate gluten in wheat starches and compared to R5 ELISA and gel-permeation high-performance liquid chromatography with fluorescence detection (GP-HPLC-FLD, which resulted in a strong correlation between LC-MS/MS and the other two methods.

Reduced-Gliadin Wheat Bread: An Alternative to the Gluten-Free Diet for Consumers Suffering Gluten-Related Pathologies

Science.gov (United States)

Gil-Humanes, Javier; Pistón, Fernando; Altamirano-Fortoul, Rossana; Real, Ana; Comino, Isabel; Sousa, Carolina; Rosell, Cristina M.; Barro, Francisco

2014-01-01

Wheat flour cannot be tolerated by those who suffer allergies to gluten. Human pathologies associated with grain proteins have increased worldwide in recent years, and the only effective treatment available is a lifelong gluten-free diet, which is complicated to follow and detrimental to gut health. This manuscript describes the development of wheat bread potentially suitable for celiac patients and other gluten-intolerant individuals. We have made bread using wheat flour with very low content of the specific gluten proteins (near gliadin-free) that are the causal agents for pathologies such as celiac disease. Loaves were compared with normal wheat breads and rice bread. Organoleptic, nutritional, and immunotoxic properties were studied. The reduced-gliadin breads showed baking and sensory properties, and overall acceptance, similar to those of normal flour, but with up to 97% lower gliadin content. Moreover, the low-gliadin flour has improved nutritional properties since its lysine content is significantly higher than that of normal flour. Conservative estimates indicate that celiac patients could safely consume 67 grams of bread per day that is made with low-gliadin flour. However, additional studies, such as feeding trials with gluten-intolerant patients, are still needed in order to determine whether or not the product can be consumed by the general celiac population, as well as the actual tolerated amount that can be safely ingested. The results presented here offer a major opportunity to improve the quality of life for millions of sufferers of gluten intolerance throughout the world. PMID:24621595

Distribution of gluten proteins in bread wheat (Triticum aestivum) grain.

Science.gov (United States)

Tosi, Paola; Gritsch, Cristina Sanchis; He, Jibin; Shewry, Peter R

2011-07-01

Gluten proteins are the major storage protein fraction in the mature wheat grain. They are restricted to the starchy endosperm, which forms white flour on milling, and interact during grain development to form large polymers which form a continuous proteinaceous network when flour is mixed with water to give dough. This network confers viscosity and elasticity to the dough, enabling the production of leavened products. The starchy endosperm is not a homogeneous tissue and quantitative and qualitative gradients exist for the major components: protein, starch and cell wall polysaccharides. Gradients in protein content and composition are the most evident and are of particular interest because of the major role played by the gluten proteins in determining grain processing quality. Protein gradients in the starchy endosperm were investigated using antibodies for specific gluten protein types for immunolocalization in developing grains and for western blot analysis of protein extracts from flour fractions obtained by sequential abrasion (pearling) to prepare tissue layers. Differential patterns of distribution were found for the high-molecular-weight subunits of glutenin (HMW-GS) and γ-gliadins when compared with the low-molecular-weight subunits of glutenin (LMW-GS), ω- and α-gliadins. The first two types of gluten protein are more abundant in the inner endosperm layers and the latter more abundant in the subaleurone. Immunolocalization also showed that segregation of gluten proteins occurs both between and within protein bodies during protein deposition and may still be retained in the mature grain. Quantitative and qualitative gradients in gluten protein composition are established during grain development. These gradients may be due to the origin of subaleurone cells, which unlike other starchy endosperm cells derive from the re-differentiation of aleurone cells, but could also result from the action of specific regulatory signals produced by the maternal tissue

Celiac disease: understanding the gluten-free diet.

Science.gov (United States)

Bascuñán, Karla A; Vespa, María Catalina; Araya, Magdalena

2017-03-01

The only effective and safe treatment of celiac disease (CD) continues being strict exclusion of gluten for life, the so-called gluten-free diet (GFD). Although this treatment is highly successful, following strict GFD poses difficulties to patients in family, social and working contexts, deteriorating his/her quality of life. We aimed to review main characteristics of GFD with special emphasis on factors that may interfere with adherence to it. We conducted a search of various databases, such as PubMed, Google Scholar, Embase, and Scielo, with focus on key words such as "gluten-free diet", "celiac disease", "gluten" and "gluten-free diet adherence". Available literature has not reached definitive conclusions on the exact amount of gluten that is harmless to celiac patients, although international agreements establish cutoff points for gluten-free products and advise the use of clinical assessment to tailor the diet according to individual needs. Following GFD must include eliminating gluten as ingredient as well as hidden component and potential cross contamination in foods. There are numerous grains to substitute wheat but composition of most gluten-free products tends to include only a small number of them, especially rice. The diet must be not only free of gluten but also healthy to avoid nutrient, vitamins and minerals deficiencies or excess. Overweight/obesity frequency has increased among celiac patients so weight gain deserves attention during follow up. Nutritional education by a trained nutritionist is of great relevance to achieve long-term satisfactory health status and good compliance. A balanced GFD should be based on a combination of naturally gluten-free foods and certified processed gluten-free products. How to measure and improve adherence to GFD is still controversial and deserves further study.

Impact of casein and egg white proteins on the structure of wheat gluten-based protein-rich food.

Science.gov (United States)

Wouters, Arno G B; Rombouts, Ine; Lagrain, Bert; Delcour, Jan A

2016-02-01

There is a growing interest in texturally and nutritionally satisfying vegetable alternatives to meat. Wheat gluten proteins have unique functional properties but a poor nutritional value in comparison to animal proteins. This study investigated the potential of egg white and bovine milk casein with well-balanced amino acid composition to increase the quality of wheat gluten-based protein-rich foods. Heating a wheat gluten (51.4 g)-water (100.0 mL) blend for 120 min at 100 °C increased its firmness less than heating a wheat gluten (33.0 g)-freeze-dried egg white (16.8 g)-water (100.0 mL) blend. In contrast, the addition of casein to the gluten-water blend negatively impacted firmness after heating. Firmness was correlated with loss of protein extractability in sodium dodecyl sulfate containing medium during heating, which was higher with egg white than with casein. Even more, heat-induced polymerization of the gluten-water blend with egg white but not with casein was greater than expected from the losses in extractability of gluten and egg white on their own. Structure formation was favored by mixing gluten with egg white but not with casein. These observations were linked to the intrinsic polymerization behavior of egg white and casein, but also to their interaction with gluten. Thus not all nutritionally suitable proteins can be used for enrichment of gluten-based protein-rich foods. © 2015 Society of Chemical Industry.

Essential amino acids in the gluten-free diet and serum in relation to depression in patients with celiac disease.

Directory of Open Access Journals (Sweden)

Nathalie J M van Hees

Full Text Available Celiac disease (CD is associated with an increased risk of major depressive disorder, possibly due to deficiencies in micronutrients in the gluten-free diet. We aimed to investigate whether essential amino acids (i.e., the precursors of serotonin, dopamine and other neurotransmitters are depleted in the diet and serum of CD patients with major depressive disorder.In a cross-sectional study we assessed dietary intake of amino acids and serum levels of amino acids, in 77 CD patients on a gluten-free diet and in 33 healthy controls. Major depressive disorder was assessed with structured interviews (using the Mini International Neuropsychiatric Interview Plus. Dietary intake was assessed using a 203-item food frequency questionnaire.Participants had a mean age of 55 years and 74% were women. The intake of vegetable protein was significantly lower in CD patients than in healthy controls (mean difference of 7.8 g/d; 95% CI: 4.7-10.8, as were serum concentrations of tyrosine, phenylalanine and tryptophan (all p < 0.005. However, within the CD patient group, the presence of major depressive disorder (n = 42 was not associated with intake or serum levels of essential amino acids.Patients with CD on a long-term gluten-free diet, with good adherence, consume significantly less vegetable protein than controls, and their serum levels of several essential amino acids were also lower. Despite its potential adverse effect, intake and serum levels of essential amino acids were not related to major depression.

A Comprehensive Review of Celiac Disease/Gluten-Sensitive Enteropathies.

Science.gov (United States)

McAllister, Brian P; Williams, Emmanuelle; Clarke, Kofi

2018-06-02

Celiac disease is a complex immune-mediated gluten-sensitive enteropathy with protean clinical manifestations. It is manifest in genetically predisposed individuals who ingest gluten in varying amounts. In broad terms, it is thought to affect 1% of the population in the USA. More specifically, the prevalence increases drastically from 1:133 in patients not-at-risk, to 1:56 in symptomatic patients, to 1:39 in patients with a second-degree relative with the diagnosis, and to 1:22 in patients with a first-degree relative with the diagnosis. It may be associated with several immune-mediated phenomena, autoimmune diseases, and complicated by vitamin and other trace element deficiencies, bone disease, and malignancy. Our understanding of celiac disease has evolved rapidly over the past two decades. This has led to several lines of enquiry on the condition and potential treatment options. More recently, several entities including gluten intolerance, non-celiac gluten sensitivity, and seronegative celiac disease have been described. These conditions are distinct from allergies or intolerance to wheat or wheat products. There are challenges in defining some of these entities since a large number of patients self-report these conditions. The absence of confirmatory diagnostic tests poses an added dilemma in distinguishing these entities. The differences in spectrum of symptoms and highlights of the variability between the pediatric and adult populations have been studied in some detail. The role of screening for celiac disease is examined in both the general population and "at risk" populations. Diagnostic strategies including the best available serologic testing, utility of HLA haplotypes DQ2 and DQ8 which are seen in over 90% of patients with celiac disease as compared with approximately 40% of the general population, and endoscopic evaluation are also reviewed. Comprehensive nutritional management after diagnosis is key to sustained health in patients with celiac disease

Navigating the gluten-free boom.

Science.gov (United States)

Gaesser, Glenn A; Angadi, Siddhartha S

2015-08-01

Gluten-free diets have gained popularity with the public at a rate greater than would be expected based on the prevalence of gluten-related disorders such celiac disease, nonceliac gluten sensitivity, and wheat allergy. This article reviews gluten-related disorders, indications for gluten-free diets, and the possible health benefits of gluten. Despite the health claims for gluten-free eating, no published experimental evidence supports weight-loss with a gluten-free diet or suggests that the general population would benefit from avoiding gluten.

The daily gluten intake in relatives of patients with coeliac disease compared with that of the general Dutch population

NARCIS (Netherlands)

vanOverbeek, FM; UilDieterman, IGA; Mol, IW; KohlerBrands, L; Heymans, HSA; Mulder, CJJ

1997-01-01

Background: It has been suggested that the amount of gluten intake in populations offers an explanation for differences in the epidemiology of coeliac disease. Investigations into first-degree relatives of coeliac disease patients have often shown that relatives exhibit intermediate features of

Digestibility of gluten proteins is reduced by baking and enhanced by starch digestion.

Science.gov (United States)

Smith, Frances; Pan, Xiaoyan; Bellido, Vincent; Toole, Geraldine A; Gates, Fred K; Wickham, Martin S J; Shewry, Peter R; Bakalis, Serafim; Padfield, Philip; Mills, E N Clare

2015-10-01

Resistance of proteins to gastrointestinal digestion may play a role in determining immune-mediated adverse reactions to foods. However, digestion studies have largely been restricted to purified proteins and the impact of food processing and food matrices on protein digestibility is poorly understood. Digestibility of a total gliadin fraction (TGF), flour (cv Hereward), and bread was assessed using in vitro batch digestion with simulated oral, gastric, and duodenal phases. Protein digestion was monitored by SDS-PAGE and immunoblotting using monoclonal antibodies specific for celiac-toxic sequences (QQSF, QPFP) and starch digestion by measuring undigested starch. Whereas the TGF was rapidly digested during the gastric phase the gluten proteins in bread were virtually undigested and digested rapidly during the duodenal phase only if amylase was included. Duodenal starch digestion was also slower in the absence of duodenal proteases. The baking process reduces the digestibility of wheat gluten proteins, including those containing sequences active in celiac disease. Starch digestion affects the extent of protein digestion, probably because of gluten-starch complex formation during baking. Digestion studies using purified protein fractions alone are therefore not predictive of digestion in complex food matrices. © 2015 The Authors. Molecular Nutrition & Food Research published by Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Celiac disease treatment: gluten-free diet and beyond.

Science.gov (United States)

Mäki, Markku

2014-07-01

The basis for celiac disease (CD) treatment is a strict lifelong gluten-free diet. On the diet, the small intestinal mucosal injury heals and gluten-induced symptoms and signs disappear. The mucosal healing is a prerequisite for sustaining health and is also obtained with a diet containing oats and trace amounts of gluten, industrially purified wheat starch-based gluten-free products. The small intestinal mucosa does not heal in noncompliant people, nor when a patient is inadvertently ingesting gluten. Development of adjunctive or alternative therapies is on its way. There are several novel treatment pipelines within academy and industry. Examples are the ideas of using glutenases as a drug to degrade the ingested gluten, polymers to bind and sequester the gluten to the feces, and also vaccine development for an immunotherapy to induce tolerance towards gluten. Clinical drug trials are to be foreseen in CD, soon also in children.

Effects of chemical composition and baking on in vitro digestibility of proteins in breads made from selected gluten-containing and gluten-free flours.

Science.gov (United States)

Wu, Tong; Taylor, Cheryl; Nebl, Thomas; Ng, Ken; Bennett, Louise E

2017-10-15

Breads prepared from cereal grains are a dietary staple, providing a significant proportion of daily energy, but not necessarily of dietary protein. However, good digestibility of proteins in bread is important to avoid potential immunogenic effects of undigested peptides, including for those gluten-intolerant. Four gluten-containing (white wheat, wholemeal wheat, spelt and rye) and four gluten-free (chick pea, lupin, buckwheat, amaranth) flours were used to make yeast-leavened breads standardized for protein. In vitro gastro-intestinal digestion of pre-mixes, doughs and breads baked for 20 and 35min was conducted followed by correlation analysis between fitted parameters of digestion profiles, chemical composition (protein, non-fibre carbohydrates, fibre, ash and total polyphenolics) and amino acid profiles. The results indicated that digestibility generally increased during proofing and decreased during baking. Relatively higher protein digestibility was correlated with ratio of non-fibre carbohydrate to protein and lower digestibility with increasing contents of fibre and total polyphenolics in pre-mixes. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Non-celiac gluten sensitivity: Time for sifting the grain

Science.gov (United States)

Elli, Luca; Roncoroni, Leda; Bardella, Maria Teresa

2015-01-01

In the last few years, a new nomenclature has been proposed for the disease induced by the ingestion of gluten, a protein present in wheat, rice, barley and oats. Besides celiac disease and wheat allergy, the most studied forms of gluten-related disorders characterized by an evident immune mechanism (autoimmune in celiac disease and IgE-mediated in wheat allergy), a new entity has been included, apparently not driven by an aberrant immune response: the non-celiac gluten sensitivity (NCGS). NCGS is characterized by a heterogeneous clinical picture with intestinal and extraintestinal symptoms arising after gluten ingestion and rapidly improving after its withdrawal from the diet. The pathogenesis of NCGS is largely unknown, but a mixture of factors such as the stimulation of the innate immune system, the direct cytotoxic effects of gluten, and probably the synergy with other wheat molecules, are clues for the complicated puzzle. In addition, the diagnostic procedures still remain problematic due to the absence of efficient diagnostic markers; thus, diagnosis is based upon the symptomatic response to a gluten-free diet and the recurrence of symptoms after gluten reintroduction with the possibility of an important involvement of a placebo effect. The temporary withdrawal of gluten seems a reasonable therapy, but the timing of gluten reintroduction and the correct patient management approach are have not yet been determined. PMID:26217073

The Overlap between Irritable Bowel Syndrome and Non-Celiac Gluten Sensitivity: A Clinical Dilemma

Directory of Open Access Journals (Sweden)

Archita Makharia

2015-12-01

Full Text Available The spectrum of gluten-related disorders has widened in recent times and includes celiac disease, non-celiac gluten sensitivity, and wheat allergy. The complex of symptoms associated with these diseases, such as diarrhea, constipation or abdominal pain may overlap for the gluten related diseases, and furthermore they can be similar to those caused by various other intestinal diseases, such as irritable bowel syndrome (IBS. The mechanisms underlying symptom generation are diverse for all these diseases. Some patients with celiac disease may remain asymptomatic or have only mild gastrointestinal symptoms and thus may qualify for the diagnosis of IBS in the general clinical practice. Similarly, the overlap of symptoms between IBS and non-celiac gluten sensitivity (NCGS often creates a dilemma for clinicians. While the treatment of NCGS is exclusion of gluten from the diet, some, but not all, of the patients with IBS also improve on a gluten-free diet. Both IBS and NCGS are common in the general population and both can coexist with each other independently without necessarily sharing a common pathophysiological basis. Although the pathogenesis of NCGS is not well understood, it is likely to be heterogeneous with possible contributing factors such as low-grade intestinal inflammation, increased intestinal barrier function and changes in the intestinal microbiota. Innate immunity may also play a pivotal role. One possible inducer of innate immune response has recently been reported to be amylase-trypsin inhibitor, a protein present in wheat endosperm and the source of flour, along with the gluten proteins.

Osteoarticular manifestations of celiac disease and non-celiac gluten hypersensitivity.

Science.gov (United States)

Dos Santos, Stéphanie; Lioté, Frédéric

2017-05-01

Celiac disease is a chronic inflammatory autoimmune enteropathy based disorder that is triggered by the ingestion of gluten in genetically susceptible individuals. The global prevalence of 1% to 2% represents only the tip of the iceberg. The diagnosis is confirmed by positive specific antibody, anti-transglutaminase or anti-endomysium, specific lesions of the small intestine and a response to strict gluten-free diet. The diagnosis is difficult and often delayed because the clinical variability is very large, ranging from digestive clinical presentation "classic" to "atypical" symptoms, often extra-intestinal, that are sometimes attributed to a concomitant disease or a complication. Among them, there are frequent musculoskeletal manifestations such as osteoporosis and osteomalacia. In the absence of risk factor, osteoporosis, in a premenopausal women or in a man less than 55 years, more is if it is severe and refractory to medications, need to rheumatologists on the track of celiac disease in the absence of digestive symptoms. Osteomalacia is related to secondary hypovitaminosis D malabsorption. Supplementation by calcifediol, water-soluble vitamin D, may be indicated. Celiac disease is associated with an autoimmune disease in almost 1/3 of the cases. Knowing these potential associations allows earlier diagnosis in patients whose only manifestation, a concomitant disease. Anemia, chronic fatigue or unexplained polyarthralgia are symptoms associated with celiac disease to look for specific antibodies. The aim of early diagnosis is to prevent the emergence of other systemic disorders and avoid complications such as bone fractures and cancer, especially intestinal lymphoma. Non-celiac gluten intolerance is a new entity defined by symptomatology similar to that of celiac disease induced by the ingestion of gluten and disappearing after crowding-out, among patients without specific antibodies and without intestinal lesion of celiac disease. This entity is a cause, at

Correlation analysis of protein quality characteristics with gluten-free bread properties.

Science.gov (United States)

Horstmann, S W; Foschia, M; Arendt, E K

2017-07-19

The interest in gluten-free cereal products has increased significantly over the last number of years and there is still a high demand for high quality products. This study aims to establish possible connections between protein properties and dough and bread quality which could advance the knowledge for gluten-free product development. The objective of the present study was to correlate protein properties with bread characteristics. Therefore, a wide range of tests (solubility, emulsifying, foaming, water hydration properties) was performed to characterize a range of food proteins (potato, pea, carob, lupin and soy). Furthermore, the performance of these proteins in a dough matrix (pasting, rheology) and bread formulation (volume, structure, and texture) was analysed. Statistical analysis showed significant (p bread characteristics. The addition of the proteins to the gluten-free bread formulation affected pasting rheological and bread characteristics such as crumb density, crumb hardness and specific volume. The addition of potato and soy protein resulted in the lowest volume with a dense crumb structure and a low consumer acceptance score. However, lupin, pea and carob containing gluten-free breads had a higher specific volume and softer and less dense crumb structure. The protein solubility (r, 0.89; p bread quality.

Estimated levels of gluten incidentally present in a Canadian gluten-free diet.

Science.gov (United States)

La Vieille, Sébastien; Dubois, Sheila; Hayward, Stephen; Koerner, Terence B

2014-02-21

Avoiding exposure to gluten is currently the only effective treatment for celiac disease. However, the evidence suggests that for most affected individuals, exposure to less than 10 mg/day is unlikely to cause histological changes to the intestinal mucosa. The daily diet of people with celiac disease does not rely solely on gluten-free pre-packaged foods, but also on naturally gluten-free grains (e.g., rice, buckwheat, ...) and foods with grain-derived ingredients (i.e., flour and starches) used for cooking and baking at home. The objective of this study was to estimate the level of incidental gluten potentially present in gluten-free diets from a Canadian perspective. We have conducted gluten exposure estimations from grain-containing foods and foods with grain-derived ingredients, taking into consideration the various rates of food consumption by different sex and age groups. These estimates have concluded that if gluten was present at levels not exceeding 20 ppm, exposure to gluten would remain below 10 mg per day for all age groups studied. However, in reality the level of gluten found in naturally gluten-free ingredients is not static and there may be some concerns related to the flours made from naturally gluten-free cereal grains. It was found that those containing a higher level of fiber and that are frequently used to prepare daily foods by individuals with celiac disease could be a concern. For this category of products, only the flours and starches labelled "gluten-free" should be used for home-made preparations.

Estimated Levels of Gluten Incidentally Present in a Canadian Gluten-Free Diet

Directory of Open Access Journals (Sweden)

Sébastien La Vieille

2014-02-01

Full Text Available Avoiding exposure to gluten is currently the only effective treatment for celiac disease. However, the evidence suggests that for most affected individuals, exposure to less than 10 mg/day is unlikely to cause histological changes to the intestinal mucosa. The daily diet of people with celiac disease does not rely solely on gluten-free pre-packaged foods, but also on naturally gluten-free grains (e.g., rice, buckwheat, ... and foods with grain-derived ingredients (i.e., flour and starches used for cooking and baking at home. The objective of this study was to estimate the level of incidental gluten potentially present in gluten-free diets from a Canadian perspective. We have conducted gluten exposure estimations from grain-containing foods and foods with grain-derived ingredients, taking into consideration the various rates of food consumption by different sex and age groups. These estimates have concluded that if gluten was present at levels not exceeding 20 ppm, exposure to gluten would remain below 10 mg per day for all age groups studied. However, in reality the level of gluten found in naturally gluten-free ingredients is not static and there may be some concerns related to the flours made from naturally gluten-free cereal grains. It was found that those containing a higher level of fiber and that are frequently used to prepare daily foods by individuals with celiac disease could be a concern. For this category of products, only the flours and starches labelled “gluten-free” should be used for home-made preparations.

Introducing Students to Protein Analysis Techniques: Separation and Comparative Analysis of Gluten Proteins in Various Wheat Strains

Science.gov (United States)

Pirinelli, Alyssa L.; Trinidad, Jonathan C.; Pohl, Nicola L. B.

2016-01-01

Polyacrylamide gel electrophoresis (PAGE) is commonly taught in undergraduate laboratory classes as a traditional method to analyze proteins. An experiment has been developed to teach these basic protein gel skills in the context of gluten protein isolation from various types of wheat flour. A further goal is to relate this technique to current…

Harnessing Aptamers to Overcome Challenges in Gluten Detection

Directory of Open Access Journals (Sweden)

Rebeca Miranda-Castro

2016-04-01

Full Text Available Celiac disease is a lifelong autoimmune disorder triggered by foods containing gluten, the storage protein in wheat, rye, and barley. The rapidly escalating number of patients diagnosed with this disease poses a great challenge to both food industry and authorities to guarantee food safety for all. Therefore, intensive efforts are being made to establish minimal disease-eliciting doses of gluten and consequently to improve gluten-free labeling. These efforts depend to a high degree on the availability of methods capable of detecting the protein in food samples at levels as low as possible. Current analytical approaches rely on the use of antibodies as selective recognition elements. With limited sensitivity, these methods exhibit some deficiencies that compromise the accuracy of the obtained results. Aptamers provide an ideal alternative for designing biosensors for fast and selective measurement of gluten in foods. This article highlights the challenges in gluten detection, the current status of the use of aptamers for solving this problem, and what remains to be done to move these systems into commercial applications.

Non-coeliac gluten or wheat sensitivity: emerging disease or misdiagnosis?

Science.gov (United States)

Potter, Michael DE; Walker, Marjorie M; Talley, Nicholas J

2017-08-04

Non-coeliac gluten or wheat sensitivity (NCG/WS) is a condition characterised by adverse gastrointestinal and/or extra-intestinal symptoms associated with the ingestion of gluten- or wheat-containing foods, in the absence of coeliac disease or wheat allergy. Up to one in 100 people in Australia may have coeliac disease but many more report adverse gastrointestinal and/or extra-intestinal symptoms after eating wheat products. In the absence of validated biomarkers, a diagnosis of NCG/WS can only be made by a double-blind, placebo-controlled, dietary crossover challenge with gluten, which is difficult to apply in clinical practice. Of people self-reporting gluten or wheat sensitivity, only a small proportion (16%) will have reproducible symptoms after a blinded gluten challenge of gluten versus placebo in a crossover dietary trial and fulfil the current consensus criteria for a diagnosis of NCG/WS. A wide range of symptoms are associated with NCG/WS, including gastrointestinal, neurological, psychiatric, rheumatological and dermatological complaints. The pathogenesis of NCG/WS is not well understood, but the innate immune system has been implicated, and there is overlap with coeliac disease and the functional gastrointestinal disorders (irritable bowel syndrome and functional dyspepsia). Identification of NCG/WS is important as gluten-free diets carry risks, are socially restricting and are costlier than regular diets.

Circulating gluten-specific FOXP3+CD39+ regulatory T cells have impaired suppressive function in patients with celiac disease.

Science.gov (United States)

Cook, Laura; Munier, C Mee Ling; Seddiki, Nabila; van Bockel, David; Ontiveros, Noé; Hardy, Melinda Y; Gillies, Jana K; Levings, Megan K; Reid, Hugh H; Petersen, Jan; Rossjohn, Jamie; Anderson, Robert P; Zaunders, John J; Tye-Din, Jason A; Kelleher, Anthony D

2017-12-01

Celiac disease is a chronic immune-mediated inflammatory disorder of the gut triggered by dietary gluten. Although the effector T-cell response in patients with celiac disease has been well characterized, the role of regulatory T (Treg) cells in the loss of tolerance to gluten remains poorly understood. We sought to define whether patients with celiac disease have a dysfunction or lack of gluten-specific forkhead box protein 3 (FOXP3) + Treg cells. Treated patients with celiac disease underwent oral wheat challenge to stimulate recirculation of gluten-specific T cells. Peripheral blood was collected before and after challenge. To comprehensively measure the gluten-specific CD4 + T-cell response, we paired traditional IFN-γ ELISpot with an assay to detect antigen-specific CD4 + T cells that does not rely on tetramers, antigen-stimulated cytokine production, or proliferation but rather on antigen-induced coexpression of CD25 and OX40 (CD134). Numbers of circulating gluten-specific Treg cells and effector T cells both increased significantly after oral wheat challenge, peaking at day 6. Surprisingly, we found that approximately 80% of the ex vivo circulating gluten-specific CD4 + T cells were FOXP3 + CD39 + Treg cells, which reside within the pool of memory CD4 + CD25 + CD127 low CD45RO + Treg cells. Although we observed normal suppressive function in peripheral polyclonal Treg cells from patients with celiac disease, after a short in vitro expansion, the gluten-specific FOXP3 + CD39 + Treg cells exhibited significantly reduced suppressive function compared with polyclonal Treg cells. This study provides the first estimation of FOXP3 + CD39 + Treg cell frequency within circulating gluten-specific CD4 + T cells after oral gluten challenge of patients with celiac disease. FOXP3 + CD39 + Treg cells comprised a major proportion of all circulating gluten-specific CD4 + T cells but had impaired suppressive function, indicating that Treg cell dysfunction might be a key

Gluten Introduction and the Risk of Coeliac Disease

DEFF Research Database (Denmark)

Szajewska, Hania; Shamir, Raanan; Mearin, Luisa

2016-01-01

-feeding should be promoted for its other well-established health benefits, neither any breast-feeding nor breast-feeding during gluten introduction has been shown to reduce the risk of CD. Gluten may be introduced into the infant's diet anytime between 4 and 12 completed months of age. In children at high risk......BACKGROUND: The European Society for Paediatric Gastroenterology, Hepatology and Nutrition recommended in 2008, based on observational data, to avoid both early (breast-fed. New evidence...... prompted ESPGHAN to revise these recommendations. OBJECTIVE: To provide updated recommendations regarding gluten introduction in infants and the risk of developing coeliac disease (CD) during childhood. SUMMARY: The risk of inducing CD through a gluten-containing diet exclusively applies to persons...

In vivo gluten challenge in coeliac disease

Directory of Open Access Journals (Sweden)

HJ Ellis

2001-01-01

Full Text Available In vivo gluten challenge has been used since the early 1950s to study the role of cereal fractions in celiac disease. While early studies relied on crude indicators of celiac toxicity, the advent of jejunal biopsy and sophisticated immunohistochemical techniques has allowed accurate studies to be performed. Studies to determine the nature of the cereal component that is toxic to patients with celiac disease have concentrated on wheat because of its nutritional importance. A number of in vitro studies indicated the presence of one or more celiac-activating epitopes with the N-terminus of the A-gliadin molecule. In vivo challenge with three synthetic peptides subsequently indicated the toxicity of a peptide corresponding to amino acids 31 to 49 of A-gliadin. In vivo gluten challenge is the gold standard for the assessment of celiac toxicity; however, jejunal biopsy is a relatively invasive procedure, thus, other methods have been investigated. Direct infusion of the rectum with gluten has been shown to result in an increase in mucosal intraepithelial lymphocytes, occurring only in celiac patients. This method has been used to study the celiac toxicity of gliadin subfractions. The in vitro technique of small intestinal biopsy organ culture is also a useful tool and appears to give the same results as in vivo challenge. The importance of tiny amounts of gliadin in the diet, such as that which occurs in wheat starch, has been studied by in vivo challenge; this technique has clarified the position of oats in the gluten-free diet. Several studies suggest that this cereal may be included in the diet of most adult celiac patients. Studies of the transport of gliadin across the enterocyte following ingestion or challenge suggest that gliadin may be metabolized by a different pathway in celiac disease. This could result in an abnormal presentation to the immune system, triggering a pathogenic rather than a tolerogenic response.

Application of Dairy Proteins as Technological and Nutritional Improvers of Calcium-Supplemented Gluten-Free Bread

Science.gov (United States)

Krupa-Kozak, Urszula; Bączek, Natalia; Rosell, Cristina M.

2013-01-01

Effect of dairy proteins on gluten-free dough behavior, and nutritional and technological properties of gluten-free bread was evaluated. Experimental doughs, containing dairy powders, showed low consistency. Obtained gluten-free breads were rich in proteins, and, regarding the energy value delivered by proteins, they could be considered as a source of proteins or high in proteins. Applied dairy proteins affected the technological properties of experimental breads causing a significant (p bread with beneficial effects on technological and nutritional properties. PMID:24241213

The immunopathogenesis of celiac disease reveals possible therapies beyond the gluten-free diet.

Science.gov (United States)

McAllister, Christopher S; Kagnoff, Martin F

2012-07-01

Celiac disease is a T cell-mediated autoimmune inflammatory disease of the small intestine that is activated by gluten. The diagnosis of celiac disease is challenging as patients display a wide range of symptoms and some are asymptomatic. A lifelong gluten-free diet is the only currently approved treatment of celiac disease. Although the diet is safe and effective, the compliance rates and patient acceptance vary. Furthermore, many patients treated with a gluten-free diet continue to be mildly to severely symptomatic with persistent histological abnormalities, and a small number of patients develop refractory celiac disease. New therapeutic adjuncts and potential alternatives to the gluten-free diet could improve the treatment options for these patients. Advances in understanding the immunopathogenesis of celiac disease have suggested several types of therapeutic strategies that may augment or supplant the gluten-free diet. Some of these strategies attempt to decrease the immunogenicity of gluten-containing grains by manipulating the grain itself or by using oral enzymes to break down immunogenic peptides that normally remain intact during digestion. Other strategies focus on preventing the absorption of these peptides, preventing tissue transglutaminase from rendering gluten peptides more immunogenic, or inhibiting their binding to celiac disease-specific antigen-presenting molecules. Strategies that limit T cell migration to the small intestine or that reestablish mucosal homeostasis and tolerance to gluten antigens are also being explored. Additionally, it is vital to develop new therapeutic options for refractory celiac disease patients. This review highlights therapeutic strategies that may ultimately improve the health and well-being of individuals with celiac disease.

Application of Dairy Proteins as Technological and Nutritional Improvers of Calcium-Supplemented Gluten-Free Bread

Directory of Open Access Journals (Sweden)

Cristina M. Rosell

2013-11-01

Full Text Available Effect of dairy proteins on gluten-free dough behavior, and nutritional and technological properties of gluten-free bread was evaluated. Experimental doughs, containing dairy powders, showed low consistency. Obtained gluten-free breads were rich in proteins, and, regarding the energy value delivered by proteins, they could be considered as a source of proteins or high in proteins. Applied dairy proteins affected the technological properties of experimental breads causing a significant (p < 0.05 increase of the specific volume, crust darkening, and crumb lightness, depending on the dairy supplementation level, rather than the protein type. Dairy proteins incorporated at a 12% level, significantly (p < 0.05 decreased the hardness; nevertheless, the highest amount of proteins tested led to the opposite effect. These results indicate that milk proteins tested could be successfully added to gluten-free bread with beneficial effects on technological and nutritional properties.

Divergence of gut permeability and mucosal immune gene expression in two gluten-associated conditions: celiac disease and gluten sensitivity

Directory of Open Access Journals (Sweden)

Esposito Pasquale

2011-03-01

Full Text Available Abstract Background Celiac disease (CD is an autoimmune enteropathy triggered by the ingestion of gluten. Gluten-sensitive individuals (GS cannot tolerate gluten and may develop gastrointestinal symptoms similar to those in CD, but the overall clinical picture is generally less severe and is not accompanied by the concurrence of tissue transglutaminase autoantibodies or autoimmune comorbidities. By studying and comparing mucosal expression of genes associated with intestinal barrier function, as well as innate and adaptive immunity in CD compared with GS, we sought to better understand the similarities and differences between these two gluten-associated disorders. Methods CD, GS and healthy, gluten-tolerant individuals were enrolled in this study. Intestinal permeability was evaluated using a lactulose and mannitol probe, and mucosal biopsy specimens were collected to study the expression of genes involved in barrier function and immunity. Results Unlike CD, GS is not associated with increased intestinal permeability. In fact, this was significantly reduced in GS compared with controls (P = 0.0308, paralleled by significantly increased expression of claudin (CLDN 4 (P = 0.0286. Relative to controls, adaptive immunity markers interleukin (IL-6 (P = 0.0124 and IL-21 (P = 0.0572 were expressed at higher levels in CD but not in GS, while expression of the innate immunity marker Toll-like receptor (TLR 2 was increased in GS but not in CD (P = 0.0295. Finally, expression of the T-regulatory cell marker FOXP3 was significantly reduced in GS relative to controls (P = 0.0325 and CD patients (P = 0.0293. Conclusions This study shows that the two gluten-associated disorders, CD and GS, are different clinical entities, and it contributes to the characterization of GS as a condition associated with prevalent gluten-induced activation of innate, rather than adaptive, immune responses in the absence of detectable changes in mucosal barrier function.

Preparation of gluten-free bread using a meso-structured whey protein particle system

NARCIS (Netherlands)

Riemsdijk, van L.E.; Goot, van der A.J.; Hamer, R.J.; Boom, R.M.

2011-01-01

This article presents a novel method for making gluten-free bread using mesoscopically structured whey protein. The use of the meso-structured protein is based on the hypothesis that the gluten structure present in a developed wheat dough features a particle structure on a mesoscopic length scale

Gluten Intolerance: Sex- and Age-Related Features

Directory of Open Access Journals (Sweden)

MJ Llorente-Alonso

2006-01-01

Full Text Available OBJECTIVE: Gluten intolerance is an immune-mediated enteropathy associated with gluten-containing foods in genetically susceptible patients. The typical form mainly affecting children shows failure to thrive and/or gastrointestinal symptoms. The adult form is less typical, presenting vague gastrointestinal symptoms, iron deficiency (with or without anemia or nonspecific serum chemistry abnormalities. The present study aims to analyze clinical and biochemical differences of celiac disease (CD according to sex and age.

A gluten-free diet effectively reduces symptoms and health care consumption in a Swedish celiac disease population.

Science.gov (United States)

Norström, Fredrik; Sandström, Olof; Lindholm, Lars; Ivarsson, Anneli

2012-09-17

A gluten-free diet is the only available treatment for celiac disease. Our aim was to investigate the effect of a gluten-free diet on celiac disease related symptoms, health care consumption, and the risk of developing associated immune-mediated diseases. A questionnaire was sent to 1,560 randomly selected members of the Swedish Society for Coeliacs, divided into equal-sized age- and sex strata; 1,031 (66%) responded. Self-reported symptoms, health care consumption (measured by health care visits and hospitalization days), and missed working days were reported both for the year prior to diagnosis (normal diet) and the year prior to receiving the questionnaire while undergoing treatment with a gluten-free diet. Associated immune-mediated diseases (diabetes mellitus type 1, rheumatic disease, thyroid disease, vitiligo, alopecia areata and inflammatory bowel disease) were self-reported including the year of diagnosis. All investigated symptoms except joint pain improved after diagnosis and initiated gluten-free diet. Both health care consumption and missed working days decreased. Associated immune-mediated diseases were diagnosed equally often before and after celiac disease diagnosis. Initiated treatment with a gluten-free diet improves the situation for celiac disease patients in terms of reduced symptoms and health care consumption. An earlier celiac disease diagnosis is therefore of great importance.

Gluten causes gastrointestinal symptoms in subjects without celiac disease: a double-blind randomized placebo-controlled trial.

Science.gov (United States)

Biesiekierski, Jessica R; Newnham, Evan D; Irving, Peter M; Barrett, Jacqueline S; Haines, Melissa; Doecke, James D; Shepherd, Susan J; Muir, Jane G; Gibson, Peter R

2011-03-01

Despite increased prescription of a gluten-free diet for gastrointestinal symptoms in individuals who do not have celiac disease, there is minimal evidence that suggests that gluten is a trigger. The aims of this study were to determine whether gluten ingestion can induce symptoms in non-celiac individuals and to examine the mechanism. A double-blind, randomized, placebo-controlled rechallenge trial was undertaken in patients with irritable bowel syndrome in whom celiac disease was excluded and who were symptomatically controlled on a gluten-free diet. Participants received either gluten or placebo in the form of two bread slices plus one muffin per day with a gluten-free diet for up to 6 weeks. Symptoms were evaluated using a visual analog scale and markers of intestinal inflammation, injury, and immune activation were monitored. A total of 34 patients (aged 29-59 years, 4 men) completed the study as per protocol. Overall, 56% had human leukocyte antigen (HLA)-DQ2 and/or HLA-DQ8. Adherence to diet and supplements was very high. Of 19 patients (68%) in the gluten group, 13 reported that symptoms were not adequately controlled compared with 6 of 15 (40%) on placebo (P=0.0001; generalized estimating equation). On a visual analog scale, patients were significantly worse with gluten within 1 week for overall symptoms (P=0.047), pain (P=0.016), bloating (P=0.031), satisfaction with stool consistency (P=0.024), and tiredness (P=0.001). Anti-gliadin antibodies were not induced. There were no significant changes in fecal lactoferrin, levels of celiac antibodies, highly sensitive C-reactive protein, or intestinal permeability. There were no differences in any end point in individuals with or without DQ2/DQ8. "Non-celiac gluten intolerance" may exist, but no clues to the mechanism were elucidated.

Biodegradability of wheat gluten based bioplastics.

Science.gov (United States)

Domenek, Sandra; Feuilloley, Pierre; Gratraud, Jean; Morel, Marie-Hélène; Guilbert, Stéphane

2004-01-01

A large variety of wheat gluten based bioplastics, which were plasticized with glycerol, were subjected to biodegradation. The materials covered the total range available for the biochemical control parameter Fi, which expresses the percentage of aggregated proteins. This quantity can be related to the density of covalent crosslinks in the wheat gluten network, which are induced by technological treatments. The biodegradability tests were performed in liquid medium (modified Sturm test) and in farmland soil. All gluten materials were fully degraded after 36 days in aerobic fermentation and within 50 days in farmland soil. No significant differences were observed between the samples. The mineralization half-life time of 3.8 days in the modified Sturm test situated gluten materials among fast degrading polymers. The tests of microbial inhibition experiments revealed no toxic effects of the modified gluten or of its metabolites. Thus, the protein bulk of wheat gluten materials is non-toxic and fully biodegradable, whatever the technological process applied.

Non‐celiac gluten sensitivity : a real disease?

OpenAIRE

Fernandes, Inês Cristina Ferreira

2016-01-01

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2016 The past years have seen an increase in the use of a gluten-­‐free diet (GFD) outside a diagnosis of coeliac disease (CD) or wheat allergy (WA). This trend has led to the identification of a new clinical entity termed non-­‐celiac gluten sensitivity (NCGS), which has clinical features that overlap with those two previously mentioned. The onset of symptoms in patients with NCGS can...

Gluten Sensitivity

Science.gov (United States)

... Getting Started Diet & Nutrition Adding Fiber to Your Gluten-Free Diet Celiac Disease in the Older Adult Flours, Grains, Thickening Agents, Starches GIG’s Gluten-Free Diet and Drug Instruction Gluten-Free Grains Heart Healthy ...

Effect of gluten free diet on immune response to gliadin in patients with non-celiac gluten sensitivity.

Science.gov (United States)

Caio, Giacomo; Volta, Umberto; Tovoli, Francesco; De Giorgio, Roberto

2014-02-13

Non-celiac gluten sensitivity is a syndrome characterized by gastrointestinal and extra-intestinal symptoms occurring in a few hours/days after gluten and/or other wheat protein ingestion and rapidly improving after exclusion of potential dietary triggers. There are no established laboratory markers for non-celiac gluten sensitivity, although a high prevalence of first generation anti-gliadin antibodies of IgG class has been reported in this condition. This study was designed to characterize the effect of the gluten-free diet on anti-gliadin antibodies of IgG class in patients with non-celiac gluten sensitivity. Anti-gliadin antibodies of both IgG and IgA classes were assayed by ELISA in 44 non-celiac gluten sensitivity and 40 celiac disease patients after 6 months of gluten-free diet. The majority of non-celiac gluten sensitivity patients (93.2%) showed the disappearance of anti-gliadin antibodies of IgG class after 6 months of gluten-free diet; in contrast, 16/40 (40%) of celiac patients displayed the persistence of these antibodies after gluten withdrawal. In non-celiac gluten sensitivity patients anti-gliadin antibodies IgG persistence after gluten withdrawal was significantly correlated with the low compliance to gluten-free diet and a mild clinical response. Anti-gliadin antibodies of the IgG class disappear in patients with non-celiac gluten sensitivity reflecting a strict compliance to the gluten-free diet and a good clinical response to gluten withdrawal.

Gluten-Free Diet Indications, Safety, Quality, Labels, and Challenges.

Science.gov (United States)

Rostami, Kamran; Bold, Justine; Parr, Alison; Johnson, Matt W

2017-08-08

A gluten-free diet (GFD) is the safest treatment modality in patient with coeliac disease (CD) and other gluten-related disorders. Contamination and diet compliance are important factors behind persistent symptoms in patients with gluten related-disorders, in particular CD. How much gluten can be tolerated, how safe are the current gluten-free (GF) products, what are the benefits and side effects of GFD? Recent studies published in Nutrients on gluten-free products' quality, availability, safety, as well as challenges related to a GFD are discussed.

Effect of Lupine Flour on Baking Characteristics of Gluten Free Cookies

OpenAIRE

Sofyan Maghaydah; Selma Abdul-hussain; Radwan Ajo; Yousef Tawalbeh; Noor Elsahoryi

2013-01-01

Celiac Disease (CD) is an immune-mediated disease in genetically susceptible individuals caused by intolerance to gluten protein in some cereals, resulting in mucosal inflammation, which causes malabsorption. An effective treatment for CD is a gluten-free diet that excludes cereals containing gluten. One of the most desirable wheat products is the cookie, which is considered suitable for all ages due to its low manufacturing cost, convenience, long shelf life and good eating quality. Therefor...

Gluten-Free Diet Indications, Safety, Quality, Labels, and Challenges

OpenAIRE

Rostami, Kamran; Bold, Justine; Parr, Alison; Johnson, Matt W.

2017-01-01

A gluten-free diet (GFD) is the safest treatment modality in patient with coeliac disease (CD) and other gluten-related disorders. Contamination and diet compliance are important factors behind persistent symptoms in patients with gluten related-disorders, in particular CD. How much gluten can be tolerated, how safe are the current gluten-free (GF) products, what are the benefits and side effects of GFD? Recent studies published in Nutrients on gluten-free products? quality, availability, saf...

Living with coeliac disease and a gluten-free diet: a Canadian perspective.

Science.gov (United States)

Zarkadas, M; Dubois, S; MacIsaac, K; Cantin, I; Rashid, M; Roberts, K C; La Vieille, S; Godefroy, S; Pulido, O M

2013-02-01

Strict adherence to a gluten-free diet is the only treatment for coeliac disease. The gluten-free diet is complex, costly and impacts on all activities involving food, making it difficult to maintain for a lifetime. The purpose of this cross-sectional study was to evaluate the difficulties experienced, the strategies used and the emotional impact of following a gluten-free diet among Canadians with coeliac disease. A questionnaire was mailed to all members (n = 10 693) of both the Canadian Celiac Association and the Fondation québécoise de la maladie cœliaque in 2008. The overall response rate was 72%. Results are presented for the 5912 respondents (≥18 years) reporting biopsy-confirmed coeliac disease and/or dermatitis herpetiformis. Two-thirds never intentionally consumed gluten. Women reported significantly greater emotional responses to a gluten-free diet but, with time, were more accepting of it than men. Difficulties and negative emotions were experienced less frequently by those on the diet for >5 years, although food labelling and eating away from home remained very problematic. Frustration and isolation because of the diet were the most common negative emotions experienced. The present study quantifies the difficulties experienced, the strategies used and the emotional impact of following a gluten-free diet. It highlights the need to improve the training and education of dietitians, other health providers and the food service industry workers about coeliac disease and a gluten-free diet, with the aim of better helping individuals improve their adherence to a gluten-free diet and their quality of life. © 2012 Canadian Celiac Association and Food Directorate Health Canada Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

Fundamental study on reactivities of gluten protein types from wheat, rye and barley with five sandwich ELISA test kits.

Science.gov (United States)

Lexhaller, Barbara; Tompos, Christine; Scherf, Katharina Anne

2017-12-15

Monitoring the compliance of gluten-free foods to the regulatory threshold of 20mg/kg of gluten is essential for celiac disease patients. The different enzyme-linked immunosorbent assays (ELISAs) for gluten detection each have specific characteristics, but there are only a few systematic comparisons. This fundamental study compared the specificities and sensitivities of the R5, G12 and Skerritt monoclonal and two polyclonal antibodies to well-defined gluten protein types (GPT) isolated from wheat, rye and barley flours. Quantitation of protein concentrations by reversed-phase high-performance liquid chromatography provided independent reference values. The ELISA responses showed high variability depending on the type of cereal, the GPT and the antibody used. Overall, ω1,2-gliadins and γ-75k-secalins were most reactive, whereas ω5-gliadins and γ-, B- and D-hordeins were detected with the lowest sensitivities. These results revealed which GPT each antibody is most sensitive to and provided novel insights that will be helpful for appropriate calibration of ELISAs. Copyright © 2017 Elsevier Ltd. All rights reserved.

Testing for Gluten-Related Disorders in Clinical Practice: The Role of Serology in Managing the Spectrum of Gluten Sensitivity

Directory of Open Access Journals (Sweden)

David Armstrong

2011-01-01

Full Text Available Immunoglobulin A tissue transglutaminase is the single most efficient serological test for the diagnosis of celiac disease. It is well known that immunoglobulin A tissue transglutaminase levels correlate with the degree of intestinal damage, and that values can fluctuate in patients over time. Serological testing can be used to identify symptomatic individuals that need a confirmatory biopsy, to screen at-risk populations or to monitor diet compliance in patients previously diagnosed with celiac disease. Thus, interpretation of serological testing requires consideration of the full clinical scenario. Antigliadin tests are no longer recommended for the diagnosis of classical celiac disease. However, our understanding of the pathogenesis and spectrum of gluten sensitivity has improved, and gluten-sensitive irritable bowel syndrome patients are increasingly being recognized. Studies are needed to determine the clinical utility of antigliadin serology in the diagnosis of gluten sensitivity.

Immunological characterization of the gluten fractions and their hydrolysates from wheat, rye and barley.

Science.gov (United States)

Rallabhandi, Prasad; Sharma, Girdhari M; Pereira, Marion; Williams, Kristina M

2015-02-18

Gluten proteins in wheat, rye and barley cause celiac disease, an autoimmune disorder of the small intestine, which affects approximately 1% of the world population. Gluten is comprised of prolamin and glutelin. Since avoidance of dietary gluten is the only option for celiac patients, a sensitive gluten detection and quantitation method is warranted. Most regulatory agencies have set a threshold of 20 ppm gluten in foods labeled gluten-free, based on the currently available ELISA methods. However, these methods may exhibit differences in gluten quantitation from different gluten-containing grains. In this study, prolamin and glutelin fractions were isolated from wheat, rye, barley, oats and corn. Intact and pepsin-trypsin (PT)-digested prolamin and glutelin fractions were used to assess their immunoreactivity and gluten recovery by three sandwich and two competitive ELISA kits. The Western blots revealed varied affinity of ELISA antibodies to gluten-containing grain proteins and no reactivity to oat and corn proteins. ELISA results showed considerable variation in gluten recoveries from both intact and PT-digested gluten fractions among different kits. Prolamin fractions showed higher gluten recovery compared to their respective glutelin fractions. Among prolamins, barley exhibited higher recovery compared to wheat and rye with most of the ELISA kits used. Hydrolysis resulted in reduced gluten recovery of most gluten fractions. These results suggest that the suitability of ELISA for accurate gluten quantitation is dependent upon various factors, such as grain source, antibody specificity, gluten proteins and the level of their hydrolysis in foods.

Experimental Strategy to Discover Microbes with Gluten-degrading Enzyme Activities.

Science.gov (United States)

Helmerhorst, Eva J; Wei, Guoxian

2014-05-05

Gluten proteins contained in the cereals barley, rye and wheat cause an inflammatory disorder called celiac disease in genetically predisposed individuals. Certain immunogenic gluten domains are resistant to degradation by mammalian digestive enzymes. Enzymes with the ability to target such domains are potentially of clinical use. Of particular interest are gluten-degrading enzymes that would be naturally present in the human body, e.g. associated with resident microbial species. This manuscript describes a selective gluten agar approach and four enzyme activity assays, including a gliadin zymogram assay, designed for the selection and discovery of novel gluten-degrading microorganisms from human biological samples. Resident and harmless bacteria and/or their derived enzymes could potentially find novel applications in the treatment of celiac disease, in the form of a probiotic agent or as a dietary enzyme supplement.

Gluten content of barium sulfate suspensions used for barium swallows in patients with celiac disease.

Science.gov (United States)

Chiu, Jennifer G; Shin, Yoona; Patel, Priti N; Mangione, Robert A

2014-01-01

To determine the availability and accuracy of information provided by hospitals, imaging centers, and manufacturers regarding gluten in barium sulfate suspensions. A total of 105 facilities were contacted via telephone to determine the gluten content of the contrast media used in those facilities. Manufacturers were contacted and their Web sites reviewed to determine the gluten content of their barium products. Thirty-nine percent of the hospitals and 52% of the imaging centers were not aware of the gluten content of the contrast media they used. Twenty-nine-and-a-half percent of the respondents provided the correct gluten content. The manufacturers noted that 5 products were tested and confirmed gluten free, 1 product was not tested but described as gluten free, 1 product's gluten content depended upon its flavor, and 1 product was reported to contain gluten. Clinicians caring for patients with celiac disease or patients who choose to restrict their gluten consumption must ensure that the barium sulfate suspension ingested is gluten free. It can be difficult to determine the gluten content of barium sulfate, as a majority of radiology departments and imaging centers did not know whether the product they use is gluten free. Educating staff members and improving product labeling would benefit the quality of care provided to patients with celiac disease.

Prediction of adherence to a gluten-free diet using protection motivation theory among adults with coeliac disease.

Science.gov (United States)

Dowd, A J; Jung, M E; Chen, M Y; Beauchamp, M R

2016-06-01

Coeliac disease is a chronic autoimmune disease that requires strict adherence to a gluten-free diet. However, strict adherence to a gluten-free diet is difficult, with findings from a recent review suggesting that up to 42% of individuals with coeliac disease do not eat a strict gluten-free diet. The present study aimed to examine psychosocial predictors of adherence (purposeful and accidental) to a gluten-free diet among adults with coeliac disease over a 1-month period. In this longitudinal study, 212 North American adults with coeliac disease completed online questionnaires at two time points, baseline and 1 month later. The results revealed that intentions partially mediated the effects of symptom severity, self-regulatory efficacy, planning and knowledge on purposeful gluten consumption. Intentions did not mediate the effects of severity, response cost, self-regulatory efficacy, planning and knowledge for accidental gluten consumption but, interestingly, self-regulatory efficacy directly predicted fewer accidental incidents of gluten-consumption. These findings delineate the differential psychological processes in understanding accidental and purposeful gluten consumption among adults with coeliac disease and emphasise the importance of bolstering self-regulatory efficacy beliefs to prevent accidental and purposeful consumption of gluten. © 2015 The British Dietetic Association Ltd.

Skepticism Regarding Vaccine and Gluten-Free Food Safety Among Patients with Celiac Disease and Non-celiac Gluten Sensitivity.

Science.gov (United States)

Rabinowitz, Loren G; Zylberberg, Haley M; Levinovitz, Alan; Stockwell, Melissa S; Green, Peter H R; Lebwohl, Benjamin

2018-05-01

There has been a marked increase in the adoption of the gluten-free (GF) diet. To query individuals with celiac disease (CD) and non-celiac gluten sensitivity (NCGS) on their beliefs toward the health effects of gluten, and safety of vaccines and GF food products. We distributed a Web-based survey to individuals with CD and NCGS on a CD center e-mail list. We used univariate and multivariate analysis to compare responses of respondents with CD and NCGS. The overall response rate was 27% (NCGS n = 217, CD n = 1291). Subjects with NCGS were more likely than those with CD to disagree with the statement that "vaccines are safe for people with celiac disease" (NCGS 41.3% vs. CD 26.4% (p diet improves energy and concentration (aOR 2.52; 95% CI 1.86-3.43). Subjects with NCGS were more likely than those with CD to have doubts about vaccine safety and believe in the value of non-GMO and organic foods. Our findings suggest that the lack of reliable information on gluten and its content in food and medications may reinforce beliefs that result in a detriment to public health.

Structural, Culinary, Nutritional and Anti-Nutritional Properties of High Protein, Gluten Free, 100% Legume Pasta.

Science.gov (United States)

Laleg, Karima; Cassan, Denis; Barron, Cécile; Prabhasankar, Pichan; Micard, Valérie

2016-01-01

Wheat pasta has a compact structure built by a gluten network entrapping starch granules resulting in a low glycemic index, but is nevertheless unsuitable for gluten-intolerant people. High protein gluten-free legume flours, rich in fibers, resistant starch and minerals are thus a good alternative for gluten-free pasta production. In this study, gluten-free pasta was produced exclusively from faba, lentil or black-gram flours. The relationship between their structure, their cooking and Rheological properties and their in-vitro starch digestion was analyzed and compared to cereal gluten-free commercial pasta. Trypsin inhibitory activity, phytic acid and α-galactosides were determined in flours and in cooked pasta. All legume pasta were rich in protein, resistant starch and fibers. They had a thick but weak protein network, which is built during the pasta cooking step. This particular structure altered pasta springiness and increased cooking losses. Black-gram pasta, which is especially rich in soluble fibers, differed from faba and lentil pasta, with high springiness (0.85 vs. 0.75) and less loss during cooking. In comparison to a commercial cereal gluten-free pasta, all the legume pasta lost less material during cooking but was less cohesive and springy. Interestingly, due to their particular composition and structure, lentil and faba pasta released their starch more slowly than the commercial gluten-free pasta during the in-vitro digestion process. Anti-nutritional factors in legumes, such as trypsin inhibitory activity and α-galactosides were reduced by up to 82% and 73%, respectively, by pasta processing and cooking. However, these processing steps had a minor effect on phytic acid. This study demonstrates the advantages of using legumes for the production of gluten-free pasta with a low glycemic index and high nutritional quality.

Acid Hydrolysis of Wheat Gluten Induces Formation of New Epitopes but Does Not Enhance Sensitizing Capacity by the Oral Route: A Study in “Gluten Free” Brown Norway Rats

Science.gov (United States)

Kroghsbo, Stine; Andersen, Nanna B.; Rasmussen, Tina F.; Madsen, Charlotte B.

2014-01-01

Background Acid hydrolyzed wheat proteins (HWPs) are used in the food and cosmetic industry as emulsifiers. Cases of severe food allergic reactions caused by HWPs have been reported. Recent data suggest that these reactions are caused by HWPs produced by acid hydrolysis. Objectives To examine the sensitizing capacity of gluten proteins per se when altered by acid or enzymatic hydrolysis relative to unmodified gluten in rats naïve to gluten. Methods High IgE-responder Brown Norway (BN) rats bred on a gluten-free diet were sensitized without the use of adjuvant to three different gluten products (unmodified, acid hydrolyzed and enzymatic hydrolyzed). Rats were sensitized by intraperitoneal (i.p.) immunization three times with 200 µg gluten protein/rat or by oral dosing for 35 days with 0.2, 2 or 20 mg gluten protein/rat/day. Sera were analyzed for specific IgG and IgE and IgG-binding capacity by ELISA. IgE functionality was measured by rat basophilic leukemia (RBL) assay. Results Regardless of the route of dosing, all products had sensitizing capacity. When sensitized i.p., all three gluten products induced a strong IgG1 response in all animals. Acid hydrolyzed gluten induced the highest level of specific IgE but with a low functionality. Orally all three gluten products induced specific IgG1 and IgE but with different dose-response relations. Sensitizing rats i.p. or orally with unmodified or enzymatic hydrolyzed gluten induced specific IgG1 responses with similar binding capacity which was different from that of acid hydrolyzed gluten indicating that acid hydrolysis of gluten proteins induces formation of ‘new’ epitopes. Conclusions In rats not tolerant to gluten acid hydrolysis of gluten enhances the sensitizing capacity by the i.p. but not by the oral route. In addition, acid hydrolysis induces formation of new epitopes. This is in contrast to the enzymatic hydrolyzed gluten having an epitope pattern similar to unmodified gluten. PMID:25207551

Effects of nitrogen and irrigation on gluten protein composition and their relationship to yellow berry disorder in wheat (triticum aestivum)

International Nuclear Information System (INIS)

Wong, B.R.; Felix, F.R.; Chavez, T

2014-01-01

In Mexico and the rest of the world, the presence of yellow berry (YB) in wheat grains (Triticum aestivum) has been related with poor quality, this defect is associated with low protein content in the grains. However, the quality of the wheat depends not only on the protein content, but also on the composition of the gluten proteins. The effect of the various agronomic factors on the composition of wheat gluten has been a subject of study worldwide. However, in Mexico, wheat quality still remains an issue, as there is a lack of knowledge regarding the optimal agronomic conditions to produce wheat with good-quality gluten. For this reason, the effects of nitrogen (N) rates and irrigations on the amount of gliadin subclasses, glutenin subunits (two main groups) and grain protein content as well as the relation of these proteins to the YB content in wheat grains were investigated. The experiment was conducted on arable farmland in the Valley of Empalme, Sonora, Mexico (27 degree 58' N, 110 degree 49' W; 10 m altitude), during the fall-winter period of 2009-2010. Tarachi, the hard wheat cultivar studied, was selected for its relative susceptibility to the presence of elevated YB content in mature wheat kernels. Three levels of N (75, 150 or 250 kg ha-1) and three levels of irrigation (1, 2 or 3 auxiliary irrigations) were studied. Using a N rate of 150 kg ha-1 with 3 auxiliary irrigations, wheat with good-quality gluten was obtained. The results suggest that the YB disorder is primarily related to the amount of protein in the wheat grain. (author)

Avoiding Gluten Cross-Contamination

Science.gov (United States)

... Meal Options for Kids with Food Allergies The Gluten-Free Diet Watch and Learn Videos View More What a ... on This Topic Does My Child Need a Gluten Free Diet Gluten is a protein found in certain grains ...

Maize Prolamins Could Induce a Gluten-Like Cellular Immune Response in Some Celiac Disease Patients

Science.gov (United States)

Ortiz-Sánchez, Juan P.; Cabrera-Chávez, Francisco; Calderón de la Barca, Ana M.

2013-01-01

Celiac disease (CD) is an autoimmune-mediated enteropathy triggered by dietary gluten in genetically prone individuals. The current treatment for CD is a strict lifelong gluten-free diet. However, in some CD patients following a strict gluten-free diet, the symptoms do not remit. These cases may be refractory CD or due to gluten contamination; however, the lack of response could be related to other dietary ingredients, such as maize, which is one of the most common alternatives to wheat used in the gluten-free diet. In some CD patients, as a rare event, peptides from maize prolamins could induce a celiac-like immune response by similar or alternative pathogenic mechanisms to those used by wheat gluten peptides. This is supported by several shared features between wheat and maize prolamins and by some experimental results. Given that gluten peptides induce an immune response of the intestinal mucosa both in vivo and in vitro, peptides from maize prolamins could also be tested to determine whether they also induce a cellular immune response. Hypothetically, maize prolamins could be harmful for a very limited subgroup of CD patients, especially those that are non-responsive, and if it is confirmed, they should follow, in addition to a gluten-free, a maize-free diet. PMID:24152750

The Gluten-Free Diet: Testing Alternative Cereals Tolerated by Celiac Patients

Directory of Open Access Journals (Sweden)

Carolina Sousa

2013-10-01

Full Text Available A strict gluten-free diet (GFD is the only currently available therapeutic treatment for patients with celiac disease, an autoimmune disorder of the small intestine associated with a permanent intolerance to gluten proteins. The complete elimination of gluten proteins contained in cereals from the diet is the key to celiac disease management. However, this generates numerous social and economic repercussions due to the ubiquity of gluten in foods. The research presented in this review focuses on the current status of alternative cereals and pseudocereals and their derivatives obtained by natural selection, breeding programs and transgenic or enzymatic technology, potential tolerated by celiac people. Finally, we describe several strategies for detoxification of dietary gluten. These included enzymatic cleavage of gliadin fragment by Prolyl endopeptidases (PEPs from different organisms, degradation of toxic peptides by germinating cereal enzymes and transamidation of cereal flours. This information can be used to search for and develop cereals with the baking and nutritional qualities of toxic cereals, but which do not exacerbate this condition.

The Oslo definitions for coeliac disease and related terms

Science.gov (United States)

Ludvigsson, Jonas F; Leffler, Daniel A; Bai, Julio; Biagi, Federico; Fasano, Alessio; Green, Peter HR; Hadjivassiliou, Marios; Kaukinen, Katri; Kelly, Ciaran; Leonard, Jonathan N; Lundin, Knut E; Murray, Joseph A; Sanders, David S; Walker, Marjorie M; Zingone, Fabiana; Ciacci, Carolina

2012-01-01

Background The literature suggests a lack of consensus on the use of terms related to coeliac disease (CD) and gluten. Methods A multi-disciplinary task force of 16 physicians from 7 countries used the electronic database PubMed to review the literature with regards to CD-related terms up to January 2011. Teams of physicians then suggested a definition for each term, followed by feedback of these definitions through a web survey on definitions, discussions during a meeting in Oslo, and phone conferences. We evaluated the following terms (in alphabetical order): Coeliac disease and the following descriptors of CD: asymptomatic, atypical, classical, latent, non-classical, overt, paediatric classical, potential, refractory, silent, subclinical, symptomatic, typical, CD serology, CD autoimmunity, genetically at risk of CD, dermatitis herpetiformis, gluten, gluten ataxia, gluten intolerance, gluten sensitivity, and gliadin-specific antibodies. Results CD was defined as “a chronic small intestinal immune-mediated enteropathy precipitated by exposure to dietary gluten in genetically predisposed individuals”. Classical CD was defined as “CD presenting with signs and symptoms of malabsorption. Diarrhoea, steatorrhoea, weight loss or growth failure is required.” We suggest that “gluten-related disorders” is the umbrella term for all diseases triggered by gluten and that the term gluten intolerance is not to be used. Other definitions are presented in the paper. Conclusion This paper presents the Oslo definitions for CD-related terms. PMID:22345659

Motives for adherence to a gluten-free diet: a qualitative investigation involving adults with coeliac disease.

Science.gov (United States)

Dowd, A J; Tamminen, K A; Jung, M E; Case, S; McEwan, D; Beauchamp, M R

2014-12-01

Currently , the only treatment for coeliac disease is life long adherence to a strict gluten-free diet. Strict adherence to a gluten-free diet is challenging, with recent reports suggesting that adherence rates range from 42% to 91%. The present study aimed to: (i) identify motives for adhering to a gluten-free diet and (ii) explore factors implicated in adherence and non-adherence behaviour in terms of accidental and purposeful gluten consumption among adults with coeliac disease. Two hundred and three adults with coeliac disease completed an online questionnaire. Using a qualitative design, relationships were examined between reported adherence and motivation to follow a gluten-free diet, as well as the onset, duration and severity of symptoms. Feelings of desperation (‘hitting rock bottom’) and needing to gain or lose weight were associated with the strictest adherence to a gluten-free diet. Participants who accidentally consumed gluten over the past week developed symptoms the most quickly and reported the most pain over the past 6 months. Participants who consumed gluten on purpose over the past week reported a shorter duration of symptoms and less pain over the past 6 months. Hitting rock bottom and needing to gain or lose weight were factors associated with the strictest adherence, when considered in the context of both accidental and purposeful gluten consumption. Future research is warranted to develop resources to help people with coeliac disease follow a strict gluten-free diet.

PROTEIN COMPLEX OF WHEAT, BUCKWHEAT AND MAIZE IN RELATION TO CELIAC DISEASE

Directory of Open Access Journals (Sweden)

Milan Chňapek

2014-02-01

Full Text Available Cereals are the most wide spread and very important plants utilized as a food source for mankind and for animals where they play role in energetical metabolism and proteosynthesis. Cereals contain proteins with unique properties. These properties allow us to produce leavened bread. Technological characteristic of cereal grain is determined by quantity and quality of storage proteins which represent alcohol soluble prolamins and glutenins soluble in acids and basis solutions. Celiac disease is one of the most frequent food intolerance caused by cereal storage proteins. Therapy consists of strict diet without consumptions of cereals or gluten. Pseudocereals are very perspective groups of plants in gluten free diet, due to absence of celiac active proteins, but on the other hand, flour from pseudocereals is not very suitable for baking. There are a lot of analytical methods applicable for detection of celiac active proteins in cereal and pseudocereal grain. Electrophoretical and immunochemical methods are the most utilized. Genotypes of wheat and maize were homogeneous and singlelined in contrast with genotypes of buckwheat. Average content of HMW-GS was highest in genotypes of bread wheat and lowest in buckwheat varieties. A celiac active fraction of storage proteins (LMW-GS and gliadins was detected at the highest content level in wheat genotypes. Genotypes of buckwheat and maize showed similar low content of this protein fraction. Presence of residual albumins and globulins in buckwheat varieties showed the highest value.

Similar Responses of Intestinal T Cells From Untreated Children and Adults With Celiac Disease to Deamidated Gluten Epitopes.

Science.gov (United States)

Ráki, Melinda; Dahal-Koirala, Shiva; Yu, Hao; Korponay-Szabó, Ilma R; Gyimesi, Judit; Castillejo, Gemma; Jahnsen, Jørgen; Qiao, Shuo-Wang; Sollid, Ludvig M

2017-09-01

Celiac disease is a chronic small intestinal inflammatory disorder mediated by an immune response to gluten peptides in genetically susceptible individuals. Celiac disease is often diagnosed in early childhood, but some patients receive a diagnosis late in life. It is uncertain whether pediatric celiac disease is distinct from adult celiac disease. It has been proposed that gluten-reactive T cells in children recognize deamidated and native gluten epitopes, whereas T cells from adults only recognize deamidated gluten peptides. We studied the repertoire of gluten epitopes recognized by T cells from children and adults. We examined T-cell responses against gluten by generating T-cell lines and T-cell clones from intestinal biopsies of adults and children and tested proliferative response to various gluten peptides. We analyzed T cells from 14 children (2-5 years old) at high risk for celiac disease who were followed for celiac disease development. We also analyzed T cells from 6 adults (26-55 years old) with untreated celiac disease. All children and adults were positive for HLA-DQ2.5. Biopsies were incubated with gluten digested with chymotrypsin (modified or unmodified by the enzyme transglutaminase 2) or the peptic-tryptic digest of gliadin (in native and deamidated forms) before T-cell collection. Levels of T-cell responses were higher to deamidated gluten than to native gluten in children and adults. T cells from children and adults each reacted to multiple gluten epitopes. Several T-cell clones were cross-reactive, especially clones that recognized epitopes from γ-and ω-gliadin. About half of the generated T-cell clones from children and adults reacted to unknown epitopes. T-cell responses to different gluten peptides appear to be similar between adults and children at the time of diagnosis of celiac disease. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

Acid Hydrolysis of Wheat Gluten Induces Formation of New Epitopes but Does Not Enhance Sensitizing Capacity by the Oral Route: A Study in “Gluten Free” Brown Norway Rats

DEFF Research Database (Denmark)

Kroghsbo, Stine; Andersen, Nanna Birch; Rasmussen, Tina Frid

2014-01-01

the sensitizing capacity of gluten proteins per se when altered by acid or enzymatic hydrolysis relative to unmodified gluten in rats naïve to gluten. Methods High IgE-responder Brown Norway (BN) rats bred on a gluten-free diet were sensitized without the use of adjuvant to three different gluten products...... (unmodified, acid hydrolyzed and enzymatic hydrolyzed). Rats were sensitized by intraperitoneal (i.p.) immunization three times with 200 µg gluten protein/rat or by oral dosing for 35 days with 0.2, 2 or 20 mg gluten protein/rat/day. Sera were analyzed for specific IgG and IgE and IgG-binding capacity...... by ELISA. IgE functionality was measured by rat basophilic leukemia (RBL) assay. Results Regardless of the route of dosing, all products had sensitizing capacity. When sensitized i.p., all three gluten products induced a strong IgG1 response in all animals. Acid hydrolyzed gluten induced the highest level...

Factors governing long-term adherence to a gluten-free diet in adult patients with coeliac disease.

Science.gov (United States)

Villafuerte-Galvez, J; Vanga, R R; Dennis, M; Hansen, J; Leffler, D A; Kelly, C P; Mukherjee, R

2015-09-01

A strict gluten-free diet is the cornerstone of treatment for coeliac disease. Studies of gluten-free diet adherence have rarely used validated instruments. There is a paucity of data on long-term adherence to the gluten-free diet in the adult population. To determine the long-term adherence to the gluten-free diet and potential associated factors in a large coeliac disease referral centre population. We performed a mailed survey of adults with clinically, serologically and histologically confirmed coeliac disease diagnosed ≥5 years prior to survey. The previously validated Celiac Disease Adherence Test was used to determine adherence. Demographic, socio-economic and potentially associated factors were analysed with adherence as the outcome. The response rate was 50.1% of 709 surveyed, the mean time on a gluten-free diet 9.9 ± 6.4 years. Adequate adherence (celiac disease adherence test score 75% of respondents. Perceived cost remains a barrier to adherence. Perceptions of effectiveness of gluten-free diet as well as its knowledge, are potential areas for intervention. © 2015 John Wiley & Sons Ltd.

Self-Reported Prevalence of Symptomatic Adverse Reactions to Gluten and Adherence to Gluten-Free Diet in an Adult Mexican Population.

Science.gov (United States)

Ontiveros, Noe; López-Gallardo, Jesús A; Vergara-Jiménez, Marcela J; Cabrera-Chávez, Francisco

2015-07-21

The prevalence of symptomatic adverse reactions to gluten and adherence to gluten-free diet in Latin American countries is unknown. These measurements are strongly linked to gluten-related disorders. This work aimed to estimate the prevalence of adverse reactions to oral gluten and the adherence to gluten-free diet in the adult Mexican population. To reach this aim, a self-administered questionnaire was designed and tested for clarity/comprehension and reproducibility. Then, a self-administered questionnaire-based cross-sectional study was conducted in the Mexican population. The estimated prevalence rates were (95% CI): 11.9% (9.9-13.5) and 7.8 (6.4-9.4) for adverse and recurrent adverse reactions to gluten respectively; adherence to gluten-free diet 3.7% (2.7-4.8), wheat allergy 0.72% (0.38-1.37); celiac disease 0.08% (0.01-0.45), and NCGS 0.97% (0.55-1.68). Estimated pooled prevalence of self-reported physician-diagnosis of gluten-related disorders was 0.88% (0.49-1.5), and 93.3% respondents reported adherence to gluten-free diet without a physician-diagnosis of gluten-related disorders. Symptom comparisons between those who reported recurrent adverse reactions to gluten and other foods showed statistically significant differences for bloating, constipation, and tiredness (p Gluten-related disorders may be underdiagnosed in the Mexican population and most people adhering to a gluten-free diet are doing it without proper diagnostic work-up of these disorders, and probably without medical/dietician advice.

Diagnosis and classification of celiac disease and gluten sensitivity.

Science.gov (United States)

Tonutti, Elio; Bizzaro, Nicola

2014-01-01

Celiac disease is a complex disorder, the development of which is controlled by a combination of genetic (HLA alleles) and environmental (gluten ingestion) factors. New diagnostic guidelines developed by ESPGHAN emphasize the crucial role of serological tests in the diagnostic process of symptomatic subjects, and of the detection of HLA DQ2/DQ8 alleles in defining a diagnosis in asymptomatic subjects belonging to at-risk groups. The serological diagnosis of CD is based on the detection of class IgA anti-tissue transglutaminase (anti-tTG) and anti-endomysial antibodies. In patients with IgA deficiency, anti-tTG or anti-deamidated gliadin peptide antibody assays of the IgG class are used. When anti-tTG antibody levels are very high, antibody specificity is absolute and CD can be diagnosed without performing a duodenum biopsy. Non-celiac gluten sensitivity is a gluten reaction in which both allergic and autoimmune mechanisms have been ruled out. Diagnostic criteria include the presence of symptoms similar to those of celiac or allergic patients; negative allergological tests and absence of anti-tTG and EMA antibodies; normal duodenal histology; evidence of disappearance of the symptoms with a gluten-free diet; relapse of the symptoms when gluten is reintroduced. Copyright © 2014 Elsevier B.V. All rights reserved.

The role of gluten in a pound cake system: A model approach based on gluten-starch blends.

Science.gov (United States)

Wilderjans, Edith; Pareyt, Bram; Goesaert, Hans; Brijs, Kristof; Delcour, Jan A

2008-10-15

In order to evaluate the role of gluten in cake-making, gluten-starch (GS) blends with different ratios of gluten to starch were tested in a research pound cake formula. The viscosities of batters made from commercial GS blends in the otherwise standardised formula increased with their gluten content. High viscosities during heating provide the batters with the capacity to retain expanding air nuclei, and thereby led to desired product volumes. In line with the above, increasing gluten levels in the cake recipes led to a more extended oven spring period. Cakes with a starch content exceeding 92.5% in the GS blend suffered from substantial collapse during cooling. They had a coarse crumb with a solid gummy layer at the bottom. Image analysis showed statistical differences in numbers of cells per cm(2), cell to total area ratio and mean cell area (pcakes with the lowest density and highest gluten levels. Relative sodium dodecyl sulfate (SDS, 2.0%) buffer (pH 6.8) extractabilities of protein from cakes baked with the different GS blends decreased with gluten content and were strongly correlated with the intensity of collapse. Taken together, the results teach that protein gives the cakes resistance to collapse, resulting in desirable volumes and an optimal grain structure with uniform cell distribution. Copyright © 2008 Elsevier Ltd. All rights reserved.

The Role of Oxidative Stress in the Etiopathogenesis of Gluten-Sensitive Enteropathy Disease

Directory of Open Access Journals (Sweden)

Kaplan Mustafa

2017-09-01

Full Text Available Background: The objective here is to examine the role of overall oxidative stress in the etiopathogenesis of gluten-sensitive enteropathy disease and its relationship with gluten free diet and autoantibodies.

Celiac disease : from basic insight to therapy development

NARCIS (Netherlands)

Stępniak, Dariusz Tomasz

2006-01-01

Celiac disease (CD) is a common disorder of the small intestine caused by intolerance to gluten, proteins found in wheat and related cereals. In this study two major questions were addressed: i) which specific properties of gluten contribute to its disease-inducing characteristics ii) how can gluten

Self-Reported Prevalence of Symptomatic Adverse Reactions to Gluten and Adherence to Gluten-Free Diet in an Adult Mexican Population

Directory of Open Access Journals (Sweden)

Noe Ontiveros

2015-07-01

Full Text Available The prevalence of symptomatic adverse reactions to gluten and adherence to gluten-free diet in Latin American countries is unknown. These measurements are strongly linked to gluten-related disorders. This work aimed to estimate the prevalence of adverse reactions to oral gluten and the adherence to gluten-free diet in the adult Mexican population. To reach this aim, a self-administered questionnaire was designed and tested for clarity/comprehension and reproducibility. Then, a self-administered questionnaire-based cross-sectional study was conducted in the Mexican population. The estimated prevalence rates were (95% CI: 11.9% (9.9–13.5 and 7.8 (6.4–9.4 for adverse and recurrent adverse reactions to gluten respectively; adherence to gluten-free diet 3.7% (2.7–4.8, wheat allergy 0.72% (0.38–1.37; celiac disease 0.08% (0.01–0.45, and NCGS 0.97% (0.55–1.68. Estimated pooled prevalence of self-reported physician-diagnosis of gluten-related disorders was 0.88% (0.49–1.5, and 93.3% respondents reported adherence to gluten-free diet without a physician-diagnosis of gluten-related disorders. Symptom comparisons between those who reported recurrent adverse reactions to gluten and other foods showed statistically significant differences for bloating, constipation, and tiredness (p < 0.05. Gluten-related disorders may be underdiagnosed in the Mexican population and most people adhering to a gluten-free diet are doing it without proper diagnostic work-up of these disorders, and probably without medical/dietician advice.

Functional replacements for gluten

NARCIS (Netherlands)

Zannini, E.; Jones, J.M.; Renzetti, S.; Arendt, E.K.

2012-01-01

Celiac disease (CD) is an immune-mediated disease triggered in genetically susceptible individuals by ingested gluten from wheat, rye, barley, and other closely related cereal grains. Currently, the only therapy able to normalize the clinical and histological manifestation of the disease is a strict

The preferred substrates for transglutaminase 2 in a complex wheat gluten digest are Peptide fragments harboring celiac disease T-cell epitopes.

Directory of Open Access Journals (Sweden)

Siri Dørum

Full Text Available BACKGROUND: Celiac disease is a T-cell mediated chronic inflammatory disorder of the gut that is induced by dietary exposure to gluten proteins. CD4+ T cells of the intestinal lesion recognize gluten peptides in the context of HLA-DQ2.5 or HLA-DQ8 and the gluten derived peptides become better T-cell antigens after deamidation catalyzed by the enzyme transglutaminase 2 (TG2. In this study we aimed to identify the preferred peptide substrates of TG2 in a heterogeneous proteolytic digest of whole wheat gluten. METHODS: A method was established to enrich for preferred TG2 substrates in a complex gluten peptide mixture by tagging with 5-biotinamido-pentylamine. Tagged peptides were isolated and then identified by nano-liquid chromatography online-coupled to tandem mass spectrometry, database searching and final manual data validation. RESULTS: We identified 31 different peptides as preferred substrates of TG2. Strikingly, the majority of these peptides were harboring known gluten T-cell epitopes. Five TG2 peptide substrates that were predicted to bind to HLA-DQ2.5 did not contain previously characterized sequences of T-cell epitopes. Two of these peptides elicited T-cell responses when tested for recognition by intestinal T-cell lines of celiac disease patients, and thus they contain novel candidate T-cell epitopes. We also found that the intact 9mer core sequences of the respective epitopes were not present in all peptide substrates. Interestingly, those epitopes that were represented by intact forms were frequently recognized by T cells in celiac disease patients, whereas those that were present in truncated versions were infrequently recognized. CONCLUSION: TG2 as well as gastrointestinal proteolysis play important roles in the selection of gluten T-cell epitopes in celiac disease.

The Preferred Substrates for Transglutaminase 2 in a Complex Wheat Gluten Digest Are Peptide Fragments Harboring Celiac Disease T-Cell Epitopes

Science.gov (United States)

Dørum, Siri; Arntzen, Magnus Ø.; Qiao, Shuo-Wang; Holm, Anders; Koehler, Christian J.; Thiede, Bernd; Sollid, Ludvig M.; Fleckenstein, Burkhard

2010-01-01

Background Celiac disease is a T-cell mediated chronic inflammatory disorder of the gut that is induced by dietary exposure to gluten proteins. CD4+ T cells of the intestinal lesion recognize gluten peptides in the context of HLA-DQ2.5 or HLA-DQ8 and the gluten derived peptides become better T-cell antigens after deamidation catalyzed by the enzyme transglutaminase 2 (TG2). In this study we aimed to identify the preferred peptide substrates of TG2 in a heterogeneous proteolytic digest of whole wheat gluten. Methods A method was established to enrich for preferred TG2 substrates in a complex gluten peptide mixture by tagging with 5-biotinamido-pentylamine. Tagged peptides were isolated and then identified by nano-liquid chromatography online-coupled to tandem mass spectrometry, database searching and final manual data validation. Results We identified 31 different peptides as preferred substrates of TG2. Strikingly, the majority of these peptides were harboring known gluten T-cell epitopes. Five TG2 peptide substrates that were predicted to bind to HLA-DQ2.5 did not contain previously characterized sequences of T-cell epitopes. Two of these peptides elicited T-cell responses when tested for recognition by intestinal T-cell lines of celiac disease patients, and thus they contain novel candidate T-cell epitopes. We also found that the intact 9mer core sequences of the respective epitopes were not present in all peptide substrates. Interestingly, those epitopes that were represented by intact forms were frequently recognized by T cells in celiac disease patients, whereas those that were present in truncated versions were infrequently recognized. Conclusion TG2 as well as gastrointestinal proteolysis play important roles in the selection of gluten T-cell epitopes in celiac disease. PMID:21124911

Gluten contamination in gluten-free bakery products: a risk for coeliac disease patients.

Science.gov (United States)

Farage, Priscila; de Medeiros Nóbrega, Yanna Karla; Pratesi, Riccardo; Gandolfi, Lenora; Assunção, Pedro; Zandonadi, Renata Puppin

2017-02-01

The present study aimed to assess the safety of gluten-free bakery products for consumption by coeliac patients. Design/setting In the current exploratory cross-sectional quantitative study, a total of 130 samples were collected from twenty-five bakeries in Brasilia (Brazil). For the quantification of gluten, an ELISA was used. The threshold of 20 ppm gluten was considered as the safe upper limit for gluten-free food, as proposed in the Codex Alimentarius. The results revealed a total of 21·5 % of contamination among the bakery products sampled. Sixty-four per cent of the bakeries sold at least one contaminated product in our sample. These findings represent a risk for coeliac patients since the ingestion of gluten traces may be sufficient to adversely impact on their health.

Is it gluten-free? Relationship between self-reported gluten-free diet adherence and knowledge of gluten content of foods.

Science.gov (United States)

Silvester, Jocelyn A; Weiten, Dayna; Graff, Lesley A; Walker, John R; Duerksen, Donald R

2016-01-01

To assess the relationship between self-reported adherence to a gluten-free diet (GFD) and the ability to determine correctly the appropriateness of particular foods in a GFD. Persons with celiac disease were recruited through clinics and support groups. Participants completed a questionnaire with items related to GFD information sources, gluten content of 17 common foods (food to avoid, food allowed, and food to question), GFD adherence, and demographic characteristics. Diagnosis was self-reported. The 82 respondents (88% female) had a median of 6 y GFD experience. Most (55%) reported strict adherence, 18% reported intentional gluten consumption and 21% acknowledged rare unintentional gluten consumption. Cookbooks, advocacy groups, and print media were the most commonly used GFD information sources (85-92%). No participant identified correctly the gluten content of all 17 foods; only 30% identified at least 14 foods correctly. The median score on the Gluten-Free Diet Knowledge Scale (GFD-KS) was 11.5 (interquartile ratio, 10-13). One in five incorrect responses put the respondent at risk of consuming gluten. GFD-KS scores did not correlate with self-reported adherence or GFD duration. Patient advocacy group members scored significantly higher on the GFD-KS than non-members (12.3 versus 10.6; P gluten ingestion overestimate GFD adherence. Individuals who believe they are following a GFD are not readily able to correctly identify foods that are GF, which suggests ongoing gluten consumption may be occurring, even among patients who believe they are "strictly" adherent. The role of patient advocacy groups and education to improve outcomes through improved adherence to a GFD requires further research. Copyright © 2016 Elsevier Inc. All rights reserved.

Intake and sources of gluten in 20- to 75-year-old Danish adults

DEFF Research Database (Denmark)

Hoppe, Camilla; Gøbel, Rikke Juul; Kristensen, Mette

2017-01-01

PURPOSE: Celiac disease, an immunological response triggered by gluten, affects ~1 % of the Western population. Information concerning gluten intake in the general population is scarce. We determined intake of gluten from wheat, barley, rye and oat in the Danish National Survey of Diet and Physical...... with the amount of cereal used in recipes. Amount of gluten was calculated as amount of cereal protein ×0.80 for wheat and oat, ×0.65 for rye and ×0.50 for barley. Dietary intake was recorded daily during seven consecutive days in pre-coded food diaries with open-answer possibilities. RESULTS: Mean total gluten...... gluten sources tended to be higher in men than in women with the exception of gluten from barley. Total gluten intake decreased with increasing age (P gluten intake from wheat (P gluten from rye (P

Specific nongluten proteins of wheat are novel target antigens in celiac disease humoral response

Science.gov (United States)

Background: Celiac disease is an immune-mediated enteropathy that is generally understood to be triggered by the ingestion of gluten proteins of wheat and related cereals. The skin manifestation of the condition is known as dermatitis herpetiformis. Antibody response to native and deamidated seque...

Whole grain gluten-free egg-free high protein pasta

Science.gov (United States)

The USDA food guide recommends that at least ½ of all the grains eaten should be whole grains. The FDA allows food Health Claim labels for food containing 51% whole gains and 11 g of dietary fiber. This is the only report demonstrating innovative whole grain, high protein, gluten-free, egg-free past...

Plasma alkylresorcinols reflect gluten intake and distinguish between gluten-rich and gluten-poor diets in a population at risk of metabolic syndrome

DEFF Research Database (Denmark)

Lind, Mads Vendelbo; Madsen, Mia Linda; Rumessen, Jüri J

2016-01-01

BACKGROUND: Many patients with celiac disease experience difficulties in adherence to a gluten-free diet. Methods for testing compliance to a gluten-free diet are costly and cumbersome. Thus, a simple biomarker of gluten intake is needed in a clinical setting and will be useful for epidemiologic...... in plasma total alkylresorcinols per 1-g increase in reported gluten intake (P gluten-free diet as well as to help investigations into the possible effects of gluten in the wider population. This trial...... 8 wk of a gluten-rich and gluten-poor diet separated by a washout period of ≥6 wk. We measured fasting plasma concentrations of alkylresorcinols to determine if they reflected differences in gluten intake as a secondary outcome of the original study. In addition, we investigated in 118 Danish adults...

Interaction of water extractable pentosans with gluten protein : effect on dough properties and gluten quality

NARCIS (Netherlands)

Wang, M.; Hamer, R.J.; Vliet, van T.; Oudgenoeg, G.

2002-01-01

The effects of modified water extractable pentosans (WEP) on gluten yield, dough properties, gluten quality and composition were studied. The results show that WEP interfere with gluten formation in both a direct and an indirect way. WEP interfere indirectly by competing for water and thus changing

Gluten-free diet is for some a necessity, for others a lifestyle

DEFF Research Database (Denmark)

Jønsson, Iben Møller; Møller, Gitte Leth; Pærregaard, Anders

2017-01-01

This review provides a brief overview of the gluten-related conditions coeliac disease (CD), wheat allergy (WA), and non-coeliac gluten sensitivity (NCGS). NCGS is a new entity which includes individuals who report symptoms when exposed to gluten and benefit from gluten-free diet, but do not have...

Effect of gluten, egg and soy proteins on the rheological and thermo-mechanical properties of wholegrain rice flour.

Science.gov (United States)

Pătraşcu, Livia; Banu, Iuliana; Vasilean, Ina; Aprodu, Iuliana

2017-03-01

The effect of protein addition on the rheological, thermo-mechanical and baking properties of wholegrain rice flour was investigated. Gluten, powdered eggs and soy protein concentrate were first analyzed in terms of rheological properties, alone and in admixture with rice flour. The temperature ramp tests showed clear differences in the rheological behavior of the batters supplemented with different proteins. The highest thermal stability was observed in case of soy protein samples. Frequency sweep tests indicated significant improvements of the rheological properties of rice flour supplemented with 15% gluten or soy proteins. The thermo-mechanical tests showed that, due to the high fat contents and low level of free water, the dough samples containing powdered eggs exhibited the highest stability. Addition of gluten resulted in a significant decrease of the dough development time, whereas samples with powdered eggs and soy proteins were more difficult to hydrate. The incorporation of proteins into the rice flour-based dough formulations significantly affected starch behavior by decreasing the peak consistency values. Concerning the quality of the rice flour-based breads, soy protein addition resulted in lighter crumb color and increased texture attributes, samples with gluten had better resilience and adhesiveness, whereas breads with egg protein were less brittle.

The Role of Celiac Disease in Severity of Liver Disorders and Effect of a Gluten Free Diet on Diseases Improvement

Science.gov (United States)

Rostami-Nejad, Mohammad; Haldane, Thea; AlDulaimi, David; Alavian, Seyed Moayed; Zali, Mohammad Reza; Rostami, Kamran

2013-01-01

Context Celiac disease (CD) is defined as a permanent intolerance to ingested gluten. The intolerance to gluten results in immune-mediated damage of small intestine mucosa manifested by villous atrophy and crypt hyperplasia. These abnormalities resolve with initiationa gluten-free diet. Evidence Acquisition PubMed, Ovid, and Google were searched for full text articles published between 1963 and 2012. The associated keywords were used, and papers described particularly the impact of celiac disease on severity of liver disorder were identified. Results Recently evidence has emerged revealingthat celiac disease not only is associated with small intestine abnormalities and malabsorption, but is also a multisystem disorder affecting other systems outside gastrointestinal tract, including musculo-skeletal, cardiovascular and nervous systems. Some correlations have been assumed between celiac and liver diseases. In particular, celiac disease is associated with changes in liver biochemistry and linked to alter the prognosis of other disorders. This review will concentrate on the effect of celiac disease and gluten-free diets on the severity of liver disorders. Conclusions Although GFD effect on the progression of CD associated liver diseases is not well defined, it seems that GFD improves liver function tests in patients with a hypertransaminasemia. PMID:24348636

Indications and Use of the Gluten Contamination Elimination Diet for Patients with Non-Responsive Celiac Disease.

Science.gov (United States)

Leonard, Maureen M; Cureton, Pamela; Fasano, Alessio

2017-10-18

For the majority of patients diagnosed with celiac disease, once a gluten-free diet is initiated, symptoms improve within weeks and may completely resolve in months. However, up to 30% of patients may show signs, symptoms or persistent small intestinal damage after one year on a gluten-free diet. These patients require evaluation for other common GI etiologies and assessment of their celiac disease status in order to make a diagnosis and suggest treatment. Here, we propose an approach to evaluating patients with celiac disease with persistent symptoms, persistently elevated serology, and or persistent villous atrophy despite a gluten-free diet. We detail how to diagnose and distinguish between non-responsive and refractory celiac disease. Finally, we introduce the indications for use of the gluten contamination elimination diet and provide information for practitioners to implement the diet when necessary in their practice.

Gluten-free diet - facts and myths.

OpenAIRE

Hejduk Bobková, Barbora

2017-01-01

The aim of this bachelor thesis was to gain a comprehensive view of the gluten-free diet and to confirm or refute the claim that the gluten-free diet became a fashion trend in nutrition. The theoretical part explains the relationship between gluten-free diet and diseases caused by intolerance of gluten. Greater attention is paid to the most serious of these, celiac disease, whose only treatment is gluten-free diet Research of commonly available sources for the general public has produced a li...

Interaction of water unextractable solids with gluten protein: Effect on dough properties and gluten quality

NARCIS (Netherlands)

Wang, M.; Oudgenoeg, G.; Vliet, T. van; Hamer, R.J.

2003-01-01

In a previous study, we have shown that water unextractable solids (WUS) interfere with gluten formation and affect the quality of the resulting gluten. In this study we aim to explain how WUS can affect the process of gluten formation. To this end, WUS were modified with NaOH, xylanase, horseradish

Interaction of water unextractable solids with gluten protein: effect on dough properties and gluten quality

NARCIS (Netherlands)

Wang, M.; Oudgenoeg, G.; Vliet, van T.; Hamer, R.J.

2003-01-01

Abstract In a previous study, we have shown that water unextractable solids (WUS) interfere with gluten formation and affect the quality of the resulting gluten. In this study we aim to explain how WUS can affect the process of gluten formation. To this end, WUS were modified with NaOH, xylanase,

Identification of food-grade subtilisins as gluten-degrading enzymes to treat celiac disease

Science.gov (United States)

Wei, Guoxian; Tian, Na; Siezen, Roland; Schuppan, Detlef

2016-01-01

Gluten are proline- and glutamine-rich proteins present in wheat, barley, and rye and contain the immunogenic sequences that drive celiac disease (CD). Rothia mucilaginosa, an oral microbial colonizer, can cleave these gluten epitopes. The aim was to isolate and identify the enzymes and evaluate their potential as novel enzyme therapeutics for CD. The membrane-associated R. mucilaginosa proteins were extracted and separated by DEAE chromatography. Enzyme activities were monitored with paranitroanilide-derivatized and fluorescence resonance energy transfer (FRET) peptide substrates, and by gliadin zymography. Epitope elimination was determined in R5 and G12 ELISAs. The gliadin-degrading Rothia enzymes were identified by LC-ESI-MS/MS as hypothetical proteins ROTMU0001_0241 (C6R5V9_9MICC), ROTMU0001_0243 (C6R5W1_9MICC), and ROTMU0001_240 (C6R5V8_9MICC). A search with the Basic Local Alignment Search Tool revealed that these are subtilisin-like serine proteases belonging to the peptidase S8 family. Alignment of the major Rothia subtilisins indicated that all contain the catalytic triad with Asp (D), His (H), and Ser (S) in the D-H-S order. They cleaved succinyl-Ala-Ala-Pro-Phe-paranitroanilide, a substrate for subtilisin with Pro in the P2 position, as in Tyr-Pro-Gln and Leu-Pro-Tyr in gluten, which are also cleaved. Consistently, FRET substrates of gliadin immunogenic epitopes comprising Xaa-Pro-Xaa motives were rapidly hydrolyzed. The Rothia subtilisins and two subtilisins from Bacillus licheniformis, subtilisin A and the food-grade Nattokinase, efficiently degraded the immunogenic gliadin-derived 33-mer peptide and the immunodominant epitopes recognized by the R5 and G12 antibodies. This study identified Rothia and food-grade Bacillus subtilisins as promising new candidates for enzyme therapeutics in CD. PMID:27469368

Gluten intake and gluten-free diet in the Netherlands

NARCIS (Netherlands)

Hopman, Geertruida Dorothea

2008-01-01

Celiac disease is an intolerance to dietary gluten in genetically predisposed individuals, leading to alterations of the small bowel mucosa. The treatment consists of a life-long, gluten-free diet. The aims of this thesis were to measure some of the environmental factors considered to play a role

Gluten sensitivity in patients with IgA nephropathy.

Science.gov (United States)

Smerud, Hilde Kloster; Fellström, Bengt; Hällgren, Roger; Osagie, Sonia; Venge, Per; Kristjánsson, Gudjón

2009-08-01

Coeliac disease is more frequent in IgA nephropathy (IgAN) patients compared to the healthy population. Several hypotheses postulate that food antigens like gluten may be involved in the onset of IgAN. In this study, we used a recently developed mucosal patch technique to evaluate the rectal mucosal inflammatory reaction to gluten in patients with IgAN (n = 27) compared to healthy subjects (n = 18). The rectal mucosal production of nitric oxide (NO) and release of myeloperoxidase (MPO) and eosinophil cationic protein (ECP) were measured. Serum samples were analysed for IgA and IgG antigliadin antibodies (AGA), IgA antibodies against tissue transglutaminase and IgA endomysium antibodies. Gluten reactivity, defined as increase in MPO and/or NO after gluten exposure, was observed in 8 of 27 IgAN patients. The prevalence of HLA-DQ2 and DQ8 was not increased among gluten-sensitive patients, and the total prevalence among IgAN patients was the same as for the normal population. An elevated serum IgA AGA response was seen in 9 of 27 IgAN patients. The increase in IgA AGA did not correlate with the gluten sensitivity as measured by NO and/or MPO. A specific serum IgG AGA response was seen in one patient only. Antibodies against tissue transglutaminase and endomysium were not observed. It is concluded that approximately one-third of our IgAN patients have a rectal mucosal sensitivity to gluten, but without signs of coeliac disease, and we hypothesize that such sub-clinical inflammation to gluten might be involved in the pathogenesis of IgAN in a subgroup of patients.

21 CFR 184.1322 - Wheat gluten.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 3 2010-04-01 2009-04-01 true Wheat gluten. 184.1322 Section 184.1322 Food and... Substances Affirmed as GRAS § 184.1322 Wheat gluten. (a) Wheat gluten (CAS Reg. No. 8002-80-0) is the principal protein component of wheat and consists mainly of gliadin and glutenin. Wheat gluten is obtained...

21 CFR 184.1321 - Corn gluten.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 3 2010-04-01 2009-04-01 true Corn gluten. 184.1321 Section 184.1321 Food and... Substances Affirmed as GRAS § 184.1321 Corn gluten. (a) Corn gluten (CAS Reg. No. 66071-96-3), also known as corn gluten meal, is the principal protein component of corn endosperm. It consists mainly of zein and...

Adherence to the Gluten-free Diet and Health-related Quality of Life in an Ethnically Diverse Pediatric Population With Celiac Disease.

Science.gov (United States)

Mager, Diana R; Marcon, Margaret; Brill, Herbert; Liu, Amanda; Radmanovich, Kristin; Mileski, Heather; Nasser, Roseann; Alzaben, Abeer; Carroll, Matthew W; Yap, Jason; Persad, Rabin; Turner, Justine M

2018-06-01

Celiac disease (CD) is an autoimmune disease that requires lifelong adherence to a gluten-free diet (GFD). Adherence to the GFD in childhood may be poor and adversely influence health-related quality of life (HRQOL). The study purpose was to determine sociodemographic and socioeconomic factors influencing adherence to the GFD and HRQOL in a multiethnic cohort of youth with CD. A multisite (Edmonton, Hamilton, Toronto) study examining child-parent HRQOL in youth with CD (n = 243) and/or mild gastrointestinal complaints (GI-CON; n = 148) was conducted. Sociodemographic (age, child-parental age/education/ethnicity/place of birth), anthropometric (weight, height, body mass index), disease (diagnosis, age at diagnosis, duration, Marsh score, serology), household characteristics (income, family size, region, number of children/total household size), HRQOL (Peds TM/KINDL and Celiac Disease DUX), GI Complaints (PedsQL: Gastrointestinal Symptom Scale) and gluten intake were measured. Younger age (children (P children (parent/child) had higher HRQOL (average, composite domains) than GI-CON (P children were comparable to healthy children. Lack of GI symptoms, non-Caucasian ethnicity and age (<10 years) were associated with increased HRQOL in composite/average domains for CD (P < 0.05). Child-parent perceptions of HRQOL in a multiethnic population with CD are comparable to healthy reference populations, but significantly higher than in parent/child GI-CON. Adherence to the GFD in ethnically diverse youth with CD was related to GI symptoms, age of the child, and ethnicity of the parent-child.

Impact of Tragacanth and Xanthan Gums on the Physical and Textural Characteristics of Gluten-free Cake

OpenAIRE

Mahsa Hojjatoleslami; Mohammad Hossain Azizi

2015-01-01

Background and Objectives: The quality of cakes made of wheat flour depends on the quantity and quality of its gluten proteins; however, these proteins may have side effects for some people, including the patients with celiac, and the only way to cure this disease is to take a lifelong gluten-free diet. Materials and Methods: This research aims to produce gluten- free cake by using rice flour and xanthan and tragacanth gums, including two treatments of xanthan gum (0.5 &1 %), two treatment...

Overview on the General Approaches to Improve Gluten-Free Pasta and Bread

Science.gov (United States)

Padalino, Lucia; Conte, Amalia; Del Nobile, Matteo Alessandro

2016-01-01

The use of gluten-free products is increasing since a growing number of people are suffering from celiac disease and thereby need gluten-free diet. Gluten is responsible for the visco-elastic characteristics of wheat-based products; therefore, its lack makes the gluten-free products not similar to wheat-based product, with scarce textural properties. This reason constitutes the major industrial limitation. Thus, obtaining good-quality gluten-free products represents a technological challenge. This review reports the main strategies adopted to produce high quality gluten-free pasta and bread. They are mainly obtained by the utilization of specific ingredients (hydrocolloids, proteins or enzymes) to be incorporated into the standard formulation or the adoption of proper technological variables that can enhance above all the functional properties, the texture and the taste. PMID:28231182

Clinical benefit of gluten-free diet in screen-detected older celiac disease patients

Directory of Open Access Journals (Sweden)

Vilppula Anitta

2011-12-01

Full Text Available Abstract Background The utility of serologic screening for celiac disease is still debatable. Evidence suggests that the disorder remains undetected even in the older population. It remains obscure whether screening makes good or harm in subjects with long-standing gluten ingestion. We evaluated whether older subjects benefit from active detection and subsequent gluten free dietary treatment of celiac disease. Methods Thirty-five biopsy-proven patients aged over 50 years had been detected by serologic mass screening. We examined the disease history, dietary compliance, symptoms, quality of life and bone mineral density at baseline and 1-2 years after the commencement of a gluten-free diet. Symptoms were evaluated by gastrointestinal symptom rating scale and quality of life by psychological general well-being questionnaires. Small bowel biopsy, serology, laboratory parameters assessing malabsorption, and bone mineral density were investigated. Results Dietary compliance was good. The patients had initially low mean serum ferritin values indicating subclinical iron deficiency, which was restored by a gluten-free diet. Vitamin B12, vitamin D and erythrocyte folic acid levels increased significantly on diet. Celiac patients had a history of low-energy fractures more often than the background population, and the diet had a beneficial effect on bone mineral density. Alleviation in gastrointestinal symptoms was observed, even though the patients reported no or only subtle symptoms at diagnosis. Quality of life remained unchanged. Of all the cases, two thirds would have been diagnosed even without screening if the family history, fractures or concomitant autoimmune diseases had been taken carefully into account. Conclusions Screen-detected patients benefited from a gluten-free diet. We encourage a high index of suspicion and active case-finding in celiac disease as an alternative to mass screening in older patients.

The everyday life of adolescent coeliacs: issues of importance for compliance with the gluten-free diet.

Science.gov (United States)

Olsson, C; Hörnell, A; Ivarsson, A; Sydner, Y M

2008-08-01

Noncompliance with the gluten-free diet is often reported among adolescents with coeliac disease. However, knowledge is limited regarding their own perspectives and experiences of managing the disease and the prescription of a gluten-free diet. The aim of this study was to explore how adolescents with coeliac disease perceive and manage their everyday lives in relation to a gluten-free diet. In total, 47 adolescents with coeliac disease, divided into 10 focus groups, were interviewed. In the qualitative analysis, themes emerged to illustrate and explain the adolescents' own perspectives on life with a gluten-free diet. The probability of compliance with the gluten-free diet was comprised by insufficient knowledge of significant others, problems with the availability and sensory acceptance of gluten-free food, insufficient social support and their perceived dietary deviance. Three different approaches to the gluten-free diet emerged: compliers, occasional noncompliers, and noncompliers. Each approach, as a coping strategy, was rational in the sense that it represented the adolescents' differing views of everyday life with coeliac disease and a prescription of a gluten-free diet. dolescents with coeliac disease experience various dilemmas related to the gluten-free diet. The study demonstrated unmet needs and implies empowerment strategies for optimum clinical outcomes.

A non-human primate model for gluten sensitivity.

Directory of Open Access Journals (Sweden)

Michael T Bethune

2008-02-01

Full Text Available Gluten sensitivity is widespread among humans. For example, in celiac disease patients, an inflammatory response to dietary gluten leads to enteropathy, malabsorption, circulating antibodies against gluten and transglutaminase 2, and clinical symptoms such as diarrhea. There is a growing need in fundamental and translational research for animal models that exhibit aspects of human gluten sensitivity.Using ELISA-based antibody assays, we screened a population of captive rhesus macaques with chronic diarrhea of non-infectious origin to estimate the incidence of gluten sensitivity. A selected animal with elevated anti-gliadin antibodies and a matched control were extensively studied through alternating periods of gluten-free diet and gluten challenge. Blinded clinical and histological evaluations were conducted to seek evidence for gluten sensitivity.When fed with a gluten-containing diet, gluten-sensitive macaques showed signs and symptoms of celiac disease including chronic diarrhea, malabsorptive steatorrhea, intestinal lesions and anti-gliadin antibodies. A gluten-free diet reversed these clinical, histological and serological features, while reintroduction of dietary gluten caused rapid relapse.Gluten-sensitive rhesus macaques may be an attractive resource for investigating both the pathogenesis and the treatment of celiac disease.

Small- bowel mucosal changes and antibody responses after low- and moderate-dose gluten challenge in celiac disease

Directory of Open Access Journals (Sweden)

Lähdeaho Marja-Leena

2011-11-01

Full Text Available Abstract Background Due to the restrictive nature of a gluten-free diet, celiac patients are looking for alternative therapies. While drug-development programs include gluten challenges, knowledge regarding the duration of gluten challenge and gluten dosage is insufficient. We challenged adult celiac patients with gluten with a view to assessing the amount needed to cause some small-bowel mucosal deterioration. Methods Twenty-five celiac disease adults were challenged with low (1-3 g or moderate (3-5g doses of gluten daily for 12 weeks. Symptoms, small-bowel morphology, densities of CD3+ intraepithelial lymphocytes (IELs and celiac serology were determined. Results Both moderate and low amounts of gluten induced small-bowel morphological damage in 67% of celiac patients. Moderate gluten doses also triggered mucosal inflammation and more gastrointestinal symptoms leading to premature withdrawals in seven cases. In 22% of those who developed significant small- intestinal damage, symptoms remained absent. Celiac antibodies seroconverted in 43% of the patients. Conclusions Low amounts of gluten can also cause significant mucosal deterioration in the majority of the patients. As there are always some celiac disease patients who will not respond within these conditions, sample sizes must be sufficiently large to attain to statistical power in analysis.

[Nutritional assessment of gluten-free diet. Is gluten-free diet deficient in some nutrient?].

Science.gov (United States)

Salazar Quero, J C; Espín Jaime, B; Rodríguez Martínez, A; Argüelles Martín, F; García Jiménez, R; Rubio Murillo, M; Pizarro Martín, A

2015-07-01

The gluten-free diet has traditionally been accepted as a healthy diet, but there are articles advocating that it may have some nutritional deficiencies. The current study assesses whether there was any change in the contributions of calories, essential elements, proportion of fatty acids, vitamins, minerals and fiber in children who were diagnosed with celiac diseases, comparing the diet with gluten prior one year after diagnosis with the diet without gluten to the year of diagnosis. The level of clinical or analytical impact that nutritional deficits could have was also assessed. A prospective,descriptive, observational study in which information was collected from a dietary survey, anthropometric and analytical data at pre-diagnosis of celiac disease and following a gluten diet and one year after celiac disease diagnosis, under gluten-free diet. A total of 37 patients meet the study criteria. A decrease in the intake of saturated fatty acids was found, with an increase of monounsaturated fatty acids and an increase in the intake of phosphorus in the diet without gluten. A deficient intake of vitamin D was found in both diets. Clinically, at year of gluten-free diet there was an improvement in weight and size. Analytically, there was an improvement in hemoglobin, ferritin, vitamin D, and parathyroid hormone in plasma. The gluten-free diet has minimal deficiencies, similar to those present in the diet with gluten, with an improvement in the lipid profile by increasing the proportion of monounsaturated fatty acids to the detriment of saturated fatty acids. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

Starch Characteristics Linked to Gluten-Free Products

Directory of Open Access Journals (Sweden)

Stefan W. Horstmann

2017-04-01

Full Text Available The increasing prevalence of coeliac disease (CD and gluten-related disorders has led to increasing consumer demand for gluten-free products with quality characteristics similar to wheat bread. The replacement of gluten in cereal-based products remains a challenge for scientists, due to its unique role in network formation, which entraps air bubbles. When gluten is removed from a flour, starch is the main component left. Starch is used as gelling, thickening, adhesion, moisture-retention, stabilizing, film forming, texturizing and anti-staling ingredient. The extent of these properties varies depending on the starch source. The starches can additionally be modified increasing or decreasing certain properties of the starch, depending on the application. Starch plays an important role in the formulation of bakery products and has an even more important role in gluten-free products. In gluten-free products, starch is incorporated into the food formulation to improve baking characteristics such as the specific volume, colour and crumb structure and texture. This review covers a number of topics relating to starch; including; an overview of common and lesser researched starches; chemical composition; morphology; digestibility; functionality and methods of modification. The emphasis of this review is on starch and its properties with respect to the quality of gluten-free products.

Starch Characteristics Linked to Gluten-Free Products.

Science.gov (United States)

Horstmann, Stefan W; Lynch, Kieran M; Arendt, Elke K

2017-04-06

The increasing prevalence of coeliac disease (CD) and gluten-related disorders has led to increasing consumer demand for gluten-free products with quality characteristics similar to wheat bread. The replacement of gluten in cereal-based products remains a challenge for scientists, due to its unique role in network formation, which entraps air bubbles. When gluten is removed from a flour, starch is the main component left. Starch is used as gelling, thickening, adhesion, moisture-retention, stabilizing, film forming, texturizing and anti-staling ingredient. The extent of these properties varies depending on the starch source. The starches can additionally be modified increasing or decreasing certain properties of the starch, depending on the application. Starch plays an important role in the formulation of bakery products and has an even more important role in gluten-free products. In gluten-free products, starch is incorporated into the food formulation to improve baking characteristics such as the specific volume, colour and crumb structure and texture. This review covers a number of topics relating to starch; including; an overview of common and lesser researched starches; chemical composition; morphology; digestibility; functionality and methods of modification. The emphasis of this review is on starch and its properties with respect to the quality of gluten-free products.

Symptoms of Functional Intestinal Disorders Are Common in Patients with Celiac Disease Following Transition to a Gluten-Free Diet.

Science.gov (United States)

Silvester, Jocelyn A; Graff, Lesley A; Rigaux, Lisa; Bernstein, Charles N; Leffler, Daniel A; Kelly, Ciarán P; Walker, John R; Duerksen, Donald R

2017-09-01

Celiac disease and functional intestinal disorders may overlap, yet the natural history of functional symptoms in patients with celiac disease is unknown. To investigate the prevalence of irritable bowel syndrome (IBS), functional dyspepsia (FD), and functional bloating (FB) symptoms among patients with celiac disease at diagnosis and during the first year of a gluten-free diet. Adults with a new diagnosis of celiac disease were surveyed at baseline, 6 months and 1 year using standardized measures for intestinal symptoms [Rome III diagnostic questionnaire and celiac symptom index (CSI)] and gluten-free diet adherence [gluten-free eating assessment tool (GF-EAT) and celiac diet adherence test]. At diagnosis, two-thirds fulfilled Rome III diagnostic questionnaire symptom criteria for IBS (52%), functional dyspepsia (27%), and/or functional bloating (9%). One year post-diagnosis, there was high adherence to a gluten-free diet as 93% reported gluten exposure less than once per month on the GF-EAT and only 8% had ongoing celiac disease symptoms (CSI score >45). The rates of those meeting IBS (22%) and functional dyspepsia (8%) symptom criteria both decreased significantly on a gluten-free diet. The prevalence of functional symptoms (any of IBS, FD or FB) at 1 year was 47%. Long-term follow-up of patients with celiac disease is necessary because many patients with celiac disease who are adherent to a gluten-free diet have persistent gastrointestinal symptoms.

Gluten-degrading bacteria are present in the human small intestine of healthy volunteers and celiac patients.

Science.gov (United States)

Herrán, Alexandra R; Pérez-Andrés, Jénifer; Caminero, Alberto; Nistal, Esther; Vivas, Santiago; Ruiz de Morales, José María; Casqueiro, Javier

2017-09-01

Gluten is the only known environmental factor that triggers celiac disease. Several studies have described an imbalance between the intestinal microbiota of different individuals based on diagnoses. Moreover, recent studies have suggested that human bacteria may play an important role in gluten hydrolysis. However, there has been no research focusing on the small intestine. This study aimed to characterize the adult small intestine microbiota possibly implicated in gluten hydrolysis. Duodenal biopsies from different diagnosed individuals were cultured in a gluten-containing medium, and the grown microbiota was analyzed by culture dependent/independent methods. Results showed that gluten-degrading bacteria can be found in the human small intestine. Indeed, 114 bacterial strains belonging to 32 species were isolated; 85 strains were able to grow in a medium containing gluten as the sole nitrogen source, 31 strains showed extracellular proteolytic activity against gluten protein and 27 strains showed peptidolytic activity towards the 33 mer peptide, an immunogenic peptide for celiac disease patients. We found that there are no differences based on the diagnosis, but each individual has its own population of gluten-hydrolyzing bacteria. These bacteria or their gluten-degrading enzymes could help to improve the quality of life of celiac disease patients'. Copyright © 2017 Institut Pasteur. Published by Elsevier Masson SAS. All rights reserved.

The Effect of Persian Gums and Tragacanth on Texture and Sensory Characteristics of Non-Gluten ‎Cakes

OpenAIRE

Afrooz Ghasemi; Mohammad Shahedi Baghe Khandan; Seyed Ali Yasini Ardakani

2017-01-01

Background: The presence of gluten proteins in rice flour leads to some problems for patients of celiac; a digestive autoimmune disease. Consumption of a non-gluten regime can decrease the effects of this disease. The aim of this study was to produce a non-gluten cake with an appropriate quality and high nutritional value by using rice flour, quinoa flour, Persian gums, and Tragacanth. Methods: The effect of addition of Persian gums, Tragacanth, and a combination of both of these compounds...

[Benefits of gluten-free diet: myth or reality?].

Science.gov (United States)

Coattrenec, Yann; Harr, Thomas; Pichard, Claude; Nendaz, Mathieu

2015-10-14

Non celiac gluten sensitivity may explain digestive and general symptoms in patients without celiac disease but this recently described entity is controversial. The role of gluten in comparison to other nutriments such as saccharides and polyols (FODMAPs) remains debated. If a gluten-free diet is clearly indicated in celiac disease and wheat allergy, it remains debatable in non-celiac gluten sensitivity given weak and contradictory evidence. There is no strong evidence for a strict indication to a gluten-free diet in endocrinological, psychiatric, and rheumatologic diseases, or to improve performance in elite sports.

Kinetics of the histological, serological and symptomatic responses to gluten challenge in adults with coeliac disease.

Science.gov (United States)

Leffler, Daniel; Schuppan, Detlef; Pallav, Kumar; Najarian, Robert; Goldsmith, Jeffery D; Hansen, Joshua; Kabbani, Toufic; Dennis, Melinda; Kelly, Ciarán P

2013-07-01

Coeliac disease is defined by gluten responsiveness, yet there are few data on gluten challenge (GC) in adults on a gluten-free diet. Lack of data regarding the kinetics of responses to gluten is a limitation in clinical practice and research when GC is performed. 20 adults with biopsy-proven coeliac disease participated. The study included two run-in visits followed by a 14-day GC at a randomly assigned dose of 3 or 7.5 g of gluten/day. Study visits occurred 3, 7, 14 and 28 days after starting GC. Duodenal biopsy was performed during the run-in and at days 3 and 14 of GC. Villous height to crypt depth ratio (Vh:Cd) and intraepithelial lymphocyte (IEL) count/100 enterocytes were measured by two pathologists. Antibodies to tissue transglutaminase and deamidated gliadin peptides, lactulose to mannitol ratio (LAMA) and symptoms were assessed at each visit. Significant reduction in Vh:Cd (2.2-1.1, padults with coeliac disease. These data permit accurate design of clinical trials and indicate that many individuals will meet coeliac diagnostic criteria after a 2-week GC.

Essential amino acids in the gluten-free diet and serum in relation to depression in patients with celiac disease

NARCIS (Netherlands)

Hees, Van Nathalie J.M.; Giltay, E.J.; Tielemans, Susanne M.A.J.; Geleijnse, J.M.; Puvill, Thomas; Janssen, Nadine; Does, Van Der Willem

2015-01-01

Introduction: Celiac disease (CD) is associated with an increased risk of major depressive disorder, possibly due to deficiencies in micronutrients in the gluten-free diet. We aimed to investigate whether essential amino acids (i.e., the precursors of serotonin, dopamine and other

Celiac disease and endocrine autoimmunity.

Science.gov (United States)

Kahaly, George J; Schuppan, Detlef

2015-01-01

Celiac disease (CD) is a small-intestinal inflammatory disease that is triggered by the ingestion of the storage proteins (gluten) of wheat, barley and rye. Endocrine autoimmunity is prevalent in patients with CD and their relatives. The genes that predispose to endocrine autoimmune diseases, e.g. type 1 diabetes, autoimmune thyroid diseases, and Addison's disease, i.e. DR3-DQ2 and DR4-DQ8, are also the major genetic determinants of CD, which is the best understood HLA-linked disease. Thus, up to 30% of first-degree relatives both of patients with CD and/or endocrine autoimmunity are affected by the other disease. In CD, certain gluten proteins bind with high affinity to HLA-DQ2 or -DQ8 in the small-intestinal mucosa, to activate gluten-specific T cells which are instrumental in the destruction of the resorptive villi. Here, the autoantigen tissue transglutaminase increases the T cell response by generating deamidated gluten peptides that bind more strongly to DQ2 or DQ8. Classical symptoms such as diarrhea and consequences of malabsorption like anemia and osteoporosis are often absent in patients with (screening-detected) CD, but this absence does not significantly affect these patients' incidence of endocrine autoimmunity. Moreover, once autoimmunity is established, a gluten-free diet is not able to induce remission. However, ongoing studies attempt to address how far a gluten-free diet may prevent or retard the development of CD and endocrine autoimmunity in children at risk. The close relationship between CD and endocrine autoimmunity warrants a broader immune genetic and endocrine screening of CD patients and their relatives. © 2015 S. Karger AG, Basel.

Effect of wheat gluten proteins on bioethanol yield from grain

Energy Technology Data Exchange (ETDEWEB)

Buresova, Iva [Agrotest Fyto, Ltd., Havlickova 2787/121, 767 01 Kromeriz (Czech Republic); Hrivna, Ludek [Mendel University in Brno, Zemedelska 1, 613 00 Brno (Czech Republic)

2011-04-15

Bioethanol can be used as motor fuel and/or as a gasoline enhancer. A high yield feedstock for bioethanol production is cereal grain. Cereal grains containing less gluten proteins (glutenin and gliadin), but high starch, are favoured by distillers because they increase the bioethanol conversion. The direct effect of wheat gluten proteins on bioethanol yield was studied on triticale grain. Examined triticale Presto 1R.1D{sub 5+10}-2 and Presto Valdy were developed by introducing selected segments of wheat chromosome 1D into triticale chromosome 1R. Even if the samples analysed in this study do not afford to make definitive assumptions, it can be noticed that in analysed cases the presence of gliadin had more significant effect on investigated parameters than the presence of glutenin. Despite the presence of glutenin subunits did not significantly decrease the investigated parameters - specific weight, Hagberg falling number and starch content in grain met the requirements for grain for bioethanol production - protein content was higher than is optimal. The fermentation experiments demonstrated good bioethanol yields but depression in grain yields caused by the presence of wheat gliadin and glutenin decreased the energy balance of Presto Valdy and Presto 1R.1D{sub 5+10}-2. (author)

Soya protein antibodies in man: their occurrence and possible relevance in coeliac disease.

Science.gov (United States)

Haeney, M R; Goodwin, B J; Barratt, M E; Mike, N; Asquith, P

1982-01-01

Circulating antibodies to soya-derived protein antigens have been measured in patients with duodenitis, Crohn's disease, ulcerative colitis and coeliac disease. Significantly raised antibody titres were found frequently in the coeliac group, particularly those patients showing a suboptimal response to a gluten-free diet, but rarely in subjects with other gastrointestinal diseases. Antisoya activity was not necessarily accompanied by antibodies to other common dietary antigens. We suggest that some coeliacs may have an associated dietary soya sensitivity which could adversely influence their response to gluten withdrawal. PMID:7040491

Gluten-Free Diet in Children: An Approach to a Nutritionally Adequate and Balanced Diet

OpenAIRE

Penagini, Francesca; Dilillo, Dario; Meneghin, Fabio; Mameli, Chiara; Fabiano, Valentina; Zuccotti, Gian Vincenzo

2013-01-01

Gluten-free diet (GFD) is the cornerstone treatment for celiac disease (CD). GFD implies a strict and lifelong elimination from the diet of gluten, the storage protein found in wheat, barley, rye and hybrids of these grains, such as kamut and triticale. The absence of gluten in natural and processed foods, despite being the key aspect of GFD, may lead to nutritional consequences, such as deficits and imbalances. The nutritional adequacy of GFD is particularly important in children, this the a...

The Celiac Patient Antibody Response to Conventional and Gluten-Removed Beer.

Science.gov (United States)

Allred, Laura K; Lesko, Katherine; McKiernan, Diane; Kupper, Cynthia; Guandalini, Stefano

2017-03-01

Enzymatic digestion, or hydrolysis, has been proposed for treating gluten-containing foods and beverages to make them safe for persons with celiac disease (CD). There are no validated testing methods that allow the quantitation of all the hydrolyzed or fermented gluten peptides in foods and beverages that might be harmful to CD patients, making it difficult to assess the safety of hydrolyzed products. This study examines an ELISA-based method to determine whether serum antibody binding of residual peptides in a fermented barley-based product is greater among active-CD patients than a normal control group, using commercial beers as a test case. Sera from 31 active-CD patients and 29 nonceliac control subjects were used to assess the binding of proteins from barley, rice, traditional beer, gluten-free beer, and enzymatically treated (gluten-removed) traditional beer. In the ELISA, none of the subjects' sera bound to proteins in the gluten-free beer. Eleven active-CD patient serum samples demonstrated immunoglobulin A (IgA) or immunoglobulin G (IgG) binding to a barley extract, compared to only one nonceliac control subject. Of the seven active-CD patients who had an IgA binding response to barley, four also responded to traditional beer, and two of these responded to the gluten-removed beer. None of the nonceliac control subjects' sera bound to all three beer samples. Binding of protein fragments in hydrolyzed or fermented foods and beverages by serum from active-CD patients, but not nonceliac control subjects, may indicate the presence of residual peptides that are celiac-specific.

Different binding motifs of the celiac disease-associated HLA molecules DQ2.5, DQ2.2, and DQ7.5 revealed by relative quantitative proteomics of endogenous peptide repertoires

DEFF Research Database (Denmark)

Bergseng, Elin; Dørum, Siri; Arntzen, Magnus Ø.

2014-01-01

Celiac disease is caused by intolerance to cereal gluten proteins, and HLA-DQ molecules are involved in the disease pathogenesis by presentation of gluten peptides to CD4+ T cells. The α- or β-chain sharing HLA molecules DQ2.5, DQ2.2, and DQ7.5 display different risks for the disease...... established binding motifs. The binding motif of DQ2.2 was strikingly different from that of DQ2.5 with position P3 being a major anchor having a preference for threonine and serine. This is notable as three recently identified epitopes of gluten recognized by T cells of DQ2.2 celiac patients harbor serine...... at position P3. This study demonstrates that relative quantitative comparison of endogenous peptides sampled from our protein metabolism by HLA molecules provides clues to understand HLA association with disease....

Celiac Disease Associated with a Benign Granulomatous Mass Demonstrating Self-Regression after Initiation of a Gluten-Free Diet.

Science.gov (United States)

Tiwari, Abhinav; Sharma, Himani; Qamar, Khola; Khan, Zubair; Darr, Umar; Renno, Anas; Nawras, Ali

2017-01-01

Celiac disease is a chronic immune-mediated enteropathy in which dietary gluten induces an inflammatory reaction predominantly in the duodenum. Celiac disease is known to be associated with benign small bowel thickening and reactive lymphadenopathy that often regresses after the institution of a gluten-free diet. A 66-year-old male patient with celiac disease presented with abdominal pain and diarrheal illness. Computerized tomography of the abdomen revealed a duodenal mass. Endoscopic ultrasound-guided fine needle aspiration of the mass revealed bizarre stromal cells which represent a nonspecific tissue reaction to inflammation. This inflammatory mass regressed after the institution of a gluten-free diet. This case report describes a unique presentation of celiac disease in the form of a granulomatous self-regressing mass. Also, this is the first reported case of bizarre stromal cells found in association with celiac disease. In addition to lymphoma and small bowel adenocarcinoma, celiac disease can present with a benign inflammatory mass, which should be serially monitored for resolution with a gluten-free diet.

Celiac Disease Associated with a Benign Granulomatous Mass Demonstrating Self-Regression after Initiation of a Gluten-Free Diet

Directory of Open Access Journals (Sweden)

Abhinav Tiwari

2017-08-01

Full Text Available Celiac disease is a chronic immune-mediated enteropathy in which dietary gluten induces an inflammatory reaction predominantly in the duodenum. Celiac disease is known to be associated with benign small bowel thickening and reactive lymphadenopathy that often regresses after the institution of a gluten-free diet. A 66-year-old male patient with celiac disease presented with abdominal pain and diarrheal illness. Computerized tomography of the abdomen revealed a duodenal mass. Endoscopic ultrasound-guided fine needle aspiration of the mass revealed bizarre stromal cells which represent a nonspecific tissue reaction to inflammation. This inflammatory mass regressed after the institution of a gluten-free diet. This case report describes a unique presentation of celiac disease in the form of a granulomatous self-regressing mass. Also, this is the first reported case of bizarre stromal cells found in association with celiac disease. In addition to lymphoma and small bowel adenocarcinoma, celiac disease can present with a benign inflammatory mass, which should be serially monitored for resolution with a gluten-free diet.

Refractory iron-deficiency anemia and gluten intolerance: Response to gluten-free diet Anemia ferropénica refractaria e intolerancia al gluten: respuesta a la dieta sin gluten

Directory of Open Access Journals (Sweden)

Luis Rodrigo-Sáez

2011-07-01

Full Text Available Introduction: refractory iron-deficiency anemia has a multifactorial origin related to various gastrointestinal conditions, with celiac disease plus malabsorption and IBD together with isolated gluten intolerance being most common. Objectives: to determine the prevalence of serum, genetic, and histological markers for gluten intolerance, and to analyze the response to gluten withdrawal from the diet in these patients. Methods: a number of patients with refractory anemia were prospectively and consecutively enrolled. A protocol to measure serum (TGt-2, genetic (HLA-DQ2/DQ8, and histological markers for celiac disease was applied. All followed a gluten-free diet for a median 3.6 years. Sustained remission of anemia during follow-up was interpreted as positive response. Results: ninety-eight patients (84% females with a mean age of 54 years were studied. Anti-TGt2 antibodies were positive in 5% of cases. A total of 67 cases (68% were haplotype HLA-DQ2 or -DQ8 (+. We found villous atrophy (Marsh III in 13% of patients, and an inflammatory pattern (Marsh I or II in 13%. All remaining 72 patients (74% had no histological duodenal changes. Age, anemia duration, number of transfusions, number of parenteral iron doses, and time on a gluten-free diet were all compared according to the presence or absence of villous atrophy and HLA-DQ2/8 positivity, and no significant differences were found for any of the analyzed variables. Response was positive in 92% of subjects. Conclusions: celiac disease with villous atrophy is rarely a cause of refractory anemia. Gluten intolerance with no histological lesions is seen in almost 75% of patients, and therefore plays a relevant role in its development.Introducción: la anemia ferropénica refractaria presenta un origen multifactorial, relacionado con diversas enfermedades digestivas, siendo las más frecuentes la enfermedad celiaca con malabsorción y la EII junto con la intolerancia al gluten aislada. Objetivos

Evaluation of commercial gluten-free foods from the Brazilian market

Science.gov (United States)

In addition to Celiac Disease, there are other gluten related disorders classified according to immunological response, e.g. autoimmune, allergic and sensitivity (non-autoimmune and non-allergic). In all cases, the only effective therapy is strict adherence to a gluten free diet, which consists of a...

Prevalence of Self-Reported Gluten Sensitivity and Adherence to a Gluten-Free Diet in Argentinian Adult Population

Science.gov (United States)

Cabrera-Chávez, Francisco; Dezar, Gimena V. A.; Islas-Zamorano, Anna P.; Espinoza-Alderete, Jesús G.; Vergara-Jiménez, Marcela J.; Magaña-Ordorica, Dalia; Ontiveros, Noé

2017-01-01

Background: Previous studies suggest that the prevalence of wheat/gluten sensitivity and adherence to a gluten-free diet (GFD) are high in Latin population despite a poor diagnosis of celiac disease. However, these prevalence rates still remain unknown in most Latin American countries. Methods: A cross-sectional survey study was conducted in Santa Fe, Argentina. Results: The estimated self-reported prevalence rates were (95% Confidence Interval [CI]): self-reported gluten sensitivity (SR-GS) 7.61% (6.2–9.2), SR-GS currently following a GFD 1.82% (1.2–2.7), celiac disease 0.58% (0.3–1.2), wheat allergy 0.33% (0.12–0.84), self-reported non-celiac gluten sensitivity (SR-NCGS) 6.28% (5.1–7.8), SR-NCGS currently following a GFD 0.91% (0.5–1.6), and adherence to a GFD 6.37% (5.1–7.9). SR-GS was more common in women (6.0%; p < 0.001) and associated with irritable bowel syndrome (p < 0.001). Among the GFD followers, 71.4% were doing it for reasons other than health-related benefits and 50.6% without medical/dietitian advice. In the non-SR-GS group, the main motivations for following a GFD were weight control and the perception that a GFD is healthier. Conclusion: In Argentina, gluten sensitivity is commonly reported and it seems that physicians/gastroenterologists are aware of celiac disease diagnosis. Trustable information about the benefits and potential consequences of following a GFD should be given to the general population. PMID:28117706

Prevalence of Self-Reported Gluten Sensitivity and Adherence to a Gluten-Free Diet in Argentinian Adult Population

Directory of Open Access Journals (Sweden)

Francisco Cabrera-Chávez

2017-01-01

Full Text Available Background: Previous studies suggest that the prevalence of wheat/gluten sensitivity and adherence to a gluten-free diet (GFD are high in Latin population despite a poor diagnosis of celiac disease. However, these prevalence rates still remain unknown in most Latin American countries. Methods: A cross-sectional survey study was conducted in Santa Fe, Argentina. Results: The estimated self-reported prevalence rates were (95% Confidence Interval [CI]: self-reported gluten sensitivity (SR-GS 7.61% (6.2–9.2, SR-GS currently following a GFD 1.82% (1.2–2.7, celiac disease 0.58% (0.3–1.2, wheat allergy 0.33% (0.12–0.84, self-reported non-celiac gluten sensitivity (SR-NCGS 6.28% (5.1–7.8, SR-NCGS currently following a GFD 0.91% (0.5–1.6, and adherence to a GFD 6.37% (5.1–7.9. SR-GS was more common in women (6.0%; p < 0.001 and associated with irritable bowel syndrome (p < 0.001. Among the GFD followers, 71.4% were doing it for reasons other than health-related benefits and 50.6% without medical/dietitian advice. In the non-SR-GS group, the main motivations for following a GFD were weight control and the perception that a GFD is healthier. Conclusion: In Argentina, gluten sensitivity is commonly reported and it seems that physicians/gastroenterologists are aware of celiac disease diagnosis. Trustable information about the benefits and potential consequences of following a GFD should be given to the general population.

Living Gluten Free

Science.gov (United States)

... Disease" Articles Celiac Disease Changes Everything / What is Celiac Disease? / Symptoms, Diagnosis & Treatment / Four Inches and Seven Pounds… / Learning to Live Well with Celiac Disease / Living Gluten-Free Spring 2015 Issue: Volume 10 ...

Fructan, Rather Than Gluten, Induces Symptoms in Patients With Self-Reported Non-Celiac Gluten Sensitivity.

Science.gov (United States)

Skodje, Gry I; Sarna, Vikas K; Minelle, Ingunn H; Rolfsen, Kjersti L; Muir, Jane G; Gibson, Peter R; Veierød, Marit B; Henriksen, Christine; Lundin, Knut E A

2018-02-01

Non-celiac gluten sensitivity is characterized by symptom improvement after gluten withdrawal in absence of celiac disease. The mechanisms of non-celiac gluten sensitivity are unclear, and there are no biomarkers for this disorder. Foods with gluten often contain fructans, a type of fermentable oligo-, di-, monosaccharides and polyols. We aimed to investigate the effect of gluten and fructans separately in individuals with self-reported gluten sensitivity. We performed a double-blind crossover challenge of 59 individuals on a self-instituted gluten-free diet, for whom celiac disease had been excluded. The study was performed at Oslo University Hospital in Norway from October 2014 through May 2016. Participants were randomly assigned to groups placed on diets containing gluten (5.7 g), fructans (2.1 g), or placebo, concealed in muesli bars, for 7 days. Following a minimum 7-day washout period (until the symptoms induced by the previous challenge were resolved), participants crossed over into a different group, until they completed all 3 challenges (gluten, fructan, and placebo). Symptoms were measured by Gastrointestinal Symptom Rating Scale Irritable Bowel Syndrome (GSRS-IBS) version. A linear mixed model for analysis was used. Overall GSRS-IBS scores differed significantly during gluten, fructan, and placebo challenges; mean values were 33.1 ± 13.3, 38.6 ± 12.3, and 34.3 ± 13.9, respectively (P = .04). Mean scores for GSRS-IBS bloating were 9.3 ± 3.5, 11.6 ± 3.5, and 10.1 ± 3.7, respectively, during the gluten, fructan, and placebo challenges (P = .004). The overall GSRS-IBS score for participants consuming fructans was significantly higher than for participants consuming gluten (P = .049), as was the GSRS bloating score (P = .003). Thirteen participants had the highest overall GSRS-IBS score after consuming gluten, 24 had the highest score after consuming fructan, and 22 had the highest score after consuming placebo. There was no difference in GSRS

Effect of pentosans on gluten formation and properties.

NARCIS (Netherlands)

Wang, M.

2003-01-01

Keywords: pentosans, gluten yield, gluten properties, glutenin macropolymerThe gluten protein polymeric network plays a pivotal role in determining the end-use quality of wheat in many food products. The properties of this polymeric network are strongly affected by wheat flour

Using LC-MS to examine the fermented food products vinegar and soy sauce for the presence of gluten.

Science.gov (United States)

Li, Haili; Byrne, Keren; Galiamov, Renata; Mendoza-Porras, Omar; Bose, Utpal; Howitt, Crispin A; Colgrave, Michelle L

2018-07-15

A strict, lifelong gluten-free (GF) diet is currently the only treatment for coeliac disease (CD). Vinegar and soy sauce are fermented condiments that often include wheat and/or barley. During fermentation cereal proteins are partially degraded by enzymes to yield peptide fragments and amino acids. Whether these fermented products contain intact or degraded gluten proteins and if they are safe for people with CD remains in question. LC-MS offers the benefit of being able to detect hydrolysed gluten that might be present in commercial vinegar and soy sauce products. LC-MS revealed the presence of gluten in malt vinegar, wherein the identified peptides derived from B-, D- and γ-hordein from barley, as well as γ-gliadin, and HMW- and LMW-glutenins from wheat that are known to contain immunopathogenic epitopes. No gluten was detected in the soy sauces examined despite wheat being a labelled ingredient indicating extensive hydrolysis of gluten during soy sauce production. Copyright © 2018 Elsevier Ltd. All rights reserved.

IMAGE ANALYSIS OF BREAD CRUMB STRUCTURE IN RELATION TO GLUTEN STRENGTH OF WHEAT

Directory of Open Access Journals (Sweden)

D. Magdić

2006-06-01

Full Text Available The objective of this study was to determine bread slice medium part properties in relation to quality parameters with a focus on gluten strength. Since sensory evaluation of bread is time consuming, expensive and subjective in nature, computerized image analysis was applied as objective method of bread crumb quality evaluation. Gluten Index method was applied as fast and reliable tool for defining gluten strength of wheat. Significant (P90 Ana, Demetra, Klara, Srpanjka and Divana have shown trend to give unequal and bigger crumb grains while cultivars Golubica, Barbara, Žitarka, Kata and Sana with optimal gluten strength (GI= 60-90 have shown finer and uniform crumb grain.

Influence of soybean and corn gluten proteins as substitutes for milk protein in milk replacers on growth, liver and thyroid functions in buffalo calves

International Nuclear Information System (INIS)

Abdelaal, A.E.; EL-Ashry, M.A.; Ibrahim, I.I.; Fekry, A.E.; Elwan, K.M.

1991-01-01

Twenty suckling buffalo calves (3 weeks old) were allotted to four nutritional groups: Control group, fed 100% skim milk based replacer (Group a); and in the other three groups 50% of milk protein was substituted by american soybean flour (Group B) Egyptian soybean meal (Group C) and corn gluten (Group D). Fat was added to all replacers at the rate of 20% on dry basis. Calf starter and hay were offered ad libitum with the liquid diets from the fourth week. Body weight was recorded weekly. Serum proteins, cholesterol, T 4, T 3, and the enzymic activities of GOT, GPT and alkaline phosphatase were determined at 6, 9 and 12 weeks of age. The use of american soybean and corn gluten proteins resulted, approximately, in the same body weight gain as in skim milk fed group (A), indicating that whole milk can be reserved from human consumption and the calves can be reared on milk replacers containing plant proteins. Substitution of milk protein with soybean and corn gluten protein resulted in a significant increase in each of serum globulins, A/G ratio and cholesterol, significant decrease in serum total proteins and GPT activity, and no change in growth rate and thyroid function

Improvement of gluten-free bread properties by the incorporation of bovine plasma proteins and different saccharides into the matrix.

Science.gov (United States)

Rodriguez Furlán, Laura T; Pérez Padilla, Antonio; Campderrós, Mercedes E

2015-03-01

The aim of this work was to improve the quality of gluten-free bread, incorporating plasma bovine proteins concentrated by ultrafiltration and freeze-dried with saccharides (inulin and sucrose). The influence of these compounds on textural properties and final bread quality was assessed. The textural studies revealed that with the addition of proteins and inulin, homogeneous and smaller air cells were achieved improving the textural properties while the bread hardness was comparable with breads with gluten. The volume of gluten-free breads increased with increasing proteins and inulin concentrations, reaching a maximum at a protein concentration of 3.5% (w/w). The addition of the enhancers improved moisture retention of the loaves after cooking and an increase of lightness of crumb with respect to the control was observed. The sensory analysis found no statistically significant difference in sensory attributes evaluated with respect to the control, so these ingredients do not negatively affect the organoleptic properties of bread. Copyright © 2014 Elsevier Ltd. All rights reserved.

Clinical features and symptom recovery on a gluten-free diet in Canadian adults with celiac disease.

Science.gov (United States)

Pulido, Olga; Zarkadas, Marion; Dubois, Sheila; Macisaac, Krista; Cantin, Isabelle; La Vieille, Sebastien; Godefroy, Samuel; Rashid, Mohsin

2013-08-01

Celiac disease can present with mild or nongastrointestinal symptoms, and may escape timely recognition. The treatment of celiac disease involves a gluten-free diet, which is complex and challenging. To evaluate clinical features and symptom recovery on a gluten-free diet in a Canadian adult celiac population. All adult members (n=10,693) of the two national celiac support organizations, the Canadian Celiac Association and Fondation québécoise de la maladie coeliaque, were surveyed using a questionnaire. A total of 5912 individuals (≥18 years of age) with biopsy-confirmed celiac disease and⁄or dermatitis herpetiformis completed the survey. The female to male ratio was 3:1, and mean (± SD) age at diagnosis was 45.2 ± 16.4 years. Mean time to diagnosis after onset of symptoms was 12.0 ± 14.4 years. Abdominal pain and bloating (84.9%), extreme weakness⁄tiredness (74.2%), diarrhea (71.7%) and anemia (67.8%) were the most commonly reported symptoms at the time of diagnosis. Many respondents continued to experience symptoms after being on a gluten-free diet for >5 years. Sex differences were reported in clinical features before diagnosis, recovery after being on gluten-free diet and perceived quality of life, with women experiencing more difficulties than men. Delays in diagnosis of celiac disease in Canada remain unacceptably long despite wider availability of serological screening tests. Many patients report continuing symptoms despite adhering to a gluten-free diet for >5 years, with women experiencing more symptoms and a lower recovery rate than men. Awareness of celiac disease needs improvement, and follow-up with a physician and a dietitian is essential for all patients with celiac disease.

The association between semaphorin 3A levels and gluten-free diet in patients with celiac disease.

Science.gov (United States)

Kessel, Aharon; Lin, Chen; Vadasz, Zahava; Peri, Regina; Eiza, Nasren; Berkowitz, Drora

2017-11-01

Celiac disease (CD) is an inflammatory disease affecting the small intestine. We aim to assess serum level and expression of semaphorin 3A (Sema3A) on T regulatory (Treg) cells in CD patients. Twenty-six newly diagnosed celiac patients, 13 celiac patients on a gluten-free diet and 16 healthy controls included in the study. Sema3A protein level in the serum of celiac patients was significantly higher compared to healthy group (7.17±1.8ng/ml vs. 5.67±1.5ng/ml, p=0.012). Sema3A expression on Treg cells was statistically lower in celiac patients compared to healthy subjects (p=0.009) and significantly lower in celiac patients compared to celiac patients on gluten free diet (p=0.04). Negative correlation was found between Sema3A on Teg cells and the level of IgA anti-tTG antibodies (r=-0.346, p<0.01) and anti-DGP (r=-0.448, p<0.01). This study suggests involvement of the Sema3A in the pathogenesis of CD. Copyright © 2017 Elsevier Inc. All rights reserved.

Prevalence and Characterization of Self-Reported Gluten Sensitivity in The Netherlands

Directory of Open Access Journals (Sweden)

Tom van Gils

2016-11-01

Full Text Available Background: A growing number of individuals reports symptoms related to the ingestion of gluten-containing food in the absence of celiac disease. Yet the actual prevalence is not well established. Methods: Between April 2015 and March 2016, unselected adults visiting marketplaces, dental practices and a university in The Netherlands were asked to complete a modified validated questionnaire for self-reported gluten sensitivity (srGS. Results: Among the 785 adults enquired, two had celiac disease. Forty-nine (6.2% reported symptoms related to the ingestion of gluten-containing food. These individuals were younger, predominantly female and lived more frequently in urban regions compared with the other respondents. Symptoms reported included bloating (74%, abdominal discomfort (49% and flatulence (47%. A total of 23 (47% srGS individuals reported having had tried a gluten-free or gluten-restricted diet. Abdominal discomfort related to fermentable oligosaccharide, disaccharide, monosaccharide and polyol (FODMAP-containing food was more often reported in srGS individuals compared with the other respondents (73.5% vs. 21.7%, p < 0.001. Conclusion: Self-reported GS is common in The Netherlands, especially in younger individuals, females and urban regions, although the prevalence was lower than in a comparable recent UK study. It cannot be excluded that FODMAPs are in part responsible for these symptoms.

The rise and fall of gluten!

Science.gov (United States)

Aziz, Imran; Branchi, Federica; Sanders, David S

2015-08-01

Mankind has existed for 2·5 million years but only in the last 10,000 years have we been exposed to wheat. Wheat was first cultivated in the Fertile Crescent (South Western Asia) with a farming expansion that lasted from about 9000BC to 4000BC. Thus it could be considered that wheat (and gluten) is a novel introduction to man's diet! Prior to 1939 the rationing system had already been devised. This led to an imperative to try to increase agricultural production. Thus it was agreed in 1941 that there was a need to establish a Nutrition Society. The very roots of the society were geared towards necessarily increasing the production of wheat. This goal was achieved and by the end of the 20th century, global wheat output had expanded 5-fold. Perhaps as a result the epidemiology of coeliac disease (CD) or gluten sensitive enteropathy has changed. CD is a state of heightened immunological responsiveness to ingested gluten in genetically susceptible individuals. CD now affects 1 % or more of all adults, for which the treatment is a strict lifelong gluten-free diet. However, there is a growing body of evidence to show that a far greater proportion of individuals without coeliac disease are taking a gluten-free diet of their own volition. This clinical entity has been termed non-coeliac gluten sensitivity (NCGS), although the condition is fraught with complexities due to overlap with other gluten-based constituents that can also trigger similar clinical symptoms. This review will explore the relationship between gluten, the rising prevalence of modern coeliac disease, and the new entity of NCGS along with its associated uncertainties.

Double-Blind Randomized Clinical Trial: Gluten versus Placebo Rechallenge in Patients with Lymphocytic Enteritis and Suspected Celiac Disease.

Directory of Open Access Journals (Sweden)

Mercè Rosinach

Full Text Available The role of gluten as a trigger of symptoms in non-coeliac gluten sensitivity has been questioned.To demonstrate that gluten is the trigger of symptoms in a subgroup of patients fulfilling the diagnostic criteria for non-coeliac gluten sensitivity (NCGS, which presented with lymphocytic enteritis, positive celiac genetics and negative celiac serology.Double-blind randomized clinical trial of gluten vs placebo rechallenge.>18 years of age, HLA-DQ2/8+, negative coeliac serology and gluten-dependent lymphocytic enteritis, and GI symptoms, with clinical and histological remission at inclusion. Eighteen patients were randomised: 11 gluten (20 g/day and 7 placebo. Clinical symptoms, quality of life (GIQLI, and presence of gamma/delta+ cells and transglutaminase deposits were evaluated.91% of patients had clinical relapse during gluten challenge versus 28.5% after placebo (p = 0.01. Clinical scores and GIQLI worsened after gluten but not after placebo (p<0.01. The presence of coeliac tissue markers at baseline biopsy on a gluten-free diet allowed classifying 9 out of the 18 (50% patients as having probable 'coeliac lite' disease.This proof-of-concept study indicates that gluten is the trigger of symptoms in a subgroup of patients fulfilling the diagnostic criteria for NCGS. They were characterized by positive celiac genetics, lymphocytic enteritis, and clinical and histological remission after a gluten-free diet.ClinicalTrials.gov NCT02472704.

Modelling of pyrolysis and combustion of gluten-glycerol-based bioplastics.

Science.gov (United States)

Gómez-Martínez, D; Barneto, A G; Martínez, I; Partal, P

2011-05-01

Non-isothermal thermogravimetric analysis, under nitrogen and air atmospheres, has been applied to study the thermal degradation of wheat gluten and gluten-glycerol-based bioplastics. In order to explain experimental data, thermal degradation has been simulated using the so-called pseudo-components, which are related to protein fraction (mainly gliadin and glutenin), residual starch and plasticiser. Thus, the proposed models have been used to shed some light on the thermal decomposition of these materials, which have been found affected by their compositions and microstructures. Modelling confirms the experimental bioplastic and gluten isolate compositions, e.g. bioplastic moisture content, starch concentration and the expected gliadin/glutenin ratio. According to the simulation, the glycerol volatilisation is affected by bioplastic moisture content and hindered by the protein matrix. A fact pointing out that glycerol/water blend plays relevant plasticizing roles in the protein matrix through diverse physicochemical interactions. Copyright © 2011 Elsevier Ltd. All rights reserved.

Paediatric Patients with Coeliac Disease on a Gluten-Free Diet: Nutritional Adequacy and Macro- and Micronutrient Imbalances.

Science.gov (United States)

Sue, Alison; Dehlsen, Kate; Ooi, Chee Y

2018-01-22

A strict, lifelong gluten-free diet is the cornerstone for management of coeliac disease. Elimination of gluten from the diet may be associated with nutritional imbalance; however, the completeness of this diet in energy and macro- and micronutrients in children is not well described. Understanding the nutritional adequacy of the gluten-free diet in children during this critical period of growth and development when dietary intake is strongly influential is important. Children, regardless of whether they have eliminated gluten from their diet, have a tendency to consume excess fat and insufficient fibre, iron, vitamin D and calcium, compared to recommendations. In the context of a gluten-free diet, these imbalances may be worsened or have more significant consequences. Paediatric studies have demonstrated that intakes of folate, magnesium, zinc and selenium may decrease on a gluten-free diet. Nutritional inadequacies may be risks of a gluten-free diet in a paediatric population. The potential implications of these inadequacies, both short and long term, remain unclear and warrant further investigation and clarification.

Non-celiac gluten hypersensitivity

DEFF Research Database (Denmark)

Husby, Steffen; Murray, Joseph

2015-01-01

used double-blind placebo-controlled food challenges (DBPCFCs) for the diagnosis of NCGS, and none in children. Innate immune reactivity to amylase trypsin inhibitors has been suggested as the pathogenic principle in NCGS, but confirmatory evidence is lacking. Also, further clinical studies including...... transglutaminase 2, characteristic histological abnormalities of the small intestine, and an almost obligatory genetic haplotype (HLA-DQ2 or DQ8). The diagnosis of NCGS is based largely on the clinical suspicion of hyper-reactivity to gluten and the absence of the characteristics of CD. Few published studies have......Non-celiac gluten sensitivity (NCGS) has been introduced recently as a potentially common disease on the basis of studies of patients with claimed reactivity to gluten but without the characteristics of celiac disease (CD). CD is characterized by antibody reactivity toward the autoantigen...

Specific Nongluten Proteins of Wheat Are Novel Target Antigens in Celiac Disease Humoral Response

Science.gov (United States)

2014-01-01

While the antigenic specificity and pathogenic relevance of immunologic reactivity to gluten in celiac disease have been extensively researched, the immune response to nongluten proteins of wheat has not been characterized. We aimed to investigate the level and molecular specificity of antibody response to wheat nongluten proteins in celiac disease. Serum samples from patients and controls were screened for IgG and IgA antibody reactivity to a nongluten protein extract from the wheat cultivar Triticum aestivum Butte 86. Antibodies were further analyzed for reactivity to specific nongluten proteins by two-dimensional gel electrophoresis and immunoblotting. Immunoreactive molecules were identified by tandem mass spectrometry. Compared with healthy controls, patients exhibited significantly higher levels of antibody reactivity to nongluten proteins. The main immunoreactive nongluten antibody target proteins were identified as serpins, purinins, α-amylase/protease inhibitors, globulins, and farinins. Assessment of reactivity toward purified recombinant proteins further confirmed the presence of antibody response to specific antigens. The results demonstrate that, in addition to the well-recognized immune reaction to gluten, celiac disease is associated with a robust humoral response directed at a specific subset of the nongluten proteins of wheat. PMID:25329597

Celiac disease: management of persistent symptoms in patients on a gluten-free diet.

Science.gov (United States)

Dewar, David H; Donnelly, Suzanne C; McLaughlin, Simon D; Johnson, Matthew W; Ellis, H Julia; Ciclitira, Paul J

2012-03-28

To investigate all patients referred to our center with non-responsive celiac disease (NRCD), to establish a cause for their continued symptoms. We assessed all patients referred to our center with non-responsive celiac disease over an 18-mo period. These individuals were investigated to establish the eitiology of their continued symptoms. The patients were first seen in clinic where a thorough history and examination were performed with routine blood work including tissue transglutaminase antibody measurement. They were also referred to a specialist gastroenterology dietician to try to identift any lapses in the diet and sources of hidden gluten ingestion. A repeat small intestinal biopsy was also performed and compared to biopsies from the referring hospital where possible. Colonoscopy, lactulose hydrogen breath testing, pancreolauryl testing and computed tomography scan of the abdomen were undertaken if the symptoms persisted. Their clinical progress was followed over a minimum of 2 years. One hundred and twelve consecutive patients were referred with NRCD. Twelve were found not to have celiac disease (CD). Of the remaining 100 patients, 45% were not adequately adhering to a strict gluten-free diet, with 24 (53%) found to be inadvertently ingesting gluten, and 21 (47%) admitting non-compliance. Microscopic colitis was diagnosed in 12% and small bowel bacterial overgrowth in 9%. Refractory CD was diagnosed in 9%. Three of these were diagnosed with intestinal lymphoma. After 2 years, 78 patients remained well, eight had continuing symptoms, and four had died. In individuals with NRCD, a remediable cause can be found in 90%: with continued gluten ingestion as the leading cause. We propose an algorithm for investigation.

Gluten-free but also gluten-enriched (gluten+) diet prevent diabetes in NOD mice; the gluten enigma in type 1 diabetes.

Science.gov (United States)

Funda, David P; Kaas, Anne; Tlaskalová-Hogenová, Helena; Buschard, Karsten

2008-01-01

Environmental factors such as nutrition or exposure to infections play a substantial role in the pathogenesis of type 1 diabetes (T1D). We have previously shown that gluten-free, non-purified diet largely prevented diabetes in non-obese diabetic (NOD) mice. In this study we tested hypothesis that early introduction of gluten-enriched (gluten+) diet may increase diabetes incidence in NOD mice. Standard, gluten-free, gluten+ modified Altromin diets and hydrolysed-casein-based Pregestimil diet were fed to NOD females and diabetes incidence was followed for 310 days. Insulitis score and numbers of gut mucosal lymphocytes were determined in non-diabetic animals. A significantly lower diabetes incidence (p gluten-free diet (5.9%, n = 34) and Pregestimil diet (10%, n = 30) compared to mice on the standard Altromin diet (60.6%, n = 33). Surprisingly, gluten+ diet also prevented diabetes incidence, even at the level found with the gluten-free diet (p gluten+, gluten-free, Pregestimil) diets, did that slightly later compared to those on the standard diet. Lower insulitis score compared to control mice was found in non-diabetic NOD mice on the gluten-free, and to a lesser extent also gluten+ and Pregestimil diets. No substantial differences in the number of CD3(+), TCR-gammadelta(+), and IgA(+) cells in the small intestine were documented. Gluten+ diet prevents diabetes in NOD mice at the level found with the non-purified gluten-free diet. Possible mechanisms of the enigmatic, dual effect of dietary gluten on the development of T1D are discussed. 2007 John Wiley & Sons, Ltd

Glyphosate, pathways to modern diseases II: Celiac sprue and gluten intolerance

OpenAIRE

Samsel, Anthony; Seneff, Stephanie

2013-01-01

Celiac disease, and, more generally, gluten intolerance, is a growing problem worldwide, but especially in North America and Europe, where an estimated 5% of the population now suffers from it. Symptoms include nausea, diarrhea, skin rashes, macrocytic anemia and depression. It is a multifactorial disease associated with numerous nutritional deficiencies as well as reproductive issues and increased risk to thyroid disease, kidney failure and cancer. Here, we propose that glyphosate, the activ...

Preparation and Quality Evaluation of Gluten-Free Biscuits

Directory of Open Access Journals (Sweden)

Simona Maria Man

2014-05-01

Full Text Available The aglutenics biscuits are intended to those persons who are suffering due to gluten intolerance, also named celiac disease. The fabrication technologies of the aglutenics products can be developed in on two ways: by separating the gluten from the grain or by replacing the grain flour with other types of gluten less flour, in case of bakery and pastry products. In this experiment, the gluten-free biscuits were obtained from the following flours mixture: maize flour (MF, rice flour (RF and soybeans flour (SF. Other raw materials were used, such as: palmtree oil, honey, maize starch, eggs, sugar powdered, vanilla essence and sodium bicarbonate. Four experimental variants (gluten-free biscuits were obtained by varying the proportion of flours ; these variants were coded as follows T1, T2 T3 and T4. The optimization of the aglutenics biscuits manufacture recipe was realized through sensory analyze, using the hedonic test (9 point scale. Samples of biscuits was subjected to the following physico-chemical analysis: moisture content, alkalinity, total carbohydrate content, total fat and protein content. Also the physical properties (length, width, thickness, weight and spread ratio were determined in order to asses the blending influence on the biscuits quality. The blend with flour levels 30:30:40 (MF:RF:SF led to the highest acceptability.

Quick Start Gluten Free Diet Guide for Celiac Disease and Non Celiac Sensitivity

Science.gov (United States)

... bread for lunch; and rice, corn or quinoa pasta for dinner. Include lean meats and proteins, fresh ... Cakes and other Baked Goods • Crackers • Croutons • Flour • Pastas • Stuffings and Dressings Foods that may contain gluten ...

Lack of serologic evidence to link IgA nephropathy with celiac disease or immune reactivity to gluten.

Directory of Open Access Journals (Sweden)

Sina Moeller

Full Text Available IgA nephropathy is the most common form of primary glomerulonephritis worldwide. Mucosal infections and food antigens, including wheat gluten, have been proposed as potential contributing environmental factors. Increased immune reactivity to gluten and/or association with celiac disease, an autoimmune disorder triggered by ingestion of gluten, have been reported in IgA nephropathy. However, studies are inconsistent about this association. We aimed to evaluate the proposed link between IgA nephropathy and celiac disease or immune reactivity to gluten by conducting a comprehensive analysis of associated serologic markers in cohorts of well-characterized patients and controls. Study participants included patients with biopsy-proven IgA nephropathy (n = 99, unaffected controls of similar age, gender, and race (n = 96, and patients with biopsy-proven celiac disease (n = 30. All serum specimens were tested for IgG and IgA antibodies to native gliadin and deamidated gliadin, as well as IgA antibody to transglutaminase 2 (TG2. Anti-TG2 antibody-positive nephropathy patients and unaffected controls were subsequently tested for IgA anti-endomysial antibody and genotyped for celiac disease-associated HLA-DQ2 and -DQ8 alleles. In comparison to unaffected controls, there was not a statistically significant increase in IgA or IgG antibody reactivity to gliadin in individuals with IgA nephropathy. In addition, the levels of celiac disease-specific serologic markers, i.e., antibodies to deamidated gliadin and TG2, did not differ between IgA nephropathy patients and unaffected controls. Results of the additional anti-endomysial antibody testing and HLA genotyping were corroborative. The data from this case-control study do not reveal any evidence to suggest a significant role for celiac disease or immune reactivity to gluten in IgA nephropathy.

Lack of serologic evidence to link IgA nephropathy with celiac disease or immune reactivity to gluten.

Science.gov (United States)

Moeller, Sina; Canetta, Pietro A; Taylor, Annette K; Arguelles-Grande, Carolina; Snyder, Holly; Green, Peter H; Kiryluk, Krzysztof; Alaedini, Armin

2014-01-01

IgA nephropathy is the most common form of primary glomerulonephritis worldwide. Mucosal infections and food antigens, including wheat gluten, have been proposed as potential contributing environmental factors. Increased immune reactivity to gluten and/or association with celiac disease, an autoimmune disorder triggered by ingestion of gluten, have been reported in IgA nephropathy. However, studies are inconsistent about this association. We aimed to evaluate the proposed link between IgA nephropathy and celiac disease or immune reactivity to gluten by conducting a comprehensive analysis of associated serologic markers in cohorts of well-characterized patients and controls. Study participants included patients with biopsy-proven IgA nephropathy (n = 99), unaffected controls of similar age, gender, and race (n = 96), and patients with biopsy-proven celiac disease (n = 30). All serum specimens were tested for IgG and IgA antibodies to native gliadin and deamidated gliadin, as well as IgA antibody to transglutaminase 2 (TG2). Anti-TG2 antibody-positive nephropathy patients and unaffected controls were subsequently tested for IgA anti-endomysial antibody and genotyped for celiac disease-associated HLA-DQ2 and -DQ8 alleles. In comparison to unaffected controls, there was not a statistically significant increase in IgA or IgG antibody reactivity to gliadin in individuals with IgA nephropathy. In addition, the levels of celiac disease-specific serologic markers, i.e., antibodies to deamidated gliadin and TG2, did not differ between IgA nephropathy patients and unaffected controls. Results of the additional anti-endomysial antibody testing and HLA genotyping were corroborative. The data from this case-control study do not reveal any evidence to suggest a significant role for celiac disease or immune reactivity to gluten in IgA nephropathy.

High-protein diets in hyperlipidemia : effect of wheat gluten on serum lipids, uric acid, and renal function

NARCIS (Netherlands)

Jenkins, D.J.A.; Kendall, C.W.C.; Vidgen, E.; Augustin, L.S.A.; Erk, van M.; Geelen, A.; Parker, T.; Faulkner, D.; Vuksan, V.; Josse, R.G.; Leiter, L.A.; Connelly, P.W.

2001-01-01

BACKGROUND: The metabolic effects of diets high in vegetable protein have not been assessed despite much recent interest in the effect of soy proteins in reducing serum cholesterol. OBJECTIVE: We assessed the metabolic effects of diets high in vegetable protein (specifically, wheat gluten) on serum

Gluten characteristics imparting bread quality in wheats differing for high molecular weight glutenin subunits at Glu D1 locus.

Science.gov (United States)

Mohan, Devinder; Gupta, Raj Kumar

2015-07-01

High yielding genotypes differing for high molecular weight glutenin subunits at Glu D1 locus in national wheat programme of India were examined for bread loaf volume, gluten and protein contents, gluten strength, gluten index and protein-gluten ratio. Number of superior bread quality genotypes in four agro-climatically diverse zones of Indian plains was comparable in both categories of wheat i.e., 5 + 10 and 2 + 12. There wasn't any difference in average bread loaf volume and grain protein content either. 5 + 10 wheats showed better gluten strength and their gluten quality was also superior in the zones where protein content was high. 2 + 10 wheats exerted more gluten due to better protein-gluten ratio. Good bread making in 5 + 10 was derived by better gluten strength and also gluten quality in certain regions but bread quality in 2 + 12 wheats was channelized through higher gluten content as they were more efficient in extracting gluten from per unit protein. Difference in route to bread quality was apparent as gluten content and gluten strength were the key gluten attributes in 5 + 10 whereas protein content and gluten index were prominent in 2 + 12 types. Unlike 2 + 12, there was a ceiling in gluten harvest of 5 + 10 wheats as higher protein failed to deliver more gluten after some limit.

Latiglutenase Improves Symptoms in Seropositive Celiac Disease Patients While on a Gluten-Free Diet.

Science.gov (United States)

Syage, Jack A; Murray, Joseph A; Green, Peter H R; Khosla, Chaitan

2017-09-01

Celiac disease (CD) is a widespread condition triggered by dietary gluten and treated with a lifelong gluten-free diet (GFD); however, inadvertent exposure to gluten can result in episodic symptoms. A previous trial of latiglutenase (clinicaltrials.gov; NCT01917630), an orally administered mixture of two recombinant gluten-specific proteases, was undertaken in symptomatic subjects with persistent injury. The primary endpoint for histologic improvement was not met, presumably due to a trial effect. In this post hoc analysis, we investigated the efficacy of latiglutenase for reducing symptoms in subgroups of the study participants based on their seropositivity. The study involved symptomatic CD patients following a GFD for at least one year prior to randomization. Patients were treated for 12 weeks with latiglutenase or placebo. Of 398 completed patients, 173 (43%) were seropositive at baseline. Symptoms were recorded daily, and weekly symptom scores were compiled. p values were calculated by analysis of covariance. A statistically significant, dose-dependent reduction was detected in the severity and frequency of symptoms in seropositive but not seronegative patients. The severity of abdominal pain and bloating was reduced by 58 and 44%, respectively, in the cohort receiving the highest latiglutenase dose (900 mg, n = 14) relative to placebo (n = 54). Symptom improvement increased from week 6 to week 12. There was also a trend toward greater symptom improvement with greater baseline symptom severity. Seropositive CD patients show symptomatic improvement from latiglutenase taken with meals and would benefit from the availability of this treatment.

The Effects of Reduced Gluten Barley Diet on Humoral and Cell-Mediated Systemic Immune Responses of Gluten-Sensitive Rhesus Macaques

Directory of Open Access Journals (Sweden)

Karol Sestak

2015-03-01

Full Text Available Celiac disease (CD affects approximately 1% of the general population while an estimated additional 6% suffers from a recently characterized, rapidly emerging, similar disease, referred to as non-celiac gluten sensitivity (NCGS. The only effective treatment of CD and NCGS requires removal of gluten sources from the diet. Since required adherence to a gluten-free diet (GFD is difficult to accomplish, efforts to develop alternative treatments have been intensifying in recent years. In this study, the non-human primate model of CD/NCGS, e.g., gluten-sensitive rhesus macaque, was utilized with the objective to evaluate the treatment potential of reduced gluten cereals using a reduced gluten (RG; 1% of normal gluten barley mutant as a model. Conventional and RG barleys were used for the formulation of experimental chows and fed to gluten-sensitive (GS and control macaques to determine if RG barley causes a remission of dietary gluten-induced clinical and immune responses in GS macaques. The impacts of the RG barley diet were compared with the impacts of the conventional barley-containing chow and the GFD. Although remission of the anti-gliadin antibody (AGA serum responses and an improvement of clinical diarrhea were noted after switching the conventional to the RG barley diet, production of inflammatory cytokines, e.g., interferon-gamma (IFN-γ, tumor necrosis factor (TNF and interleukin-8 (IL-8 by peripheral CD4+ T helper lymphocytes, persisted during the RG chow treatment and were partially abolished only upon re-administration of the GFD. It was concluded that the RG barley diet might be used for the partial improvement of gluten-induced disease but its therapeutic value still requires upgrading—by co-administration of additional treatments.

The effects of reduced gluten barley diet on humoral and cell-mediated systemic immune responses of gluten-sensitive rhesus macaques.

Science.gov (United States)

Sestak, Karol; Thwin, Hazel; Dufour, Jason; Aye, Pyone P; Liu, David X; Moehs, Charles P

2015-03-06

Celiac disease (CD) affects approximately 1% of the general population while an estimated additional 6% suffers from a recently characterized, rapidly emerging, similar disease, referred to as non-celiac gluten sensitivity (NCGS). The only effective treatment of CD and NCGS requires removal of gluten sources from the diet. Since required adherence to a gluten-free diet (GFD) is difficult to accomplish, efforts to develop alternative treatments have been intensifying in recent years. In this study, the non-human primate model of CD/NCGS, e.g., gluten-sensitive rhesus macaque, was utilized with the objective to evaluate the treatment potential of reduced gluten cereals using a reduced gluten (RG; 1% of normal gluten) barley mutant as a model. Conventional and RG barleys were used for the formulation of experimental chows and fed to gluten-sensitive (GS) and control macaques to determine if RG barley causes a remission of dietary gluten-induced clinical and immune responses in GS macaques. The impacts of the RG barley diet were compared with the impacts of the conventional barley-containing chow and the GFD. Although remission of the anti-gliadin antibody (AGA) serum responses and an improvement of clinical diarrhea were noted after switching the conventional to the RG barley diet, production of inflammatory cytokines, e.g., interferon-gamma (IFN-γ), tumor necrosis factor (TNF) and interleukin-8 (IL-8) by peripheral CD4+ T helper lymphocytes, persisted during the RG chow treatment and were partially abolished only upon re-administration of the GFD. It was concluded that the RG barley diet might be used for the partial improvement of gluten-induced disease but its therapeutic value still requires upgrading-by co-administration of additional treatments.

Evolution of Gluten Content in Cereal-Based Gluten-Free Products: An Overview from 1998 to 2016

Directory of Open Access Journals (Sweden)

María Ángeles Bustamante

2017-01-01

Full Text Available The treatment of Celiac disease consists in a strict lifelong gluten-free (GF diet. As the ingestion of small amounts can have damaging complications, there has been an ongoing discussion regarding the safe threshold for dietary residual gluten. The aim was to analyze the evolution of gluten content in cereal-based GF foodstuffs (n = 3141 from 1998 to 2016 measured by the enzyme-linked immunosorbent assay (ELISA technique. Eight categories were defined: flours, breakfast cereals/bars, bakery, pasta, breads, dough, snacks, and yeasts, and these were divided into GF labeled-foods (GF-L or reportedly GF foodstuffs, but not certified (GF-NC. Gluten-detection was decreased over time in line with the evolving European regulations about food information and gluten content claims. This decline started sooner in GF-L products than in GF-NC. As a whole, gluten was detected in 371 samples, with breakfast cereals/bars being the most contaminated group. Snacks and yeasts changed from being high gluten-detected samples to being totally GF over the years. The downside is that, of contaminated samples, those in the low levels of gluten detection range have decreased while flour samples containing over 100 mg/kg gluten have risen in the 2013–2016 period. Obtained data confirm that GF cereal-based foods are becoming safer but gluten control must be maintained.

Relationship of molecular weight distribution profile of unreduced gluten protein extracts with quality characteristics of bread.

Science.gov (United States)

Chaudhary, Nisha; Dangi, Priya; Khatkar, B S

2016-11-01

A statistical correlation was established among the molecular weight distribution patterns of unreduced gluten proteins and physicochemical, rheological and bread-making quality characteristics of wheat varieties. Size exclusion chromatography fractionated the gluten proteins apparently into five peaks. Peak I signified glutenins (30-130kDa), peak II as gliadins (20-55kDa), peak III as very low molecular weight monomeric gliadins (10-28kDa), peak IV and V, collectively, as albumins and globulins (bread loaf volume (r=0.848(∗∗)); however, peak II had negative (r=-0.818(∗∗)) impact. Bread firmness increased with increment in peak II (r=0.625(∗∗)), and decreased with accretion in peak I (r=-0.623(∗∗)). Copyright © 2016 Elsevier Ltd. All rights reserved.

Celiac disease or non-celiac gluten sensitivity? An approach to clinical differential diagnosis.

Science.gov (United States)

Kabbani, Toufic A; Vanga, Rohini R; Leffler, Daniel A; Villafuerte-Galvez, Javier; Pallav, Kumar; Hansen, Joshua; Mukherjee, Rupa; Dennis, Melinda; Kelly, Ciaran P

2014-05-01

Differentiating between celiac disease (CD) and non-celiac gluten sensitivity (NCGS) is important for appropriate management but is often challenging. We retrospectively reviewed records from 238 patients who presented for the evaluation of symptoms responsive to gluten restriction without prior diagnosis or exclusion of CD. Demographics, presenting symptoms, serologic, genetic, and histologic data, nutrient deficiencies, personal history of autoimmune diseases, and family history of CD were recorded. NCGS was defined as symptoms responsive to a gluten-free diet (GFD) in the setting of negative celiac serology and duodenal biopsies while on a gluten-containing diet or negative human leukocyte antigen (HLA) DQ2/DQ8 testing. Of the 238 study subjects, 101 had CD, 125 had NCGS, 9 had non-celiac enteropathy, and 3 had indeterminate diagnosis. CD subjects presented with symptoms of malabsorption 67.3% of the time compared with 24.8% of the NCGS subjects (Pdiseases (P=0.002), or nutrient deficiencies (P2× upper limit of normal IgA trans-glutaminase antibody (tTG) or IgA/IgG deaminated gliadan peptide antibody (DGP) with clinical response to GFD was 130 (confidence interval (CI): 18.5-918.3). The positive likelihood ratio of the combination of gluten-responsive symptoms and negative IgA tTG or IgA/IgG DGP on a regular diet for NCGS was 9.6 (CI: 5.5-16.9). When individuals with negative IgA tTG or IgA/IgG DGP also lacked symptoms of malabsorption (weight loss, diarrhea, and nutrient deficiencies) and CD risk factors (personal history of autoimmune diseases and family history of CD), the positive likelihood ratio for NCGS increased to 80.9. On the basis of our findings, we have developed a diagnostic algorithm to differentiate CD from NCGS. Subjects with negative celiac serologies (IgA tTG or IgA/IgG DGP) on a regular diet are unlikely to have CD. Those with negative serology who also lack clinical evidence of malabsorption and CD risk factors are highly likely to have

Coeliac disease: review of diagnosis and management.

Science.gov (United States)

Walker, Marjorie M; Ludvigsson, Jonas F; Sanders, David S

2017-08-21

Coeliac disease is an immune-mediated systemic disease triggered by exposure to gluten, and manifested by small intestinal enteropathy and gastrointestinal and extra-intestinal symptoms. Recent guidelines recommend a concerted use of clear definitions of the disease. In Australia, the most recent estimated prevalence is 1.2% in adult men (1:86) and 1.9% in adult women (1:52). Active case finding is appropriate to diagnose coeliac disease in high risk groups. Diagnosis of coeliac disease is important to prevent nutritional deficiency and long term risk of gastrointestinal malignancy. The diagnosis of coeliac disease depends on clinico-pathological correlation: history, presence of antitransglutaminase antibodies, and characteristic histological features on duodenal biopsy (when the patient is on a gluten-containing diet). Human leucocyte antigen class II haplotypes DQ2 or DQ8 are found in nearly all patients with coeliac disease, but are highly prevalent in the general population at large (56% in Australia) and testing can only exclude coeliac disease for individuals with non-permissive haplotypes. Adhering to a gluten free diet allows duodenal mucosal healing and alleviates symptoms. Patients should be followed up with a yearly review of dietary adherence and a health check. Non-coeliac gluten or wheat protein sensitivity is a syndrome characterised by both gastrointestinal and extra-intestinal symptoms related to the ingestion of gluten and possibly other wheat proteins in people who do not have coeliac disease or wheat allergy recognised by diagnostic tests.

Detection of gluten immunogenic peptides in the urine of patients with coeliac disease reveals transgressions in the gluten-free diet and incomplete mucosal healing.

Science.gov (United States)

Moreno, María de Lourdes; Cebolla, Ángel; Muñoz-Suano, Alba; Carrillo-Carrion, Carolina; Comino, Isabel; Pizarro, Ángeles; León, Francisco; Rodríguez-Herrera, Alfonso; Sousa, Carolina

2017-02-01

Gluten-free diet (GFD) is the only management for coeliac disease (CD). Available methods to assess GFD compliance are insufficiently sensitive to detect occasional dietary transgressions that may cause gut mucosal damage. We aimed to develop a method to determine gluten intake and monitor GFD compliance in patients with CD and to evaluate its correlation with mucosal damage. Urine samples of 76 healthy subjects and 58 patients with CD subjected to different gluten dietary conditions were collected. A lateral flow test (LFT) with the highly sensitive and specific G12 monoclonal antibody for the most dominant gluten immunogenic peptides (GIP) and a LFT reader were used to quantify GIP in solid-phase extracted urines. GIP were detectable in concentrated urines from healthy individuals previously subjected to GFD as early as 4-6 h after single gluten intake, and remained detectable for 1-2 days. The urine assay revealed infringement of the GFD in about 50% of the patients. Analysis of duodenal biopsies revealed that most of patients with CD (89%) with no villous atrophy had no detectable GIP in urine, while all patients with quantifiable GIP in urine showed incomplete intestinal mucosa recovery. GIP are detected in urine after gluten consumption, enabling a new and non-invasive method to monitor GFD compliance and transgressions. The method was sensitive, specific and simple enough to be convenient for clinical monitoring of patients with CD as well as for basic and clinical research applications including drug development. NCT02344758. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The Relationship Between Protein Fractions of Wheat Gluten and the Quality of Ring-Shaped Rolls Evaluated by the Echolocation Method

Directory of Open Access Journals (Sweden)

Grazina Juodeikiene

2005-01-01

Full Text Available This paper presents the results of the relationship between separate protein fractions and the quality of baked ring-shaped rolls. The qualitative and quantitative protein composition of flour derived from some wheat varieties grown in Lithuania has been determined. The protein properties are evaluated by SDS-PAGE. A new method of the analysis of swelling, based on the principle of echolocation, has been used to determine the quality of this specific kind of baked goods. For the application of this method the wheat flour, which is most suitable for the production of ring-shaped rolls, made from the wheat variety Portal (Pasvalys PVRS, has been selected. This flour has the following quality parameters: proteins 10.5 %, gluten 22.0 %, gluten index 47 r.u. Correlation between the flour quality parameters and the quality of the final bread product shows that γ-gliadins (r=–0.63, LMM glutenins (r=0.55, HMM glutenins (r=0.63 and the content of gluten (r=0.87 have the greatest influence on the quality of the ring-shaped rolls.

Effects of dietary corn gluten meal on growth performance and protein metabolism in relation to IGF-I and TOR gene expression of juvenile cobia ( Rachycentron canadum)

Science.gov (United States)

Luo, Yiwen; Ai, Qinghui; Mai, Kangsen; Zhang, Wenbing; Xu, Wei; Zhang, Yanjiao; Liufu, Zhiguo

2013-09-01

A growth experiment was conducted on cobia ( Rachycentron canadum, initial weight 108.2 g ± 3.0 g) to investigate the effects of dietary corn gluten meal (CGM) levels on the fish growth, whole body composition and protein metabolism in relation to specific gene expression. Five isonitrogenous (crude protein 45%) and isoenergetic (gross energy 20 kJ g-1) practical diets were formulated by replacing 0% (the control), 17.5%, 35.0%, 52.5%, and 70.0% of fish meal (FM) protein with CGM protein. No significant differences were observed in the survival, feed intake (FI), specific growth rate (SGR), feed efficiency (FE) and protein productive value (PPV) among fish fed diets with 0%, 17.5%, 35.0%, and 52.5% of CGM protein. However, these indices were significantly lower in fish fed the diet with 70.0% of CGM protein than those in fish fed the control diet ( P cobia. The present results might be useful for developing cost effective and sustainable cobia dietary formulations.

Non-Celiac Gluten Sensitivity and Autoimmunity. A Case Report.

Directory of Open Access Journals (Sweden)

Carlos Isasi

2014-12-01

Full Text Available Introduction, objective: To present a case report in which the finding of non-coeliac gluten sensitivity was decisive for the treatment of a complex autoimmune disease. Materials and methods: A 43-year-old woman with polyarthritis, psoriatic features, anti-SSA/Ro and anti-cyclic citrullinated peptide antibodies, with refractory course, was evaluated for gluten sensitivity despite negative serology for coeliac disease. Results: The patient carried the HLA DQ2 haplotype and duodenal biopsy showed lymphocytic enteritis. A gluten-free diet resolved the clinical picture and permitted tapering of immunosuppressive therapy. Conclusion: Non-coeliac gluten sensitivity can be associated with autoimmunity despite the absence of the specific autoantibodies of coeliac disease.

Celiac disease: implications for patient management.

Science.gov (United States)

Ryan, Megan; Grossman, Sheila

2011-01-01

Celiac disease is an autoimmune disorder that is known specifically for causing inflammation of the mucosa in the small intestine. Through multiple diagnostic and screening tools such as small intestinal biopsy sample, serological testing, and human leukocyte antigen testing, healthcare providers can diagnose this disease that contains components related to genetic predisposition and intake of gluten proteins found in wheat, barley, and rye. There are some who believe that having an autoimmune disease may predispose one to acquiring another disease. With patients experiencing mostly diarrhea, abdominal pain, and weight loss, the implementation of a gluten-free diet is the treatment that healthcare providers recommend. Through monitoring gluten intake and providing nutritional supplementation, those diagnosed with celiac disease can lead a relatively normal life without complications. With celiac disease affecting all age ranges in the population, and with a documented higher frequency, there is a growing awareness in society that can be easily seen in grocery stores, restaurants, and food manufacturers.

[Non-celiac gluten sensitivity: a critical review of current evidence].

Science.gov (United States)

Molina-Infante, Javier; Santolaria, Santos; Montoro, Miguel; Esteve, María; Fernández-Bañares, Fernando

2014-01-01

Non-celiac gluten sensitivity (NCGS) is an emerging disorder characterized by intestinal and extra-intestinal symptoms related to the ingestion of gluten-containing food in non-celiac patients. Its prevalence has been estimated to be six to ten-times higher than that of celiac disease (CD). A gluten-free diet is the most widely recommended therapy, but the causative agent remains unknown and there are no consensus diagnostic criteria. Recent studies on NCGS have included patients with possibly overlooked minor CD and diarrhea-predominant irritable bowel syndrome without self-reported gluten intolerance, but showing a response to a gluten-free diet. Furthermore, FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols) have recently been postulated as the culprit component for NCGS in wheat, instead of gluten. This review updates evidence on the pathophysiology of NCGS and the efficacy of different dietary interventions in its treatment, stressing the need for proper screening for CD before a diagnosis of NCGS is made. Copyright © 2013 Elsevier España, S.L. and AEEH y AEG. All rights reserved.

Whole grain gluten-free pastas and flatbreads

Science.gov (United States)

Whole grain gluten-free products were formulated and evaluated for acceptance by volunteer tasters. The tastes judged acceptance of whole grain, gluten-free, egg-free pastas for corn 83%, sorghum 79%, brown rice 77% and millet 50%. The acceptance for similar high protein pasta was corn-garbanzo 70...

Expression Pattern of Fatty Acid Binding Proteins in Celiac Disease Enteropathy

Directory of Open Access Journals (Sweden)

Natalia M. Bottasso Arias

2015-01-01

Full Text Available Celiac disease (CD is an immune-mediated enteropathy that develops in genetically susceptible individuals following exposure to dietary gluten. Severe changes at the intestinal mucosa observed in untreated CD patients are linked to changes in the level and in the pattern of expression of different genes. Fully differentiated epithelial cells express two isoforms of fatty acid binding proteins (FABPs: intestinal and liver, IFABP and LFABP, respectively. These proteins bind and transport long chain fatty acids and also have other important biological roles in signaling pathways, particularly those related to PPARγ and inflammatory processes. Herein, we analyze the serum levels of IFABP and characterize the expression of both FABPs at protein and mRNA level in small intestinal mucosa in severe enteropathy and normal tissue. As a result, we observed higher levels of circulating IFABP in untreated CD patients compared with controls and patients on gluten-free diet. In duodenal mucosa a differential FABPs expression pattern was observed with a reduction in mRNA levels compared to controls explained by the epithelium loss in severe enteropathy. In conclusion, we report changes in FABPs’ expression pattern in severe enteropathy. Consequently, there might be alterations in lipid metabolism and the inflammatory process in the small intestinal mucosa.

Microbial Proteases in Baked Goods: Modification of Gluten and Effects on Immunogenicity and Product Quality

Directory of Open Access Journals (Sweden)

Nina G. Heredia-Sandoval

2016-08-01

Full Text Available Gluten-related diseases are a range of inflammatory disorders of the small intestine, characterized by an adverse response to gluten ingestion; therefore, the treatment is a gluten withdrawal. In spite of the increased market of gluten-free products, widely available breads with high acceptability are still missing due to the technological challenge of substituting the special gluten properties. Instead of using alternative ingredients for baking, some attempts have been done to decrease gluten immunogenicity by its enzymatic degradation with microbial proteases. Although the gluten immunogenicity reduction has been reached to an acceptable level, some quality parameters of the products are affected. This review focus on the use of microbial peptidases to prepare less immunogenic baked goods and their effect on product quality.

Microbial Proteases in Baked Goods: Modification of Gluten and Effects on Immunogenicity and Product Quality.

Science.gov (United States)

Heredia-Sandoval, Nina G; Valencia-Tapia, Maribel Y; Calderón de la Barca, Ana M; Islas-Rubio, Alma R

2016-08-30

Gluten-related diseases are a range of inflammatory disorders of the small intestine, characterized by an adverse response to gluten ingestion; therefore, the treatment is a gluten withdrawal. In spite of the increased market of gluten-free products, widely available breads with high acceptability are still missing due to the technological challenge of substituting the special gluten properties. Instead of using alternative ingredients for baking, some attempts have been done to decrease gluten immunogenicity by its enzymatic degradation with microbial proteases. Although the gluten immunogenicity reduction has been reached to an acceptable level, some quality parameters of the products are affected. This review focus on the use of microbial peptidases to prepare less immunogenic baked goods and their effect on product quality.

Label-free SPR detection of gluten peptides in urine for non-invasive celiac disease follow-up.

Science.gov (United States)

Soler, Maria; Estevez, M-Carmen; Moreno, Maria de Lourdes; Cebolla, Angel; Lechuga, Laura M

2016-05-15

Motivated by the necessity of new and efficient methods for dietary gluten control of celiac patients, we have developed a simple and highly sensitive SPR biosensor for the detection of gluten peptides in urine. The sensing methodology enables rapid and label-free quantification of the gluten immunogenic peptides (GIP) by using G12 mAb. The overall performance of the biosensor has been in-depth optimized and evaluated in terms of sensitivity, selectivity and reproducibility, reaching a limit of detection of 0.33 ng mL(-1). Besides, the robustness and stability of the methodology permit the continuous use of the biosensor for more than 100 cycles with excellent repeatability. Special efforts have been focused on preventing and minimizing possible interferences coming from urine matrix enabling a direct analysis in this fluid without requiring extraction or purification procedures. Our SPR biosensor has proven to detect and identify gluten consumption by evaluating urine samples from healthy and celiac individuals with different dietary gluten conditions. This novel biosensor methodology represents a novel approach to quantify the digested gluten peptides in human urine with outstanding sensitivity in a rapid and non-invasive manner. Our technique should be considered as a promising opportunity to develop Point-of-Care (POC) devices for an efficient, simple and accurate gluten free diet (GFD) monitoring as well as therapy follow-up of celiac disease patients. Copyright © 2015 Elsevier B.V. All rights reserved.

Supplementation of Reduced Gluten Barley Diet with Oral Prolyl Endopeptidase Effectively Abrogates Enteropathy-Associated Changes in Gluten-Sensitive Macaques

Directory of Open Access Journals (Sweden)

Karol Sestak

2016-06-01

Full Text Available Celiac disease (CD is an autoimmune disorder that affects approximately three million people in the United States. Furthermore, non-celiac gluten sensitivity (NCGS affects an estimated additional 6% of the population, e.g., 20 million in the U.S. The only effective treatment of CD and NCGS requires complete removal of gluten sources from the diet. While required adherence to a gluten-free diet (GFD is extremely difficult to accomplish, efforts to develop additional supportive treatments are needed. To facilitate these efforts, we developed a gluten-sensitive (GS rhesus macaque model to study the effects of novel therapies. Recently reported results from phase one of this project suggest that partial improvement—but not remission—of gluten-induced disease can be accomplished by 100-fold reduction of dietary gluten, i.e., 200 ppm—by replacement of conventional dietary sources of gluten with a mutant, reduced gluten (RG barley (lys3a-derived source. The main focus of this (phase two study was to determine if the inflammatory effects of the residual gluten in lys3a mutant barley grain could be further reduced by oral supplementation with a prolylendopeptidase (PE. Results reveal that PE supplementation of RG barley diet induces more complete immunological, histopathological and clinical remission than RG barley diet alone. The combined effects of RG barley diet and PE supplementation resulted in a further decrease of inflammatory mediators IFN-γ and TNF secretion by peripheral lymphocytes, as well as decreased plasma anti-gliadin and anti-intestinal tissue transglutaminase (TG2 antibodies, diminished active caspase production in small intestinal mucosa, and eliminated clinical diarrhea—all comparable with a gluten-free diet induced remission. In summary, the beneficial results of a combined RG barley and PE administration in GS macaques may warrant the investigation of similar synergistic approaches.

Clinical Features and Symptom Recovery on a Gluten-Free Diet in Canadian Adults with Celiac Disease

Directory of Open Access Journals (Sweden)

Olga Pulido

2013-01-01

Full Text Available BACKGROUND: Celiac disease can present with mild or nongastrointestinal symptoms, and may escape timely recognition. The treatment of celiac disease involves a gluten-free diet, which is complex and challenging.

Proof of concept of microbiome-metabolome analysis and delayed gluten exposure on celiac disease autoimmunity in genetically at-risk infants.

Directory of Open Access Journals (Sweden)

Maria Sellitto

Full Text Available Celiac disease (CD is a unique autoimmune disorder in which the genetic factors (DQ2/DQ8 and the environmental trigger (gluten are known and necessary but not sufficient for its development. Other environmental components contributing to CD are poorly understood. Studies suggest that aspects of gluten intake might influence the risk of CD occurrence and timing of its onset, i.e., the amount and quality of ingested gluten, together with the pattern of infant feeding and the age at which gluten is introduced in the diet. In this study, we hypothesize that the intestinal microbiota as a whole rather than specific infections dictates the switch from tolerance to immune response in genetically susceptible individuals. Using a sample of infants genetically at risk of CD, we characterized the longitudinal changes in the microbial communities that colonize infants from birth to 24 months and the impact of two patterns of gluten introduction (early vs. late on the gut microbiota and metabolome, and the switch from gluten tolerance to immune response, including onset of CD autoimmunity. We show that infants genetically susceptible to CD who are exposed to gluten early mount an immune response against gluten and develop CD autoimmunity more frequently than at-risk infants in which gluten exposure is delayed until 12 months of age. The data, while derived from a relatively small number of subjects, suggest differences between the developing microbiota of infants with genetic predisposition for CD and the microbiota from infants with a non-selected genetic background, with an overall lack of bacteria of the phylum Bacteriodetes along with a high abundance of Firmicutes and microbiota that do not resemble that of adults even at 2 years of age. Furthermore, metabolomics analysis reveals potential biomarkers for the prediction of CD. This study constitutes a definite proof-of-principle that these combined genomic and metabolomic approaches will be key to

Interaction mechanisms of condensed tannins (proanthocyanidins) with wheat gluten proteins

Science.gov (United States)

Proanthocyanidins (PA) crosslink wheat gluten, increasing its polymer size and strength. However, precise mechanisms behind these interactions are unknown. This study used PA of different MW profiles (mDP 8.3 and 19.5) to investigate the interactions involved in PA polymerization of gluten. The high...

Prevalence of gluten-free diet adherence among individuals without celiac disease in the USA: results from the Continuous National Health and Nutrition Examination Survey 2009-2010.

Science.gov (United States)

DiGiacomo, Daniel V; Tennyson, Christina A; Green, Peter H; Demmer, Ryan T

2013-08-01

Clinical inference suggests the prevalence of non-celiac gluten sensitivity is substantially higher than that of celiac disease in the USA. Unfortunately, there are currently no data supporting these claims. The authors analyzed nationally representative data to estimate the prevalence of adherence to a gluten-free diet among participants without celiac disease and also to characterize the demographics and general health status of these participants. The Continuous National Health and Nutrition Examination Survey (NHANES) 2009-2010 enrolled 7762 individuals representing the civilian, non-institutionalized, US population free of celiac disease. Participants responded to interviewer administered questionnaires regarding current adherence to a gluten-free diet. Prevalence estimates were computed using SAS survey procedures. There were 49 individuals who reported current adherence to a gluten-free diet reflecting a weighted prevalence of 0.548% (95% CI 0.206-0.889). The prevalence of a gluten-free diet was higher in females (0.58%) than males (0.37%), although this was not statistically significant (p = 0.34). Participants reporting a gluten-free diet were older (46.6 vs. 40.5 years, p = 0.005), had higher high-density lipoprotein, lower iron and lower body mass index. The estimated national prevalence of non-celiac gluten sensitivity is 0.548%, approximately half that of celiac disease. Future studies are merited in order to better understand the population burden of non-celiac gluten sensitivity.

Gluten-free diet in children: an approach to a nutritionally adequate and balanced diet.

Science.gov (United States)

Penagini, Francesca; Dilillo, Dario; Meneghin, Fabio; Mameli, Chiara; Fabiano, Valentina; Zuccotti, Gian Vincenzo

2013-11-18

Gluten-free diet (GFD) is the cornerstone treatment for celiac disease (CD). GFD implies a strict and lifelong elimination from the diet of gluten, the storage protein found in wheat, barley, rye and hybrids of these grains, such as kamut and triticale. The absence of gluten in natural and processed foods, despite being the key aspect of GFD, may lead to nutritional consequences, such as deficits and imbalances. The nutritional adequacy of GFD is particularly important in children, this the age being of maximal energy and nutrient requirements for growth, development and activity. In recent years, attention has focused on the nutritional quality of gluten-free products (GFPs) available in the market. It is well recognized that GFPs are considered of lower quality and poorer nutritional value compared to the gluten-containing counterparts. The present review focuses on the nutritional adequacy of GFD at the pediatric age, with the aim being to increase awareness of the potential complications associated with this diet, to identify strategies in order to avoid them and to promote a healthier diet and lifestyle in children with CD.

Quality of shear fractionated wheat gluten – comparison to commercial vital wheat gluten

NARCIS (Netherlands)

Zalm, van der E.E.J.; Goot, van der A.J.; Boom, R.M.

2011-01-01

The functional properties of gluten obtained with a shear-induced separation process, recently proposed by Peighambardoust et al. (2008), are compared with a commercially available vital wheat gluten. Two tests were performed. First, a relatively strong wheat flour, Soissons, was enriched with

Fecal Gluten Peptides Reveal Limitations of Serological Tests and Food Questionnaires for Monitoring Gluten-Free Diet in Celiac Disease Patients

Science.gov (United States)

Comino, Isabel; Fernández-Bañares, Fernando; Esteve, María; Ortigosa, Luís; Castillejo, Gemma; Fambuena, Blanca; Ribes-Koninckx, Carmen; Sierra, Carlos; Rodríguez-Herrera, Alfonso; Salazar, José Carlos; Caunedo, Ángel; Marugán-Miguelsanz, J M; Garrote, José Antonio; Vivas, Santiago; lo Iacono, Oreste; Nuñez, Alejandro; Vaquero, Luis; Vegas, Ana María; Crespo, Laura; Fernández-Salazar, Luis; Arranz, Eduardo; Jiménez-García, Victoria Alejandra; Antonio Montes-Cano, Marco; Espín, Beatriz; Galera, Ana; Valverde, Justo; Girón, Francisco José; Bolonio, Miguel; Millán, Antonio; Cerezo, Francesc Martínez; Guajardo, César; Alberto, José Ramón; Rosinach, Mercé; Segura, Verónica; León, Francisco; Marinich, Jorge; Muñoz-Suano, Alba; Romero-Gómez, Manuel; Cebolla, Ángel; Sousa, Carolina

2016-01-01

Objectives: Treatment for celiac disease (CD) is a lifelong strict gluten-free diet (GFD). Patients should be followed-up with dietary interviews and serology as CD markers to ensure adherence to the diet. However, none of these methods offer an accurate measure of dietary compliance. Our aim was to evaluate the measurement of gluten immunogenic peptides (GIP) in stools as a marker of GFD adherence in CD patients and compare it with traditional methods of GFD monitoring. Methods: We performed a prospective, nonrandomized, multicenter study including 188 CD patients on GFD and 84 healthy controls. Subjects were given a dietary questionnaire and fecal GIP quantified by enzyme-linked immunosorbent assay (ELISA). Serological anti-tissue transglutaminase (anti-tTG) IgA and anti-deamidated gliadin peptide (anti-DGP) IgA antibodies were measured simultaneously. Results: Of the 188 celiac patients, 56 (29.8%) had detectable GIP levels in stools. There was significant association between age and GIP in stools that revealed increasing dietary transgressions with advancing age (39.2% in subjects ≥13 years old) and with gender in certain age groups (60% in men ≥13 years old). No association was found between fecal GIP and dietary questionnaire or anti-tTG antibodies. However, association was detected between GIP and anti-DGP antibodies, although 46 of the 53 GIP stool-positive patients were negative for anti-DGP. Conclusions: Detection of gluten peptides in stools reveals limitations of traditional methods for monitoring GFD in celiac patients. The GIP ELISA enables direct and quantitative assessment of gluten exposure early after ingestion and could aid in the diagnosis and clinical management of nonresponsive CD and refractory CD. Trial registration number NCT02711397. PMID:27644734

Molecular and immunological characterization of gluten proteins isolated from oat cultivars that differ in toxicity for celiac disease.

Directory of Open Access Journals (Sweden)

Ana Real

Full Text Available A strict gluten-free diet (GFD is the only currently available therapeutic treatment for patients with celiac disease (CD. Traditionally, treatment with a GFD has excluded wheat, barley and rye, while the presence of oats is a subject of debate. The most-recent research indicates that some cultivars of oats can be a safe part of a GFD. In order to elucidate the toxicity of the prolamins from oat varieties with low, medium, and high CD toxicity, the avenin genes of these varieties were cloned and sequenced, and their expression quantified throughout the grain development. At the protein level, we have accomplished an exhaustive characterization and quantification of avenins by RP-HPLC and an analysis of immunogenicity of peptides present in prolamins of different oat cultivars. Avenin sequences were classified into three different groups, which have homology with S-rich prolamins of Triticeae. Avenin proteins presented a lower proline content than that of wheat gliadin; this may contribute to the low toxicity shown by oat avenins. The expression of avenin genes throughout the development stages has shown a pattern similar to that of prolamins of wheat and barley. RP-HPLC chromatograms showed protein peaks in the alcohol-soluble and reduced-soluble fractions. Therefore, oat grains had both monomeric and polymeric avenins, termed in this paper gliadin- and glutenin-like avenins. We found a direct correlation between the immunogenicity of the different oat varieties and the presence of the specific peptides with a higher/lower potential immunotoxicity. The specific peptides from the oat variety with the highest toxicity have shown a higher potential immunotoxicity. These results suggest that there is wide range of variation of potential immunotoxicity of oat cultivars that could be due to differences in the degree of immunogenicity in their sequences.

Formulation of gluten-free flour culinary products of high nutritional value

Directory of Open Access Journals (Sweden)

Y. P. Dombrovskaya

2016-01-01

Full Text Available The article is devoted to the production of gluten-free foods that are necessary for people suffering from this disease as celiac disease. The article reveals the relevance of developing recipes for gluten-free foods, which are not inferior to traditional in many respects. Classic recipes gluten-free bakery products, mainly based on rice, buckwheat, corn flour, which have little nutritional value. In this regard, the current development of technologies and formulations pastry dishes with use of nonconventional vegetable raw materials rich in dietary fibers, proteins and other beneficial substances that improve the biological and nutritional value of these products. The paper describes the formulation of gluten-free muffins, was based on the recipe of the cake "Capital". The main raw material for the new compositions of selected rice flour, and as enriching additives – flax flour and flour from the eggshell. Was conducted baking tests on the basis of which was chosen percentage of the input substances and the assessment of quality of semifinished and finished products. The quality of semi-finished products was evaluated by such indicators as humidity and the microstructure of the test. The quality of finished products was assessed using organoleptic and physical-chemical parameters, the results presented in the tables. Investigated the antioxidant activity of products. Produced sensometrical evaluation of aroma of control and experimental samples. Calculated chemical composition. The content of protein, vitamins, mineral substances in the experimental sample is significantly increased compared to control. Making flour egg shell has achieved the ratio of Ca-Mg-P as close to a perfect 1:0,39:1,53 Replacement of wheat flour with flaxseed and rice flour and the introduction of egg shell improve the amino acid composition of the product. The biological value increased by 2.3%.

Value of IgA tTG in Predicting Mucosal Recovery in Children with Celiac Disease on a Gluten Free Diet

Science.gov (United States)

Leonard, Maureen M.; Weir, Dascha C.; DeGroote, Maya; Mitchell, Paul D.; Singh, Prashant; Silvester, Jocelyn A.; Leichtner, Alan M.; Fasano, Alessio

2017-01-01

Objective Our objective was to determine the rate of mucosal recovery in pediatric patients with celiac disease on a gluten free diet. We also sought to determine whether IgA tissue transglutaminase (tTG) correlates with mucosal damage at the time of a repeat endoscopy with duodenal biopsy in these patients. Methods We performed a retrospective chart review of one-hundred and three pediatric patients, under 21 years of age, with a diagnosis of celiac disease defined as Marsh 3 histology, and who underwent a repeat endoscopy with duodenal biopsy at least twelve months after initiating a gluten free diet. Results We found that 19% of pediatric patients treated with a gluten free diet had persistent enteropathy. At the time of the repeat biopsy, tTG was elevated in 43% of cases with persistent enteropathy and 32% of cases in which there was mucosal recovery. Overall the positive predictive value of the autoantibody tissue transglutaminase was 25% and the negative predictive value was 83% in patients on a gluten free diet for a median of 2.4 years. Conclusions Nearly one in five children with celiac disease in our population had persistent enteropathy despite maintaining a gluten free diet and IgA tTG was not an accurate marker of mucosal recovery. Neither the presence of symptoms nor positive serology were predictive of a patient’s histology at the time of repeat biopsy. These findings suggest a revisitation of monitoring and management criteria of celiac disease in childhood. PMID:28112686

[Histological diagnosis and complications of celiac disease. Update according to the new S2k guidelines].

Science.gov (United States)

Aust, D E; Bläker, H

2015-03-01

Celiac disease is a relatively common immunological systemic disease triggered by the protein gluten in genetically predisposed individuals. Classical symptoms like chronic diarrhea, steatorrhea, weight loss and growth retardation are nowadays relatively uncommon. Diagnostic workup includes serological tests for IgA antibodies against tissue transglutaminase 2 (anti-TG2-IgA) and total IgA and histology of duodenal biopsies. Histomorphological classification should be done according to the modified Marsh-Oberhuber classification. Diagnosis of celiac disease should be based on serological, clinical, and histological findings. The only treatment is a life-long gluten-free diet. Unchanged or recurrent symptoms under gluten-free diet may indicate refractory celiac disease. Enteropathy-associated T-cell lymphoma and adenocarcinomas of the small intestine are known complications of celiac disease.

Quality characteristics of gluten-free cookies made of buckwheat, corn, and rice flour with/without transglutaminase.

Science.gov (United States)

Altındağ, Gülçin; Certel, Muharrem; Erem, Fundagül; İlknur Konak, Ülgen

2015-04-01

Buckwheat is one of the most valuable pseudo-cereals in terms of its nutritional composition, and it is suitable for celiac patients because of its gluten-free characteristic. However, gluten is the main structure-forming protein responsible for the development of structure in baked products. Therefore, it is a challenge to produce high-quality gluten-free products. Transglutaminase addition is a relatively common application used in the production of gluten-free baked goods. The objective of this study was to investigate the combination of buckwheat flour with rice and corn flour at different levels in gluten-free cookie formulations and the impact of transglutaminase on the quality of cookies. Quality parameters evaluated were proximal chemical composition, spread ratio, color, and textural parameters (hardness and fracturability). Spread ratio, protein, crude fiber, ash content, and also b* and hardness values were significantly (p flour combinations. Further, addition of transglutaminase resulted in increased moisture content, spread ratio, and fracturability but decreased hardness values. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Pure Oats as Part of the Canadian Gluten-Free Diet in Celiac Disease: The Need to Revisit the Issue.

Science.gov (United States)

de Souza, M Cristina P; Deschênes, Marie-Eve; Laurencelle, Suzanne; Godet, Patrick; Roy, Claude C; Djilali-Saiah, Idriss

2016-01-01

The question about recommending pure, noncontaminated oats as part of the gluten-free diet of patients with celiac disease remains controversial. This might be due to gluten cross contamination and to the possible immunogenicity of some oat cultivars. In view of this controversy, a review of the scientific literature was conducted to highlight the latest findings published between 2008 and 2014 to examine the current knowledge on oats safety and celiac disease in Europe and North America. Results showed that regular oats consumed in Canada are largely contaminated. Overall, the consumption of pure oats has been generally considered to be safe for adults and children. However, it appears that some oat cultivars may trigger an immune response in sensitive individuals. Therefore, further long-term studies on the impact of consumption of oats identifying the cultivar(s) constitute an important step forward for drawing final recommendations. Furthermore, a closer and more accurate monitoring of the dietary intake of noncontaminated oats would be paramount to better determine what its actual contribution in the gluten-free diet of adults and children with celiac disease are in order to draw sound recommendations on the safety of pure oats as part of the gluten-free diet.

Nutritional and sensory challenges of gluten-free bakery products: a review.

Science.gov (United States)

Stantiall, Sophie E; Serventi, Luca

2018-06-01

There is a growing need for gluten-free bakery products. Currently, gluten-free bakery products deliver lower protein, fibre and mineral content and elevated glycaemic index (GI) than gluten-containing foods. Only a mixture of rice and buckwheat flour or a low addition of either egg white or whey protein, has shown potential for the improvement of both nutrition and sensory qualities. To increase the fibre content, isolated cereal fibre and soluble fibre isolates have been incorporated into gluten-free formulations with some sensory success. Studies have shown that the GI of modern gluten-free products is no longer a major concern with the improvement of ingredient formulations and processing methods. The currently low mineral content can be increased with the use of mineral-rich ingredients such as amaranth, buckwheat or flaxseed flour. Nonetheless, consumers still show a preference to refined, low fibre breads over wholegrain fibre-rich bread.

A radioimmunoassay for wheat gliadin to assess the suitability of gluten free foods for patients with coeliac disease.

Science.gov (United States)

Ciclitira, P J; Ellis, H J; Evans, D J; Lennox, E S

1985-03-01

Coeliac disease is a clinical condition characterised by malabsorption secondary to abnormalities of the small intestine. The condition is known to be exacerbated by wheat gliadin, rye, barley and possibly oats. The only assays that are available for testing for the presence of wheat gluten in foods are double diffusion against rabbit anti-gliadin antiserum and measurement of Kjeldahl nitrogen in products derived from wheat flour. We have developed a radioimmunoassay for wheat gliadin with a detection limit of 1 ng. Nominally gluten free foods based on wheat starch have been shown to contain up to 1.9 X 10(-2)% wheat gliadin. Bread made from Nutregen wheat starch which has now been withdrawn contains 6.4 mg gliadin per standard 30 g slice. A radioimmunoassay for wheat gliadin could be used to define standards for the suitability of gluten free products based on wheat starch for patients with coeliac disease.

Applying Simulation Method in Formulation of Gluten-Free Cookies

Directory of Open Access Journals (Sweden)

Nikitina Marina

2017-01-01

Full Text Available At present time priority direction in the development of new food products its developing of technology products for special purposes. These types of products are gluten-free confectionery products, intended for people with celiac disease. Gluten-free products are in demand among consumers, it needs to expand assortment, and improvement of quality indicators. At this article results of studies on the development of pastry products based on amaranth flour does not contain gluten. Study based on method of simulation recipes gluten-free confectionery functional orientation to optimize their chemical composition. The resulting products will allow to diversify and supplement the necessary nutrients diet for people with gluten intolerance, as well as for those who follow a gluten-free diet.

Gluten sensitivity and neurological manifestations

Directory of Open Access Journals (Sweden)

Agostino Berio

2015-12-01

Full Text Available The authors report on six cases of gluten-sensitivity, also defined non-celiac gluten sensitivity, characterized by abdominal features (diarrhea, bloating, pain, genetic positivity for predisposition to celiac disease (DQB1* 02 in all cases; DQA1*05 in three; DQA1*02 in two, DQB1*03 in two, negative anti-t-Transglutaminase antibodies, normal mucosa on biopsy in four cases, type 1 of Marsh in one case. The subjects presented frequent central nervous system (CNS symptoms: headache in three patients, somnolence in one, electroencephalogram aspecific alterations in three (in two of them with previous seizures, leptomeningeal cyst in one, intracranial calcification in one, cerebral gliosis in two. After a gluten-free diet, all intestinal and clinical CNS features remitted, but re-appeared after gluten reintroduction. On the basis of the neurological signs, the authors stress the relevance of immune innate system in the pathogenesis of these cases with possible subsequent evolution on immune adaptive system involvement.

Gluten-free but also gluten-enriched (gluten+) diet prevent diabetes in NOD mice; the gluten enigma in type 1 diabetes

DEFF Research Database (Denmark)

Funda, D.P.; Kaas, A.; Tlaskalova-Hogenova, H.

2008-01-01

BACKGROUND: Environmental factors such as nutrition or exposure to infections play a substantial role in the pathogenesis of type 1 diabetes (T1D). We have previously shown that gluten-free, non-purified diet largely prevented diabetes in non-obese diabetic (NOD) mice. In this study we tested...... hypothesis that early introduction of gluten-enriched (gluten+) diet may increase diabetes incidence in NOD mice. METHODS: Standard, gluten-free, gluten+ modified Altromin diets and hydrolysed-casein-based Pregestimil diet were fed to NOD females and diabetes incidence was followed for 310 days. Insulitis...... score and numbers of gut mucosal lymphocytes were determined in non-diabetic animals. RESULTS: A significantly lower diabetes incidence (p diet (5.9%, n = 34) and Pregestimil diet (10%, n = 30) compared to mice on the standard Altromin diet (60.6%, n...

Salivary Gluten Degradation and Oral Microbial Profiles in Healthy Individuals and Celiac Disease Patients

NARCIS (Netherlands)

Tian, N.; Faller, L.; Leffler, D.A.; Kelly, C.P.; Hansen, J.; Bosch, J.A.; Wei, G.; Paster, B.J.; Schuppan, D.; Helmerhorst, E.J.

Celiac disease (CD) is a chronic immune-mediated enteropathy induced by dietary gluten in genetically predisposed individuals. Saliva harbors the second highest bacterial load of the gastrointestinal (GI) tract after the colon. We hypothesized that enzymes produced by oral bacteria may be involved

Gluten-free diet may alleviate depressive and behavioural symptoms in adolescents with coeliac disease: a prospective follow-up case-series study

Directory of Open Access Journals (Sweden)

Sipilä Ilkka

2005-03-01

Full Text Available Abstract Background Coeliac disease in adolescents has been associated with an increased prevalence of depressive and disruptive behavioural disorders, particularly in the phase before diet treatment. We studied the possible effects of a gluten-free diet on psychiatric symptoms, on hormonal status (prolactin, thyroidal function and on large neutral amino acid serum concentrations in adolescents with coeliac disease commencing a gluten-free diet. Methods Nine adolescents with celiac disease, aged 12 to 16 years, were assessed using the semi-structured K-SADS-Present and Lifetime Diagnostic interview and several symptom scales. Seven of them were followed at 1 to 2, 3, and 6 months on a gluten-free diet. Results Adolescent coeliac disease patients with depression had significantly lower pre-diet tryptophan/ competing amino-acid (CAA ratios and free tryptophan concentrations, and significantly higher biopsy morning prolactin levels compared to those without depression. A significant decrease in psychiatric symptoms was found at 3 months on a gluten-free diet compared to patients' baseline condition, coinciding with significantly decreased coeliac disease activity and prolactin levels and with a significant increase in serum concentrations of CAAs. Conclusion Although our results of the amino acid analysis and prolactin levels in adolescents are only preliminary, they give support to previous findings on patients with coeliac disease, suggesting that serotonergic dysfunction due to impaired availability of tryptophan may play a role in vulnerability to depressive and behavioural disorders also among adolescents with untreated coeliac disease.

Grain Quality Evaluation and Characterization of Gluten Powder ...

African Journals Online (AJOL)

The aim of this research was to study the grain quality, proximate composition, gluten isolation and characterization of three bread wheat varieties namely Pavon 76, HAR 2501 and HAR 2536 grown in Arsi and Bale areas of Ethiopia. The wheat varieties had a protein content of 10.60, 11.53 and 10.70% while the wet gluten ...

A comparison of antibody testing, permeability testing, and zonulin levels with small-bowel biopsy in celiac disease patients on a gluten-free diet.

Science.gov (United States)

Duerksen, D R; Wilhelm-Boyles, C; Veitch, R; Kryszak, D; Parry, D M

2010-04-01

Active celiac disease is associated with positive endomysial (EMA) and tissue transglutaminase (TTG) antibodies, elevated zonulin levels, and increased intestinal permeability. There is little known about what happens to these immunologic and structural abnormalities in patients on a gluten-free diet and their correlation with small-bowel biopsy changes. Adult patients previously diagnosed with celiac disease and on a gluten-free diet for greater than 1 year were considered for the study. All patients underwent the following: measurement of EMA and TTG antibodies, serum zonulin levels, intestinal permeability (IP) testing with lactulose/mannitol ratios, food diary analysis for gluten ingestion and small- bowel biopsy. A total of 21 patients on a gluten-free diet for a mean of 9.7 years completed the study. There were ten patients who had normalization of intestinal biopsies, IP and TTG, and EM antibodies. Six patients had Marsh type 2 or 3 lesions and all had either abnormal IP (5/6) or TTG antibody (4/6). In patients with Marsh type 3 lesions, there was a correlation between IP and zonulin levels. A subgroup of patients with celiac disease on a gluten-free diet has complete normalization of intestinal biopsies, intestinal permeability defects, and antibody levels. Patients with Marsh type 3 lesions have abnormal TTG antibodies and intestinal permeability with zonulin levels that correlate with IP. These abnormalities may be due to continued gluten ingestion. Further study is needed to determine the clinical utility of TTG antibodies and IP testing in following patients with celiac disease.

A radioimmunoassay for wheat gliadin to assess the suitability of gluten free foods for patients with coeliac disease

International Nuclear Information System (INIS)

Ciclitira, P.J.; Ellis, H.J.; Evans, D.J.; Lennox, E.S.

1985-01-01

Coeliac disease is a clinical condition characterised by malabsorption secondary to abnormalities of the small intestine. The condition is known to be exacerbated by wheat gliadin, rye, barley and possibly oats. The only assays that are available for testing for the presence of wheat gluten in foods are double diffusion against rabbit anti-gliadin antiserum and measurement of Kjeldahl nitrogen in products derived from wheat flour. We have developed a radioimmunoassay for wheat gliadin with a detection limit of 1 ng. Nominally gluten free foods based on wheat starch have been shown to contain up to 1.9x10 -2 % wheat gliadin. Bread made from Nutregen wheat starch which has now been withdrawn contains 6.4 mg gliadin per standard 30 g slice. A radioimmunoassay for wheat gliadin could be used to define standards for the suitability of gluten free products based on wheat starch for patients with coeliac disease. (author)

Might gluten traces in wheat substitutes pose a risk in patients with celiac disease? A population-based probabilistic approach to risk estimation

NARCIS (Netherlands)

Gibert, A.; Kruizinga, A.G.; Neuhold, S.; Houben, G.F.; Canela, M.A.; Fasano, A.; Catassi, C.

2013-01-01

Background: In patients with treated celiac disease (CD), the ingestion of gluten traces contained in gluten-free (GF) wheat substitutes (eg, GF bread, flour, and pasta) could cause persisting intestinal mucosal damage. Objective: The objective was to evaluate the proportion of CD patients at risk

76 FR 79196 - Gluten in Drug Products; Request for Information and Comments

Science.gov (United States)

2011-12-21

... individuals (Refs. 1 and 2). In these individuals, the symptoms of celiac disease are triggered by the... its deliberations about ways to help individuals with celiac disease avoid the presence of gluten in.... Celiac Disease Celiac disease (also known as celiac sprue and gluten-sensitive enteropathy) is an immune...

Proximal Limb Weakness in a Patient with Celiac Disease: Copper Deficiency, Gluten Sensitivity, or Both as the Underlying Cause?

Directory of Open Access Journals (Sweden)

J. David Avila

2016-01-01

Full Text Available Celiac disease has been associated with several neurologic disorders which may result from micronutrient deficiencies, coexisting autoimmune conditions, or gluten sensitivity. Copper deficiency can produce multiple neurologic manifestations. Myeloneuropathy is the most common neurologic syndrome and it is often irreversible, despite copper replacement. We report the case of a 55-year-old man who presented with progressive proximal limb weakness and weight loss in the setting of untreated celiac disease without gastrointestinal symptoms. He had anemia, neutropenia, and severe hypocupremia. The pattern of weakness raised the suspicion that there was an underlying myopathy, although this was not confirmed by electrodiagnostic studies. Weakness and hematologic abnormalities resolved completely within 1 month of total parenteral nutrition with copper supplementation and a gluten-free diet. Myopathy can rarely occur in patients with celiac disease, but the mechanism is unclear. Pure proximal limb weakness has not been previously reported in copper deficiency. We propose that this may represent a novel manifestation of hypocupremia and recommend considering copper deficiency and gluten sensitivity in patients presenting with proximal limb weakness.

Using chemometric techniques to characterize gluten-free cookies containing the whole flour of a new quinoa cultivar

International Nuclear Information System (INIS)

Pagamunici, Lilian M.; Gohara, Aline K.; Souza, Aloisio H.P.; Batiston, Weliton P.; Gomes, Sandra T.M.; Visentainer, Jesui V.; Matsushita, Makoto

2014-01-01

Celiac disease is defined as intolerance to the gluten proteins present in certain cereals used to prepare foodstuffs. We developed and performed physico-chemical, sensory, and nutritional assessments of three formulations of gluten-free cookies containing Linum usitatissimum L. and different levels of whole Chenopodium quinoa BRS Piabiru flour. No gluten was detected in the prepared cookie formulations. The crude protein and total lipid contents ranged from 85.58 to 97.55 and 121.69 to 166.19 g per kg of sample, respectively. The polyunsaturated/saturated and n-6:n-3 fatty acid ratios ranged from 0.85:1 to 0.92:1 and 3.08:1 to 4.38:1, respectively. Formulation C had the best alpha-linolenic acid content, lipid fraction nutritional indices and mineral content per portion, with excellent sensory characteristics. Multivariate analysis highlighted the effect of the concentration of quinoa on the nutritional and sensory qualities of the product. (author)

Using chemometric techniques to characterize gluten-free cookies containing the whole flour of a new quinoa cultivar

Energy Technology Data Exchange (ETDEWEB)

Pagamunici, Lilian M.; Gohara, Aline K.; Souza, Aloisio H.P. [Universidade Estadual de Maringa (UEM), PR (Brazil). Centro de Ciencias Agrarias; Bittencourt, Paulo R.S.; Torquato, Alex S. [Universidade Tecnologica Federal do Parana (UTFPR), Medianeira, PR (Brazil); Batiston, Weliton P.; Gomes, Sandra T.M.; Visentainer, Jesui V.; Matsushita, Makoto, E-mail: mmakoto@uem.br [Universidade Estadual de Maringa (UEM), PR (Brazil). Dept. de Quimica; Souza, Nilson E. [Universidade Tecnologica Federal do Parana (UTFPR), Londrina, PR (Brazil)

2014-02-15

Celiac disease is defined as intolerance to the gluten proteins present in certain cereals used to prepare foodstuffs. We developed and performed physico-chemical, sensory, and nutritional assessments of three formulations of gluten-free cookies containing Linum usitatissimum L. and different levels of whole Chenopodium quinoa BRS Piabiru flour. No gluten was detected in the prepared cookie formulations. The crude protein and total lipid contents ranged from 85.58 to 97.55 and 121.69 to 166.19 g per kg of sample, respectively. The polyunsaturated/saturated and n-6:n-3 fatty acid ratios ranged from 0.85:1 to 0.92:1 and 3.08:1 to 4.38:1, respectively. Formulation C had the best alpha-linolenic acid content, lipid fraction nutritional indices and mineral content per portion, with excellent sensory characteristics. Multivariate analysis highlighted the effect of the concentration of quinoa on the nutritional and sensory qualities of the product. (author)

Part of celiac population still at risk despite current gluten thresholds

NARCIS (Netherlands)

Bruins Slot, I.D.; Bremer, M.G.E.G.; Hamer, R.J.; Fels, van der Ine

2015-01-01

In order to assist celiac disease (CD) patients in making safe food choices, gluten-free food products are labelled as such. The exact meaning of the gluten-free label differs throughout the world. This paper discusses the different thresholds that are currently used to label products gluten-free

Sourdough Fermentation of Wheat Flour does not Prevent the Interaction of Transglutaminase 2 with α2-Gliadin or Gluten

Directory of Open Access Journals (Sweden)

Niklas Engström

2015-03-01

Full Text Available The enzyme transglutaminase 2 (TG2 plays a crucial role in the initiation of celiac disease by catalyzing the deamidation of gluten peptides. In susceptible individuals, the deamidated peptides initiate an immune response leading to celiac disease. Several studies have addressed lactic fermentation plus addition of enzymes as a means to degrade gluten in order to prevent adverse response in celiacs. Processing for complete gluten degradation is often harsh and is not likely to yield products that are of comparable characteristics as their gluten-containing counterparts. We are concerned that incomplete degradation of gluten may have adverse effects because it leads to more available TG2-binding sites on gluten peptides. Therefore, we have investigated how lactic acid fermentation affects the potential binding of TG2 to gluten protein in wheat flour by means of estimating TG2-mediated transamidation in addition to measuring the available TG2-binding motif QLP, in α2-gliadin. We show that lactic fermentation of wheat flour, as slurry or as part of sourdough bread, did not decrease the TG2-mediated transamidation, in the presence of a primary amine, to an efficient level (73%–102% of unfermented flour. Nor did the lactic fermentation decrease the available TG2 binding motif QLP in α2-gliadin to a sufficient extent in sourdough bread (73%–122% of unfermented control to be useful for celiac safe food.

Creation of the first ultra-low gluten barley (Hordeum vulgare L.) for coeliac and gluten-intolerant populations.

Science.gov (United States)

Tanner, Gregory J; Blundell, Malcolm J; Colgrave, Michelle L; Howitt, Crispin A

2016-04-01

Coeliac disease is a well-defined condition that is estimated to affect approximately 1% of the population worldwide. Noncoeliac gluten sensitivity is a condition that is less well defined, but is estimated to affect up to 10% of the population, and is often self-diagnosed. At present, the only remedy for both conditions is a lifelong gluten-free diet. A gluten-free diet is often expensive, high in fat and low in fibre, which in themselves can lead to adverse health outcomes. Thus, there is an opportunity to use novel plant breeding strategies to develop alternative gluten-free grains. In this work, we describe the breeding and characterization of a novel ultra-low gluten (ULG) barley variety in which the hordein (gluten) content was reduced to below 5 ppm. This was achieved using traditional breeding strategies to combine three recessive alleles, which act independently of each other to lower the hordein content in the parental varieties. The grain of the initial variety was shrunken compared to wild-type barleys. We implemented a breeding strategy to improve the grain size to near wild-type levels and demonstrated that the grains can be malted and brewed successfully. The ULG barley has the potential to provide novel healthy foods and beverages for those who require a gluten-free diet. © 2015 The Authors. Plant Biotechnology Journal published by Society for Experimental Biology and The Association of Applied Biologists and John Wiley & Sons Ltd.

LOWER BIFIDOBACTERIA COUNTS IN ADULT PATIENTS WITH CELIAC DISEASE ON A GLUTEN-FREE DIET

Directory of Open Access Journals (Sweden)

Lisléia GOLFETTO

2014-04-01

Full Text Available Context The ingestion of gluten is responsible for the symptoms of Celiac disease, but other environmental factors can also influence. Strains of the Bifidobacterium genus have been shown to afford protection against the inflammatory response and mucosal damage caused by gliadin peptides in vitro. Objectives This study was designed to compare the concentration of fecal bifidobacteria and pH of patients with celiac disease on gluten-free diet and control subjects in order to identify if the imbalance on fecal microbiota still remain during the treatment of celiac disease and identify the necessity of dietary supplementation with pre- or probiotics. Methods It was analyzed the feces of 42 healthy subjects and 14 celiac patients. The bifidobacteria count in feces was done in selective medium BIM-25. Microscopic analysis of the colonies was performed by Gram stain. The identification of the genus Bifidobacterium was performed by determination of fructose-6-phosphate phosphoketolase. Fecal pH was measured using a pH meter. Results The concentration of bifidobacteria per gram of feces was significantly higher in healthy subjects (controls (1.5 ± 0.63 x108 CFU/g when compared to celiac patients (2.5 ± 1.5 x107 CFU/g. The fecal pH was not different between celiac patients (7.19 ± 0.521 and controls (7.18 ± 0.522. Conclusions These results suggest that with lower levels of bifidobacteria, celiac patients have an imbalance in the intestinal microbiota, regardless of pH, even while on a gluten-free diet. This fact could favor the pathological process of the disorder.

[Treating coeliac disease. How do we measure adherence to the gluten-free diet?

Science.gov (United States)

Aranda, Elisa A; Araya, Magdalena

Coeliac disease (CD) is a systemic autoimmune disorder triggered by gluten consumption in genetically susceptible individuals. It exhibits several clinical features, such as blood auto-antibodies (anti-endomysial antibodies EMA, anti-transglutaminase antibodies tTG, anti-deamidated gliadin peptides PGD), plus variable degrees of damage in the small intestinal mucosa. In Chile, tTG is positive in 0.76% in individuals >15 years, with the prevalence of CD being estimated at 0.6%. Approximately17% of first-degree relatives of coeliac patients have been reported tTG positive. To date, the gluten free diet (GFD) is the only known treatment for CD. To be effective, this must be lifelong, permanent, and strict. Gluten content in the GFD is not zero, but is limited to a cut-off of 3ppm (ormg/kg of product) in Chile. Mortality higher than that of the general population has been reported among coeliac patients, and poor adherence to GFD is associated with complications (mainly autoimmune processes and cancer). GFD is difficult to maintain strictly and poor adherence is by far the main cause of lack of response to treatment. Follow-up of adherence is also difficult because there are no objective measurements to assess it. In clinical practice determination of serum EMA, tTG and PGD is routinely used for these purposes, although more recently, the interview by an expert dietitian, validated questionnaires and measurement of faecal 33-mer peptide are being assessed as alternatives or complements to measure adherence to GFD. A review is presented with the current concepts on the available tools to follow up patients on GFD, emphasising those available in Chilel. Copyright © 2016 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Beneficial effects of gluten free diet in potential coeliac disease in adult population.

Science.gov (United States)

Imperatore, Nicola; Tortora, Raffaella; De Palma, Giovanni Domenico; Capone, Pietro; Gerbino, Nicolò; Donetto, Sara; Testa, Anna; Caporaso, Nicola; Rispo, Antonio

2017-08-01

To date, potential coeliac disease (PCD) occurring in adults remains an almost unexplored condition. To explore the prognostic role of Marsh grade in adult PCD patients, and to evaluate the effects of gluten-containing diet (GCD) in asymptomatic PCD patients. We retrospectively evaluated all consecutive adult PCD patients followed-up for at least 6 years. Patients were divided into: Group A (patients with Marsh 0 histology) and Group B (Marsh 1 patients). Symptomatic patients were started gluten-free diet (GFD), while asymptomatic subjects were kept on GCD and were followed-up. 56 PCD patients were enrolled (21 in Group A and 35 in Group B). Forty-three patients were symptomatic and started GFD. Of these, none of 15 patients in Group A and 8 of 28 patients in Group B developed immune-mediated disorders (IMD) during follow-up (P=0.03; OR=4.2). The 13 asymptomatic PCD patients were kept on GCD. During the follow-up, 9 patients developed CD-related symptoms, 6 villous atrophy and 8 IMD. At the end, patients kept on GCD were at higher risk of developing IMD than those following a GFD (61% vs 18%, P=0.03, OR=3.3). Although PCD with normal mucosa seems to be a milder disease, the continuation of GCD places patients at a high risk of developing villous atrophy and IMD compared to commencement of GFD. Adult PCD patients should start GFD even if not symptomatic. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

The impact of disulfide bond dynamics in wheat gluten protein on the development of fermented pastry crumb.

Science.gov (United States)

Ooms, Nand; Jansens, Koen J A; Pareyt, Bram; Reyniers, Stijn; Brijs, Kristof; Delcour, Jan A

2018-03-01

Gluten proteins functionality during pastry production was examined by including redox agents in the ingredient bill. Addition of reducing and oxidizing agents respectively increased and decreased dough height during fermentation. The presence of large gas bubbles in the samples with oxidizing agents may have caused a 'stacking'-effect and a more effective dough lift. During baking, the level of extractable proteins decreased to comparable values for all samples, except when potassium iodate (KIO 3 ) was used in the recipe. As a result of its use, a lower level of gliadin was incorporated into the gluten polymer and dough layers tended to 'slide' apart during baking, thereby causing collapse. Most likely, KIO 3 caused glutenin oxidation within each individual dough layer to such extent during the dough stage that insufficient thiol groups were available for forming dough layer interconnections during baking, after margarine melting. Furthermore, addition of redox agents impacted the product's crumb structure. Copyright © 2017 Elsevier Ltd. All rights reserved.

Presence of celiac disease epitopes in modern and old hexaploid wheat varieties: wheat breeding may have contributed to increased prevalence of celiac disease

NARCIS (Netherlands)

Broeck, van den H.C.; Jong, de H.C.; Salentijn, E.M.J.; Dekking, L.; Bosch, H.J.; Hamer, R.J.; Gilissen, L.J.W.J.; Meer, van der I.M.; Smulders, M.J.M.

2010-01-01

Gluten proteins from wheat can induce celiac disease (CD) in genetically susceptible individuals. Specific gluten peptides can be presented by antigen presenting cells to gluten-sensitive T-cell lymphocytes leading to CD. During the last decades, a significant increase has been observed in the

Effect of an oats-containing gluten-free diet on symptoms and quality of life in coeliac disease. A randomized study.

Science.gov (United States)

Peräaho, M; Kaukinen, K; Mustalahti, K; Vuolteenaho, N; Mäki, M; Laippala, P; Collin, P

2004-01-01

Evidence suggests the acceptability of oats in a gluten-free diet in coeliac disease. We investigated the impact of an oats-containing diet on quality of life and gastrointestinal symptoms. Thirty-nine coeliac disease patients on a gluten-free diet were randomized to take either 50 g of oats-containing gluten-free products daily or to continue without oats for 1 year. Quality of life was assessed using the Psychological General Well-Being questionnaire and gastrointestinal symptoms using the Gastrointestinal Symptom Rating Scale. Small-bowel mucosal villous architecture, CD3+, alphabeta+, gammadelta+ intraepithelial lymphocytes, serum endomysial and tissue transglutaminase antibodies were investigated. Twenty-three subjects were randomized to the oats-containing diet and 16 to the traditional gluten-free diet. All adhered strictly to their respective diet. Quality of life did not differ between the groups. In general, there were more gastrointestinal symptoms in the oats-consuming group. Patients taking oats suffered significantly more often from diarrhoea, but there was a simultaneous trend towards a more severe average constipation symptom score. The villous structure did not differ between the groups, but the density of intraepithelial lymphocytes was slightly but significantly higher in the oats group. The severity of symptoms was not dependent on the degree of inflammation. Antibody levels did not increase during the study period. The oats-containing gluten-free diet caused more intestinal symptoms than the traditional diet. Mucosal integrity was not disturbed, but more inflammation was evident in the oats group. Oats provide an alternative in the gluten-free diet, but coeliac patients should be aware of the possible increase in intestinal symptoms.

Development of antimicrobial active packaging materials based on gluten proteins.

Science.gov (United States)

Gómez-Heincke, Diana; Martínez, Inmaculada; Partal, Pedro; Guerrero, Antonio; Gallegos, Críspulo

2016-08-01

The incorporation of natural biocide agents into protein-based bioplastics, a source of biodegradable polymeric materials, manufactured by a thermo-mechanical method is a way to contribute to a sustainable food packaging industry. This study assesses the antimicrobial activity of 10 different biocides incorporated into wheat gluten-based bioplastics. The effect that formulation, processing, and further thermal treatments exert on the thermo-mechanical properties, water absorption characteristics and rheological behaviour of these materials is also studied. Bioplastics containing six of the 10 examined bioactive agents have demonstrated suitable antimicrobial activity at 37 °C after their incorporation into the bioplastic. Moreover, the essential oils are able to create an antimicrobial atmosphere within a Petri dish. Depending on the selected biocide, its addition may alter the bioplastics protein network in a different extent, which leads to materials exhibiting less water uptake and different rheological and thermo-mechanical behaviours. © 2015 Society of Chemical Industry. © 2015 Society of Chemical Industry.

Re-challenge Studies in Non-celiac Gluten Sensitivity: A Systematic Review and Meta-Analysis

Directory of Open Access Journals (Sweden)

Elena Lionetti

2017-09-01

Full Text Available Background: Non-celiac gluten sensitivity (NCGS is a clinical entity characterized by intestinal and/or extra-intestinal symptoms related to the ingestion of gluten in individuals that are not affected by either celiac disease (CD or wheat allergy (WA. Since we do not have specific biomarkers for NCGS, the diagnosis is based on the evidence of a clear relationship between the ingestion of gluten (re-challenge and clinical symptoms, after a remission during the gluten-free diet (GFD. Several re-challenge studies have been published so far to evaluate the real prevalence of NCGS, reporting conflicting results. In the present article, we provide a systematic review with meta-analysis of the existing literature on re-challenge studies to evaluate prevalence figures of NCGS after re-challenge procedures.Methods: All clinical trials performing a gluten re-challenge with or without a placebo control in patients with a suspected diagnosis of NCGS were included. Search results were limited to studies published in English language. No publication date or publication status restrictions were imposed.Results: Eleven studies were included in the meta-analysis. There was a considerable heterogeneity related to different sample size, type, and amount of gluten administered, duration of challenge and different type of placebo. The overall pooled percentage of patients with a diagnosis of NCGS relapsing after a gluten challenge was 30%, ranging between 7 and 77%. The meta-analysis showed a not significant relative risk (RR of relapse after gluten challenge as compared to placebo (RR = 0.4; 95% CI = −0.15–0.9; p = 0.16. The overall pooled percentage of patients with a diagnosis of NCGS relapsing after a gluten challenge performed according to the recent Salerno criteria was significantly higher as compared to the percentage of patients relapsing after placebo (40 vs. 24%; p = 0.003, with a significant RR of relapse after gluten challenge as compared to

Tax-Deductible Provisions for Gluten-Free Diet in Canada Compared with Systems for Gluten-Free Diet Coverage Available in Various Countries

Directory of Open Access Journals (Sweden)

Maria Ines Pinto-Sanchez

2015-01-01

Full Text Available Celiac disease affects 1% of the North American population, with an estimated 350,000 Canadians diagnosed with this condition. The disease is triggered by the ingestion of gluten, and a lifelong, strict gluten-free diet (GFD is the only currently available treatment. Compliance with a strict GFD is essential not only for intestinal mucosal recovery and alleviation of symptoms, but also for the prevention of complications such as anemia, osteoporotic fractures and small bowel lymphoma. However, a GFD is difficult to follow, socially inconvenient and expensive. Different approaches, such as tax reduction, cash transfer, food provision, prescription and subsidy, have been used to reduce the additional costs of the GFD to patients with celiac disease. The current review showed that the systems in place exhibit particular advantages and disadvantages in relation to promoting uptake and compliance with GFD. The tax offset system used in Canada for GFD coverage takes the form of a reimbursement of a cost previously incurred. Hence, the program does not help celiac patients meet the incremental cost of the GFD – it simply provides some future refund of that cost. An ideal balanced approach would involve subsidizing gluten-free products through controlled vouchers or direct food provision to those who most need it, independently of ‘ability or willingness to pay’. Moreover, if the cost of such a program is inhibitive, the value of the benefits could be made taxable to ensure that any patient contribution, in terms of additional taxation, is directly related to ability to pay. The limited coverage of GFD in Canada is concerning. There is an unmet need for GFD among celiac patients in Canada. More efforts are required by the Canadian medical community and the Canadian Celiac Association to act as agents in identifying ways of improving resource allocation in celiac disease.

Tax-deductible provisions for gluten-free diet in Canada compared with systems for gluten-free diet coverage available in various countries.

Science.gov (United States)

Pinto-Sanchez, Maria Ines; Verdu, Elena F; Gordillo, Maria C; Bai, Julio C; Birch, Stephen; Moayyedi, Paul; Bercik, Premysl

2015-03-01

Celiac disease affects 1% of the North American population, with an estimated 350,000 Canadians diagnosed with this condition. The disease is triggered by the ingestion of gluten, and a lifelong, strict gluten-free diet (GFD) is the only currently available treatment. Compliance with a strict GFD is essential not only for intestinal mucosal recovery and alleviation of symptoms, but also for the prevention of complications such as anemia, osteoporotic fractures and small bowel lymphoma. However, a GFD is difficult to follow, socially inconvenient and expensive. Different approaches, such as tax reduction, cash transfer, food provision, prescription and subsidy, have been used to reduce the additional costs of the GFD to patients with celiac disease. The current review showed that the systems in place exhibit particular advantages and disadvantages in relation to promoting uptake and compliance with GFD. The tax offset system used in Canada for GFD coverage takes the form of a reimbursement of a cost previously incurred. Hence, the program does not help celiac patients meet the incremental cost of the GFD - it simply provides some future refund of that cost. An ideal balanced approach would involve subsidizing gluten-free products through controlled vouchers or direct food provision to those who most need it, independently of 'ability or willingness to pay'. Moreover, if the cost of such a program is inhibitive, the value of the benefits could be made taxable to ensure that any patient contribution, in terms of additional taxation, is directly related to ability to pay. The limited coverage of GFD in Canada is concerning. There is an unmet need for GFD among celiac patients in Canada. More efforts are required by the Canadian medical community and the Canadian Celiac Association to act as agents in identifying ways of improving resource allocation in celiac disease.

Tax-deductible provisions for gluten-free diet in Canada compared with systems for gluten-free diet coverage available in various countries

Science.gov (United States)

Pinto-Sanchez, Maria Ines; Verdu, Elena F; Gordillo, Maria C; Bai, Julio C; Birch, Stephen; Moayyedi, Paul; Bercik, Premysl

2015-01-01

Celiac disease affects 1% of the North American population, with an estimated 350,000 Canadians diagnosed with this condition. The disease is triggered by the ingestion of gluten, and a lifelong, strict gluten-free diet (GFD) is the only currently available treatment. Compliance with a strict GFD is essential not only for intestinal mucosal recovery and alleviation of symptoms, but also for the prevention of complications such as anemia, osteoporotic fractures and small bowel lymphoma. However, a GFD is difficult to follow, socially inconvenient and expensive. Different approaches, such as tax reduction, cash transfer, food provision, prescription and subsidy, have been used to reduce the additional costs of the GFD to patients with celiac disease. The current review showed that the systems in place exhibit particular advantages and disadvantages in relation to promoting uptake and compliance with GFD. The tax offset system used in Canada for GFD coverage takes the form of a reimbursement of a cost previously incurred. Hence, the program does not help celiac patients meet the incremental cost of the GFD – it simply provides some future refund of that cost. An ideal balanced approach would involve subsidizing gluten-free products through controlled vouchers or direct food provision to those who most need it, independently of ‘ability or willingness to pay’. Moreover, if the cost of such a program is inhibitive, the value of the benefits could be made taxable to ensure that any patient contribution, in terms of additional taxation, is directly related to ability to pay. The limited coverage of GFD in Canada is concerning. There is an unmet need for GFD among celiac patients in Canada. More efforts are required by the Canadian medical community and the Canadian Celiac Association to act as agents in identifying ways of improving resource allocation in celiac disease. PMID:25803021

The shutdown of celiac disease-related gliadin epitopes in bread wheat by RNAi provides flours with increased stability and better tolerance to over-mixing.

Directory of Open Access Journals (Sweden)

Javier Gil-Humanes

Full Text Available Celiac disease is a food-sensitive enteropathy triggered by the ingestion of wheat gluten proteins and related proteins from barley, rye, and some varieties of oat. There are no interventional therapies and the only solution is a lifelong gluten-free diet. The down-regulation of gliadins by RNAi provides wheat lines with all the gliadin fractions strongly down-regulated (low-gliadin. The technological properties of doughs prepared from the low-gliadin lines indicated a general weakening effect, although some of the lines displayed similar properties to that of the wild-type lines. In contrast, the stability was increased significantly in some of the transgenic lines, indicating better tolerance to over-mixing. Results reported here are the first analyses of the mixing and bread-making quality of the wheat lines with all gliadin fractions strongly down-regulated. Flour from these lines may be an important breakthrough in the development of new products for the celiac community. These lines might be used directly or blended with other non-toxic cereals, as raw material for developing food products that can be safely tolerated by CD patients and others with gluten intolerance or gluten sensitivity, incrementing the range of available food products and enhancing their diet.

The shutdown of celiac disease-related gliadin epitopes in bread wheat by RNAi provides flours with increased stability and better tolerance to over-mixing.

Science.gov (United States)

Gil-Humanes, Javier; Pistón, Fernando; Barro, Francisco; Rosell, Cristina M

2014-01-01

Celiac disease is a food-sensitive enteropathy triggered by the ingestion of wheat gluten proteins and related proteins from barley, rye, and some varieties of oat. There are no interventional therapies and the only solution is a lifelong gluten-free diet. The down-regulation of gliadins by RNAi provides wheat lines with all the gliadin fractions strongly down-regulated (low-gliadin). The technological properties of doughs prepared from the low-gliadin lines indicated a general weakening effect, although some of the lines displayed similar properties to that of the wild-type lines. In contrast, the stability was increased significantly in some of the transgenic lines, indicating better tolerance to over-mixing. Results reported here are the first analyses of the mixing and bread-making quality of the wheat lines with all gliadin fractions strongly down-regulated. Flour from these lines may be an important breakthrough in the development of new products for the celiac community. These lines might be used directly or blended with other non-toxic cereals, as raw material for developing food products that can be safely tolerated by CD patients and others with gluten intolerance or gluten sensitivity, incrementing the range of available food products and enhancing their diet.

Anxiety and depression in adult patients with celiac disease on a gluten-free diet

Institute of Scientific and Technical Information of China (English)

Winfried; Huser; Karl-Heinz; Janke; Bodo; Klump; Michael; Gregor; Andreas; Hinz

2010-01-01

AIM: To compare anxiety and depression levels in adult patients with celiac disease (CD) on a gluten-free diet (GFD) with controls.METHODS: The levels of anxiety, depression and of a probable anxiety or depressive disorder were assessed by the Hospital Anxiety and Depression Scale in 441 adult patients with CD recruited by the German Celiac Society, in 235 age-and sex-matched patients with inflammatory bowel disease (IBD) in remission or with slight disease activity, and in 441 adult persons of a representa...

Structural analysis of gluten-free doughs by fractional rheological model

Science.gov (United States)

Orczykowska, Magdalena; Dziubiński, Marek; Owczarz, Piotr

2015-02-01

This study examines the effects of various components of tested gluten-free doughs, such as corn starch, amaranth flour, pea protein isolate, and cellulose in the form of plantain fibers on rheological properties of such doughs. The rheological properties of gluten-free doughs were assessed by using the rheological fractional standard linear solid model (FSLSM). Parameter analysis of the Maxwell-Wiechert fractional derivative rheological model allows to state that gluten-free doughs present a typical behavior of viscoelastic quasi-solid bodies. We obtained the contribution dependence of each component used in preparations of gluten-free doughs (either hard-gel or soft-gel structure). The complicate analysis of the mechanical structure of gluten-free dough was done by applying the FSLSM to explain quite precisely the effects of individual ingredients of the dough on its rheological properties.

Renal disease in patients with celiac disease.

Science.gov (United States)

Boonpheng, Boonphiphop; Cheungpasitporn, Wisit; Wijarnpreecha, Karn

2018-04-01

Celiac disease, an inflammatory disease of small bowel caused by sensitivity to dietary gluten and related protein, affects approximately 0.5-1% of the population in the Western world. Extra-intestinal symptoms and associated diseases are increasingly recognized including diabetes mellitus type 1, thyroid disease, dermatitis herpetiformis and ataxia. There have also been a number of reports of various types of renal involvement in patients with celiac disease including diabetes nephropathy, IgA nephropathy, membranous nephropathy, membranoproliferative glomerulonephritis, nephrotic syndrome related to malabsorption, oxalate nephropathy, and associations of celiac disease with chronic kidney disease and end-stage kidney disease. This review aims to present the current literature on possible pathologic mechanisms underlying renal disease in patients with celiac disease.

Gluten, pills and talk : assessing emergent technologies from a patients'perspective

NARCIS (Netherlands)

Veen, M.

2011-01-01

How can research in the area of celiac disease take patients into account? Celiac disease is an intolerance for gluten, for which a lifelong gluten-free diet is the only treatment currently available. The aim of this thesis is to gain insight into the everyday life of patients, so as to better align

Legumes as Functional Ingredients in Gluten-Free Bakery and Pasta Products.

Science.gov (United States)

Foschia, Martina; Horstmann, Stefan W; Arendt, Elke K; Zannini, Emanuele

2017-02-28

The increasing demand for gluten-free food products from consumers has triggered food technologists to investigate a wide range of gluten-free ingredients from different sources to reproduce the unique network structure developed by gluten in a wheat-dough system. In recent times, the attention has been focused on novel application of legume flour or ingredients. The interest in this crop category is mainly attributed to their functional properties, such as solubility and water-binding capacity, which play an important role in gluten-free food formulation and processing. Their nutritional profile may also counteract the lack of nutrients commonly highlighted in commercial gluten-free bakery and pasta products, providing valuable sources of protein, dietary fiber, vitamins, minerals, and complex carbohydrates, which in turn have a positive impact on human health. This review reports the main chemical and functional characteristics of legumes and their functional application in gluten-free products.

Impact of acid and alkaline pretreatments on the molecular network of wheat gluten and on the mechanical properties of compression-molded glassy wheat gluten bioplastics.

Science.gov (United States)

Jansens, Koen J A; Lagrain, Bert; Brijs, Kristof; Goderis, Bart; Smet, Mario; Delcour, Jan A

2013-10-02

Wheat gluten can be converted into rigid biobased materials by high-temperature compression molding at low moisture contents. During molding, a cross-linked protein network is formed. This study investigated the effect of mixing gluten with acid/alkali in 70% ethanol at ambient temperature for 16 h followed by ethanol removal, freeze-drying, and compression molding at 130 and 150 °C on network formation and on types of cross-links formed. Alkaline pretreatment (0-100 mmol/L sodium hydroxide or 25 mmol/L potassium hydroxide) strongly affected gluten cross-linking, whereas acid pretreatment (0-25 mmol/L sulfuric acid or 25 mmol/L hydrochloric acid) had limited effect on the gluten network. Molded alkaline-treated gluten showed enhanced cross-linking but also degradation when treated with high alkali concentrations, whereas acid treatment reduced gluten cross-linking. β-Elimination of cystine and lanthionine formation occurred more pronouncedly at higher alkali concentrations. In contrast, formation of disulfide and nondisulfide cross-links during molding was hindered in acid-pretreated gluten. Bioplastic strength was higher for alkali than for acid-pretreated samples, whereas the flexural modulus was only slightly affected by either alkaline or acid pretreatment. Apparently, the ratio of disulfide to nondisulfide cross-links did not affect the mechanical properties of rigid gluten materials.

Polymerization kinetics of wheat gluten upon thermosetting. A mechanistic model.

Science.gov (United States)

Domenek, Sandra; Morel, Marie-Hélène; Bonicel, Joëlle; Guilbert, Stéphane

2002-10-09

Size exclusion high-performance liquid chromatography analysis was carried out on wheat gluten-glycerol blends subjected to different heat treatments. The elution profiles were analyzed in order to follow the solubility loss of protein fractions with specific molecular size. Owing to the known biochemical changes involved during the heat denaturation of gluten, a mechanistic mathematical model was developed, which divided the protein denaturation into two distinct reaction steps: (i) reversible change in protein conformation and (ii) protein precipitation through disulfide bonding between initially SDS-soluble and SDS-insoluble reaction partners. Activation energies of gluten unfolding, refolding, and precipitation were calculated with the Arrhenius law to 53.9 kJ x mol(-1), 29.5 kJ x mol(-1), and 172 kJ x mol(-1), respectively. The rate of protein solubility loss decreased as the cross-linking reaction proceeded, which may be attributed to the formation of a three-dimensional network progressively hindering the reaction. The enhanced susceptibility to aggregation of large molecules was assigned to a risen reaction probability due to their higher number of cysteine residues and to the increased percentage of unfolded and thereby activated proteins as complete protein refolding seemed to be an anticooperative process.

Improved xenobiotic metabolism and reduced susceptibility to cancer in gluten-sensitive macaques upon introduction of a gluten-free diet.

Directory of Open Access Journals (Sweden)

Karol Sestak

2011-04-01

Full Text Available A non-human primate (NHP model of gluten sensitivity was employed to study the gene perturbations associated with dietary gluten changes in small intestinal tissues from gluten-sensitive rhesus macaques (Macaca mulatta.Stages of remission and relapse were accomplished in gluten-sensitive animals by administration of gluten-free (GFD and gluten-containing (GD diets, as described previously. Pin-head-sized biopsies, obtained non-invasively by pediatric endoscope from duodenum while on GFD or GD, were used for preparation of total RNA and gene profiling, using the commercial Rhesus Macaque Microarray (Agilent Technologies,targeting expression of over 20,000 genes.When compared with normal healthy control, gluten-sensitive macaques showed differential gene expressions induced by GD. While observed gene perturbations were classified into one of 12 overlapping categories--cancer, metabolism, digestive tract function, immune response, cell growth, signal transduction, autoimmunity, detoxification of xenobiotics, apoptosis, actin-collagen deposition, neuronal and unknown function--this study focused on cancer-related gene networks such as cytochrome P450 family (detoxification function and actin-collagen-matrix metalloproteinases (MMP genes.A loss of detoxification function paralleled with necessity to metabolize carcinogens was revealed in gluten-sensitive animals while on GD. An increase in cancer-promoting factors and a simultaneous decrease in cancer-preventing factors associated with altered expression of actin-collagen-MMP gene network were noted. In addition, gluten-sensitive macaques showed reduced number of differentially expressed genes including the cancer-associated ones upon withdrawal of dietary gluten. Taken together, these findings indicate potentially expanded utility of gluten-sensitive rhesus macaques in cancer research.

Gluten-Free Diet Does Not Appear to Induce Endoscopic Remission of Eosinophilic Esophagitis in Children with Coexistent Celiac Disease

Directory of Open Access Journals (Sweden)

Joseph R Abraham

2012-01-01

Full Text Available BACKGROUND: Celiac disease and eosinophilic esophagitis are usually considered to be separate gastrointestinal diseases; however, it appears that they may coexist more often than would be expected. It is unknown whether eosinophilic esophagitis in patients with celiac disease responds to a gluten-free diet.

Gluten exacerbates IgA nephropathy in humanized mice through gliadin-CD89 interaction.

Science.gov (United States)

Papista, Christina; Lechner, Sebastian; Ben Mkaddem, Sanae; LeStang, Marie-Bénédicte; Abbad, Lilia; Bex-Coudrat, Julie; Pillebout, Evangéline; Chemouny, Jonathan M; Jablonski, Mathieu; Flamant, Martin; Daugas, Eric; Vrtovsnik, François; Yiangou, Minas; Berthelot, Laureline; Monteiro, Renato C

2015-08-01

IgA1 complexes containing deglycosylated IgA1, IgG autoantibodies, and a soluble form of the IgA receptor (sCD89), are hallmarks of IgA nephropathy (IgAN). Food antigens, notably gluten, are associated with increased mucosal response and IgAN onset, but their implication in the pathology remains unknown. Here, an IgAN mouse model expressing human IgA1 and CD89 was used to examine the role of gluten in IgAN. Mice were given a gluten-free diet for three generations to produce gluten sensitivity, and then challenged for 30 days with a gluten diet. A gluten-free diet resulted in a decrease of mesangial IgA1 deposits, transferrin 1 receptor, and transglutaminase 2 expression, as well as hematuria. Mice on a gluten-free diet lacked IgA1-sCD89 complexes in serum and kidney eluates. Disease severity depended on gluten and CD89, as shown by reappearance of IgAN features in mice on a gluten diet and by direct binding of the gluten-subcomponent gliadin to sCD89. A gluten diet exacerbated intestinal IgA1 secretion, inflammation, and villous atrophy, and increased serum IgA1 anti-gliadin antibodies, which correlated with proteinuria in mice and patients. Moreover, early treatment of humanized mice with a gluten-free diet prevented mesangial IgA1 deposits and hematuria. Thus, gliadin-CD89 interaction may aggravate IgAN development through induction of IgA1-sCD89 complex formation and a mucosal immune response. Hence, early-stage treatment with a gluten-free diet could be beneficial to prevent disease.

Qualitative effect of added gluten on dough properties and quality of Chinese steamed bread

Science.gov (United States)

Glutens isolated from fifteen soft red winter (SRW) wheat flours were added into a SRW wheat flour to obtain protein levels of 9.6% and 11.3% for determination of the qualitative effect of gluten protein on the dough properties and quality of northern-style Chinese steamed bread (CSB). Sodium dodecy...

Food label usage and reported difficulty with following a gluten-free diet among individuals in the USA with coeliac disease and those with noncoeliac gluten sensitivity.

Science.gov (United States)

Verrill, L; Zhang, Y; Kane, R

2013-10-01

Individuals with coeliac disease (CD) and those with noncoeliac gluten sensitivity (GS) have reported difficulty following a gluten-free diet (GFD); however, few studies have explored the link between the food label, gluten-free (GF) claims and the difficulty associated with following a GFD. The present study surveyed adults with CD (n = 1,583) and adults with GS (n = 797) about their reported difficulty following a GFD, including assessing the role of food labels and GF claims, as well as other factors known to contribute to this difficulty. A two-sample t-test and chi-squared tests for equality of means or proportions were used for the descriptive data and ordinal logistic regression (OLR) was used to model associations. On average, individuals with GS reported slightly more difficulty following the GFD than did participants with CD. According to the OLR results, reading the food label often was significantly associated with less reported difficulty following a GFD, whereas consuming packaged processed foods and looking for GF claims more often were significantly associated with more reported difficulty for both respondent groups. Individuals with GS may rely more heavily on the GF claim for information about a product's gluten content. Individuals with CD, on the other hand, may be more experienced food label readers and may rely more on the ingredient list for finding GF foods. More studies are needed aiming to understand the role of the food label in facilitating consumers' ability to follow a GFD. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

Gluten Intolerance Group

Science.gov (United States)

... Intolerance Group (GIG), the industry leader in the certification of gluten-free products and food services, announced today that a wide ... of gluten-free products. One of the top certification programs in the world, GFCO inspects products and manufacturing facilities for gluten, in an effort ...

Diagnosis of Non-Celiac Gluten Sensitivity (NCGS: The Salerno Experts’ Criteria

Directory of Open Access Journals (Sweden)

Carlo Catassi

2015-06-01

Full Text Available Non-Celiac Gluten Sensitivity (NCGS is a syndrome characterized by intestinal and extra-intestinal symptoms related to the ingestion of gluten-containing food, in subjects that are not affected by either celiac disease or wheat allergy. Given the lack of a NCGS biomarker, there is the need for standardizing the procedure leading to the diagnosis confirmation. In this paper we report experts’ recommendations on how the diagnostic protocol should be performed for the confirmation of NCGS. A full diagnostic procedure should assess the clinical response to the gluten-free diet (GFD and measure the effect of a gluten challenge after a period of treatment with the GFD. The clinical evaluation is performed using a self-administered instrument incorporating a modified version of the Gastrointestinal Symptom Rating Scale. The patient identifies one to three main symptoms that are quantitatively assessed using a Numerical Rating Scale with a score ranging from 1 to 10. The double-blind placebo-controlled gluten challenge (8 g/day includes a one-week challenge followed by a one-week washout of strict GFD and by the crossover to the second one-week challenge. The vehicle should contain cooked, homogeneously distributed gluten. At least a variation of 30% of one to three main symptoms between the gluten and the placebo challenge should be detected to discriminate a positive from a negative result. The guidelines provided in this paper will help the clinician to reach a firm and positive diagnosis of NCGS and facilitate the comparisons of different studies, if adopted internationally.

Improved Quantitation of Gluten in Wheat Starch for Celiac Disease Patients by Gel-Permeation High-Performance Liquid Chromatography with Fluorescence Detection (GP-HPLC-FLD).

Science.gov (United States)

Scherf, Katharina Anne; Wieser, Herbert; Koehler, Peter

2016-10-12

Purified wheat starch (WSt) is commonly used in gluten-free products for celiac disease (CD) patients. It is mostly well-tolerated, but doubts about its safety for CD patients persist. One reason may be that most ELISA kits primarily recognize the alcohol-soluble gliadin fraction of gluten, but insufficiently target the alcohol-insoluble glutenin fraction. To address this problem, a new sensitive method based on the sequential extraction of gliadins, glutenins, and gluten from WSt followed by gel-permeation high-performance liquid chromatography with fluorescence detection (GP-HPLC-FLD) was developed. It revealed that considerable amounts of glutenins were present in most WSt. The gluten contents quantitated by GP-HPLC-FLD as sum of gliadins and glutenins were higher than those by R5 ELISA (gluten as gliadin content multiplied by a factor of 2) in 19 out of 26 WSt. Despite its limited selectivity, GP-HPLC-FLD may be applied as confirmatory method to ELISA to quantitate gluten in WSt.

Effects of gluten and transglutaminase on microstructure, sensory characteristics and instrumental texture of oat bread

Directory of Open Access Journals (Sweden)

M. SALMENKALLIO-MARTTILA

2008-12-01

Full Text Available Effects of added gluten and transglutaminase on microstructure, instrumental texture and sensory characteristics of bread baked with 51% wholemeal oat flour were compared in order to determine how changes in the state of macromolecules – protein and starch – correlate with changes in sensory and instrumental structure. Light microscopy, instrumental texture profile analysis, and descriptive sensory analysis were used to analyse the test breads. Addition of gluten and transglutaminase affected the structure of the protein network and distribution of water between the protein and starch phases. The differences in microstructure were quantified by determining the areas of starch and protein in the micrographs by image analysis. Breads baked with added gluten and water were softer and less gummy than the oat and wheat reference breads in the texture profile analysis. Addition of transglutaminase made the breads harder and gummier than the breads baked without the added enzyme. In the descriptive sensory analysis breads baked with added gluten or added gluten and water were evaluated as more soft and springy than the reference oat bread. Sensory characteristics of bread texture correlated well with the texture and microstructure measured instrumentally.;

Does a Coeliac School increase psychological well-being in women suffering from coeliac disease, living on a gluten-free diet?

Science.gov (United States)

Ring Jacobsson, Lisa; Friedrichsen, Maria; Göransson, Anne; Hallert, Claes

2012-03-01

To assess the effects of an active method of patient education on the psychological well-being of women with coeliac disease in remission. Despite remission with a gluten-free diet, adults with coeliac disease and especially women experience a subjective poor health. Self-management education seems to be promising tool to help patients suffering from coeliac disease to cope with their disorder. A randomised controlled trial. A total of 106 women, ≥ 20 years, with confirmed coeliac disease, who had been on a gluten-free diet for a minimum of five years. The intervention group (n = 54) underwent a 10-session educational programme, 'Coeliac School', based on problem-based learning. The controls (n = 52) received information regarding coeliac disease sent home on a regular basis. The primary outcomes were psychological general well-being measured with a validated questionnaire. Participants in the Coeliac School reported a significant improvement in psychological well-being at 10 weeks, whereas the controls given usual care reported a worsening in psychological well-being. After six months, a significant improvement remained for the index of vitality. Patient education increased psychological well-being in women with coeliac disease. There is a need to refine the methods of patient education to make the effects of well-being more pronounced over time. Patient education using problem-based learning promotes self-management in coeliac disease by improving the well-being of patients who have been struggling with the gluten-free diet for years. © 2011 Blackwell Publishing Ltd.

Improved Xenobiotic Metabolism and Reduced Susceptibility to Cancer in Gluten-Sensitive Macaques upon Introduction of a Gluten-Free Diet

Science.gov (United States)

Sestak, Karol; Conroy, Lauren; Aye, Pyone P.; Mehra, Smriti; Doxiadis, Gaby G.; Kaushal, Deepak

2011-01-01

Background A non-human primate (NHP) model of gluten sensitivity was employed to study the gene perturbations associated with dietary gluten changes in small intestinal tissues from gluten-sensitive rhesus macaques (Macaca mulatta). Methodology Stages of remission and relapse were accomplished in gluten-sensitive animals by administration of gluten-free (GFD) and gluten-containing (GD) diets, as described previously. Pin-head-sized biopsies, obtained non-invasively by pediatric endoscope from duodenum while on GFD or GD, were used for preparation of total RNA and gene profiling, using the commercial Rhesus Macaque Microarray (Agilent Technologies),targeting expression of over 20,000 genes. Principal Findings When compared with normal healthy control, gluten-sensitive macaques showed differential gene expressions induced by GD. While observed gene perturbations were classified into one of 12 overlapping categories - cancer, metabolism, digestive tract function, immune response, cell growth, signal transduction, autoimmunity, detoxification of xenobiotics, apoptosis, actin-collagen deposition, neuronal and unknown function - this study focused on cancer-related gene networks such as cytochrome P450 family (detoxification function) and actin-collagen-matrix metalloproteinases (MMP) genes. Conclusions/Significance A loss of detoxification function paralleled with necessity to metabolize carcinogens was revealed in gluten-sensitive animals while on GD. An increase in cancer-promoting factors and a simultaneous decrease in cancer-preventing factors associated with altered expression of actin-collagen-MMP gene network were noted. In addition, gluten-sensitive macaques showed reduced number of differentially expressed genes including the cancer-associated ones upon withdrawal of dietary gluten. Taken together, these findings indicate potentially expanded utility of gluten-sensitive rhesus macaques in cancer research. PMID:21533263

Anti-Saccharomyces cerevisiae and perinuclear anti-neutrophil cytoplasmic antibodies in coeliac disease before and after gluten-free diet.

Science.gov (United States)

Granito, A; Zauli, D; Muratori, P; Muratori, L; Grassi, A; Bortolotti, R; Petrolini, N; Veronesi, L; Gionchetti, P; Bianchi, F B; Volta, U

2005-04-01

Anti-Saccharomyces cerevisiae and perinuclear anti-neutrophil cytoplasmic autoantibodies are markers of Crohn's disease and ulcerative colitis respectively. To determine the prevalence of anti-S. cerevisiae and perinuclear anti-neutrophil cytoplasmic autoantibodies in a large series of coeliac disease patients before and after gluten free diet, and to correlate anti-S. cerevisiae-positivity with intestinal mucosal damage. One hundred and five consecutive coeliac disease patients and 141 controls (22 ulcerative colitis, 24 Crohn's disease, 30 primary sclerosing cholangitis, 15 postenteritis syndrome, 50 blood donors) were tested for anti-S. cerevisiae by enzyme-linked immunosorbent assay and for perinuclear anti-neutrophil cytoplasmic autoantibodies by indirect immunofluorescence. In coeliac disease anti-S. cerevisiae (immunoglobulin G and/or immunoglobulin A) were slightly less frequent (59%) than in Crohn's disease (75%, P = 0.16) and significantly more frequent than in ulcerative colitis (27%), primary sclerosing cholangitis (30%), postenteritis syndrome (26%) and blood donors (4%) (P = 0.009, P = 0.0002, P = 0.025, P < 0.0001). No correlation was found between anti-S. cerevisiae and degree of mucosal damage. Perinuclear anti-neutrophil cytoplasmic autoantibodies were detected only in one coeliac. After gluten free diet the disappearance of anti-S. cerevisiae-immunoglobulin A (93%) was more frequent than that of immunoglobulin G (17%, P = 0.0001); perinuclear anti-neutrophil cytoplasmic autoantibodies disappeared in the only coeliac positive at diagnosis. More than half of untreated coeliacs are anti-S. cerevisiae-positive irrespective of the severity of mucosal damage. Differently from immunoglobulin A, anti-S. cerevisiae-immunoglobulin G persisted in more than 80% after gluten free diet. The high prevalence of anti-S. cerevisiae in coeliac disease suggests that they may be the effect of a non-specific immune response in course of chronic small bowel disease.

Novel Therapeutic/Integrative Approaches for Celiac Disease and Dermatitis Herpetiformis

Directory of Open Access Journals (Sweden)

Alessio Fasano

2012-01-01

Full Text Available Celiac disease (CD is an immune-mediated enteropathy triggered by the ingestion of gluten in genetically susceptible individuals. Gluten is a protein component in wheat and other cereals like rye and barley. At present, the only available treatment is a strict gluten-free diet. Recent advances have increased our understanding of the molecular basis for this disorder. Last decade has seen new scientific developments in this disease and led to the formulation of new concepts of pathophysiology that offer possible targets for new treatments or interventions integrative to the gluten-free diet.

Dermatomyositis Associated with Celiac Disease: Response to a Gluten-Free Diet

Directory of Open Access Journals (Sweden)

Min Soo Song

2006-01-01

Full Text Available The association between dermatomyositis and celiac disease in children has been well documented. In the adult population, however, the association has not been clearly established. A rare case of concomitant dermatomyositis and celiac disease in a 40-year-old woman is presented. After having been diagnosed with dermatomyositis and iron deficiency anemia, this patient was referred to the gastroenterology clinic to exclude a gastrointestinal malignancy. Blood tests revealed various vitamin deficiencies consistent with malabsorption. The results of gastroscopy with duodenal biopsy were consistent with celiac disease. After she was put on a strict gluten-free diet, both nutritional deficiencies and the dermatomyositis resolved. The patient’s human leukocyte antigen haplotype study was positive for DR3 and DQ2, which have been shown to be associated with both juvenile dermatomyositis and celiac disease. It is suggested that patients with newly diagnosed dermatomyositis be investigated for concomitant celiac disease even in the absence of gastrointestinal symptoms.

Hypervigilance to a Gluten-Free Diet and Decreased Quality of Life in Teenagers and Adults with Celiac Disease.

Science.gov (United States)

Wolf, Randi L; Lebwohl, Benjamin; Lee, Anne R; Zybert, Patricia; Reilly, Norelle R; Cadenhead, Jennifer; Amengual, Chelsea; Green, Peter H R

2018-06-01

Avoidance of gluten is critical for individuals with celiac disease (CD), but there is also concern that "extreme vigilance" to a strict gluten-free diet may increase symptoms such as anxiety and fatigue, and therefore, lower quality of life (QOL). We examined the associations of QOL with energy levels and adherence to, and knowledge about, a gluten-free diet. This is a cross-sectional prospective study of 80 teenagers and adults, all with biopsy-confirmed CD, living in a major metropolitan area. QOL was assessed with CD-specific measures. Dietary vigilance was based on 24-h recalls and an interview. Knowledge was based on a food label quiz. Open-ended questions described facilitators and barriers to maintaining a gluten-free diet. The extremely vigilant adults in our sample had significantly lower QOL scores than their less vigilant counterparts [(mean (SD): 64.2 (16.0) vs 77.2 (12.2), p = 0.004]. Extreme vigilance was also associated with greater knowledge [5.7 (0.7) vs 5.1 (0.8), p = 0.035]. Adults with lower energy levels had significantly lower overall QOL scores than adults with higher energy levels [68.0 (13.6) vs 78.9 (13.0), p = 0.006]. Patterns were similar for teenagers. Cooking at home and using internet sites and apps were prevalent strategies used by the hypervigilant to maintain a strict gluten-free diet. Eating out was particularly problematic. There are potential negative consequences of hypervigilance to a strict gluten-free diet. Clinicians must consider the importance of concurrently promoting both dietary adherence and social and emotional well-being for individuals with CD.

Altered duodenal microbiota composition in celiac disease patients suffering from persistent symptoms on a long-term gluten-free diet.

Science.gov (United States)

Wacklin, Pirjo; Laurikka, Pilvi; Lindfors, Katri; Collin, Pekka; Salmi, Teea; Lähdeaho, Marja-Leena; Saavalainen, Päivi; Mäki, Markku; Mättö, Jaana; Kurppa, Kalle; Kaukinen, Katri

2014-12-01

A significant fraction of celiac disease patients suffer from persistent symptoms despite a long-term gluten-free diet (GFD) and normalized small bowel mucosa. The commonly suggested reasons, such as inadvertent gluten-intake or presence of other gastrointestinal disease, do not explain the symptoms in all these patients. Recently, alterations in intestinal microbiota have been associated with autoimmune disorders, including celiac disease. This led us to test a hypothesis that abnormal intestinal microbiota may be associated with persisting gastrointestinal symptoms in treated celiac disease patients. Duodenal microbiota was analyzed in 18 GFD-treated patients suffering from persistent symptoms and 18 treated patients without symptoms by 16S rRNA gene pyrosequencing. The celiac disease patients had been following a strict GFD for several years and had restored small bowel mucosa and negative celiac autoantibodies. Their symptoms on GFD were assessed with Gastrointestinal Symptom Rating Scale. The results of several clustering methods showed that the treated celiac disease patients with persistent symptoms were colonized by different duodenal microbiota in comparison with patients without symptoms. The treated patients with persistent symptoms had a higher relative abundance of Proteobacteria (P=0.04) and a lower abundance of Bacteroidetes (P=0.01) and Firmicutes (P=0.05). Moreover, their microbial richness was reduced. The results indicated intestinal dysbiosis in patients with persistent symptoms even while adhering to a strict GFD. Our findings indicate that dysbiosis of microbiota is associated with persistent gastrointestinal symptoms in treated celiac disease patients and open new possibilities to treat this subgroup of patients.

Rheological behaviour of wheat glutens at small and large deformations. Effect of gluten composition

NARCIS (Netherlands)

Janssen, A. M.; vanVliet, T; Vereijken, JM

Glutens derived from two wheal cultivars with a known difference in bread making quality, i.e. cv. Katepwa (good) and cv. Obelisk (poor), were fractionated into gliadin and glutenin. Cultivar Katepwa gluten contained more glutenin than cv. Obelisk gluten. Reconstituted glutens were prepared by

Gluten-free but also gluten-enriched (gluten+) diet prevent diabetes in NOD mice; the gluten enigma in type 1 diabetes

Czech Academy of Sciences Publication Activity Database

Funda, David P.; Kaas, A.; Tlaskalová, Helena; Buschard, K.

2007-01-01

Roč. 24, - (2007), s. 59-63 ISSN 1520-7552 R&D Projects: GA AV ČR IAA5020405; GA ČR GA303/06/1329 Institutional research plan: CEZ:AV0Z50200510 Keywords : gluten * gluten -free * type 1 diabetes Subject RIV: EE - Microbiology, Virology Impact factor: 3.087, year: 2007

Evaluation of gluten in gluten-free-labeled foods and assessment of exposure level to gluten among celiac patients in Lebanon.

Science.gov (United States)

Hassan, Hussein; Elaridi, Jomana; Bassil, Maya

2017-11-01

The aim of the study was to evaluate gluten contamination in all the gluten-free (GF)-labeled food products sold in Lebanon. Over a 2-year period, a total of 173 food samples collected from 135 brand names were analyzed. Gluten contamination was detected in 33 of 173 (19%) samples, and its content ranged between 2.5 and >80 mg kg -1 . In 10 of the 173 samples (6%), the quantity of gluten exceeded the upper limit of 20 mg kg -1 . Out of the 10 contaminated products, eight (80%) were locally manufactured. Among these 10 products, eight (80%) were wheat-starch-based foods. Of the 40 brand names tested twice in 2014 and 2015, 15 (38%) showed significantly (p < .05) different gluten content between the 2 years. Using a food frequency questionnaire, exposure level to gluten through the contaminated products was evaluated among 15 celiac patients. Two patients reported consuming these products more than twice per week.

A comparative study among methods used for wheat flour analysis and for measurements of gluten properties using the Wheat Gluten Quality Analyser (WGQA

Directory of Open Access Journals (Sweden)

Maria Cristina Ferrari

2014-06-01

Full Text Available This study aimed at comparing both the results of wheat flour quality assessed by the new equipment Wheat Gluten Quality Analyser (WGQA and those obtained by the extensigraph and farinograph. Fifty-nine wheat samples were evaluated for protein and gluten contents; the rheological properties of gluten and wheat flour were assessed using the WGQA and the extensigraph/farinograph methods, respectively, in addition to the baking test. Principal component analysis (PCA and linear regression were used to evaluate the results. The parameters of energy and maximum resistance to extension determined by the extensigraph and WGQA showed an acceptable level for the linear correlation within the range from 0.6071 to 0.6511. The PCA results obtained using WGQA and the other rheological apparatus showed values similar to those expected for wheat flours in the baking test. Although all equipment used was effective in assessing the behavior of strong and weak flours, the results of medium strength wheat flour varied. WGQA has shown to use less amount of sample and to be faster and easier to use in relation to the other instruments used.

Recent developments in gluten-free bread baking approaches: a review

Directory of Open Access Journals (Sweden)

Kun WANG

Full Text Available Abstract Celiac disease (CD is one of the most common human intestinal malabsorption diseases. The only effective treatment for patients with CD is to follow a gluten-free (GF diet strictly. Nowadays, the increasing incidence of CD promotes worldwide interests for various desirable GF products. However, baking without gluten, the key ingredient for bread structure and quality, is a big challenge for all bakers and cereal researchers. Several approaches have been applied to understand and improve gluten-free bread (GFB elaboration and further studies are still required. The main focus of this review is to discuss the approaches for GFB improvements in recent 5 years, including the use of novel alternative flours, functional ingredients, processing aids, additives, innovative techniques, and their combinations.

Rheological Properties of Gluten Free Dough Systems

OpenAIRE

Tandazo, Stephany Aurea

2013-01-01

Bread is the one of the oldest processed foods and a major wheat based product. The basic process involves mixing of ingredients until the flour is converted into dough, followed by baking the dough into a loaf. A very important step in breadmaking is to know how to make good quality dough. However, the increasing knowledge of people being diagnosed with celiac disease (gluten intolerance) has encouraged scientists to develop healthier and better quality gluten-free products that would greatl...

Health-related quality of life in children and adolescents with celiac disease

DEFF Research Database (Denmark)

Skjerning, Halfdan; Mahony, Ruth O; Husby, Steffen

2014-01-01

Celiac disease (CD) is a chronic inflammatory disease requiring constant management with a gluten-free diet (GFD). Little is known about how CD impacts on health-related quality of life (HRQOL) in children and adolescents, and how they feel about and cope with CD and GFD. This qualitative study...

Celiac Disease in Patients with Cystic Fibrosis-Related Bone Disease

Directory of Open Access Journals (Sweden)

Melissa S. Putman

2017-01-01

Full Text Available Both cystic fibrosis (CF and celiac disease can cause low bone mineral density (BMD and fractures. Celiac disease may occur at a higher frequency in patients with CF than the general population, and symptoms of these conditions may overlap. We report on two patients presenting with CF-related bone disease in the past year who were subsequently found to have concurrent celiac disease. Because adherence to a gluten-free diet may improve BMD in patients with celiac disease, this could have important implications for treatment. Clinicians should consider screening for celiac disease in patients with CF who have low BMD, worsening BMD in the absence of other risk factors, and/or difficult to treat vitamin D deficiency.

Celiac disease : towards new therapeutic modalities

NARCIS (Netherlands)

Mitea, Doina Cristina

2011-01-01

What is known about celiac disease? Celiac disease is one of the most common food intolerances, approximately 1% of the population being a celiac disease patient. It is now known that celiac disease is precipitated by ingestion of gluten, the major storage proteins in wheat, and similar proteins in

Coeliac disease and gastrointestinal symptom screening in adult first-degree relatives.

Science.gov (United States)

Vaquero, Luis; Rodríguez-Martín, Laura; Alvarez-Cuenllas, Begoña; Hernando, Mercedes; Iglesias-Blazquez, Cristina; Menéndez-Arias, Cristina; Vivas, Santiago

2017-12-01

The first-degree relatives (FDRs) of patients with coeliac disease are the main risk group for disease development. The study aims to evaluate the screening strategy in FDRs with negative coeliac serology based on human leukocyte antigen (HLA) genotyping, followed by duodenal biopsy, and to analyze the prevalence of gastrointestinal symptoms and the influence of gluten intake. Adult FDRs with negative coeliac serology were invited to participate (n = 205), and a total of 139 completed the study protocol. HLA genotyping, transglutaminase antibody assessment, and duodenal biopsy were performed. Symptomatology was assessed using questionnaires during the various phases of dietary modification (baseline diet, gluten-free diet, and gluten overload). The study included 139 participants (mean age, 42 years; 53.2% women). HLA-DQ2/8 was positive in 78.4% of the participants (homozygous, 15.1%; heterozygous, 63.3%). Histopathological alterations were noted in 37.1% of participants who underwent duodenal biopsy (Marsh I, 32.7%; Marsh IIIa, 4.4%). At baseline, symptoms were observed in 45.7% of the participants, and the proportion decreased to 24.5% after the gluten-free diet (P < 0.001). Symptoms were not associated with the presence of histological alterations or genetic risk. However, younger age (odds ratio [OR] = 0.91), female sex (OR = 2.9), and the presence of autoimmune disorders (OR = 2.8) were independently associated with a significant symptom response to the gluten-free diet. Duodenal lymphocytosis and atrophy are frequently noted in FDRs, despite negative serological markers. In addition, gastrointestinal symptoms are commonly present and associated with gluten intake regardless of the histological pathology. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Structure characterization of the central repetitive domain of high molecular weight gluten proteins .2. Characterization in solution and in the dry state

NARCIS (Netherlands)

van Dijk, A.A.; De Boef, E.; Bekkers, A.; van Wijk, L.L.; van Swieten, E.; Hamer, R.J.; Robillard, G.T.

The structure of the central repetitive domain of high molecular weight (HMW) wheat gluten proteins was characterized in solution and in the dry state using HMW proteins Bx6 and Bx7 and a subcloned, bacterially expressed part of the repetitive domain of HMW Dx5. Model studies of the HMW consensus

Macrocospic and physiochemical characterization of a sugarless and gluten-free cake enriched with fibers made from pumpkin seed (Cucurbita maxima, L. flour and cornstarch

Directory of Open Access Journals (Sweden)

Cristiane Mesquita da Silva Gorgônio

2011-03-01

Full Text Available The Consumers' interest for products with caloric reduction has increased, and their development is a technological challenge. The consumption of cakes has grown in importance and the demand for dietary products has stimulated the use of sweeteners and the optimization of bakery products. The consumption of fibers is related to chronic diseases prevention. Pumpkin seeds (maximum Cucurbita, L., rich in fibers, can be used as a source of fiber in food products. A gluten-free diet is not easy to follow since gluten free products are not always available. The objective of this work was to perform a physicochemical characterization of cakes prepared with flours blends (FB based on Pumpkin Seed Flour (PSF. The cakes were elaborated with FB in the ratios of 30:70 (C30 and 40:60 (C40 of PSF and cornstarch (CS, respectively. The results showed gluten absence and near-neutral pH. The chemical analysis of C30 and B40 showed increase of ashes, lipids, proteins, and insoluble dietary fiber and a decrease in the content of carbohydrates and calories. The chemical composition of C40 presented the greatest content of lipids, proteins, and dietary fibers, the lowest content of calories, and the best physical parameters. Therefore, both products proved suitable for human consumption.

Accumulation of Heavy Metals in People on a Gluten-Free Diet.

Science.gov (United States)

Raehsler, Stephanie L; Choung, Rok Seon; Marietta, Eric V; Murray, Joseph A

2018-02-01

Specific foods such as fish and rice have high concentrations of metals such as arsenic, mercury, lead, cadmium, and cobalt. Many gluten-free diets (GFDs) include these foods, so we evaluated whether a GFD was associated with increased metal bioaccumulation. We performed a population-based, cross-sectional study using data collected from the National Health and Nutrition Examination Survey (NHANES), from 2009 through 2012, collecting information on the diagnosis of celiac disease and adherence to a GFD. We tested NHANES blood samples to identify individuals with undiagnosed celiac disease, using assays for immunoglobulin A tissue transglutaminase followed by a confirmatory test for endomysial antibody. Among a total of 11,354 NHANES participants, celiac disease was diagnosed in 55 participants, based on test results or a reported clinical diagnosis. We collected NHANES survey data on blood levels of lead, mercury, and cadmium from subjects who were on a GFD (n = 115) and participants who were not on a GFD (n = 11,239). Levels of total arsenic in urine samples were available from 3901 subjects not following a GFD and 32 individuals following a GFD. NHANES participants were asked questions about fish and shellfish consumption. We performed multivariate logistic regression analyses to associate gluten-related conditions with blood concentrations of mercury, cadmium, and lead and urine concentration of total arsenic, adjusting for demographic characteristics, as well as for rice consumption or seafood intake. Geometric means were reported for urinary concentrations of total arsenic and blood concentrations of mercury, cadmium, and lead for demographic groups and subjects with gluten-related conditions (subjects without celiac disease who avoid gluten). Persons following a GFD had significantly increased total blood mercury levels (1.37 mcg/L) compared with persons not on a GFD (0.93 mcg/L) (P = .008), as well as increased blood levels of lead (1.42 vs 1.13 mcg/L; P�

Serum zinc, copper and iron status of children with coeliac disease on three months of gluten-free diet with or without four weeks of zinc supplements: a randomised controlled trial.

Science.gov (United States)

Negi, K; Kumar, R; Sharma, L; Datta, S P; Choudhury, M; Kumar, P

2018-04-01

Data about the effect of zinc supplementation with gluten-free diet on normalisation of plasma zinc, copper and iron in patients with coeliac disease are scanty. We evaluated the effect of zinc supplementation on serum zinc, copper and iron levels in patients with coeliac disease, by randomising 71 children newly diagnosed with coeliac disease into two groups: Group A = gluten-free diet (GFD); and Group B = gluten-free diet with zinc supplements (GFD +Zn). The rise in iron and zinc was significantly higher in the latter, but the mean rise of copper levels was slightly higher in the former, but the difference was not significant.

Increased Mercury Levels in Patients with Celiac Disease following a Gluten-Free Regimen

Directory of Open Access Journals (Sweden)

Luca Elli

2015-01-01

Full Text Available Background and Aim. Although mercury is involved in several immunological diseases, nothing is known about its implication in celiac disease. Our aim was to evaluate blood and urinary levels of mercury in celiac patients. Methods. We prospectively enrolled 30 celiac patients (20 treated with normal duodenal mucosa and 10 untreated with duodenal atrophy and 20 healthy controls from the same geographic area. Blood and urinary mercury concentrations were measured by means of flow injection inductively coupled plasma mass spectrometry. Enrolled patients underwent dental chart for amalgam fillings and completed a food-frequency questionnaire to evaluate diet and fish intake. Results. Mercury blood/urinary levels were 2.4±2.3/1.0±1.4, 10.2±6.7/2.2±3.0 and 3.7±2.7/1.3±1.2 in untreated CD, treated CD, and healthy controls, respectively. Resulting mercury levels were significantly higher in celiac patients following a gluten-free diet. No differences were found regarding fish intake and number of amalgam fillings. No demographic or clinical data were significantly associated with mercury levels in biologic samples. Conclusion. Data demonstrate a fourfold increase of mercury blood levels in celiac patients following a gluten-free diet. Further studies are needed to clarify its role in celiac mechanism.

Gluten intake in 6- to 36-month-old Danish infants and children

DEFF Research Database (Denmark)

Hoppe, Camilla; Trolle, Ellen; Gondolf, Ulla Holmboe

2013-01-01

the intake of gluten from wheat, barley, rye and oats in a cross-sectional National Danish Survey of Dietary Habits among Infants and Young Children (2006–2007). The study population comprised a random sample of 1743 children aged 6–36 months, recruited from the National Danish Civil Registry. The protein...... contents from wheat, rye, barley and oats were found in the National Danish Food Composition Table, and multiplied with the amounts in the recipes. The amounts of gluten were calculated as the amount of cereal protein × 0·80 for wheat and oats, ×0·65 for rye and ×0·50 for barley. Dietary intake...... was recorded daily for seven consecutive days in pre-coded food records supplemented with open-answer possibilities. Gluten intake increased with age (P

Effects of gliadin addition on the rheological, microscopic and thermal characteristics of wheat gluten.

Science.gov (United States)

Khatkar, B S; Barak, Sheweta; Mudgil, Deepak

2013-02-01

In the present study, micro-structural, thermal and rheological changes in the gluten network upon addition of gliadins at 5% and 10% levels were investigated using scanning electron microscopy (SEM), thermo gravimetric analysis (TGA), differential scanning calorimetry (DSC) and dynamic rheometry. The addition of gliadins decreased the peak dough height inferring decrease in dough strength. The dough stability also decreased from 3.20 to 1.40 min upon addition of 10% gliadin to the base flour. The TGA profile and the glass transition behavior of the control gluten and gluten obtained from dough with gliadin added at 5% and 10% levels showed decrease in thermal stability. The SEM micrograph of the control gluten showed foam like protein matrix. As the gliadin percentage in the gluten was increased, the compactness of the gluten structure reduced considerably leading to the formation of a more open weak gluten network. Copyright © 2012 Elsevier B.V. All rights reserved.

Starch facilitates enzymatic wheat gluten hydrolysis

NARCIS (Netherlands)

Hardt, N.A.; Boom, R.M.; Goot, van der A.J.

2015-01-01

Wheat gluten can be hydrolyzed by either using (vital) wheat gluten or directly from wheat flour. This study investigates the influence of the presence of starch, the main component of wheat, on enzymatic wheat gluten hydrolysis. Wheat gluten present in wheat flour (WFG) and vital wheat gluten (VWG)

The Effect of Depressive Symptoms on the Association between Gluten-Free Diet Adherence and Symptoms in Celiac Disease: Analysis of a Patient Powered Research Network.

Science.gov (United States)

Joelson, Andrew M; Geller, Marilyn G; Zylberberg, Haley M; Green, Peter H R; Lebwohl, Benjamin

2018-04-26

The prevalence of depression in celiac disease (CD) is high, and patients are often burdened socially and financially by a gluten-free diet. However, the relationship between depression, somatic symptoms and dietary adherence in CD is complex and poorly understood. We used a patient powered research network (iCureCeliac ® ) to explore the effect that depression has on patients' symptomatic response to a gluten-free diet (GFD). We identified patients with biopsy-diagnosed celiac disease who answered questions pertaining to symptoms (Celiac Symptom Index (CSI)), GFD adherence (Celiac Dietary Adherence Test (CDAT)), and a 5-point, scaled question regarding depressive symptoms relating to patients' celiac disease. We then measured the correlation between symptoms and adherence (CSI vs. CDAT) in patients with depression versus those without depression. We also tested for interaction of depression with regard to the association with symptoms using a multiple linear regression model. Among 519 patients, 86% were female and the mean age was 40.9 years. 46% of patients indicated that they felt "somewhat," "quite a bit," or "very much" depressed because of their disorder. There was a moderate correlation between worsened celiac symptoms and poorer GFD adherence ( r = 0.6, p symptoms and worsening dietary adherence ( r = 0.5, p symptoms related to their disorder, correlation between adherence and symptoms was weaker than those without depressive symptoms. This finding was confirmed with a linear regression analysis, showing that depressive symptoms may modify the effect of a GFD on celiac symptoms. Depressive symptoms may therefore mask the relationship between inadvertent gluten exposure and symptoms. Additional longitudinal and prospective studies are needed to further explore this potentially important finding.

A randomised, double-blind, cross-over trial to evaluate bread, in which gluten has been pre-digested by prolyl endoprotease treatment, in subjects self-reporting benefits of adopting a gluten-free or low-gluten diet.

Science.gov (United States)

Rees, Dinka; Holtrop, Grietje; Chope, Gemma; Moar, Kim M; Cruickshank, Morven; Hoggard, Nigel

2018-03-01

The aim of the present study was to determine if the enzyme Aspergillus niger prolyl endoprotease (ANPEP), which degrades the immunogenic proline-rich residues in gluten peptides, can be used in the development of new wheat products, suitable for gluten-sensitive (GS) individuals. We have carried out a double-blind, randomised, cross-over trial with two groups of adults; subjects, self-reporting benefits of adopting a gluten-free or low-gluten diet (GS, n 16) and a control non-GS group (n 12). For the trial, volunteers consumed four wheat breads: normal bread, bread treated with 0·8 or 1 % ANPEP and low-protein bread made from biscuit flour. Compared with controls, GS subjects had a favourable cardiovascular lipid profile - lower LDL (4·0 (sem 0·3) v. 2·8 (sem 0·2) mmol/l; P=0·008) and LDL:HDL ratio (3·2 (sem 0·4) v. 1·8 (sem 0·2); P=0·005) and modified haematological profile. The majority of the GS subjects followed a low-gluten lifestyle, which helps to reduce the gastrointestinal (GI) symptoms severity. The low-gluten lifestyle does not have any effect on the quality of life, fatigue or mental state of this population. Consumption of normal wheat bread increased GI symptoms in GS subjects compared with their habitual diet. ANPEP lowered the immunogenic gluten in the treated bread by approximately 40 %. However, when compared with the control bread for inducing GI symptoms, no treatment effects were apparent. ANPEP can be applied in the production of bread with taste, texture and appearance comparable with standard bread.

The Gluten-Free Diet: Can Oats and Wheat Starch Be Part of It?

Science.gov (United States)

Poley, J Rainer

2017-01-01

Objective and Conclusion: Uncertainty still exists about the use of oats and wheat starch as part of a gluten-free diet in patients with celiac disease (CD). This review should help to clarify the issues at hand. Whereas uncontaminated (from gluten/gliadin) oats and oats from cultivars not containing celiac-activating sequences of proline and glutamine can be used without risk of intestinal damage, wheat starch should not be used, unless it is free of gluten-that is, deglutinized-because even small amounts of gluten over time are able to induce small intestinal mucosal damage.

Living gluten-free: adherence, knowledge, lifestyle adaptations and feelings towards a gluten-free diet.

Science.gov (United States)

Silvester, J A; Weiten, D; Graff, L A; Walker, J R; Duerksen, D R

2016-06-01

A gluten-free diet (GFD) requires tremendous dedication, involving substantive changes to diet and lifestyle that may have a significant impact upon quality of life. The present study aimed io assess dietary adherence, knowledge of a GFD, and the emotional and lifestyle impact of a GFD. Community dwelling adults following a GFD completed a questionnaire with items related to reasons for avoiding gluten, diagnostic testing, GFD adherence, knowledge and sources of information about a GFD, the Work and Social Adjustment Scale, and the effect of a GFD diet on lifestyle, feelings and behaviours. Strict GFD adherence among the 222 coeliac disease (CD) patients was 56%. Non-CD individuals (n = 38) were more likely to intentionally ingest gluten (odds ratio = 3.7; 95% confidence interval = 1.4-9.4). The adverse impact of a GFD was modest but most pronounced in the social domain. Eating shifted from the public to the domestic sphere and there were feelings of social isolation. Affective responses reflected resilience because acceptance and relief were experienced more commonly than anxiety or anger. Non-CD respondents were less knowledgeable and less likely to consult health professionals. They experienced less anger and depression and greater pleasure in eating than CD respondents. The findings obtained in the present suggest there is good potential for positive adaptation to the demands of a GFD; nevertheless, there is a measurable degree of social impairment that merits further study. The GFD may be a viable treatment option for conditions other than CD; however, education strategies regarding the need for diagnostic testing to exclude CD are required. © 2015 The British Dietetic Association Ltd.

Medical nutrition therapy: use of sourdough lactic acid bacteria as a cell factory for delivering functional biomolecules and food ingredients in gluten free bread

LENUS (Irish Health Repository)

2011-08-30

Abstract Celiac disease (CD) is an immune-mediated disease, triggered in genetically susceptible individuals by ingesting gluten from wheat, rye, barley, and other closely related cereal grains. Currently, the estimated prevalence of CD is around 1 % of the population in the western world and medical nutritional therapy (MNT) is the only accepted treatment for celiac disease. To date, the replacement of gluten in bread presents a significant technological challenge for the cereal scientist due to the low baking performance of gluten free products (GF). The increasing demand by the consumer for high quality gluten-free (GF) bread, clean labels and natural products is rising. Sourdough has been used since ancient times for the production of rye and wheat bread, its universal usage can be attributed to the improved quality, nutritional properties and shelf life of sourdough based breads. Consequently, the exploitation of sourdough for the production of GF breads appears tempting. This review will highlight how sourdough LAB can be an efficient cell factory for delivering functional biomolecules and food ingredients to enhance the quality of gluten free bread.

Novel Insights to Celiac Disease: A review article

Directory of Open Access Journals (Sweden)

Alireza Pourtalebi-Firoozabadi

2016-04-01

Full Text Available Celiac disease is a chronic, systemic and autoimmune disorder of gastrointestinal track that involves approximately 1% of individuals of all ages throughout the world. The collaboration of environmental factor such as gluten proteins and genetic factors, notably HLA-DQ2 and/or HLA-DQ8 trigger the disease. Gluten-free diet is the simply and merely safe and proficient existing treatment. This article summarizes the latest trends in celiac disease.

Analysis of Quality-Related Parameters in Mature Kernels of Polygalacturonase Inhibiting Protein (PGIP) Transgenic Bread Wheat Infected with Fusarium graminearum.

Science.gov (United States)

Masci, Stefania; Laino, Paolo; Janni, Michela; Botticella, Ermelinda; Di Carli, Mariasole; Benvenuto, Eugenio; Danieli, Pier Paolo; Lilley, Kathryn S; Lafiandra, Domenico; D'Ovidio, Renato

2015-04-22

Fusarium head blight, caused by the fungus Fusarium graminearum, has a detrimental effect on both productivity and qualitative properties of wheat. To evaluate its impact on wheat flour, we compared its effect on quality-related parameters between a transgenic bread wheat line expressing a bean polygalacturonase inhibiting protein (PGIP) and its control line. We have compared metabolic proteins, the amounts of gluten proteins and their relative ratios, starch content, yield, extent of pathogen contamination, and deoxynivalenol (DON) accumulation. These comparisons showed that Fusarium significantly decreases the amount of starch in infected control plants, but not in infected PGIP plants. The flour of PGIP plants contained also a lower amount of pathogen biomass and DON accumulation. Conversely, both gluten and metabolic proteins were not significantly influenced either by the transgene or by fungal infection. These results indicate that the transgenic PGIP expression reduces the level of infection, without changing significantly the wheat seed proteome and other quality-related parameters.

Enzyme-linked immunosorbent assay gliadin assessment in processed food products available for persons with celiac disease: a feasibility study for developing a gluten-free food database.

Science.gov (United States)

Agakidis, Charalampos; Karagiozoglou-Lampoudi, Thomais; Kalaitsidou, Marina; Papadopoulos, Theodoros; Savvidou, Afroditi; Daskalou, Efstratia; Dimitrios, Triantafyllou

2011-12-01

Inappropriate food labeling and unwillingness of food companies to officially register their own gluten-free products in the Greek National Food Intolerance Database (NFID) result in a limited range of processed food products available for persons with celiac disease (CDP). The objective of the study was to evaluate the feasibility of developing a gluten-free food product database based on the assessment of the gluten content in processed foods available for CDP. Gluten was assessed in 41 processed food products available for CDP. Group A consisted of 26 products for CDP included in the NFID, and group B contained 15 food products for CDP not registered in the NFID but listed in the safe lists of the local Celiac Association (CA). High-sensitivity ω-gliadin enzyme-linked immunosorbent assay (ELISA) was used for analysis. Gluten was lower than 20 ppm in 37 of 41 analyzed products (90.2%): in 24 of 26 (92.3%) products in group A and in 13 of 15 (86.7%) products in group B (P = .61). No significant difference was found between the 2 groups regarding gluten content. No product in either group contained gluten in excess of 100 ppm. Most of the analyzed products included in the Greek NFID or listed in the lists of the local CA, even those not officially labeled "gluten free," can be safely consumed by CDP. The use of commercially available ω-gliadin ELISA is able to identify those products that contain inappropriate levels of gluten, making feasible it to develop an integrated gluten-free processed food database.

The effect of gluten on the host-microbial metabolism assessed by urinary metabolomics

DEFF Research Database (Denmark)

Roager, Henrik Munch; Frandsen, Henrik Lauritz; Gøbel, Rikke Juul

A gluten-free diet clearly improves the life of patients with celiac disease, but the scientific evidence supporting possible health benefits of a gluten-free diet for non-celiac adults is limited. Therefore, as urine reflects the host and gut microbial metabolism, the study aimed to assess...... a gluten-rich (21.6±5.7g/day) or a gluten-poor (~1g/day) diet for 8 weeks, crossing over to the other diet after 6 weeks washout. Urine samples were standardised collected at the beginning and end of each diet intervention period and were analysed by gas chromatography mass spectrometry (GC-MS) and liquid...... the long-term metabolic effect of gluten on the urine metabolome of non-celiac individuals by a cross-over intervention study (gluten-poor and gluten rich, respectively) using a non-targeted metabolomics approach. Fifty-one non-celiac adult participants (30 female, 21 male) were randomized to either...

[What medication should be prescribed to a patient with coeliac disease?

Science.gov (United States)

Pérez-Diez, C; Guillén-Lorente, S; Palomo-Palomo, P

2018-03-01

Coeliac disease is a permanent intolerance to gluten proteins from wheat, rye, barley and triticale. Although strict adherence is complicated, the only effective treatment is a gluten-free diet throughout life. Some drugs contain starch as an excipient, and there is a risk related to the gluten content, which must be avoided in these patients. Current legislation requires the analysis of the protein content of wheat starch, or the absence of starches from another source where rice, maize, or potato starches are used as excipients. But, it does not specify that reference should be made to traces of gluten that are residues of the process of production of the active ingredient. As regards the case described, there needs to be awareness of the importance of adequately informing patients and reviewing/updating current legislation to ensure the safe use of drugs. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Management of Nonceliac Gluten Sensitivity by Gastroenterology Specialists: Data from an Italian Survey

Directory of Open Access Journals (Sweden)

Federica Branchi

2015-01-01

Full Text Available Background and Aim. Nonceliac gluten sensitivity is syndrome characterized by symptoms disappearing after a gluten-free diet. Its existence is still argument of discussion among specialists. Our aim was to evaluate the knowledge about nonceliac gluten sensitivity among gastroenterology specialists. Methods. During October 2013 a questionnaire was sent through a medical newsletter to Italian gastroenterologists. Twelve questions investigated their knowledge on nonceliac gluten sensitivity, including their diagnostic and therapeutic approach. Results. A total of 212 gastroenterologists filled in the questionnaire. The 98.6% were aware of the existence of a syndrome called “nonceliac gluten sensitivity” and 77% believe in its existence. However, only 56% gave a correct definition of the term. The majority of specialists diagnosed gluten sensitive patients and the number of diagnoses was not statistically different from that of celiac disease. Moreover, a gluten-free diet was prescribed by 64% of the specialists and among them the 73% noted an increase of gluten sensitive patients attending their outpatient services. Conclusions. Our study indicated that most of the specialists recognize nonceliac gluten sensitivity and prescribe gluten-free diet, although 44% of the specialists are not able to give its correct definition; underlining the necessity of medical education on this topic is needed.

Immune Development and Intestinal Microbiota in Celiac Disease

Directory of Open Access Journals (Sweden)

Tamara Pozo-Rubio

2012-01-01

Full Text Available Celiac disease (CD is an immune-mediated enteropathy, triggered by dietary wheat gluten and similar proteins of barley and rye in genetically susceptible individuals. The etiology of this disorder is complex, involving both environmental and genetic factors. The major genetic risk factor for CD is represented by HLA-DQ genes, which account for approximately 40% of the genetic risk; however, only a small percentage of carriers develop the disease. Gluten is the main environmental factor responsible for the signs and symptoms of the disease, but exposure to gluten does not fully explain the manifestation of CD. Epidemiological and clinical data suggest that environmental factors other than gluten might play a role in disease development, including early feeding practices (e.g., breast milk versus formula and duration of breastfeeding, infections, and alterations in the intestinal microbiota composition. Herein, we review what is known about the influence of dietary factors, exposure to infectious agents, and intestinal microbiota composition, particularly in early life, on the risk of developing CD, as well as the possible dietary strategies to induce or increase gluten tolerance.

Especially for Women: Could Gluten be Causing Your Symptoms?

Science.gov (United States)

... loss during menstruation. Anemia is often an early symptom of celiac disease, resulting from the intestine’s inability to absorb iron ... Anxiety More common among women than men. Possible symptoms of celiac disease and non-celiac gluten sensitivity. Other Autoimmune Diseases ...

New Insights into the Pathogenesis of Celiac Disease

Directory of Open Access Journals (Sweden)

Valli De Re

2017-08-01

Full Text Available Celiac disease (CD is an autoimmune and multisystem gluten-related disorder that causes symptoms involving the gastrointestinal tract and other organs. Pathogenesis of CD is only partially known. It had been established that ingestion of gluten proteins present in wheat and other cereals are necessary for the disease and develops in individuals genetically predisposed carrying the DQ2 or DQ8 human leukocyte antigen haplotypes. In this review, we had pay specific attention on the last discoveries regarding the three cellular components mainly involved in the development and maintenance of CD: T-cells, B-cells, and microbioma. All of them had been showed critical for the interaction between inflammatory immune response and gluten peptides. Although the mechanisms of interaction among overall these components are not yet fully understood, recent proteomics and molecular studies had shed some lights in the pathogenic role of tissue transglutaminase 2 in CD and in the alteration of the intestinal barrier function induced by host microbiota.

New Insights into the Pathogenesis of Celiac Disease.

Science.gov (United States)

De Re, Valli; Magris, Raffaella; Cannizzaro, Renato

2017-01-01

Celiac disease (CD) is an autoimmune and multisystem gluten-related disorder that causes symptoms involving the gastrointestinal tract and other organs. Pathogenesis of CD is only partially known. It had been established that ingestion of gluten proteins present in wheat and other cereals are necessary for the disease and develops in individuals genetically predisposed carrying the DQ2 or DQ8 human leukocyte antigen haplotypes. In this review, we had pay specific attention on the last discoveries regarding the three cellular components mainly involved in the development and maintenance of CD: T-cells, B-cells, and microbioma. All of them had been showed critical for the interaction between inflammatory immune response and gluten peptides. Although the mechanisms of interaction among overall these components are not yet fully understood, recent proteomics and molecular studies had shed some lights in the pathogenic role of tissue transglutaminase 2 in CD and in the alteration of the intestinal barrier function induced by host microbiota.

[Effects of dietary wheat gluten level on decreasing plasma homocysteine concentration in rats].

Science.gov (United States)

Liu, Yiqun; Han, Feng; Sun, Licui; Lu, Jiaxi; Sugiyama, Kimio; Huang, Zhenwu

2015-05-01

To investigate the effects of different level of casein and wheat gluten on decreasing plasma homocysteine concentration in rats. 48 rats of the Wistar were fed with different level of casein (12.5%, 25% and 50%) and wheat gluten (14.5%, 29% and 58%) diets for 14 days, and they were killed by decapitation to obtain blood and livers was subject to analysis the concentration of homocysteine, cysteine and other amino acids, as well as BHMT and CBS activities. Body weight gain in rats fed wheat gluten dietary was significantly less than casein dietary, but food intake was significantly decreased in wheat gluten group with increasing of the protein content. The plasma homocysteine concentration in rats fed wheat gluten was marketly less than casein, however plasma cysteine concentration in wheat gluten was higher than casein group. The effects of wheat gluten on plasma homocysteine concentration are mainly depends on the low contents of methionine and high cysteine content, but the low contents of lyscine and threonine are not ignored. The mainly mechanism is that the increased cysteine concentration promot enzyme activities of homocystein metabolism, and increase the consumption of homocysteine.

Effect of high temperature on cell structure and gluten protein accumulation in the endosperm of the developing wheat (Triticum aestivum L.) grain

Science.gov (United States)

High temperature during grain fill is one of the more significant environmental factors that alters wheat yield and flour quality. To identify endosperm responses to high temperature, cell structure and gluten protein composition were investigated in developing wheat (Triticum aestivum L. cv. Butte ...

Gluten-Free Labeling of Foods

Science.gov (United States)

... issued a final rule defining “gluten-free” for food labeling, which will help consumers, especially those living with ... free” label on foods. Food Facts: Gluten and Food Labeling: FDA’s Regulation of “Gluten-Free” Claims Blog: A ...

Dietary gluten and the development of celiac disease and type 1 diabetes

Directory of Open Access Journals (Sweden)

Ciacci C

2016-04-01

Full Text Available Carolina Ciacci, Fabiana Zingone Department of Medicine and Surgery, Celiac Center, University of Salerno, Fisciano, Italy Abstract: The objective of this study was to perform a review of the present knowledge on the epidemiology and pathogenesis of the association between celiac disease (CD and type 1 diabetes mellitus (T1DM. Results from this review show that the estimated prevalence rate of CD in T1DM ranges from 4% to 11.5%, which seems higher in children than in adults, while there is no sex predominance in the prevalence of CD in T1DM. On the basis of the previous literature, screening for CD should be considered at diabetes diagnosis in all subjects and again within 2 and 5 years after diagnosis, even in the absence of symptoms. The anti-islet antibodies detection test, instead, is not recommended in CD, just as in the general population, except for CD patients having a relative with T1DM. Both genes and environmental factors seem to play a role in this association. HLADQ2 has been found to be the most frequent allele in the patients with both CD and T1DM, while gluten may be considered the trigger that induces the production of autoantibodies and the development, in genetically predisposed individuals, of both diseases. Keywords: diabetes, celiac disease, genetics, environmental, epidemiological

Detection of Gluten during the Fermentation Process To Produce Soy Sauce.

Science.gov (United States)

Cao, Wanying; Watson, Damien; Bakke, Mikio; Panda, Rakhi; Bedford, Binaifer; Kande, Parnavi S; Jackson, Lauren S; Garber, Eric A E

2017-04-03

Advances have been made to provide people with celiac disease (CD) access to a diverse diet through an increase in the availability of gluten-free food products and regulations designed to increase label reliability. Despite advances in our knowledge regarding CD and analytical methods to detect gluten, little is known about the effects of fermentation on gluten detection. The enzyme-linked immunosorbent assay (ELISA) and lateral flow devices routinely used by analytical laboratories and regulatory agencies to test for the presence of gluten in food were examined for their ability to detect gluten during the fermentation processes leading to the production of soy sauce, as well as in finished products. Similar results were observed irrespective of whether the soy sauce was produced using pilot-plant facilities or according to a homemade protocol. In both cases, gluten was not detected after moromi (brine-based) fermentation, which is the second stage of fermentation. The inability to detect gluten after moromi fermentation was irrespective of whether the assay used a sandwich configuration that required two epitopes or a competitive configuration that required only one epitope. Consistent with these results was the observation that ELISA, lateral flow devices, and Western immunoblot analyses were unable to detect gluten in commercial soy sauce, teriyaki sauce, and Worcestershire sauce. Although reports are lacking on problems associated with the consumption of fermented soy-containing sauces by consumers with CD, additional research is needed to determine whether all immunopathogenic elements in gluten are hydrolyzed during soy sauce production.

The Clinical Response to Gluten Challenge: A Review of the Literature

Science.gov (United States)

Bruins, Maaike J.

2013-01-01

The aim of this review was to identify, evaluate and summarize all relevant studies reporting on the clinical response to gluten challenge by adult or pediatric patients with suspected or diagnosed coeliac disease (CD) on a gluten-free diet. We evaluated the effect of gluten challenge on changes in symptoms, intestinal mucosa histology, and serum antibodies. A systematic electronic search was performed for studies published as of 1966 using PubMed and Scopus databases. In the reviewed studies, doses ranged from 0.2 to 30 g/day of wheat gluten or comprised a gluten-containing diet. The onset of symptoms upon gluten intake varied largely from days to months and did not parallel serum antibody or histological changes. Within 3 months of gluten challenge, 70%–100% of pediatric CD patients became positive for AGA-IgA and EMA-IgA antibodies and 50%–70% for AGA-IgG. A limited number of trials suggest that no more than half of adult patients developed positive AGA-IgA, EMA-IgA, tTG-IgA or DGP-IgA/IgG titers. Approximately 50%–100% of pediatric and adult patients experienced mucosal relapse of gluten provocation within 3 months, which was preceded by increased mucosal intra-epithelial lymphocytes within several days of challenge. A 3-month high-dose gluten challenge should be suitable to diagnose the majority of CD patients. In some cases prolonged challenge may be needed to verify diagnosis. Combination testing for antibodies and mucosal histology may fasten the diagnosis. PMID:24284613

The Clinical Response to Gluten Challenge: A Review of the Literature

Directory of Open Access Journals (Sweden)

Maaike J. Bruins

2013-11-01

Full Text Available The aim of this review was to identify, evaluate and summarize all relevant studies reporting on the clinical response to gluten challenge by adult or pediatric patients with suspected or diagnosed coeliac disease (CD on a gluten-free diet. We evaluated the effect of gluten challenge on changes in symptoms, intestinal mucosa histology, and serum antibodies. A systematic electronic search was performed for studies published as of 1966 using PubMed and Scopus databases. In the reviewed studies, doses ranged from 0.2 to 30 g/day of wheat gluten or comprised a gluten-containing diet. The onset of symptoms upon gluten intake varied largely from days to months and did not parallel serum antibody or histological changes. Within 3 months of gluten challenge, 70%–100% of pediatric CD patients became positive for AGA-IgA and EMA-IgA antibodies and 50%–70% for AGA-IgG. A limited number of trials suggest that no more than half of adult patients developed positive AGA-IgA, EMA-IgA, tTG-IgA or DGP-IgA/IgG titers. Approximately 50%–100% of pediatric and adult patients experienced mucosal relapse of gluten provocation within 3 months, which was preceded by increased mucosal intra-epithelial lymphocytes within several days of challenge. A 3-month high-dose gluten challenge should be suitable to diagnose the majority of CD patients. In some cases prolonged challenge may be needed to verify diagnosis. Combination testing for antibodies and mucosal histology may fasten the diagnosis.

Characterization of the Bread Made with Durum Wheat Semolina Rendered Gluten Free by Sourdough Biotechnology in Comparison with Commercial Gluten-Free Products.

Science.gov (United States)

Rizzello, Carlo Giuseppe; Montemurro, Marco; Gobbetti, Marco

2016-09-01

Durum wheat semolina was fermented with sourdough lactic acid bacteria and fungal proteases aiming at a complete gluten hydrolysis. The gluten-free (GF) semolina, added with naturally GF ingredients and structuring agents, was used to produce bread (rendered GF bread; rGFB) at industrial level. An integrated approach including the characterization of the main chemical, nutritional, structural, and sensory features was used to compare rGFB to a gluten-containing bread and to 5 commercial naturally GF breads. High-performance liquid chromatography was used for free amino acids (FAAs), organic acids, and ethanol analysis. A methanolic extract was used for determining total phenols and antioxidant activity. The bread characterization also included the analysis of dietary fibers, mycotoxins, vitamins, and heavy metals. Beyond chemical analysis, nutritional profile was evaluated considering the in vitro protein digestibility and the predicted glycemic index, while the instrumental texture profile analysis was performed to investigate the structure and the physical/mechanical properties of the baked goods. Beyond the huge potential of market expansion, the main advantages of durum wheat semolina rendered GF can be resumed in the high availability of FAAs, the high protein digestibility, the low starch hydrolysis index, and the better technological properties of bread compared to the commercial GF products currently present on the market. Vitamins, minerals, and dietary fiber profiles are comparable to those of gluten-containing wheat bread. Also the sensory profile, determined by a panel test, can be considered the most similar to those of conventional baked goods, showing all the sourdough bread classic attributes. © 2016 Institute of Food Technologists®

Focus on Inclusive Education: The Educational and Social Challenges of Children with Celiac Disease: What Educators Should Know

Science.gov (United States)

Chick, Kay A.

2014-01-01

Celiac disease is a genetic autoimmune disease in which gluten, a protein found in wheat, rye, barley, and contaminated oats, attacks the lining of the small intestine. Children with this disease must eliminate gluten from their diet. This article provides educators with essential information on celiac disease and the federal laws that protect the…

Wheat gluten in extruded fish feed: Effects on morphology and on physical and functional properties

NARCIS (Netherlands)

Draganovic, V.; Goot, van der A.J.; Boom, R.M.; Jonkers, J.

2013-01-01

This article focuses on understanding the role of vital wheat gluten on the structural parameters of extruded fish feed and its correlation to the physical and functional properties. Gluten–soy protein concentrate blends with five gluten concentrations (0–200 g kg-1) were produced. An abrupt

QUALITY OF GLUTEN-FREE BUCKWHEAT-RICE BREAD

Directory of Open Access Journals (Sweden)

Petra Dvořáková

2013-02-01

Full Text Available In case of celiac disease the products containing gluten must be excluded from the nutrition. The offer of gluten-free products (especially pastry is low and in addition the gluten-free breads are typical of dry crust and crumb and higher firmness in comparison with wheat bread. This work deals with gluten-free mixtures prepared from buckwheat and rice flour and the effect of rising amount of these flours on bread quality, crumb hardness, elasticity, chewiness and gumminess. With rising portion of buckwheat flour in the mixture the bread volume, dough and bread yield increased. The biggest improvement was found for mean bread volume (30% between the samples FO 1090 (166.7 cm3 and FO 9010 (216.7 cm3. The texture analysis showed positive effect of rice flour on hardness, chewiness and gumminess. Hardness decreased from 114.5 N (F 100 to 91.3 N (FO 1090. Very similar results showed chewiness and gumminess. Chewiness of F 100 (314.0 was reduced by 32.5% to 212.2 at the sample FO 1090. Gumminess was improved almost linearly through the samples, the biggest difference (44.3% was found between the check sample F 100 (88.3 and FO 1090 (49.7.

Comparative efficiency of different methods of gluten extraction in indigenous varieties of wheat.

Science.gov (United States)

Imran, Samra; Hussain, Zaib; Ghafoor, Farkhanda; Nagra, Saeedahmad; Ziai, Naheeda Ashbeal

2013-06-01

The present study investigated six varieties of locally grown wheat (Lasani, Sehar, Miraj-08, Chakwal-50, Faisalabad-08 and Inqlab) procured from Punjab Seed Corporation, Lahore, Pakistan for their proximate contents. On the basis of protein content and ready availability, Faisalabad-08 (FD-08) was selected to be used for the assessment of comparative efficiency of various methods used for gluten extraction. Three methods, mechanical, chemical and microbiological were used for the extraction of gluten from FD-08. Each method was carried out under ambient conditions using a drying temperature of 55 degrees C. Mechanical method utilized four different processes viz:- dough process, dough batter process, batter process and ethanol washing process using standard 150 mesh. The starch thus obtained was analyzed for its proximate contents. Dough batter process proved to be the most efficient mechanical method and was further investigated using 200 and 300 mesh. Gluten content was determined using sandwich omega-gliadin enzyme-linked immunosorbent assay (ELISA).The results of dough batter process using 200 mesh indicated a starch product with gluten content of 678 ppm. Chemical method indicated high gluten content of more than 5000 ppm and the microbiological method reduced the gluten content from 2500 ppm to 398 ppm. From the results it was observed that no gluten extraction method is viable to produce starch which can fulfill the criteria of a gluten free product (20 ppm).

Health-related quality of life in adolescents with screening-detected celiac disease, before and one year after diagnosis and initiation of gluten-free diet, a prospective nested case-referent study

Directory of Open Access Journals (Sweden)

Nordyke Katrina

2013-02-01

Full Text Available Abstract Background Celiac disease (CD is a chronic disorder in genetically predisposed individuals in which a small intestinal immune-mediated enteropathy is precipitated by dietary gluten. It can be difficult to diagnose because signs and symptoms may be absent, subtle, or not recognized as CD related and therefore not prompt testing within routine clinical practice. Thus, most people with CD are undiagnosed and a public health intervention, which involves screening the general population, is an option to find those with unrecognized CD. However, how these screening-detected individuals experience the diagnosis and treatment (gluten-free diet is not fully understood. The aim of this study is to investigate the health-related quality of life (HRQoL of adolescents with screening-detected CD before and one year after diagnosis and treatment. Methods A prospective nested case-referent study was done involving Swedish adolescents who had participated in a CD screening study when they were in the sixth grade and about 12 years old. Screening-detected adolescents (n = 103 and referents without CD who participated in the same screening (n = 483 answered questionnaires at the time of the screening and approximately one year after the screening-detected adolescents had received their diagnosis that included the EQ-5D instrument used to measure health status and report HRQoL. Results The HRQoL for the adolescents with screening-detected CD is similar to the referents, both before and one year after diagnosis and initiation of the gluten-free diet, except in the dimension of pain at follow-up. In the pain dimension at follow-up, fewer cases reported problems than referents (12.6% and 21.9% respectively, Adjusted OR 0.50, 95% CI 0.27-0.94. However, a sex stratified analysis revealed that the significant difference was for boys at follow-up, where fewer screening-detected boys reported problems (4.3% compared to referent boys (18.8% (Adjusted OR 0

Impact of an active patient education program on gastrointestinal symptoms in women with celiac disease following a gluten-free diet: a randomized controlled trial.

Science.gov (United States)

Jacobsson, Lisa Ring; Friedrichsen, Maria; Göransson, Anne; Hallert, Claes

2012-01-01

Despite living with a gluten-free diet, Swedish women with celiac disease report a higher rate of gastrointestinal symptoms than women without the disease. This study was designed to assess the impact of active patient education on gastrointestinal symptoms in women with a gluten-free diet. A total of 106 Swedish women, aged 20 years or older, with celiac disease on a gluten-free diet for a minimum of 5 years took part in a randomized controlled trial. The intervention group (n = 54) underwent a 10-session educational program, "Celiac School," based on problem-based learning. Controls (n = 52) were sent information regarding celiac disease at home. The outcome measure was gastrointestinal symptoms at 10 weeks and 6 months after intervention, assessed with the Gastrointestinal Symptom Rating Scale. After 10 weeks of "Celiac School," the participating women reported significant improvements that remained 6 months later (p = .029). The controls did not improve significantly. A comparison of the development of scores, from baseline to 10 weeks, could not demonstrate a significant difference in the overall index between the 2 groups but showed a significant improvement concerning 1 of its components, namely the index reflecting Abdominal Pain (p = .007). Intervention methods should be refined to reach an even more pronounced effect.

Assessment of the effects of fish meal, wheat gluten, soy protein concentrate and feed moisture on extruder system parameters and the technical quality of fish feed

NARCIS (Netherlands)

Draganovic, V.; Goot, van der A.J.; Boom, R.M.; Jonkers, J.

2011-01-01

Evaluation of feed ingredient functionality plays a vital role in modern fish feed manufacturing practice. The aim of this study was to examine the extrusion behaviour of blends containing alternative protein sources from plant origin to fish meal (FM), such as wheat gluten (WG) and soy protein

Production of a novel wheat gluten hydrolysate containing dipeptidyl peptidase-IV inhibitory tripeptides using ginger protease.

Science.gov (United States)

Taga, Yuki; Hayashida, Osamu; Kusubata, Masashi; Ogawa-Goto, Kiyoko; Hattori, Shunji

2017-09-01

Wheat gluten is a Pro-rich protein complex comprising glutenins and gliadins. Previous studies have reported that oral intake of enzymatic hydrolysates of gluten has beneficial effects, such as suppression of muscle injury and improvement of hepatitis. Here, we utilized ginger protease that preferentially cleaves peptide bonds with Pro at the P 2 position to produce a novel type of wheat gluten hydrolysate. Ginger protease efficiently hydrolyzed gluten, particularly under weak acidic conditions, to peptides with an average molecular weight of ginger protease can be used as a functional food for patients with type 2 diabetes.

The effect of high temperature on cell structure and gluten protein accumulation in the endosperm of the developing wheat (Triticum aestivum L.) grain

Science.gov (United States)

High temperature during grain fill is one of the more significant environmental factors that alters wheat yield and flour quality. To identify endosperm responses to high temperature, cell structure and gluten protein composition were investigated in developing wheat (Triticum aestivum L. cv. Butte ...

Determination of gluten in glucose syrups

Czech Academy of Sciences Publication Activity Database

Dostálek, P.; Gabrovská, D.; Rysová, J.; Mena, M. C.; Hernando, A.; Méndez, E.; Chmelík, Josef; Šalplachta, Jiří

2009-01-01

Roč. 22, č. 7-8 (2009), s. 762-765 ISSN 0889-1575 R&D Projects: GA MZe 1B53002 Institutional research plan: CEZ:AV0Z40310501 Keywords : glucose syrup * gluten determination * celiac disease Subject RIV: CB - Analytical Chemistry, Separation Impact factor: 2.423, year: 2009

Gluten detection in foods available in the United States - a market survey.

Science.gov (United States)

Sharma, Girdhari M; Pereira, Marion; Williams, Kristina M

2015-02-15

Many gluten-free (GF) food choices are now available in supermarkets. However, the unintentional presence of gluten in these foods poses a serious health risk to wheat-allergic and celiac patients. Different GF labelled foods (275) and non-GF labelled foods, without wheat/rye/barley on the ingredient label (186), were analysed for gluten content by two different enzyme linked immunosorbent assay (ELISA) kits. Considering the gluten threshold of 20ppm, GF labelled foods had 98.9% GF labelling compliance with 1.1% (3 out of 275) of foods being mislabelled/misbranded. Among the non-GF labelled foods, 19.4% (36 out of 186) of foods had >20ppm of gluten, as measured by at least one ELISA kit, of which 19 foods had >100ppm of gluten. The presence of oats in non-GF labelled foods was strongly correlated with a positive ELISA result. Gluten was also found in a significant number of foods with gluten/wheat-related advisory warnings. Published by Elsevier Ltd.

Effect of Gliadin on Permeability of Intestinal Biopsy Explants from Celiac Disease Patients and Patients with Non-Celiac Gluten Sensitivity

Science.gov (United States)

Hollon, Justin; Leonard Puppa, Elaine; Greenwald, Bruce; Goldberg, Eric; Guerrerio, Anthony; Fasano, Alessio

2015-01-01

Background: Intestinal exposure to gliadin leads to zonulin upregulation and consequent disassembly of intercellular tight junctions and increased intestinal permeability. We aimed to study response to gliadin exposure, in terms of barrier function and cytokine secretion, using intestinal biopsies obtained from four groups: celiac patients with active disease (ACD), celiac patients in remission (RCD), non-celiac patients with gluten sensitivity (GS) and non-celiac controls (NC). Methods: Ex-vivo human duodenal biopsies were mounted in microsnapwells and luminally incubated with either gliadin or media alone. Changes in transepithelial electrical resistance were monitored over 120 min. Media was subsequently collected and cytokines quantified. Results: Intestinal explants from all groups (ACD (n = 6), RCD (n = 6), GS (n = 6), and NC (n = 5)) demonstrated a greater increase in permeability when exposed to gliadin vs. media alone. The increase in permeability in the ACD group was greater than in the RCD and NC groups. There was a greater increase in permeability in the GS group compared to the RCD group. There was no difference in permeability between the ACD and GS groups, between the RCD and NC groups, or between the NC and GS groups. IL-10 was significantly greater in the media of the NC group compared to the RCD and GS groups. Conclusions: Increased intestinal permeability after gliadin exposure occurs in all individuals. Following gliadin exposure, both patients with gluten sensitivity and those with active celiac disease demonstrate a greater increase in intestinal permeability than celiacs in disease remission. A higher concentration of IL-10 was measured in the media exposed to control explants compared to celiac disease in remission or gluten sensitivity. PMID:25734566

Effect of Gliadin on Permeability of Intestinal Biopsy Explants from Celiac Disease Patients and Patients with Non-Celiac Gluten Sensitivity

Directory of Open Access Journals (Sweden)

Justin Hollon

2015-02-01

Full Text Available Background: Intestinal exposure to gliadin leads to zonulin upregulation and consequent disassembly of intercellular tight junctions and increased intestinal permeability. We aimed to study response to gliadin exposure, in terms of barrier function and cytokine secretion, using intestinal biopsies obtained from four groups: celiac patients with active disease (ACD, celiac patients in remission (RCD, non-celiac patients with gluten sensitivity (GS and non-celiac controls (NC. Methods: Ex-vivo human duodenal biopsies were mounted in microsnapwells and luminally incubated with either gliadin or media alone. Changes in transepithelial electrical resistance were monitored over 120 min. Media was subsequently collected and cytokines quantified. Results: Intestinal explants from all groups (ACD (n = 6, RCD (n = 6, GS (n = 6, and NC (n = 5 demonstrated a greater increase in permeability when exposed to gliadin vs. media alone. The increase in permeability in the ACD group was greater than in the RCD and NC groups. There was a greater increase in permeability in the GS group compared to the RCD group. There was no difference in permeability between the ACD and GS groups, between the RCD and NC groups, or between the NC and GS groups. IL-10 was significantly greater in the media of the NC group compared to the RCD and GS groups. Conclusions: Increased intestinal permeability after gliadin exposure occurs in all individuals. Following gliadin exposure, both patients with gluten sensitivity and those with active celiac disease demonstrate a greater increase in intestinal permeability than celiacs in disease remission. A higher concentration of IL-10 was measured in the media exposed to control explants compared to celiac disease in remission or gluten sensitivity.

Oral health status and salivary properties in relation to gluten-free diet in children with celiac disease.

Science.gov (United States)

Shteyer, Eyal; Berson, Tamar; Lachmanovitz, Odelia; Hidas, Ariela; Wilschanski, Michael; Menachem, Moti; Shachar, Edna; Shapira, Joseph; Steinberg, Doron; Moskovitz, Moti

2013-07-01

Patients with celiac disease (CD) have a wide variety of symptoms, from being asymptomatic to having chronic diarrhea, abdominal pain, and extraintestinal symptoms. In the oral cavity, enamel defects and recurrent aphthous stomatitis are the most common symptoms. The aim of the study was to assess oral health, bacterial colonization and salivary buffering capacity of patients with CD at diagnosis were compared with patients with CD receiving a gluten-free diet (GFD) and healthy children. Three groups were prospectively investigated: newly diagnosed CD, CD treated with GFD, and a control group. All of the children were examined by pediatric dentists, and saliva samples were collected for bacterial and pH analysis. Ninety children were enrolled in the study, 30 in each group. A higher prevalence of enamel hypoplasia (66%) was found in children with CD. Plaque index was significantly lower in the celiac-treated group, which correlated with oral health behavior: teeth brushing and frequency of eating between meals. Children receiving GFD brushed their teeth and used fluoride significantly more often than other children in the study. No difference between groups was found in snack consumption, mutans streptococci and lactobacilli counts in saliva, as well as pH and buffer capacity. A lower degree of plaque was found in children with CD receiving GFD. This finding could not be explained by salivary properties or bacteria, but rather by better oral hygiene. The results should raise the awareness of pediatric gastroenterologists toward oral health-related issues in children with CD.

Anti-gluten immune response following Toxoplasma gondii infection in mice.

Directory of Open Access Journals (Sweden)

Emily G Severance

Full Text Available Gluten sensitivity may affect disease pathogenesis in a subset of individuals who have schizophrenia, bipolar disorder or autism. Exposure to Toxoplasma gondii is a known risk factor for the development of schizophrenia, presumably through a direct pathological effect of the parasite on brain and behavior. A co-association of antibodies to wheat gluten and to T. gondii in individuals with schizophrenia was recently uncovered, suggesting a coordinated gastrointestinal means by which T. gondii and dietary gluten might generate an immune response. Here, we evaluated the connection between these infectious- and food-based antigens in mouse models. BALB/c mice receiving a standard wheat-based rodent chow were infected with T. gondii via intraperitoneal, peroral and prenatal exposure methods. Significant increases in the levels of anti-gluten IgG were documented in all infected mice and in offspring from chronically infected dams compared to uninfected controls (repetitive measures ANOVAs, two-tailed t-tests, all p≤0.00001. Activation of the complement system accompanied this immune response (p≤0.002-0.00001. Perorally-infected females showed higher levels of anti-gluten IgG than males (p≤0.009 indicating that T. gondii-generated gastrointestinal infection led to a significant anti-gluten immune response in a sex-dependent manner. These findings support a gastrointestinal basis by which two risk factors for schizophrenia, T. gondii infection and sensitivity to dietary gluten, might be connected to produce the immune activation that is becoming an increasingly recognized pathology of psychiatric disorders.

The effects of gluten-free diet versus hypocaloric diet among patients with fibromyalgia experiencing gluten sensitivity symptoms: protocol for a pilot, open-label, randomized clinical trial.

Science.gov (United States)

Slim, Mahmoud; Molina-Barea, Rocio; Garcia-Leiva, Juan Miguel; Rodríguez-Lopez, Carmen Maria; Morillas-Arques, Piedad; Rico-Villademoros, Fernando; Calandre, Elena P

2015-01-01

Fibromyalgia is a chronic musculoskeletal pain syndrome characterized by a broad spectrum of manifestations. Patients with fibromyalgia frequently suffer from manifestations similar to those experienced by patients with gluten-related disorders raising the possibility that some patients with fibromyalgia could suffer from underlying gluten sensitivity. This study aims to assess whether avoiding gluten among patients with fibromyalgia and gluten sensitivity is beneficial. Adult patients with fibromyalgia presenting gluten sensitivity symptoms are randomly allocated to receive gluten-free diet or hypocaloric diet for 24 weeks. The primary outcome measure is the mean change in the number of experienced gluten sensitivity symptoms. Secondary outcome measures include the mean changes in the body mass index, Revised Fibromyalgia Impact Questionnaire, Pittsburgh Sleep Quality Index, Brief Pain Inventory, Beck Depression Inventory-II, State-Trait Anxiety Inventory, Short-Form Health Survey and Patient Global Impression Scale of Severity. Other secondary outcome measures include the frequency of potential adverse events and the proportion of responders according to the Patient Global Impression Scale of Improvement. Previous studies assessing dietary interventions in fibromyalgia primarily evaluated their effects on the severity and impact of fibromyalgia symptoms and pain. The current study is the first to evaluate the effects of gluten-free diet on the gluten sensitivity symptoms experienced by patients with fibromyalgia. The results of this study will contribute to a better understanding of the potential role of gluten sensitivity in fibromyalgia. Copyright © 2014 Elsevier Inc. All rights reserved.

Starch and antioxidant compound release during in vitro gastrointestinal digestion of gluten-free pasta.

Science.gov (United States)

Camelo-Méndez, Gustavo A; Agama-Acevedo, Edith; Rosell, Cristina M; de J Perea-Flores, Maria; Bello-Pérez, Luis A

2018-10-15

The microstructure of cooked gluten-free pasta depends on the ingredients used, and this microstructure affects the starch hydrolysis (SH), the release of phenolic compounds (PC) and their antioxidant capacity (AC). The aim of this study was to evaluate the SD and bioaccessibility of PC during in vitro gastrointestinal digestion of gluten-free pasta and its relationship with the microstructure. The highest SH was during the intestinal phase (≈60%), but pasta with the highest content of unripe plantain and chickpea presented the lowest release of PC (≈60%). The insoluble dietary fibre could be responsible (≈12.5%) for these effects. The cooked pasta showed high AC in the intestinal phase. Regions with gelatinized starch granules in a less dense protein network and other regions with intact or swollen granules surrounded by a protein network were observed. The starch digestion and bioaccessibility of PC were related to the structure of the matrix. Copyright © 2018 Elsevier Ltd. All rights reserved.

Thermal behavior of native and hydrophobized wheat gluten, gliadin and glutenin-rich fractions by modulated DSC.

Science.gov (United States)

Micard, V; Guilbert, S

2000-06-13

The glass transition temperature (T(g)) of hydrophobized and native wheat gluten and its protein fractions, with water mass fraction from 0 to 0.2, was studied using modulated differential scanning calorimetry. The T(g) values of unplasticized products were approximately 175 degrees C whatever the treatment (hydrophobization) or the fraction tested, except for the gliadin-rich fraction (162 degrees C). Experimental change in heat capacity at the glass transition (DeltaC(p)) ranged from 0.32 to 0. 50 J/g/ degrees C depending on the gluten fractions. The Gordon-Taylor fit of T(g) evolution as a function of water content showed that glutenin-rich fractions were more sensitive to water plasticization than the gliadin-rich fraction. The Kwei equation gave better fit to experimental data and demonstrated that the water plasticization of gluten and its fractions is influenced by secondary interactions. However, the application of the Couchman-Karasz equation without fitting predicts satisfactorily the plasticization of gluten proteins by water.

Structure characterization of the central repetitive domain of high molecular weight gluten proteins. II. Characterization in solution and in the dry state

OpenAIRE

Dijk, Alard A. van; Boef, Esther de; Bekkers, August; Wijk, Lourens L. van; Swieten, Eric van; Hamer, Rob J.; Robillard, George T.

1997-01-01

The structure of the central repetitive domain of high molecular weight HMW) wheat gluten proteins was characterized in solution and in the dry state using HMW proteins Bx6 and Bx7 and a subcloned, bacterially expressed part of the repetitive domain of HMW Dx5. Model studies of the HMW consensus peptides PGQGQQ and GYYPTSPQQ formed the basis for the data analysis (van Dijk AA et al., 1997, Protein Sci 6:637-648). In solution, the repetitive domain contained a continuous nonoverlapping series ...

The Availability of Food for a Gluten-free Diet and Possibilities at Dining Establishments

Directory of Open Access Journals (Sweden)

Olga Regnerová

2016-01-01

Full Text Available The aim of the paper is to evaluate options for customers-consumers with a gluten-free diet (coeliac disease patients at food establishments on the Czech market. A gluten-free diet is the only treatment for patients with coeliac disease and it significantly affects their health. The availability of food was investigated during February and March 2014 in three types of food operations. These establishments were visited in forty-three urban, rural and non-residential areas, and the availability of food for people with a gluten-free diet was investigated through interviews at 226 facilities. The preferences of the specific group of customers with a gluten-free diet were determined through comprehensive comparative research. The data was collected from February to June 2014, and 441 respondents were interviewed. The survey revealed that the majority of consumers who must follow this diet fall in the age group of up to 40 years old. This age group consists of preschool and school-age children, students and people of working age who frequently eat away from home. The paper deals with the evaluation of the level of public food services used by customers with gluten intolerance and gives some recommendations for improving the availability and offer of food for a gluten-free diet in selected types of hospitality establishments.

Non-celiac gluten sensitivity (NCGS – an old diagnosis recently rediscovered

Directory of Open Access Journals (Sweden)

Kamil K. Hozyasz

2016-02-01

Full Text Available Non-celiac gluten sensitivity (NCGS is a newly recognised clinical entity by academic medical professionals, but it is better to consider it an old diagnosis recently rediscovered. The overall prevalence of NCGS in the general population is currently unknown largely because patients often self-diagnose and place themselves on the celiac-type gluten-free diet (GFD without medical supervision. NCGS is an umbrella term and may incorporate different subgroups of patients. Now there is no specific biomarker that can be used to identify the entity. NCGS diagnosis can be reached only by excluding celiac disease and wheat allergy. Symptoms must disappear with the withdrawal of gluten and reappear quickly when gluten is reintroduced. NCGS existence has been recently supported by two expert meetings, however mechanisms by which gluten triggers symptoms, mimicking irritable bowel syndrome and skin rashes, numbness,”foggy mind”, disturbed sleep patterns, have yet to be identified. Knowledge about NCGS natural history and outcome is still lacking. NCNG is the entity awaiting better diagnostics criteria, however a dietary approach for the management of patients with gastrointestinal symptoms and lack of well being no longer seems elusive. There is a growing segment of the population that seeks out gluten-free products because of a wider notion that gluten-free constitutes a healthier option. Major area of concern that must be addressed by medical professionals is the high cost of GFD.

Treatment of both native and deamidated gluten peptides with an endo-peptidase from Aspergillus niger prevents stimulation of gut-derived gluten-reactive T cells from either children or adults with celiac disease

DEFF Research Database (Denmark)

Toft-Hansen, Henrik; Rasmussen, Karina Søndergård; Nielsen, Anne Staal

2014-01-01

the proliferative response by a gluten-specific CD4+ T cell clone and seven gluten-reactive T cell lines to protease-digested gluten peptides. A proline-specific endo-peptidase from Aspergillus niger (AnP2), was particularly efficient at diminishing proliferation after stimulation with cleaved antigen, and could...

Influence of intestinal microbiota in celiac disease pathogenesis and risk

OpenAIRE

OLIVARES SEVILLA, MARTA

2016-01-01

[EN] Celiac disease (CD) is a chronic enteropathy triggered by cereal gluten proteins in genetically predisposed individuals. The etiology is strongly associated with the genes of the human leukocyte antigen (HLA) encoding the DQ2/DQ8 molecules. Most CD patients carry this genotype but this is also present in the 40% of the general population and only a small percentage develops the disease. Thus, the HLA-DQ genotype is necessary but not solely responsible for the disease development. Gluten ...

How gluten properties are affected by pentosans

NARCIS (Netherlands)

Wang, M.; Vliet, T. van; Hamer, R.J.

2004-01-01

During the wet separation of starch and gluten, both water extractable pentosans (WEP) and water unextractable solids (WUS) have a negative effect on gluten yield. Gluten properties are also affected: the gluten becomes less extensible. In comparison to the control, addition of WUS or WEP resulted

How gluten properties are effected by pentosans

NARCIS (Netherlands)

Wang, M.; Vliet, van T.; Hamer, R.J.

2004-01-01

During the wet separation of starch and gluten, both water extractable pentosans (WEP) and water unextractable solids (WUS) have a negative effect on gluten yield. Gluten properties are also affected: the gluten becomes less extensible. In comparison to the control, addition of WUS or WEP resulted

Benefits and Limitations of Lab-on-a-Chip Method over Reversed-Phase High-Performance Liquid Chromatography Method in Gluten Proteins Evaluation

Directory of Open Access Journals (Sweden)

Dragan Živančev

2015-01-01

Full Text Available RP-HPLC (reversed-phase high-performance liquid chromatography is widely used to determine the amounts of the different gluten protein types. However, this method is time-consuming, especially at early stages of wheat breeding, when large number of samples needs to be analyzed. On the other hand, LoaC (Lab-on-a-Chip technique has the potential for a fast, reliable, and automatable analysis of proteins. In the present study, benefits and limitations of Lab-on-a-Chip method over RP-HPLC method in gluten proteins evaluation were explored in order to determine in which way LoaC method should be improved in order to make its results more compliant with the results of RP-HPLC method. Strong correlation (P≤0.001 was found between numbers of HMW glutenin peaks determined by LoaC and RP-HPLC methods. Significant correlations (P≤0.05 were obtained between percentages of HMW and LMW glutenin subunits calculated with regard to total HMW + LMW area. Even more significant correlation (P≤0.001 was found when percentages of individual HMW areas were calculated with regard to total HMW. RP-HPLC method showed superiority in determination of gliadins since larger number and better resolution of gliadin peaks were obtained by this method.

Nutritional status variation and intestinal and extra intestinal symptomatology in patients with celiac disease and non-celiac gluten sensitivity given specialized dietary advice

Directory of Open Access Journals (Sweden)

Priscila Vaz de Melo RIBEIRO

Full Text Available ABSTRACT Objective: To investigate the nutritional status variation and symptomatology of patients with celiac disease and non-celiac gluten sensitivity after specialized dietary advice Methods: This prospective study included 80 patients with celiac disease and non-celiac gluten sensitivity. Clinical, metabolic, and nutritional variables were collected from medical records, and the symptomatology was investigated by the Metabolic Screening Questionnaire. The variables were assessed on two occasions (T1 - before dietary advice and T2 - after dietary advice with an interval of three months between T1 and T2 Results: The median age was 42 years. The prevalences of celiac disease and non-celiac gluten sensitivity were 66.2% and 33.8%, respectively. Normal weight prevailed at T1 (58.8% and T2 (56.3%, but 30.0% of the patients at T1 and 34.9% of the patients at T2 had excess weight. The two conditions had similar symptomatology. The most frequent signs and symptoms on both occasions involved the gastrointestinal tract, followed by energy/activity and emotions. All symptoms decreased significantly after the introduction of a proper diet Conclusion: The patients were normal weight on both study occasions (T1 and T2, and the symptoms improved after dietary advice. Thus, we reinforce the importance of proper dietary management in both clinical conditions to make dietary adjustments that improve these individuals' symptomatology.

The Effect of Depressive Symptoms on the Association between Gluten-Free Diet Adherence and Symptoms in Celiac Disease: Analysis of a Patient Powered Research Network

Directory of Open Access Journals (Sweden)

Andrew M. Joelson

2018-04-01

Full Text Available Background: The prevalence of depression in celiac disease (CD is high, and patients are often burdened socially and financially by a gluten-free diet. However, the relationship between depression, somatic symptoms and dietary adherence in CD is complex and poorly understood. We used a patient powered research network (iCureCeliac® to explore the effect that depression has on patients’ symptomatic response to a gluten-free diet (GFD. Methods: We identified patients with biopsy-diagnosed celiac disease who answered questions pertaining to symptoms (Celiac Symptom Index (CSI, GFD adherence (Celiac Dietary Adherence Test (CDAT, and a 5-point, scaled question regarding depressive symptoms relating to patients’ celiac disease. We then measured the correlation between symptoms and adherence (CSI vs. CDAT in patients with depression versus those without depression. We also tested for interaction of depression with regard to the association with symptoms using a multiple linear regression model. Results: Among 519 patients, 86% were female and the mean age was 40.9 years. 46% of patients indicated that they felt “somewhat,” “quite a bit,” or “very much” depressed because of their disorder. There was a moderate correlation between worsened celiac symptoms and poorer GFD adherence (r = 0.6, p < 0.0001. In those with a positive depression screen, there was a moderate correlation between worsening symptoms and worsening dietary adherence (r = 0.5, p < 0.0001 whereas in those without depression, the correlation was stronger (r = 0.64, p < 0.0001. We performed a linear regression analysis, which suggests that the relationship between CSI and CDAT is modified by depression. Conclusions: In patients with depressive symptoms related to their disorder, correlation between adherence and symptoms was weaker than those without depressive symptoms. This finding was confirmed with a linear regression analysis, showing that depressive symptoms may

Celiac disease and school food service in Piedmont Region: Evaluation of gluten-free meal.

Science.gov (United States)

Bioletti, L; Capuano, M T; Vietti, F; Cesari, L; Emma, L; Leggio, K; Fransos, L; Marzullo, A; Ropolo, S; Strumia, C

2016-01-01

The Law 123/2005 recognizes celiac disease as a social disease and so Ministry of Public Health annually allocates specific resources to Regions for managing gluten-free meals in school canteens. Therefore in 2009 Piedmont Region approved a specific project, in collaboration with Food Hygiene and Nutrition Department (SIAN) of several ASL (Local Health Authority), including ASL TO3 as regional leader, and the "Italian Celiac Association - Piedmont and Valle d'Aosta". This project was intended to facilitate the natural integration of celiac people in social life. A retrospective analysis of data has been carried out to assess the management of gluten- free meal of school food services in Piedmont Region in 2010. Furthermore the intervention efficacy has been evaluated comparing the critical points observed in 2010 and 2012. The object of the study includes primary and secondary schools that have provided gluten-free food service in Piedmont Region. These school were examined by SIAN staff. (the examination included the check of hygienic aspects and qualitative assessment of the meal). The data were collected using the same checklist throughout the region. All data were included in the unified regional system ("Reteunitaria"). The results show that 29% of the sampled schools (277) are acceptable in all eight sections (supply, storage, process analysis, equipment check, packaging and transport, distribution of meals, self-control plan and qualitative assessment), whereas 71% are inadequate for at least one of the profiles (60% does not perform the qualitative valuation of service) and in 18% of schools three to seven insufficiencies are observed. Correlations between the number of total insufficiencies and the most critical sections of the check list were performed (with lower scores in "good") such as process analysis, distribution of meals, self-control plan and qualitative assessment. The analysis process has achieved a high score in the field of deficiency for at

Challenges in gluten-free diet in coeliac disease: Prague consensus

Czech Academy of Sciences Publication Activity Database

Samasca, G.; Lerner, U.; Girbovan, A.; Sur, G.; Lupan, I.; Makovický, Peter; Matthias, T.; Freeman, H.J.

2017-01-01

Roč. 47, č. 5 (2017), s. 394-397 ISSN 0014-2972 Institutional support: RVO:68378050 Keywords : Adult * biomarkers * childhood * dietary adherence * gluten-free diet * transition Subject RIV: EB - Genetics ; Molecular Biology OBOR OECD: Nutrition, Dietetics Impact factor: 2.714, year: 2016

Glycated Lysine Residues: A Marker for Non-Enzymatic Protein Glycation in Age-Related Diseases

Directory of Open Access Journals (Sweden)

Nadeem A. Ansari

2011-01-01

Full Text Available Nonenzymatic glycosylation or glycation of macromolecules, especially proteins leading to their oxidation, play an important role in diseases. Glycation of proteins primarily results in the formation of an early stage and stable Amadori-lysine product which undergo further irreversible chemical reactions to form advanced glycation endproducts (AGEs. This review focuses these products in lysine rich proteins such as collagen and human serum albumin for their role in aging and age-related diseases. Antigenic characteristics of glycated lysine residues in proteins together with the presence of serum autoantibodies to the glycated lysine products and lysine-rich proteins in diabetes and arthritis patients indicates that these modified lysine residues may be a novel biomarker for protein glycation in aging and age-related diseases.

Label free targeted detection and quantification of celiac disease immunogenic epitopes by mass spectrometry

NARCIS (Netherlands)

Broeck, van den H.C.; Cordewener, J.H.G.; Nessen, M.A.; America, A.H.P.; Meer, van der I.M.

2015-01-01

Celiac disease (CD) is a food-related disease caused by certain gluten peptides containing T-cell stimulating epitopes from wheat, rye, and barley. CD-patients have to maintain a gluten-free diet and are therefore dependent on reliable testing and labeling of gluten-free products. So far, the

The roles of MHC class II genes and post-translational modification in celiac disease.

Science.gov (United States)

Sollid, Ludvig M

2017-08-01

Our increasing understanding of the etiology of celiac disease, previously considered a simple food hypersensitivity disorder caused by an immune response to cereal gluten proteins, challenges established concepts of autoimmunity. HLA is a chief genetic determinant, and certain HLA-DQ allotypes predispose to the disease by presenting posttranslationally modified (deamidated) gluten peptides to CD4 + T cells. The deamidation of gluten peptides is mediated by transglutaminase 2. Strikingly, celiac disease patients generate highly disease-specific autoantibodies to the transglutaminase 2 enzyme. The dual role of transglutaminase 2 in celiac disease is hardly coincidental. This paper reviews the genetic mapping and involvement of MHC class II genes in disease pathogenesis, and discusses the evidence that MHC class II genes, via the involvement of transglutaminase 2, influence the generation of celiac disease-specific autoantibodies.

Celiac Disease Diet: How Do I Get Enough Grains?

Science.gov (United States)

Celiac disease diet: How do I get enough grains? I have celiac disease, and I find it difficult to get enough ... Michael F. Picco, M.D. Because people with celiac disease must avoid gluten — a protein found in foods ...

Celiac disease : how complicated can it get?

NARCIS (Netherlands)

Tjon, Jennifer May-Ling

2011-01-01

Celiac disease (CD) is a common inflammatory disorder of the small intestine which is triggered by ingested gluten proteins. Previous studies identified crucial steps in the development of celiac disease and based on this knowledge, we propose a threshold model for the development of celiac disease

Gastrointestinal Symptoms in Celiac Disease Patients on a Long-Term Gluten-Free Diet.

Science.gov (United States)

Laurikka, Pilvi; Salmi, Teea; Collin, Pekka; Huhtala, Heini; Mäki, Markku; Kaukinen, Katri; Kurppa, Kalle

2016-07-14

Experience suggests that many celiac patients suffer from persistent symptoms despite a long-term gluten-free diet (GFD). We investigated the prevalence and severity of these symptoms in patients with variable duration of GFD. Altogether, 856 patients were classified into untreated (n = 128), short-term GFD (1-2 years, n = 93) and long-term GFD (≥3 years, n = 635) groups. Analyses were made of clinical and histological data and dietary adherence. Symptoms were evaluated by the validated GSRS questionnaire. One-hundred-sixty healthy subjects comprised the control group. Further, the severity of symptoms was compared with that in peptic ulcer, reflux disease, inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS). Altogether, 93% of the short-term and 94% of the long-term treated patients had a strict GFD and recovered mucosa. Untreated patients had more diarrhea, indigestion and abdominal pain than those on GFD and controls. There were no differences in symptoms between the short- and long-term GFD groups, but both yielded poorer GSRS total score than controls (p = 0.03 and p = 0.05, respectively). Furthermore, patients treated 1-2 years had more diarrhea (p = 0.03) and those treated >10 years more reflux (p = 0.04) than controls. Long-term treated celiac patients showed relatively mild symptoms compared with other gastrointestinal diseases. Based on our results, good response to GFD sustained in long-term follow-up, but not all patients reach the level of healthy individuals.

Rheological and secondary structural characterization of rice flour-zein composites for noodles slit from gluten-free sheeted dough.

Science.gov (United States)

Jeong, Sungmin; Kim, Hee Won; Lee, Suyong

2017-04-15

Rice flour-zein composites in a hydrated viscoelastic state were utilized to compensate for the role of wheat gluten in gluten-free sheeted dough. The use of zein above its glass transition temperature was able to form a viscoelastic protein network of non-wheat dough with rice flour. The mixing stability and development time of the rice dough were positively increased with increasing levels of zein. The protein secondary structural analysis by FTIR spectroscopy demonstrated that the rice doughs with high levels of zein showed significant increases in β-sheet structures whose intensity was almost doubled by the use of 10% zein. The use of zein at more than 5% (w/w) successfully produced gluten-free dough sheets that could be slit into thin and long noodle strands. In addition, the composites were effective in improving the rheological characteristics of gluten-free noodle strands by increasing their maximum force to extension, compared to wheat-based noodles. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effects of alkali on protein polymerization and textural characteristics of textured wheat protein.

Science.gov (United States)

Li, Ting; Guo, Xiao-Na; Zhu, Ke-Xue; Zhou, Hui-Ming

2018-01-15

The impact of alkali addition on the degree of gluten polymerization and textural characteristics of textured wheat protein was investigated. Results showed that the extrusion process increased the average molecular weight of gluten as evidenced by SDS-PAGE and SDS extractable protein. The addition of alkali not only promoted the degree of gluten polymerization, but also induced dehydroalanine-derived cross-linking. Alkali addition decreased the content of cystine and increased the contents of dehydroalanine and lanthionine. The obvious decrease of free SH showed that dehydroalanine-derived cross-linking was quantitatively less crucial than disulfide cross-linking. Furthermore, the protein cross-linking induced by alkali improved the texture properties of gluten extrudates. SEM analysis showed extrusion under alkaline condition conferred a more fibrous microstructure as a consequence of a compact gluten network. Copyright © 2017 Elsevier Ltd. All rights reserved.

Health-Related Quality of Life in Children with Celiac Disease: A Study Based on the Critical Incident Technique

Directory of Open Access Journals (Sweden)

Carlo Catassi

2013-11-01

Full Text Available Celiac Disease (CD is a chronic autoimmune disease triggered by dietary gluten. Gluten avoidance, which is the only available treatment for CD, could impact on quality of life of children with CD. We present the results of a qualitative study on the emotional impact of gluten free diet (GFD on the everyday life of children affected with CD. We investigated 76 celiac patients aged 2–18 years (average age: 9.5 years. By using the Critical Incident Technique (CIT, we defined emotions related to difficulties and awkward situations experienced by the patients. Written answers to open-ended questions from either children (older than 8 years and parents (children younger than 8 years were analyzed qualitatively. We found 80 dilemmas experienced in three different arenas (food situations at school, meals at home, meals outside and characterized lived experiences of children with CD in everyday life (specific emotions, difficulties in relationships and in management of daily life. Children with CD experience strong emotions related to the GFD, permeating several aspects of everyday life. These dilemmas may be missed by a conventional, questionnaire-based approach to the psycho-social consequences of CD treatment.

Rodent malaria in rats exacerbated by milk protein, attenuated by low-protein vegetable diet

NARCIS (Netherlands)

Doorne, C.W. van; Eling, W.M.C.; Luyken, R.

1998-01-01

Young male Wistar rats were fed a purified, vegetable, low-protein diet containing 6% protein from maize gluten and 2% from soy protein isolate, or comparable diets in which maize gluten was replaced partly or completely by the equivalent amount of a milk protein concentrate. Diets with adequate

Thermo-reversible inhibition makes aqualysin 1 from Thermus aquaticus a potent tool for studying the contribution of the wheat gluten network to the crumb texture of fresh bread.

Science.gov (United States)

Verbauwhede, Annelien E; Lambrecht, Marlies A; Fierens, Ellen; Hermans, Senne; Shegay, Oksana; Brijs, Kristof; Delcour, Jan A

2018-10-30

The thermo-active serine peptidase aqualysin 1 (Aq1) of Thermus aquaticus was applied in bread making to study the relative contribution of thermoset gluten to bread crumb texture. Aq1 is active between 30 °C and 90 °C with an optimum activity temperature of around 65 °C. It is inhibited by wheat endogenous serine peptidase inhibitors during dough mixing and fermentation and starts hydrolyzing gluten proteins during baking above 80 °C when the enzyme is no longer inhibited and most of the starch is gelatinized and contributes to structure formation. Aq1 activity reduced the molecular weight of gluten proteins and significantly increased their extractability in sodium dodecyl sulfate containing medium. While it had no impact on the specific bread volume and only limited impact on hardness, cohesiveness, springiness, resilience and chewiness, it impacted bread crumb coherence. We conclude that starch has a greater impact on crumb texture than thermoset gluten. Copyright © 2018 Elsevier Ltd. All rights reserved.

Biochemical and immunochemical evidences supporting the inclusion of quinoa (Chenopodium quinoa Willd.) as a gluten-free ingredient.

Science.gov (United States)

Peñas, Elena; Uberti, Francesca; di Lorenzo, Chiara; Ballabio, Cinzia; Brandolini, Andrea; Restani, Patrizia

2014-12-01

To date, the only acceptable therapeutic approach for celiac disease (CD) is a strict elimination from the diet of gluten-containing foods, but this diet does not always guarantee an adequate nutritional intake. Pseudocereals are receiving considerable attention as interesting alternatives for the formulation of gluten-free products, and quinoa grains arise as nutritive substitutes of conventional cereals. The aim of this study was the characterization of different quinoa samples corresponding to 11 quinoa varieties, using polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate (SDS-PAGE) and immunoblotting techniques to assess their suitability for celiac subjects. Some of these varieties were grown in Italy to assess if the reproduction in a new habitat can guarantee the retention of the "safe" protein pattern. None of the quinoa varieties studied presented protein bands with electrophoretic mobility comparable with those of wheat gliadins, the toxic protein for celiac subjects. All the quinoa samples showed a low binding affinity for both specific anti-gliadin antibodies and IgAs from celiac subjects, confirming that quinoa can be considered as a safe ingredient for celiac patients. However, reliable varieties should be previously selected since the immuno cross-reactivity with anti-gliadin antibodies can vary significantly.

Dietary Factors and Mucosal Immune Response in Celiac Disease Patients Having Persistent Symptoms Despite a Gluten-free Diet.

Science.gov (United States)

Laurikka, Pilvi; Lindfors, Katri; Oittinen, Mikko; Huhtala, Heini; Salmi, Teea; Lähdeaho, Marja-Leena; Ilus, Tuire; Mäki, Markku; Kaukinen, Katri; Kurppa, Kalle

2018-03-02

The aim of this study was to investigate the role of dietary factors, distinct small-bowel mucosal immune cell types, and epithelial integrity in the perpetuation of gastrointestinal symptoms in treated celiac disease patients. For unexplained reasons, many celiac disease patients suffer from persistent symptoms, despite a strict gluten-free diet (GFD) and recovered intestinal mucosa. We compared clinical and serological data and mucosal recovery in 22 asymptomatic and 25 symptomatic celiac patients on a long-term GFD. The density of CD3 and γδ intraepithelial lymphocytes (IELs), CD25 and FOXP3 regulatory T cells, and CD117 mast cells, and the expression of tight junction proteins claudin-3 and occludin, heat shock protein 60, interleukin 15, and Toll-like receptor 2 and 4 were evaluated in duodenal biopsies. All subjects kept a strict GFD and had negative celiac autoantibodies and recovered mucosal morphology. The asymptomatic patients had higher mean fiber intake (20.2 vs. 15.2 g/d, P=0.028) and density of CD3 IELs (59.3 vs. 45.0 cell/mm, P=0.045) than those with persistent symptoms. There was a similar but nonsignificant trend in γδ IELs (17.9 vs. 13.5, P=0.149). There were no differences between the groups in other parameters measured. Low fiber intake may predispose patients to persistent symptoms in celiac disease. There were no differences between the groups in the markers of innate immunity, epithelial stress or epithelial integrity. A higher number of IELs in asymptomatic subjects may indicate that the association between symptoms and mucosal inflammation is more complicated than previously thought.

Celiac disease - sprue

Science.gov (United States)

Sprue; Nontropical sprue; Gluten intolerance; Gluten-sensitive enteropathy; Gluten-free diet celiac disease ... intestines will heal if you follow a lifelong gluten-free diet . Do not eat foods, drink beverages, or take ...

Quantitative and qualitative differences in celiac disease epitopes among durum wheat varieties identified through deep RNA-amplican sequencing

NARCIS (Netherlands)

Salentijn, E.M.J.; Esselink, D.G.; Goryunova, S.V.; Meer, van der I.M.; Gilissen, L.J.W.J.; Smulders, M.J.M.

2013-01-01

Background - Wheat gluten is important for the industrial quality of bread wheat (Triticum aestivum L.) and durum wheat (T. turgidum L.). Gluten proteins are also the source of immunogenic peptides that can trigger a T cell reaction in celiac disease (CD) patients, leading to inflammatory responses

Molekylaere mekanismer bag den immunologiske reaktion mod gluten hos patienter med cøliaki

DEFF Research Database (Denmark)

Nielsen, Christian; Husby, Steffen; Lillevang, Søren T

2003-01-01

Coeliac disease is a complex inflammatory disorder of the small intestine, induced by dietary gluten in genetically susceptible individuals. Recently, the nature of gluten-derived peptides recognized by gut-derived T cells from patients has been elucidated. It has further been established...... that the binding of such peptides to HLA-DQ2 and DQ8 molecules is enhanced following the modification of the peptides by the ubiquitous enzyme tissue transglutaminase. This knowledge has allowed the establishment of a molecular basis for the well-known association between coeliac disease and the expression...... of these HLA-molecules. This article summarizes the latest progress in coeliac disease molecular biology....

Unusual Onset of Celiac Disease and Addison's Disease in a 12-Year-Old Boy.

Science.gov (United States)

Miconi, Francesco; Savarese, Emanuela; Miconi, Giovanni; Cabiati, Gabriele; Rapaccini, Valentina; Principi, Nicola; Esposito, Susanna

2017-07-29

Celiac disease (CD) is an autoimmune disorder deriving from an aberrant adaptive immune response against gluten-containing grains in genetically predisposed subjects. In a number of patients, CD is associated with one or more other autoimmune diseases. Primary Addison's disease (AD) and CD may co-exist, although this association is relatively uncommon in children. In addition, it is not precisely defined whether a gluten-free diet influences the course of AD. A case of CD in a 12-year-old boy presenting as acute adrenal insufficiency is described here. A gluten-free diet had a significant therapeutic role in this case, wherein most of the clinical signs and symptoms of AD disappeared in a few days. In addition, the dosage of cortisol acetate, initially administered to treat the AD, was able to be rapidly reduced. This case highlights that CD can be associated with AD in children, and a gluten-free diet seems to positively influence the course of AD.

Celiac disease

DEFF Research Database (Denmark)

Hvas, Christian Lodberg; Jensen, Michael Dam; Reimer, Maria Christina

2015-01-01

This national clinical guideline approved by the Danish Society for Gastroenterology and Hepatology describes the diagnosis and treatment of celiac disease (CD) in adults. CD is a chronic immunemediated enteropathy of the small intestine triggered by the ingestion of gluten-containing proteins......, which are found in wheat, rye, and barley. The disease prevalence is 0.5-1.0%, but CD remains under-diagnosed. The diagnosis relies on the demonstration of lymphocyte infiltration, crypt hyperplasia, and villous atrophy in duodenal biopsies. Serology, malabsorption, biochemical markers......, and identification of specific HLA haplotypes may contribute to CD diagnosis. Classical CD presents with diarrhoea and weight loss, but non-classical CD with vague or extraintestinal symptoms is common. The treatment for CD is a lifelong gluten-free diet (GFD), which, in the majority of patients, normalises...

Novel Immune Response to Gluten in Individuals with Schizophrenia

Science.gov (United States)

Background: A link between celiac disease and schizophrenia, has been speculated for several years. The reported association is based primarily on reports of elevated levels of antibodies to gliadin (a component of gluten). However, the significance of such antibodies in schizophrenia and whethe...

Addition of a Short Course of Prednisolone to a Gluten-Free Diet vs. Gluten-Free Diet Alone in Recovery of Celiac Disease: A Pilot Randomized Controlled Trial.

Science.gov (United States)

Abbas, Asad; Shahab, Tabassum; Sherwani, Rana K; Alam, Seema

2018-01-28

Background A gluten-free diet (GFD) is the standard of care in the management of patients with celiac disease, but clinical and histological recovery are often delayed. In newly diagnosed patients, strict compliance to GFD is difficult to achieve; this is especially true in developing countries where gluten-free food is often difficult to obtain. Steroids, when used alone, can be effective in inducing recovery in patients with celiac disease. We performed a randomized controlled trial to study the effect of a short course of prednisolone combined with a GFD on the recovery of celiac disease. Materials and methods This study was a single-center, randomised, open-label trial. This investigation was done in a pediatric gastroenterology unit of a tertiary teaching hospital in north India.Twenty-eight newly diagnosed celiac disease patients were enrolled in the study. Prednisolone was given at 1 mg/kg for four weeks; duodenal biopsies and IgA anti-tissue transglutaminase (tTg) levels were assessed at eight weeks, six months, and 12 months from the start of the study. Outcome measures The primary outcome measures used to indicate clinical, histological, and immunological recovery of celiac disease were clinical improvement at eight weeks and the proportion of patients with improved histology by at least one grade and who were tissue transglutaminase (tTg) seronegative at eight weeks. The secondary measures were the proportion of patients showing normalization of histological features and the proportions of patients becoming seronegative at six months and one year of GFD. Results Patients were randomized into the GFD only (n = 14) or GFD with prednisolone (GFD+P) (n = 14) groups. No significant differences were detected in clinical recovery at eight weeks; none of the patients became seronegative at eight weeks, six months, or 12 months. The proportion of patients with improvement in histology by at least one grade was higher in the GFD+P group at eight weeks, and there

Trace gluten contamination may play a role in mucosal and clinical recovery in a subgroup of diet-adherent non-responsive celiac disease patients

Science.gov (United States)

2013-01-01

Background Patients with persistent symptoms and/or villous atrophy despite strict adherence to a gluten-free diet (GFD) have non-responsive celiac disease (NRCD). A subset of these patients has refractory celiac disease (RCD), yet some NRCD patients may simply be reacting to gluten cross-contamination. Here we describe the effects of a 3-6 month diet of whole, unprocessed foods, termed the Gluten Contamination Elimination Diet (GCED), on NRCD. We aim to demonstrate that this diet reclassifies the majority of patients thought to have RCD type 1 (RCD1). Methods We reviewed the records of all GFD-adherent NRCD patients cared for in our celiac center from 2005-2011 who were documented to have started the GCED. Response to the GCED was defined as being asymptomatic after the diet, with normal villous architecture on repeat biopsy, if performed. Results Prior to the GCED, all patients were interviewed by an experienced dietitian and no sources of hidden gluten ingestion were identified. 17 patients completed the GCED; 15 were female (88%). Median age at start of the GCED was 42 years (range 6-73). Fourteen patients (82%) responded to the GCED. Six patients met criteria for RCD prior to the GCED; 5 (83%) were asymptomatic after the GCED and no longer meet RCD criteria. Of the 14 patients who responded to the GCED, 11 (79%) successfully returned to a traditional GFD without resurgence of symptoms. Conclusions The GCED may be an effective therapeutic option for GFD-adherent NRCD patients. Response to this diet identifies a subgroup of patients, previously classified as RCD1, that is not truly refractory to dietary treatment. Preventing an inaccurate diagnosis of RCD1 avoids immunotherapy. Most patients are able to return to a traditional GFD without return of symptoms. PMID:23448408

MONITORING OF A GLUTEN CONTENT IN SELECTED MEAT PRODUCTS FROM THREE BIGGEST MEAT PRODUCERS IN SLOVAKIA

Directory of Open Access Journals (Sweden)

Ladislav Staruch

2012-02-01

Full Text Available The work is focused on a monitoring of a gluten content in selected meat products from three biggest and most popular meat producers in Slovakia. Gluten is a type of protein complex which is typical naturally presented component of wheat, barley and rye. Flour from this sources with natural gluten content is also added into the some type of meat products and other foodstuffs for a technological reasons hand in hand with economic reasons.  Some of the gluten quantities could be hazardous for sensitive people as celiatics and allergic to gluten. Within the context of this reasons there is a need to control the amounts of this hidden type of gluten inclusive of spice mixes using in a meat production. Monitoring by itself was realized with a use of the sandwich ELISA RIDASCREEN® Fast Gliadin test. ELISA means enzyme linked immunosorbent assay. It is based on a specific reaction among the enzyme and antigen leading to a creation of a complex.  This test provides us exact quantitification of a gluten content in this type of food products using a colorimetric reaction of a complex by observing of all fundamentals of this technique. There were analysed 16 meat products and 5 types of spice mixes in total.doi:10.5219/167

Development of wheat varieties with reduced contents of celiac-immunogenic epitopes through conventional and GM strategies

NARCIS (Netherlands)

Smulders, M.J.M.; Jouanin, A.A.; Schaart, J.G.; Visser, R.G.F.; Cockram, J.; Leigh, F.; Wallington, E.; Boyd, L.A.; Broeck, van den H.C.; Meer, van der I.M.; Gilissen, L.J.W.J.

2014-01-01

Cereals, especially wheat, may cause several food-related diseases, of which gluten intolerance (coeliac disease, CD) is the best defined: specific immunogenic epitopes, nine amino acid-long peptide sequences, have been identified from various gluten proteins. These may activate T cells, causing

Biomarkers to Monitor Gluten-Free Diet Compliance in Celiac Patients

Directory of Open Access Journals (Sweden)

María de Lourdes Moreno

2017-01-01

Full Text Available Gluten-free diet (GFD is the only treatment for celiac disease (CD. There is a general consensus that strict GFD adherence in CD patients leads to full clinical and histological remission accompanied by improvement in quality of life and reduced long-term complications. Despite the importance of monitoring the GFD, there are no clear guidelines for assessing the outcome or for exploring its adherence. Available methods are insufficiently accurate to identify occasional gluten exposure that may cause intestinal mucosal damage. Serological tests are highly sensitive and specific for diagnosis, but do not predict recovery and are not useful for follow-up. The use of serial endoscopies, it is invasive and impractical for frequent monitoring, and dietary interview can be subjective. Therefore, the detection of gluten immunogenic peptides (GIP in feces and urine have been proposed as new non-invasive biomarkers to detect gluten intake and verify GFD compliance in CD patients. These simple immunoassays in human samples could overcome some key unresolved scientific and clinical problems in CD management. It is a significant advance that opens up new possibilities for the clinicians to evaluate the CD treatment, GFD compliance, and improvement in the quality of life of CD patients.

BL-7010 demonstrates specific binding to gliadin and reduces gluten-associated pathology in a chronic mouse model of gliadin sensitivity.

Directory of Open Access Journals (Sweden)

Justin L McCarville

Full Text Available Celiac disease (CD is an autoimmune disorder in individuals that carry DQ2 or DQ8 MHC class II haplotypes, triggered by the ingestion of gluten. There is no current treatment other than a gluten-free diet (GFD. We have previously shown that the BL-7010 copolymer poly(hydroxyethyl methacrylate-co-styrene sulfonate (P(HEMA-co-SS binds with higher efficiency to gliadin than to other proteins present in the small intestine, ameliorating gliadin-induced pathology in the HLA-HCD4/DQ8 model of gluten sensitivity. The aim of this study was to investigate the efficiency of two batches of BL-7010 to interact with gliadin, essential vitamins and digestive enzymes not previously tested, and to assess the ability of the copolymer to reduce gluten-associated pathology using the NOD-DQ8 mouse model, which exhibits more significant small intestinal damage when challenged with gluten than HCD4/DQ8 mice. In addition, the safety and systemic exposure of BL-7010 was evaluated in vivo (in rats and in vitro (genetic toxicity studies. In vitro binding data showed that BL-7010 interacted with high affinity with gliadin and that BL-7010 had no interaction with the tested vitamins and digestive enzymes. BL-7010 was effective at preventing gluten-induced decreases in villus-to-crypt ratios, intraepithelial lymphocytosis and alterations in paracellular permeability and putative anion transporter-1 mRNA expression in the small intestine. In rats, BL-7010 was well-tolerated and safe following 14 days of daily repeated administration of 3000 mg/kg. BL-7010 did not exhibit any mutagenic effect in the genetic toxicity studies. Using complementary animal models and chronic gluten exposure the results demonstrate that administration of BL-7010 is effective and safe and that it is able to decrease pathology associated with gliadin sensitization warranting the progression to Phase I trials in humans.

Designing a Score-Based Method for the Evaluation of the Nutritional Quality of the Gluten-Free Bakery Products and their Gluten-Containing Counterparts

NARCIS (Netherlands)

Morreale, Federico; Angelino, Donato; Pellegrini, Nicoletta

2018-01-01

Gluten-free (GF) products are consumed both by individuals with celiac disease and by an increasing number of people with no specific medical needs. Although the technological quality of GF products has been recently improved, their nutritional quality is still scarcely addressed. Moreover, the few

The Effect of Gluten-free Diet on Clinical Symptoms and the Intestinal Mucosa of Patients With Potential Celiac Disease.

Science.gov (United States)

Mandile, Roberta; Discepolo, Valentina; Scapaticci, Serena; Del Vecchio, Maria Rosaria; Maglio, Maria Antonia; Greco, Luigi; Troncone, Riccardo; Auricchio, Renata

2018-04-01

In this prospective study, we evaluated the effect of gluten-free diet (GFD) in a cohort of 65 children with potential celiac disease. Patients received GFD for signs/symptoms (N = 47) or parents' choice (N = 18). Most frequent signs/symptoms were low body mass index (36%), recurrent abdominal pain (34%), and diarrhea (19%). Of the 35/47 patients followed-up on GFD, only 54% (19/35) showed a complete clinical response. In 9 of 65 patients an intestinal biopsy was also performed after at least 1 year of GFD. No significant differences were observed in terms of Marsh grade (P = 0.33), lamina propria CD25+ cells (P = 0.80), CD3+ (P = 0.9), and γδ+ (P = 0.59) intraepithelial lymphocytes density and intestinal anti-TG2 deposits (P = 0.60). In conclusion, caution is necessary before attributing all symptoms to gluten in this condition.

Swedish children with celiac disease comply well with a gluten-free diet, and most include oats without reporting any adverse effects: a long-term follow-up study.

Science.gov (United States)

Tapsas, Dimitrios; Fälth-Magnusson, Karin; Högberg, Lotta; Hammersjö, Jan-Åke; Hollén, Elisabet

2014-05-01

The only known treatment for celiac disease is a gluten-free diet (GFD), which initially meant abstention from wheat, rye, barley, and oats. Recently, oats free from contamination with wheat have been accepted in the GFD. Yet, reports indicate that all celiac disease patients may not tolerate oats. We hypothesized that celiac children comply well with a GFD and that most have included oats in their diet. A food questionnaire was used to check our patients; 316 questionnaires were returned. Mean time on the GFD was 6.9 years, and 96.8% of the children reported that they were trying to keep a strict GFD. However, accidental transgressions occurred in 263 children (83.2%). In 2 of 3 cases, mistakes took place when the patients were not at home. Symptoms after incidental gluten intake were experienced by 162 (61.6%) patients, mostly (87.5%) from the gastrointestinal tract. Small amounts of gluten (gluten consumption. Oats were included in the diet of 89.4% of the children for a mean of 3.4 years. Most (81.9%) ate purified oats, and 45.3% consumed oats less than once a week. Among those who did not consume oats, only 5.9% refrained because of symptoms. General compliance with the GFD was good. Only the duration of the GFD appeared to influence adherence to the diet. Most patients did not report adverse effects after long-term consumption of oats. Copyright © 2014 Elsevier Inc. All rights reserved.

Shear structuring as a new method to make anisotropic structures from soy-gluten blends

NARCIS (Netherlands)

Grabowska, K.J.; Tekidou, S.; Boom, R.M.; Goot, van der A.J.

2014-01-01

The concept of shear-induced structuring was applied to concentrated blends of soy protein isolate (SPI) and wheat gluten (WG) to create novel semi-solid food textures. Concurrent simple shear deformation and heating (95 °C) of the protein blends generated original structures consisting of fibers or

BUCKWHEAT AS A GLUTEN-FREE CEREAL IN COMBINATION WITH MAIZE FLOUR

Directory of Open Access Journals (Sweden)

Stanislav Kráčmar

2012-02-01

Full Text Available Celiac disease is an autoimmune disorder of the small intestine that occurs in genetically predisposed people of all ages. Symptoms include chronic diarrhoea, and fatigue. The only treatment is long life diet with absence of gluten. Many researches concerning gluten-free nutrition have been done but it is still a big challenge. The main aim of this work was to observe changes in gluten-free breads quality made from maize-buckwheat mixtures depending on ratio of maize and buckwheat flour. To obtain samples, bread baking test was applied and these were provided to analyses (dough and pastry yield, baking loss, specific volume and texture analysis. The results showed that rising amount of maize flour in mixtures improved texture characteristics such as chewiness and gumminess, concerning specific volume of breads no significant differences were found and it was proved, that all texture parameters deteriorate with staling time.

Effectiveness of Germination on Protein Hydrolysis as a Way To Reduce Adverse Reactions to Wheat.

Science.gov (United States)

Boukid, Fatma; Prandi, Barbara; Buhler, Sofie; Sforza, Stefano

2017-11-15

In this work, the aim is to study the effectiveness of germination on wheat protein degradation, with a specific focus on proteins involved in adverse reactions to wheat. The effects of 8 days of germination at 25 °C on the chemical composition and the protein profile were determined. Germination did not have a significant effect on starch, protein, lipid, and ash contents. General protein profile, as indicated by SDS-PAGE analysis, revealed that germination induced a relevant degradation in protein fraction. After in vitro gastrointestinal digestion, gluten peptides involved in celiac disease (CD) were identified and quantified using UPLC/ESI-MS technique. Also, CM3 protein, involved in baker's asthma and intestinal inflammation, was quantified by measuring a marker peptide. Statistical analysis underlined that germination and genotype had significant impact on the amount of both components. Regarding gluten peptides related to CD, germination enabled an average reduction of 47% in peptides eliciting adaptive immune response and 46% in peptides eliciting innate immune response. CM3 protein showed also a high average reduction (56%). Thus, this study suggests that germination might be a good bioalternative to provide a low "impact" raw ingredient for special wheat-based foodstuffs.

Gluten and casein supplementation does not increase symptoms in children with autism spectrum disorder.

Science.gov (United States)

Pusponegoro, Hardiono D; Ismael, Sofyan; Firmansyah, Agus; Sastroasmoro, Sudigdo; Vandenplas, Yvan

2015-11-01

A gluten- and casein-free diet is often given to children with autism spectrum disorder (ASD). We aimed to determine the effect of gluten and casein supplementation on maladaptive behaviour, gastrointestinal symptom severity and intestinal fatty acids binding protein (I-FABP) excretion in children with ASD. A randomised, controlled, double-blind trial was performed on 74 children with ASD with severe maladaptive behaviour and increased urinary I-FABP. Subjects were randomised to receive gluten-casein or a placebo for seven days. We evaluated maladaptive behaviour before and after supplementation, using I-FABP excretion, the approach withdrawal problem composite subtest of the Pervasive Developmental Disorder Behavior Inventory and the Gastrointestinal Symptom Severity Index. The mean approach withdrawal problem composite score was significantly higher before supplementation than after, both in the placebo and in the gluten-casein group. However, the mean difference was not significant and may have been caused by additional therapy. There was no significant difference in gastrointestinal symptoms and urinary I-FABP excretion. Administrating gluten-casein to children with ASD for one week did not increase maladaptive behaviour, gastrointestinal symptom severity or urinary I-FABP excretion. The effect of prolonged administration or other mechanisms of enterocyte damage in ASD should be explored. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Seroreactive marker for inflammatory bowel disease and associations with antibodies to dietary proteins in bipolar disorder.

Science.gov (United States)

Severance, Emily G; Gressitt, Kristin L; Yang, Shuojia; Stallings, Cassie R; Origoni, Andrea E; Vaughan, Crystal; Khushalani, Sunil; Alaedini, Armin; Dickerson, Faith B; Yolken, Robert H

2014-05-01

Immune sensitivity to wheat glutens and bovine milk caseins may affect a subset of individuals with bipolar disorder. Digested byproducts of these foods are exorphins that have the potential to impact brain physiology through action at opioid receptors. Inflammation in the gastrointestinal (GI) tract might accelerate exposure of food antigens to systemic circulation and help explain elevated gluten and casein antibody levels in individuals with bipolar disorder. We measured a marker of GI inflammation, anti-Saccharomyces cerevisiae antibodies (ASCA), in non-psychiatric controls (n = 207), in patients with bipolar disorder without a recent onset of psychosis (n = 226), and in patients with bipolar disorder with a recent onset of psychosis (n = 38). We compared ASCA levels to antibodies against gluten, casein, Epstein-Barr virus (EBV), herpes simplex virus 1 (HSV-1), influenza A, influenza B, measles, and Toxoplasma gondii. Elevated ASCA conferred a 3.5-4.4-fold increased odds ratio of disease association (age-, race-, and gender-corrected multinomial logistic regressions, p ≤ 0.00001) that was independent of type of medication received. ASCA correlated with food antibodies in both bipolar disorder groups (R(2)  = 0.29-0.59, p ≤ 0.0005), and with measles and T. gondii immunoglobulin G (IgG) in the recent onset psychosis bipolar disorder group (R(2)  = 0.31-0.36, p ≤ 0.004-0.01). Elevated seropositivity of a GI-related marker and its association with antibodies to food-derived proteins and self-reported GI symptoms suggest a GI comorbidity in at least a subgroup of individuals with bipolar disorder. Marker seroreactivity may also represent part of an overall heightened activated immune state inherent to this mood disorder. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The intestinal T cell response to alpha-gliadin in adult celiac disease is focused on a single deamidated glutamine targeted by tissue transglutaminase

DEFF Research Database (Denmark)

Arentz-Hansen, H; Körner, R; Molberg, O

2000-01-01

The great majority of patients that are intolerant of wheat gluten protein due to celiac disease (CD) are human histocompatibility leukocyte antigen (HLA)-DQ2(+), and the remaining few normally express HLA-DQ8. These two class II molecules are chiefly responsible for the presentation of gluten...... for T cell recognition. Gluten-specific T cell lines from 16 different adult patients all responded to one or both of these deamidated peptides, indicating that these epitopes are highly relevant to disease pathology. Binding studies showed that the deamidated peptides displayed an increased affinity...

Enrichment of gluten-free cakes with lupin (Lupinus albus L.) or buckwheat (Fagopyrum esculentum M.) flours.

Science.gov (United States)

Levent, Hacer; Bilgiçli, Nermin

2011-11-01

In the present study, the effect of debittered lupin flour (LF) and whole buckwheat flour (BF) on the nutritional and sensory quality of gluten-free cake was studied. LF (10, 20, 30 and 40%) and BF (5, 10, 15 and 20%) were partially replaced with corn starch and rice flour mixture (1:1 w/w) in the gluten-free cake recipe. LF increased the protein, calcium, iron, manganese, phosphorus and zinc contents of the cakes, while BF caused a significant increase (P cakes. According to the overall acceptability rating, it was concluded that gluten-free cake could be produced with satisfactory results by the addition of LF and BF up to 30% and 10%, respectively.

Clinical benefit of a gluten-free diet in type 1 diabetic children with screening-detected celiac disease

DEFF Research Database (Denmark)

Hansen, Dorte; Brock-Jacobsen, Bendt; Lund, Elisabeth

2006-01-01

OBJECTIVE: This study was performed to 1) determine the prevalence of celiac disease in Danish children with type 1 diabetes and 2) estimate the clinical effects of a gluten-free diet (GFD) in patients with diabetes and celiac disease. RESEARCH DESIGN AND METHODS: In a region comprising 24......% of the Danish population, all patients diabetes were identified and 269 (89%) were included in the study. The diagnosis of celiac disease was suspected in patients with endomysium and tissue transglutaminase antibodies in serum and confirmed by intestinal biopsy. Patients with celiac...... a lower SD score (SDS) for height (P diabetes onset (P = 0.041). A GFD was obtained in 31 of 33 patients. After 2 years of follow-up, there was an increase in weight SDS (P = 0.006) and in children

Frequency and Cause of Persistent Symptoms in Celiac Disease Patients on a Long-term Gluten-free Diet.

Science.gov (United States)

Stasi, Elisa; Marafini, Irene; Caruso, Roberta; Soderino, Federica; Angelucci, Erika; Del Vecchio Blanco, Giovanna; Paoluzi, Omero A; Calabrese, Emma; Sedda, Silvia; Zorzi, Francesca; Pallone, Francesco; Monteleone, Giovanni

2016-03-01

To estimate the frequency and cause of nonresponsive celiac disease (CD). Treatment of CD is based on life-long adherence to a gluten-free diet (GFD). Some celiac patients experience persistence of symptoms despite a GFD. This condition is defined as nonresponsive CD. Celiac patients on a GFD for at least 12 months underwent diet compliance assessment, laboratory tests, breath tests, endoscopic, and histologic evaluations according to the symptoms/signs reported. Seventy of 321 (21.8%) patients had persistent or recurrent symptoms/signs. The cause of symptom persistence was evaluated in 56 of 70 patients. Thirteen of 56 (23%) patients were antiendomysial antibody positive. Among the patients with negative serology, 1 had fibromyalgia, and 3 had evidence that disproved the diagnosis of CD. The remaining 39 patients with negative serology underwent duodenal biopsy sampling, which evidenced histologic alterations in 24 patients. Among the 15 patients with normal histology 3 were lactose intolerant, 9 had irritable bowel syndrome, 2 had gastroesophageal reflux disease, and in 1 patient a cause for the persistent symptom was not identified. In patients with confirmed diagnosis of CD, exposure to dietary gluten was the main cause of persistence of symptoms/signs, and consistently after dietary modification, symptoms resolved in 63% of the patients at later time points during follow-up. Nonresponsive CD occurs in nearly one fifth of celiac patients on GFD and its occurrence suggests further investigations to optimize the management of celiac patients.

The present and the future in the diagnosis and management of celiac disease

Science.gov (United States)

Castillo, Natalia E.; Theethira, Thimmaiah G.; Leffler, Daniel A.

2015-01-01

Celiac disease is an autoimmune enteropathy caused by gluten in genetically predisposed individuals. In celiac disease, adaptive and innate immune activation results in intestinal damage and a wide range of clinical manifestations. In the past, celiac disease was thought to result in signs and symptoms solely related to the gastrointestinal tract. Now, more than half of the adult population presents with extra-intestinal manifestations that can also be expected to improve on a gluten-free diet. For this reason, it is recommended that physicians have a low threshold of suspicion for celiac disease. Current knowledge of the immune pathogenesis of this autoimmune disease has served as a catalyst for the development of novel diagnostic tools and therapeutics. Over the years, highly sensitive and specific serological assays, in addition to genetic markers, have been found to target specific steps in the cascade pathway of celiac disease. Also the advent of the gluten challenge has enabled experts to design diagnostic algorithms and monitor clinical responses in clinical trials. The gluten challenge has provided substantial benefit in the advance of novel therapeutics as an adjuvant treatment to the gluten free diet. Generally, a strict gluten-free diet is highly burdensome to patients and can be limited in its efficacy. Alternative therapies—including gluten modification, modulation of intestinal permeability and immune response—could be central to the future treatment of celiac disease. PMID:25326000