Coeliac Disease: Background and biochemical aspects

Pathogenesis of Celiac Disease and Other Gluten Related Disorders in Wheat and Strategies for Mitigating Them

Wheat is a major cereal crop providing energy and nutrients to the billions of people around the world. Gluten is a structural protein in wheat, that is necessary for its dough making properties, but it is responsible for imparting certain intolerances among some individuals, which are part of this review. Most important among these intolerances is celiac disease, that is gluten triggered T-cell mediated autoimmune enteropathy and results in villous atrophy, inflammation and damage to intestinal lining in genetically liable individuals containing human leukocyte antigen DQ2/DQ8 molecules on antigen presenting cells. Celiac disease occurs due to presence of celiac disease eliciting epitopes in gluten, particularly highly immunogenic alpha-gliadins. Another gluten related disorder is non-celiac gluten-sensitivity in which innate immune-response occurs in patients along with gastrointestinal and non-gastrointestinal symptoms, that disappear upon removal of gluten from the diet. In wheat allergy, either IgE or non-IgE mediated immune response occurs in individuals after inhalation or ingestion of wheat. Following a life-long gluten-free diet by celiac disease and non-celiac gluten-sensitivity patients is very challenging as none of wheat cultivar or related species stands safe for consumption. Hence, different molecular biology, genetic engineering, breeding, microbial, enzymatic, and chemical strategies have been worked upon to reduce the celiac disease epitopes and the gluten content in wheat. Currently, only 8.4% of total population is affected by wheat-related issues, while rest of population remains safe and should not remove wheat from the diet, based on false media coverage.

In Vitro Bioavailability of Calcium, Magnesium, Iron, Zinc, and Copper from Gluten-Free Breads Supplemented with Natural Additives

The aim of this study was to measure the content of calcium, magnesium, iron, zinc, and copper and determine the bioavailability of these ingredients in gluten-free breads fortified with milk and selected seeds. Due to the increasing prevalence of celiac disease and mineral deficiencies, it has become necessary to produce food with higher nutritional values which maintains the appropriate product characteristics. This study was designed for gluten-free breads fortified with milk and seeds such as flax, poppy, sunflower seeds, pumpkin seeds or nuts, and flour with amaranth. Subsequently, digestion was performed in vitro and the potential bioavailability of the minerals was measured. In the case of calcium, magnesium, iron, and copper, higher bioavailability was observed in rice bread, and, in the case of copper and zinc, in buckwheat bread. This demonstrated a clear increase in bioavailability of all the minerals when the bread were enriched. However, satisfactory results are obtained only for the individual micronutrients.

The influence of gluten-free bakery products consumption on selected anthropometric parameters

The aim of the study was to evaluate the effect of a short-term consumption (six weeks) of gluten-free bakery products on the anthropometric parameters. The study group was composed of volunteers from the general population and consisted of 30 healthy adults. The amount of bakery product was determined as follows: women consumed 150 - 200 grams per day; men 200 - 250 grams per day. Anthropometric measurements were made by using InBody 720, we received data such as body weight, Body Mass Index (BMI) and Waist-to-Hip Ratio (WHR), which we evaluated the presence of overweight and obesity in the monitored groups. We also observed visceral fat area (VFA). We found out that the 6-week consumption of gluten-free bread and bakery products showed a significant reduction in body weight and BMI (p <0.01), but also to a significant increase in VFA (p <0.05). By the impact of consumption we recorded the increase of body weight and BMI in 70% of participants (in 30% there was slight increase), decrease of WHR in 33% (increase in 43%) and decrease of VFA in 43% (increase in 57%). For other participants, the values remained unchanged. Two months after the termination of the consumption of gluten-free products we found out the increase of body weight and BMI, WHR remained unchanged, however in the case of VFA showed significant increase of values. We can summarize that dietary habits play a crucial role in the development of overweight and obesity and the consumption of bread and bakery products can also affect it. However, the overall effect of bread and bakery consumption on the development of overweight depends on many factors, such as the composition of the bread and bakery products and the presence of gluten.

Progress in Research and Development of Potato Staple Food Processing Technology

In 2014, potato production in China amounted to 96 million tons, which was the highest in the world. As one of the most important nutritional foods in the world, potato is rich in starch, dietary fiber, vitamins, minerals, etc. Potatoes stand barren environment, drought, saline, and alkaline environment, and cold weather, with a short growing season. These features make them the best rain-fed crops suitable for production even when the annual rainfall is below 400 mm. In 2013, the Chinese Ministry of Agriculture suggested a potato staple food strategy using potatoes to make Chinese traditional staple foods such as steamed bread, noodles, etc. Our research group carried out a study on processing technology of potato staple food, especially fermented staple food. Some new processing technologies of potato staple food have been investigated and developed. The aim of this paper is to give an overview of the possible effects of adding potato flour in the dough and of the microstructure characteristics, technological parameters, total polyphenol content, and antioxidant activity of staple foods. We also systematically describe the processing technology of potato staple foods, which may be of great importance in promoting further expansion of the potato-processing industry and increasing the economic benefit of the companies.

Characteristics of starch breads enriched with red potatoes

Starch breads may often be low in nutritional value, in comparison to traditional products, as they contain less dietary fibre, protein and micro and macro elements. As an effect a risk of mineral deficiencies and digestive problems caused by lack of dietary fibre could be expected in persons adhering to gluten free diet. To eliminate such problems, a continuous research on gluten-free bread nutritional enrichment, has been done in recent years. Raw material used to enrich gluten free products should include: inulin, lupine, radish, soy, lucerne sprouts, oilseeds, different type of dried fruits. Among the most commonly used raw materials, there are flours from gluten free cereals and pseudocereals such as buckwheat, amaranth and maize are very popular. It seem that valuable alternative could be considered a red, purple or pink potatoes as starch breads additives. The aim of this work was to investigate the effect addition of freeze-dried color potatoes on crude fiber, polyphenols, anthocyanins and flavonoids and nutritional value of gluten free breads. It could be concluded, that freeze-dried color (red, purple, pink) potatoes enriched the gluten free breads (starch breads) with health promoting bioactive components, like polyphenols, and highly valuable protein. The most promising additive was Magenta Love red potato variety lyophilisates, because gluten free breads enriched with this component were characterized by high protein content and the highest content of free and bound polyphenols, flavonoids, anthocyanins. The presence of all these components increased the nutritional and pro-health value of gluten free product as starch bread.

The progression of coeliac disease: its neurological and psychiatric implications

The aim of the paper is to show the various neurological and psychiatric symptoms in coeliac disease (CD). CD is a T cell-mediated, tissue-specific autoimmune disease which affects genetically susceptible individuals after dietary exposure to proline- and glutamine-rich proteins contained in certain cereal grains. Genetics, environmental factors and different immune systems, together with the presence of auto-antigens, are taken into account when identifying the pathogenesis of CD. CD pathogenesis is related to immune dysregulation, which involves the gastrointestinal system, and the extra-intestinal systems such as the nervous system, whose neurological symptoms are evidenced in CD patients. A gluten-free diet (GFD) could avoid cerebellar ataxia, epilepsy, neuropathies, migraine and mild cognitive impairment. Furthermore, untreated CD patients have more symptoms and psychiatric co-morbidities than those treated with a GFD. Common psychiatric symptoms in untreated CD adult patients include depression, apathy, anxiety, and irritability and schizophrenia is also common in untreated CD. Several studies show improvement in psychiatric symptoms after the start of a GFD. The present review discusses the state of the art regarding neurological and psychiatric complications in CD and highlights the evidence supporting a role for GFD in reducing neurological and psychiatric complications.

Effects of gluten-free breads, with varying functional supplements, on the biochemical parameters and antioxidant status of rat serum

This paper examines the effects of gluten-free bread enriched with functional ingredients (milk powder, poppy, sunflower and pumpkin seeds, egg yolk, carum, hazel nuts and amaranth) on the morphological and biochemical parameters and antioxidant status of rats serum. Rats were provided test diets--gluten-free breads and water ad libitum. After 14 days, the animals were weighed and killed. A hazel nut-amaranth bread diet significantly increased the level of thrombocytes when compared to control bread. A mixed bread diet significantly decreased cholesterol levels in rats. All fortified breads decreased triglyceride levels and alanine transaminase activity and caused an increase in antiradical activity of the serum. In rats fed with poppy-milk bread, milk-seed bread and mixed bread, a marked decrease in superoxide dismutase activity was found. Enriched breads reduced the levels of triglyceride and improved the antiradical properties of serum, although the physiological relevance of this needs to be confirmed by human studies.

Formulation Optimization of Gluten-Free Functional Spaghetti Based on Maize Flour and Oat Bran Enriched in b-Glucans

The aim of this work concerns the manufacturing process of gluten-free functional spaghetti based on maize flour and oat bran, enriched with β-glucans (22%). More specifically, the goal of the study was to obtain oat bran-loaded maize spaghetti with sensory properties close to unloaded pasta. To this aim, the study has been organized in two subsequent trials. In the first one, the oat bran amount added to spaghetti was continuously increased until the overall sensory quality of pasta reached the set sensory threshold (oat bran concentration = 20%). The second experimental step was aimed to improve the overall sensory quality of oat bran loaded maize spaghetti. In particular, an attempt was made to increase the sensory quality of spaghetti added with 20% oat bran by means of structuring agents. To this aim, the effects of different kinds of some hydrocolloids and egg white powder on the rheological properties of dough, as well as on quality attributes of pasta were examined. The rheological analysis showed that the addition of hydrocolloids and white egg to the dough enriched with 20% oat bran did not cause any substantial difference in the viscoelastic properties, compared to samples without any structuring agents. The best overall quality for both fresh and dry spaghetti was obtained by the addition of carboxymethylcellulose and chitosan at a concentration of 2%.

Effect of hydrocolloids on selected properties of gluten-free dough and bread

Addition of hydrocolloids (H/C) in gluten-free (GF) bread formulation is necessary in order to act as polymeric substances that should mimic the viscoelastic properties of gluten and increase the dough’s gas-retaining ability. The properties of H/C vary depending on their origin and chemical structure. Addition of H/C (hydroxypropylmethylcellulose (HPMC), xanthan, κ-carrageenan and guar gum) of different origins at 1%, 1.5% and 2% (w/w) in GF formulations based on corn starch and rice flour was carried out to investigate the effects on dough rheology and bread quality. The consistency, viscosity and thermal properties of doughs were evaluated. According to results, 1% and 1.5% addition of H/C (except from xanthan) contributed to bread with higher loaf volume and better color compared to control GF bread as well as to increased shelf life due to its moisture-absorption ability. Sensory evaluation by a trained panel revealed a preference for bread containing 1.5% HPMC because of its loaf volume, appearance and firmness characteristics. The micrographs of the dough showed a continuous matrix between starch and HPMC obtaining a more aerated structure.

In vitro digestive stability of complexes between gliadin and synthetic blocking peptides

Celiac disease is caused by an inappropriate immune response to incompletely digested gluten proteins. We investigated whether synthetic peptides with high affinity to wheat gliadin could be selected with a phage display technique and whether complexes between such peptides and gliadin could sustain gastric and pancreatic digestion. Two synthetic peptides, P61 and P64, were selected because of their high affinity to immobilized gliadin. They were allowed to form complexes with gliadin, whereafter the complexes were subjected to in vitro digestion with gastric and pancreatic enzymes. The digestion products were analyzed with Western blot and RP HPLC. The results showed that both peptides formed stable complexes with intact gliadin and that complexes between gliadin and peptide P64 partly resisted gastrointestinal digestion. The two peptides reduced the binding of serum anti-gliadin IgA antibodies by 12%, and 11.5%, respectively, and the binding of anti-gliadin antibodies of the IgG isotype by 13% and 10%. Thus peptides produced by a phage display technique could interact stably with gliadin partly masking epitopes for antibody binding. A combination of peptides of this kind may be used to block gliadin-immune system interactions.

Identification of gliadin-binding peptides by phage display

Background

Coeliac disease (CD) is a common and complex disorder of the small intestine caused by intolerance to wheat gluten and related edible cereals like barley and rye. Peptides originating from incomplete gliadin digestion activate the lamina propria infiltrating T cells to release proinflammatory cytokines, which in turn cause profound tissue remodelling of the small intestinal wall. There is no cure for CD except refraining from consuming gluten-containing products.

Results

Phage from a random oligomer display library were enriched by repeated pannings against immobilised gliadin proteins. Phage from the final panning round were plated, individual plaques picked, incubated with host bacteria, amplified to a population size of 10¹¹ to 10¹² and purified. DNA was isolated from 1000 purified phage populations and the region covering the 36 bp oligonucleotide insert from which the displayed peptides were translated, was sequenced. Altogether more than 150 different peptide-encoding sequences were identified, many of which were repeatedly isolated under various experimental conditions. Amplified phage populations, each expressing a single peptide, were tested first in pools and then one by one for their ability to inhibit binding of human anti-gliadin antibodies in ELISA assays. These experiments showed that several of the different peptide-expressing phage tested inhibited the interaction between gliadin and anti-gliadin antibodies. Finally, four different peptide-encoding sequences were selected for further analysis, and the corresponding 12-mer peptides were synthesised in vitro. By ELISA assays it was demonstrated that several of the peptides inhibited the interaction between gliadin molecules and serum anti-gliadin antibodies. Moreover, ELISA competition experiments as well as dot-blot and western blot revealed that the different peptides interacted with different molecular sites of gliadin.

Conclusions

We believe that several of the isolated and characterised gliadin-binding peptides described here could provide valuable tools for researchers in the field of CD by facilitating studies on localisation and uptake of various gliadin peptides in the small intestine. In future work, the potential of these peptides to detoxify gluten will be investigated.

Enzymatic strategies to detoxify gluten: implications for celiac disease

Celiac disease is a permanent intolerance to the gliadin fraction of wheat gluten and to similar barley and rye proteins that occurs in genetically susceptible subjects. After ingestion, degraded gluten proteins reach the small intestine and trigger an inappropriate T cell-mediated immune response, which can result in intestinal mucosal inflammation and extraintestinal manifestations. To date, no pharmacological treatment is available to gluten-intolerant patients, and a strict, life-long gluten-free diet is the only safe and efficient treatment available. Inevitably, this may produce considerable psychological, emotional, and economic stress. Therefore, the scientific community is very interested in establishing alternative or adjunctive treatments. Attractive and novel forms of therapy include strategies to eliminate detrimental gluten peptides from the celiac diet so that the immunogenic effect of the gluten epitopes can be neutralized, as well as strategies to block the gluten-induced inflammatory response. In the present paper, we review recent developments in the use of enzymes as additives or as processing aids in the food biotechnology industry to detoxify gluten.

Nonmeat Protein Alternatives as Meat Extenders and Meat Analogs

  The direct consumption of vegetable proteins in food products has been increasing over the years because of animal diseases, global shortage of animal protein, strong demand for wholesome and religious (halal) food, and economic reasons. The increasing importance of legume and oilseed proteins in the manufacturing of various functional food products is due to their high-protein contents. However, the greatest obstacle to utilizing these legumes and oilseeds is the presence of antinutrients; but these antinutrients can be successfully removed or inactivated by employing certain processing methods. In contrast, the potential negative impact of the antinutrients is partially balanced by the fact that they may have a health-promoting role. Legumes and oilseeds provide well-balanced amino acid profiles when consumed with cereals. Soybean proteins, wheat gluten, cottonseed proteins, and other plant proteins have been used for texturization. Texturized vegetable proteins can extend meat products while providing an economical, functional, and high-protein food ingredient or can be consumed directly as a meat analog. Meat analogs are successful because of their healthy image (cholesterol free), meat-like texture, and low cost. Mycoprotein is fungal in origin and is used as a high-protein, low-fat, health-promoting food ingredient. Mycoprotein has a good taste and texture. Texturized vegetable proteins and a number of mycoprotein products are accepted as halal foods. This article summarizes information regarding the molecular, nutritional, and functional properties of alternative protein sources to meat and presents current knowledge to encourage further research to optimize the beneficial effects of alternative protein sources.

Use of selected enterococci and Rhizopus oryzae proteases to hydrolyse wheat proteins responsible for celiac disease

AIMS

This work aimed at using a pool of selected enterococci and fungal proteases to hydrolyse wheat gluten during long-time fermentation.

METHODS AND RESULTS

A liquid dough made with wheat flour (20% w/w) was fermented with three Enterococcus strains (dough A) or with the combination of enterococci and Rhizopus oryzae proteases (dough B). After 48 h of fermentation, dough A and B had a concentration of water-soluble peptides approximately threefold higher than the chemically acidified dough (CAD), used as the control. The same was found for the concentration of free amino acids, being higher in dough B with respect to dough A. SDS-PAGE analysis showed that albumin and glutenin fractions were partially hydrolysed, while gliadins almost disappeared in dough A and B, as confirmed by two-dimensional electrophoresis, RP-HPLC and R5-ELISA analyses.

CONCLUSIONS

The combined use of enterococci and fungal proteases showed a decrease of the gluten concentration of more than 98% during long-time fermentation.

SIGNIFICANCE AND IMPACT OF THE STUDY

The use of the mixture of selected enterococci and R. oryzae proteases should be considered as a potential tool to decrease gluten concentration in foods.

Psyllium as a substitute for gluten in bread

Celiac disease is an antibody-mediated enteropathy that presents permanent intolerance to ingested gluten. Currently, only one kind of treatment is available: the complete dietary elimination of all sources of gluten. The aim of the present study was to evaluate the effect of replacing gluten with psyllium on sensory characteristics of bread dough and to compare the chemical, nutritional, technological, and sensory characteristics of the modified preparations. This study is experimental and was subdivided into five steps: selection and development of preparation, chemical analysis, sensory analysis, and statistical analysis. Modified samples of the bread dough achieved a 93.0% acceptance rate for individuals with celiac disease and up to 97.0% for individuals without celiac disease. The most affected characteristics were odor and texture. In terms of chemical composition of the bread dough, energy was reduced by 32.1% and the fat fraction was 42.3% before being cooked. Data obtained from sensory analysis of psyllium doughs indicate that the products had good acceptance by individuals with celiac disease as well as by individuals without celiac disease. This suggests that psyllium can replace gluten in preparations. Furthermore, in terms of chemical composition, products made with modified dough had less fat and fewer calories.

Serum mannan-binding lectin levels in patients with celiac disease: an analysis of clinical and autoimmune features

Mannan-binding lectin (MBL) is the central protein in the activation of complement through the lectin pathway. MBL plasma concentration is genetically determined and varies significantly among individuals. Recent findings suggest that MBL is associated with the pathogenesis of celiac disease (CD). In this study, MBL and C-reactive protein (CRP) levels were determined in 101 celiac patients and 120 controls, with the aim to associate with the presence of gluten in the diet, disease severity, and the presence of concomitant autoimmune diseases. MBL concentration was determined by ELISA and CRP by nephelometry, using a high-sensitivity method. EmA-IgA and other autoantibodies were tested by indirect immunofluorescence. Although a significant increase in MBL levels was observed in male patients compared to female (P = 0.024), the absence of any other association suggests that circulating MBL and CRP concentrations are not associated with clinical and autoimmune CD features in Brazilian patients.

Highly efficient gluten degradation by lactobacilli and fungal proteases during food processing: new perspectives for celiac disease

Presently, the only effective treatment for celiac disease is a life-long gluten-free diet. In this work, we used a new mixture of selected sourdough lactobacilli and fungal proteases to eliminate the toxicity of wheat flour during long-time fermentation. Immunological (R5 antibody-based sandwich and competitive enzyme-linked immunosorbent assay [ELISA] and R5 antibody-based Western blot), two-dimensional electrophoresis, and mass spectrometry (matrix-assisted laser desorption ionization-time of flight, strong-cation-exchange-liquid chromatography/capillary liquid chromatography-electrospray ionization-quadrupole-time of flight [SCX-LC/CapLC-ESI-Q-TOF], and high-pressure liquid chromatography-electrospray ionization-ion trap mass spectrometry) analyses were used to determine the gluten concentration. Assays based on the proliferation of peripheral blood mononuclear cells (PBMCs) and gamma interferon production by PBMCs and intestinal T-cell lines (iTCLs) from 12 celiac disease patients were used to determine the protein toxicity of the pepsin-trypsin digests from fermented wheat dough (sourdough). As determined by R5-based sandwich and competitive ELISAs, the residual concentration of gluten in sourdough was 12 ppm. Albumins, globulins, and gliadins were completely hydrolyzed, while ca. 20% of glutenins persisted. Low-molecular-weight epitopes were not detectable by SCX-LC/CapLC-ESI-Q-TOF mass spectrometry and R5-based Western blot analyses. The kinetics of the hydrolysis of the 33-mer by lactobacilli were highly efficient. All proteins extracted from sourdough activated PBMCs and induced gamma interferon production at levels comparable to the negative control. None of the iTCLs demonstrated immunoreactivity towards pepsin-trypsin digests. Bread making was standardized to show the suitability of the detoxified wheat flour. Food processing by selected sourdough lactobacilli and fungal proteases may be considered an efficient approach to eliminate gluten toxicity.

Sourdough lactobacilli and celiac disease

Celiac disease (CD) is one of the most common food intolerance. The only effective treatment for CD is a strict adherence to a gluten-free diet throughout the patient's lifetime. Gluten-free products are not widely available and are usually more expensive than their gluten-containing counterparts. There is, therefore, an urgent need to develop safe and effective therapeutic alternatives, to develop high-quality gluten-free products and to investigate the potential of the bread making biotechnology following ancient protocols which include long-time fermentation by selected sourdough lactic acid bacteria. This review describes the most relevant results related to biotechnologies that use selected sourdough lactic acid bacteria and probiotics as starters for sourdough fermentation to investigate their potential to decrease the risk of gluten contamination in gluten-free products. As shown by studies in vitro on celiac intestinal tissue and in vivo on CD patients, the bacterial proteolytic activity is rather promising not only as currently demonstrated for eliminating traces of contaminant gluten but probably also in perspective for the manufacture of tolerated baked goods.