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Wagh SK, Lammers KM, Padul MV, Rodriguez-Herrera A, Dodero VI. Celiac Disease and Possible Dietary Interventions: From Enzymes and Probiotics to Postbiotics and Viruses. Int J Mol Sci 2022; 23:ijms231911748. [PMID: 36233048 PMCID: PMC9569549 DOI: 10.3390/ijms231911748] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/20/2022] [Accepted: 09/29/2022] [Indexed: 11/24/2022] Open
Abstract
Celiac Disease (CeD) is a chronic small intestinal immune-mediated enteropathy caused by the ingestion of dietary gluten proteins in genetically susceptible individuals. CeD is one of the most common autoimmune diseases, affecting around 1.4% of the population globally. To date, the only acceptable treatment for CeD is strict, lifelong adherence to a gluten-free diet (GFD). However, in some cases, GFD does not alter gluten-induced symptoms. In addition, strict adherence to a GFD reduces patients’ quality of life and is often a socio-economic burden. This narrative review offers an interdisciplinary overview of CeD pathomechanism and the limitations of GFD, focusing on current research on possible dietary interventions. It concentrates on the recent research on the degradation of gluten through enzymes, the modulation of the microbiome, and the different types of “biotics” strategies, from probiotics to the less explored “viromebiotics” as possible beneficial complementary interventions for CeD management. The final aim is to set the context for future research that may consider the role of gluten proteins and the microbiome in nutritional and non-pharmacological interventions for CeD beyond the sole use of the GFD.
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Affiliation(s)
- Sandip K. Wagh
- Department of Organic and Bioorganic Chemistry, Bielefeld University, 33615 Bielefeld, Germany
- Department of Biochemistry, Dr. Babasaheb Ambedkar Marathwada University, Aurangabad 431004, India
| | | | - Manohar V. Padul
- Department of Biochemistry, The Institute of Science, Dr. Homi Bhabha State University, Mumbai 400032, India
| | | | - Veronica I. Dodero
- Department of Organic and Bioorganic Chemistry, Bielefeld University, 33615 Bielefeld, Germany
- Correspondence:
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Wagh SK, Lammers KM, Padul MV, Rodriguez-Herrera A, Dodero VI. Celiac Disease and Possible Dietary Interventions: From Enzymes and Probiotics to Postbiotics and Viruses. Int J Mol Sci 2022. [PMID: 36233048 DOI: 10.3390/ijms231911748.pmid:36233048;pmcid:pmc9569549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
Celiac Disease (CeD) is a chronic small intestinal immune-mediated enteropathy caused by the ingestion of dietary gluten proteins in genetically susceptible individuals. CeD is one of the most common autoimmune diseases, affecting around 1.4% of the population globally. To date, the only acceptable treatment for CeD is strict, lifelong adherence to a gluten-free diet (GFD). However, in some cases, GFD does not alter gluten-induced symptoms. In addition, strict adherence to a GFD reduces patients' quality of life and is often a socio-economic burden. This narrative review offers an interdisciplinary overview of CeD pathomechanism and the limitations of GFD, focusing on current research on possible dietary interventions. It concentrates on the recent research on the degradation of gluten through enzymes, the modulation of the microbiome, and the different types of "biotics" strategies, from probiotics to the less explored "viromebiotics" as possible beneficial complementary interventions for CeD management. The final aim is to set the context for future research that may consider the role of gluten proteins and the microbiome in nutritional and non-pharmacological interventions for CeD beyond the sole use of the GFD.
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Affiliation(s)
- Sandip K Wagh
- Department of Organic and Bioorganic Chemistry, Bielefeld University, 33615 Bielefeld, Germany
- Department of Biochemistry, Dr. Babasaheb Ambedkar Marathwada University, Aurangabad 431004, India
| | | | - Manohar V Padul
- Department of Biochemistry, The Institute of Science, Dr. Homi Bhabha State University, Mumbai 400032, India
| | | | - Veronica I Dodero
- Department of Organic and Bioorganic Chemistry, Bielefeld University, 33615 Bielefeld, Germany
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The Efficacy of Plant Enzymes Bromelain and Papain as a Tool for Reducing Gluten Immunogenicity from Wheat Bran. Processes (Basel) 2022. [DOI: 10.3390/pr10101948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Gluten-free products made from naturally gluten-free raw materials have an inferior taste and can cause deficiencies in various nutrients, especially non-starch polysaccharides. To address this problem, scientists are searching for new strategies to eliminate harmful gluten from wheat, rye, and barley and to produce balanced products with good organoleptic properties. This study evaluated the possibility of hydrolysing gluten in wheat bran, a by-product obtained after the dry fractionation of wheat, using plant enzymes. The gluten content of wheat bran after treatment with papain, bromelain, and their combination under different hydrolysis conditions was investigated. The amount of gluten was determined using an enzyme-linked immunosorbent assay ELISA R5 and the reduction in immunogenic gliadins was analysed using high-performance reverse phase liquid chromatography. The results of the study showed that 4 h hydrolysis with bromelain and papain reduced the levels of gluten immunogenic compounds in bran from 58,650.00 to 2588.20–3544.50 mg/kg; however, they did not reach the gluten-free limit. A higher hydrolysis efficiency of 95.59% was observed after treatment with papain, while the combination of both enzymes and bromelain alone were less effective. The results presented in this article will be helpful to other researchers and manufacturers of wheat-based products when selecting methods to reduce gluten immunogenicity and contribute to the development of sustainable technologies.
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Juhász A, Nye-Wood MG, Tanner GJ, Colgrave ML. Digestibility of wheat alpha-amylase/trypsin inhibitors using a caricain digestive supplement. Front Nutr 2022; 9:977206. [PMID: 36034932 PMCID: PMC9399795 DOI: 10.3389/fnut.2022.977206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 07/25/2022] [Indexed: 11/22/2022] Open
Abstract
Wheat is a major source of nutrition, though in susceptible people it can elicit inappropriate immune responses. Wheat allergy and non-celiac wheat sensitivity are caused by various wheat proteins, including alpha-amylase trypsin inhibitors (ATIs). These proteins, like the gluten proteins which can cause celiac disease, are incompletely digested in the stomach such that immunogenic epitopes reach the lower digestive system where they elicit the undesirable immune response. The only completely effective treatment for these immune reactions is to eliminate the food trigger from the diet, though inadvertent or accidental consumption can still cause debilitating symptoms in susceptible people. One approach used is to prevent the causal proteins from provoking an immune reaction by enhancing their digestion using digestive protease supplements that act in the stomach or intestine, cleaving them to prevent or quench the harmful immune response. In this study, a digestive supplement enriched in caricain, an enzyme naturally present in papaya latex originally designed to act against gluten proteins was assessed for its ability to digest wheat ATIs. The digestion efficiency was quantitatively measured using liquid chromatography-mass spectrometry, including examination of the cleavage sites and the peptide products. The peptide products were measured across a digestion time course under conditions that mimic gastric digestion in vivo, involving the use of pepsin uniquely or in combination with the supplement to test for additive effects. The detection of diverse cleavage sites in the caricain supplement-treated samples suggests the presence of several proteolytic enzymes that act synergistically. Caricain showed rapid action in vitro against known immunogenic ATIs, indicating its utility for digestion of wheat ATIs in the upper digestive tract.
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Affiliation(s)
- Angéla Juhász
- School of Science, Edith Cowan University, Joondalup, WA, Australia
| | | | - Gregory J Tanner
- School of Biosciences, University of Melbourne, Melbourne, VIC, Australia
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Tanner GJ. Relative Rates of Gluten Digestion by Nine Commercial Dietary Digestive Supplements. Front Nutr 2021; 8:784850. [PMID: 34950690 PMCID: PMC8688929 DOI: 10.3389/fnut.2021.784850] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 11/08/2021] [Indexed: 01/08/2023] Open
Abstract
Endopeptidases containing supplements may digest gluten and reduce the impact on celiac and gluten-sensitive subjects who inadvertently consume gluten. We investigated the relative rate of disappearance of coeliac relevant epitopes in extracts of nine commercial supplements, using two competitive enzyme-linked immunosorbent assays (ELISAs)—Ridascreen (detects QQPFP, QQQFP, LQPFP, and QLPFP) and Gluten-Tec (detects Glia-α20 and PFRPQQPYPQ). All epitopes are destroyed by cleavage after P and Q amino acids. Rates at pH 3.5 and pH 7.0 were measured. These experiments were designed to measure relative rates of epitope digestion not to mimic in vivo digestion. The supplements were: 1 GluteGuard, 2 GlutenBlock, 3 GliadinX, 4 GlutnGo, 5 GlutenRescue, 6 Eat E-Z Gluten+, 7 Glutenease, 8 Glutezyme, and 9 Gluten Digest. The mean initial rate and half-lives of epitope digestion were deduced and extrapolated to rates at the recommended dose of one supplement in a fasting stomach volume. At pH 7, supplement 1 was the fastest acting of the supplements, with Ridascreen ELISA, more than twice as fast as the next fastest supplements, 5, 6, 7, and 8. Supplements 2, 3, and 4 showed little activity at pH 7.0. Supplement 1 was also the fastest acting at pH 7 with Gluten-Tec ELISA, more than three times the rate for supplements 2 and 3, with supplements 4–9 showing minimal activity. At pH 3.5, supplement 1 acted more than five times as fast as the next fastest supplements, 2 and 3, when measured by Ridascreen, but supplements 2 and 3 were over two times faster than supplement 1 when measured by Gluten-Tec. Supplements 4–9 demonstrated minimal activity at pH 3.5 with either ELISA. Supplement 1 most rapidly digested the key immuno-reactive gluten epitopes identified by the R5 antibody in the Codex-approved competitive Ridascreen ELISA method and associated with the pathology of celiac disease.
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Dunaevsky YE, Tereshchenkova VF, Belozersky MA, Filippova IY, Oppert B, Elpidina EN. Effective Degradation of Gluten and Its Fragments by Gluten-Specific Peptidases: A Review on Application for the Treatment of Patients with Gluten Sensitivity. Pharmaceutics 2021; 13:1603. [PMID: 34683896 PMCID: PMC8541236 DOI: 10.3390/pharmaceutics13101603] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 09/22/2021] [Accepted: 09/29/2021] [Indexed: 12/21/2022] Open
Abstract
To date, there is no effective treatment for celiac disease (CD, gluten enteropathy), an autoimmune disease caused by gluten-containing food. Celiac patients are supported by a strict gluten-free diet (GFD). However, in some cases GFD does not negate gluten-induced symptoms. Many patients with CD, despite following such a diet, retain symptoms of active disease due to high sensitivity even to traces of gluten. In addition, strict adherence to GFD reduces the quality of life of patients, as often it is difficult to maintain in a professional or social environment. Various pharmacological treatments are being developed to complement GFD. One promising treatment is enzyme therapy, involving the intake of peptidases with food to digest immunogenic gluten peptides that are resistant to hydrolysis due to a high prevalence of proline and glutamine amino acids. This narrative review considers the features of the main proline/glutamine-rich proteins of cereals and the conditions that cause the symptoms of CD. In addition, we evaluate information about peptidases from various sources that can effectively break down these proteins and their immunogenic peptides, and analyze data on their activity and preliminary clinical trials. Thus far, the data suggest that enzyme therapy alone is not sufficient for the treatment of CD but can be used as a pharmacological supplement to GFD.
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Affiliation(s)
- Yakov E. Dunaevsky
- A.N. Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, 119991 Moscow, Russia; (Y.E.D.); (M.A.B.); (E.N.E.)
| | | | - Mikhail A. Belozersky
- A.N. Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, 119991 Moscow, Russia; (Y.E.D.); (M.A.B.); (E.N.E.)
| | - Irina Y. Filippova
- Chemical Faculty, Lomonosov Moscow State University, 119991 Moscow, Russia; (V.F.T.); (I.Y.F.)
| | - Brenda Oppert
- USDA Agricultural Research Service, Center for Grain and Animal Health Research, Manhattan, KS 66502, USA
| | - Elena N. Elpidina
- A.N. Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, 119991 Moscow, Russia; (Y.E.D.); (M.A.B.); (E.N.E.)
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Segura V, Ruiz-Carnicer Á, Sousa C, Moreno MDL. New Insights into Non-Dietary Treatment in Celiac Disease: Emerging Therapeutic Options. Nutrients 2021; 13:2146. [PMID: 34201435 PMCID: PMC8308370 DOI: 10.3390/nu13072146] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/11/2021] [Accepted: 06/15/2021] [Indexed: 02/07/2023] Open
Abstract
To date, the only treatment for celiac disease (CD) consists of a strict lifelong gluten-free diet (GFD), which has numerous limitations in patients with CD. For this reason, dietary transgressions are frequent, implying intestinal damage and possible long-term complications. There is an unquestionable need for non-dietary alternatives to avoid damage by involuntary contamination or voluntary dietary transgressions. In recent years, different therapies and treatments for CD have been developed and studied based on the degradation of gluten in the intestinal lumen, regulation of the immune response, modulation of intestinal permeability, and induction of immunological tolerance. In this review, therapeutic lines for CD are evaluated with special emphasis on phase III and II clinical trials, some of which have promising results.
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Affiliation(s)
| | | | | | - María de Lourdes Moreno
- Departamento de Microbiología y Parasitología, Facultad de Farmacia, Universidad de Sevilla, 41012 Sevilla, Spain; (V.S.); (Á.R.-C.); (C.S.)
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Jayawardana IA, Montoya CA, McNabb WC, Boland MJ. Possibility of minimizing gluten intolerance by co-consumption of some fruits – A case for positive food synergy? Trends Food Sci Technol 2019. [DOI: 10.1016/j.tifs.2019.10.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Scherf KA, Wieser H, Koehler P. Novel approaches for enzymatic gluten degradation to create high-quality gluten-free products. Food Res Int 2016; 110:62-72. [PMID: 30029707 DOI: 10.1016/j.foodres.2016.11.021] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 11/04/2016] [Accepted: 11/15/2016] [Indexed: 02/08/2023]
Abstract
Celiac disease (CD), a chronic enteropathy of the small intestine caused by ingestion of gluten, is one of the most prevalent food hypersensitivities worldwide. The essential treatment is a strict lifelong gluten-free diet based on the avoidance of gluten-containing products from wheat, rye, barley and, in rare cases, oats. Products made from naturally gluten-free raw materials often have inferior nutritional, textural and sensory properties compared to the corresponding gluten-containing products. Therefore, the incorporation of wheat, rye and barley flours after efficient removal of the harmful component gluten into gluten-free products would be beneficial. Gluten modification resulting in decreased CD-immunoreactivity may be achieved via the formation of crosslinks using microbial transglutaminase. To effectively eliminate CD-immunoreactivity, plant, fungal, bacterial, animal or engineered peptidases are capable of degrading gluten proteins and peptides into harmless fragments. The application of peptidases from germinated cereal grains, fungal peptidases and/or lactic acid bacteria during food processing yielded high-quality sourdough wheat breads, pasta, wheat starch and bran, rye products and beer, all with gluten contents below the Codex Alimentarius threshold of 20mg/kg for gluten-free products. As with all gluten-free products, the legislative compliance of such treated materials needs to be monitored closely. Provided that all safety requirements are met, gluten-containing raw materials treated in an adequate way to remove CD-active gluten fragments may be used together with naturally gluten-free ingredients to create an extended choice of high-quality gluten-free products.
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Affiliation(s)
- Katharina Anne Scherf
- Deutsche Forschungsanstalt für Lebensmittelchemie, Leibniz Institut, Lise-Meitner-Straße 34, D-85354 Freising, Germany.
| | - Herbert Wieser
- Deutsche Forschungsanstalt für Lebensmittelchemie, Leibniz Institut, Lise-Meitner-Straße 34, D-85354 Freising, Germany
| | - Peter Koehler
- Deutsche Forschungsanstalt für Lebensmittelchemie, Leibniz Institut, Lise-Meitner-Straße 34, D-85354 Freising, Germany
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Cornell HJ, Stelmasiak T, Small DM, Buddrick O. Application of the rat liver lysosome assay to determining the reduction of toxic gliadin content during breadmaking. Food Chem 2016; 192:924-7. [PMID: 26304430 DOI: 10.1016/j.foodchem.2015.07.105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Revised: 07/10/2015] [Accepted: 07/22/2015] [Indexed: 12/18/2022]
Abstract
Enriched caricain was able to detoxify a major proportion of the gliadin in wholemeal wheat dough by allowing it to react for 5h at 37 °C during the fermentation stage. A reduction of 82% in toxicity, as determined by the rat-liver lysosome assay, was achieved using 0.03% enzyme on weight of dough. Without enzyme, only 26% reduction occurred. The difference in reduction of toxicity achieved is statistically significant (p < 0.01). The results are very similar to those obtained in our previous work using an immuno assay and the same enzyme preparation. They confirm the value of caricain as a means of reducing the toxicity of gliadin and open the way for enzyme therapy as an adjunct to the gluten free diet. This approach should lead to better control over the elimination of dietary gluten intake in conditions such as coeliac disease and dermatitis herpetiformis.
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Affiliation(s)
- Hugh J Cornell
- Applied Chemistry, School of Applied Sciences, RMIT University, Melbourne, VIC 3001, Australia
| | | | - Darryl M Small
- Applied Chemistry, School of Applied Sciences, RMIT University, Melbourne, VIC 3001, Australia
| | - Oliver Buddrick
- Applied Chemistry, School of Applied Sciences, RMIT University, Melbourne, VIC 3001, Australia.
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Buddrick O, Cornell HJ, Small DM. Reduction of toxic gliadin content of wholegrain bread by the enzyme caricain. Food Chem 2015; 170:343-7. [DOI: 10.1016/j.foodchem.2014.08.030] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Revised: 07/23/2014] [Accepted: 08/10/2014] [Indexed: 12/21/2022]
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