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McDermid JM, Almond MA, Roberts KM, Germer EM, Geller MG, Taylor TA, Sinley RC, Handu D. Celiac Disease: An Academy of Nutrition and Dietetics Evidence-Based Nutrition Practice Guideline. J Acad Nutr Diet 2023; 123:1793-1807.e4. [PMID: 37499866 DOI: 10.1016/j.jand.2023.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 07/20/2023] [Indexed: 07/29/2023]
Abstract
Celiac disease is an autoimmune disorder in which the immune system of genetically susceptible individuals elicits a reaction to gluten causing small intestine damage. If left undiagnosed and untreated, the resulting nutrition malabsorption can lead to anemia, bone disease, growth faltering, or other consequences. The condition is lifelong and lacks a cure; the only treatment is lifelong adherence to a gluten-free diet (GFD). This diet is challenging to follow and adversely influences quality of life; however, it is essential to ensure intestinal recovery and prevent future negative health consequences. The Academy of Nutrition and Dietetics convened an expert panel complemented by a celiac disease patient advocate to evaluate evidence for six topics, including medical nutrition therapy; the GFD; oat consumption; micronutrients; pro-/prebiotics; and the low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet. This publication outlines the Academy of Nutrition and Dietetics Evidence Analysis Library methods used to complete the systematic review and guideline development, and summarizes the recommendations and supporting evidence. The guidelines affirm that all individuals with celiac disease should follow a GFD (1C, Imperative) that may include gluten-free oats in adults (2D, Conditional). Children should follow a nutritionally adequate GFD that supports healthy growth and development (Consensus, Imperative) and does not unnecessarily restrict gluten-free oats (Consensus, Conditional). The guidelines indicate nutritional care should include routine nutritional assessment (Consensus, Imperative) and medical nutrition therapy (Consensus, Imperative). At this time, the guidelines do not support a recommendation for the addition of the low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet (2C, Conditional); prebiotic or probiotic supplementation (2D, Conditional); or micronutrient supplementation (in the absence of nutritional deficiency) (Consensus, Conditional). The 2021 Celiac Disease Evidence-Based Nutrition Guideline will assist registered dietitian nutritionists in providing appropriate evidence-based medical nutrition therapy to support people with celiac disease in achieving and maintaining nutritional health and avoiding adverse celiac disease consequences throughout their lives.
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Affiliation(s)
| | - M Angie Almond
- Wake Forest Baptist Medical Center, Winston-Salem, North Carolina
| | | | - Emily M Germer
- Matthew Walker Comprehensive Health Center, Nashville, Tennessee
| | | | | | | | - Deepa Handu
- Academy of Nutrition and Dietetics, Chicago, Illinois.
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2
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Yan H, Zhang H, Zhou P, Ren C, Peng Y. Genome-Wide Association Mapping of QTL Underlying Groat Protein Content of a Diverse Panel of Oat Accessions. Int J Mol Sci 2023; 24:ijms24065581. [PMID: 36982656 PMCID: PMC10053717 DOI: 10.3390/ijms24065581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/06/2023] [Accepted: 03/13/2023] [Indexed: 03/17/2023] Open
Abstract
Groat protein content (GPC) is a key quality trait attribute in oat. Understanding the variation of GPC in oat germplasms and identifying genomic regions associated with GPC are essential for improving this trait. In this study, the GPC of 174 diverse oat accessions was evaluated in three field trials. The results showed a wide variation in GPC, ranging from 6.97% to 22.24% in this panel. Hulless oats displayed a significantly higher GPC compared to hulled oats across all environments. A GWAS analysis was performed based on 38,313 high-quality SNPs, which detected 27 non-redundant QTLs with 41 SNPs significantly associated with GPC. Two QTLs on chromosome 6C (QTL16) and 4D (QTL11) were consistently detected in multiple environments, with QTL16 being the most significant and explaining the highest proportion of the phenotypical variation in all tested environments except in CZ20. Haplotype analysis showed that the favorable haplotypes for GPC are more prevalent in hulless oats. These findings provide a foundation for future efforts to incorporate favorable alleles into new cultivars through introgression, fine mapping, and cloning of promising QTLs.
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Affiliation(s)
- Honghai Yan
- State Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural University, Chengdu 611130, China;
- Triticeae Research Institute, Sichuan Agricultural University, Chengdu 611130, China
| | - Haixu Zhang
- Triticeae Research Institute, Sichuan Agricultural University, Chengdu 611130, China
| | - Pingping Zhou
- Triticeae Research Institute, Sichuan Agricultural University, Chengdu 611130, China
| | - Changzhong Ren
- National Oat Improvement Center, Baicheng Academy of Agricultural Sciences, Baicheng 137000, China
| | - Yuanying Peng
- State Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural University, Chengdu 611130, China;
- Triticeae Research Institute, Sichuan Agricultural University, Chengdu 611130, China
- Correspondence:
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Immonen M, Chandrakusuma A, Hokkanen S, Partanen R, Mäkelä-Salmi N, Myllärinen P. The effect of deamidation and lipids on the interfacial and foaming properties of ultrafiltered oat protein concentrates. Lebensm Wiss Technol 2022. [DOI: 10.1016/j.lwt.2022.114016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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4
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Gell G, Karsai I, Berki Z, Horváth Á, Florides CG, Birinyi Z, Nagy-Réder D, Varga B, Cseh A, Békés F, Veisz O. Effect of additional water supply during grain filling on protein composition and epitope characteristics of winter oats. Curr Res Food Sci 2022; 5:2146-2161. [DOI: 10.1016/j.crfs.2022.10.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 10/12/2022] [Accepted: 10/30/2022] [Indexed: 11/06/2022] Open
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5
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Boosting biomedical document classification through the use of domain entity recognizers and semantic ontologies for document representation: The case of gluten bibliome. Neurocomputing 2022. [DOI: 10.1016/j.neucom.2021.10.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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6
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The Role of Nutrition in Immune-Mediated, Inflammatory Skin Disease: A Narrative Review. Nutrients 2022; 14:nu14030591. [PMID: 35276950 PMCID: PMC8840467 DOI: 10.3390/nu14030591] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/23/2022] [Accepted: 01/27/2022] [Indexed: 11/16/2022] Open
Abstract
Immune-mediated inflammatory skin diseases are characterized by a complex multifactorial etiology, in which genetic and environmental factors interact both in genesis and development of the disease. Nutrition is a complex and fascinating scenario, whose pivotal role in induction, exacerbation, or amelioration of several human diseases has already been well documented. However, owing to the complexity of immune-mediated skin disease clinical course and breadth and variability of human nutrition, their correlation still remains an open debate in literature. It is therefore important for dermatologists to be aware about the scientific basis linking nutrition to inflammatory skin diseases such as psoriasis, atopic dermatitis, hidradenitis suppurativa, bullous diseases, vitiligo, and alopecia areata, and whether changes in diet can influence the clinical course of these diseases. The purpose of this narrative review is to address the role of nutrition in immune-mediated inflammatory skin diseases, in light of the most recent and validate knowledge on this topic. Moreover, whether specific dietary modifications could provide meaningful implementation in planning a therapeutic strategy for patients is evaluated, in accordance with regenerative medicine precepts, a healing-oriented medicine that considers the whole person, including all aspects of the lifestyle.
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7
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Gell G, Bugyi Z, Florides CG, Birinyi Z, Réder D, Szegő Z, Mucsi E, Schall E, Ács K, Langó B, Purgel S, Simon K, Varga B, Vida G, Veisz O, Tömösközi S, Békés F. Investigation of Protein and Epitope Characteristics of Oats and Its Implications for Celiac Disease. Front Nutr 2021; 8:702352. [PMID: 34660657 PMCID: PMC8511309 DOI: 10.3389/fnut.2021.702352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 08/23/2021] [Indexed: 12/14/2022] Open
Abstract
The use of pure oats (oats cultivated with special care to avoid gluten contamination from wheat, rye, and barley) in the gluten-free diet (GFD) represents important nutritional benefits for the celiac consumer. However, emerging evidence suggests that some oat cultivars may contain wheat gliadin analog polypeptides. Consequently, it is necessary to screen oats in terms of protein and epitope composition to be able to select safe varieties for gluten-free applications. The overall aim of our study is to investigate the variability of oat protein composition directly related to health-related and techno-functional properties. Elements of an oat sample population representing 162 cultivated varieties from 20 countries and the protein composition of resulting samples have been characterized. Size distribution of the total protein extracts has been analyzed by size exclusion-high performance liquid chromatography (SE-HPLC) while the 70% ethanol-extracted proteins were analyzed by RP-HPLC. Protein extracts separated into three main groups of fractions on the SE-HPLC column: polymeric proteins, avenins (both containing three subgroups based on their size), and soluble proteins, representing respectively 68.79–86.60, 8.86–27.72, and 2.89–11.85% of the total protein content. The ratio of polymeric to monomeric proteins varied between 1.37 and 3.73. Seventy-six reversed phase-HPLC-separated peaks have been differentiated from the ethanol extractable proteins of the entire population. Their distribution among the cultivars varied significantly, 6–23 peaks per cultivar. The number of appearances of peaks also showed large variation: one peak has been found in 107 samples, while 15 peaks have been identified, which appeared in less than five cultivars. An estimation method for ranking the avenin-epitope content of the samples has been developed by using MS spectrometric data of collected RP-HPLC peaks and bioinformatics methods. Using ELISA methodology with the R5 antibody, a high number of the investigated samples were found to be contaminated with wheat, barley, or rye.
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Affiliation(s)
- Gyöngyvér Gell
- Department of Biological Resources, Agricultural Institute, Centre for Agricultural Research, EötvösLoránd Research Network, Martonvásár, Hungary.,Department of Applied Biotechnology and Food Science, Research Group of Cereal Science and Food Quality, Budapest University of Technology and Economics, Budapest, Hungary
| | - Zsuzsanna Bugyi
- Department of Applied Biotechnology and Food Science, Research Group of Cereal Science and Food Quality, Budapest University of Technology and Economics, Budapest, Hungary
| | | | - Zsófia Birinyi
- Department of Biological Resources, Agricultural Institute, Centre for Agricultural Research, EötvösLoránd Research Network, Martonvásár, Hungary
| | - Dalma Réder
- Department of Biological Resources, Agricultural Institute, Centre for Agricultural Research, EötvösLoránd Research Network, Martonvásár, Hungary
| | - Zsuzsanna Szegő
- Department of Applied Biotechnology and Food Science, Research Group of Cereal Science and Food Quality, Budapest University of Technology and Economics, Budapest, Hungary
| | - Edina Mucsi
- Department of Applied Biotechnology and Food Science, Research Group of Cereal Science and Food Quality, Budapest University of Technology and Economics, Budapest, Hungary
| | - Eszter Schall
- Department of Applied Biotechnology and Food Science, Research Group of Cereal Science and Food Quality, Budapest University of Technology and Economics, Budapest, Hungary
| | - Katalin Ács
- Cereal Research Non-Profit Ltd., Szeged, Hungary
| | | | | | | | - Balázs Varga
- Cereal Breeding Department, Agricultural Institute, Centre for Agricultural Research, EötvösLoránd Research Network, Martonvásár, Hungary
| | - Gyula Vida
- Cereal Breeding Department, Agricultural Institute, Centre for Agricultural Research, EötvösLoránd Research Network, Martonvásár, Hungary
| | - Ottó Veisz
- Cereal Breeding Department, Agricultural Institute, Centre for Agricultural Research, EötvösLoránd Research Network, Martonvásár, Hungary
| | - Sándor Tömösközi
- Department of Applied Biotechnology and Food Science, Research Group of Cereal Science and Food Quality, Budapest University of Technology and Economics, Budapest, Hungary
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Demirkesen I, Ozkaya B. Recent strategies for tackling the problems in gluten-free diet and products. Crit Rev Food Sci Nutr 2020; 62:571-597. [DOI: 10.1080/10408398.2020.1823814] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Ilkem Demirkesen
- Department of Animal Health, Food and Feed Research, General Directorate of Agricultural Research and Policies, Ministry of Agriculture and Forestry, Ankara, Turkey
| | - Berrin Ozkaya
- Department of Food Engineering, Ankara University, Ankara, Turkey
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9
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Kosová K, Leišová-Svobodová L, Dvořáček V. Oats as a Safe Alternative to Triticeae Cereals for People Suffering from Celiac Disease? A Review. PLANT FOODS FOR HUMAN NUTRITION (DORDRECHT, NETHERLANDS) 2020; 75:131-141. [PMID: 32133597 DOI: 10.1007/s11130-020-00800-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Oats represent a promising alternative to small-grain cereals from Triticeae group (wheat, barley, rye) for persons suffering from any form of gluten intolerance, especially celiac disease (CD), since oat-specific prolamins avenins reveal generally lower gluten content and immunoreactivity. Recent studies on avenin molecular structure revealed large genetic variability in avenin sequences affecting the spectrum of gluten peptides produced by hydrolases in human digestive tract. The aim of the present review is to summarise recent knowledge obtained in laboratory studies focused on the effect of avenin-derived peptides on reactivity of crucial components of human immune system such as dendritic cells (DC) and T-cells. The other part of the review summarises the results of clinical studies with CD patients including oat products in their diet. Since different clinical studies revealed contradictory results regarding potential safety of oats for CD patients, the focus has to be directed at genetic variability in oat avenins. Identification of avenin isoforms with minimum CD immunoreactivity will open up ways leading to designing novel oat cultivars suitable for CD patients. Knowledge on immunoreactivity of gluten peptides together with breeding new oat cultivars revealing minimum avenin immunoreactivity with respect to CD as well as application of food processing technologies leading to gluten content reduction should result in development of gluten-free oats safe for celiacs.
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Affiliation(s)
- Klára Kosová
- Division of Crop Genetics and Breeding, Crop Research Institute, Prague, 6-Ruzyně, Czechia.
| | | | - Václav Dvořáček
- Division of Crop Genetics and Breeding, Crop Research Institute, Prague, 6-Ruzyně, Czechia
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10
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Sharma N, Bhatia S, Chunduri V, Kaur S, Sharma S, Kapoor P, Kumari A, Garg M. Pathogenesis of Celiac Disease and Other Gluten Related Disorders in Wheat and Strategies for Mitigating Them. Front Nutr 2020; 7:6. [PMID: 32118025 PMCID: PMC7020197 DOI: 10.3389/fnut.2020.00006] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 01/20/2020] [Indexed: 12/12/2022] Open
Abstract
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.
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Affiliation(s)
- Natasha Sharma
- Agri-Food Biotechnology Laboratory, National Agri-Food Biotechnology Institute, Mohali, India
| | - Simran Bhatia
- Agri-Food Biotechnology Laboratory, National Agri-Food Biotechnology Institute, Mohali, India
| | - Venkatesh Chunduri
- Agri-Food Biotechnology Laboratory, National Agri-Food Biotechnology Institute, Mohali, India
| | - Satveer Kaur
- Agri-Food Biotechnology Laboratory, National Agri-Food Biotechnology Institute, Mohali, India
| | - Saloni Sharma
- Agri-Food Biotechnology Laboratory, National Agri-Food Biotechnology Institute, Mohali, India
| | - Payal Kapoor
- Agri-Food Biotechnology Laboratory, National Agri-Food Biotechnology Institute, Mohali, India
| | - Anita Kumari
- Agri-Food Biotechnology Laboratory, National Agri-Food Biotechnology Institute, Mohali, India
| | - Monika Garg
- Agri-Food Biotechnology Laboratory, National Agri-Food Biotechnology Institute, Mohali, India
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11
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Raju N, Joshi AKR, Vahini R, Deepika T, Bhaskarachari K, Devindra S. Gluten contamination in labelled and naturally gluten-free grain products in southern India. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2020; 37:531-538. [PMID: 32011974 DOI: 10.1080/19440049.2020.1711970] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Consumption of a gluten-free diet or avoiding exposure to gluten is the only feasible and effective treatment available for coeliac patients to date. Although many grains and their products are naturally gluten-free, the possibility of gluten cross-contamination must be considered. Since such data are not available for Indian markets, we carried out this pilot study (n = 160) to assess gluten contamination in various grain-based food products from the category of breakfast products, flours, and batters made from grain that are naturally gluten free. The gluten was extracted from samples using 60% ethanol and gluten analysis was carried out using a commercially available competitive ELISA, which utilises a monoclonal antibody. Nearly 9.8% of the products labelled as gluten-free and 36.7% of the products made from naturally gluten-free grain were found to contain gluten above 20 mg/kg. Among products made from naturally gluten-free grain, 35.9% of the flour samples and 85% of the oat samples (11.67-1830 mg/kg) were contaminated with gluten. In the case of flours, unbranded samples collected from local markets (70%) and directly from local mills (30%) showed gluten content above Codex safety levels (20-400 mg/kg). Among products labelled as gluten free (n = 51), only 5 samples showed gluten contamination above 20 mg/kg although levels were well within 100 mg/kg (32.5 ± 5.8). Our study suggests that there is a likelihood of gluten contamination in products that are sourced from local retailers and millers.
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Affiliation(s)
- Nagaraju Raju
- Department of Dietetics, National Institute of Nutrition (ICMR), Hyderabad, India
| | - Apurva Kumar R Joshi
- Department of Dietetics, National Institute of Nutrition (ICMR), Hyderabad, India
| | - Raidu Vahini
- Department of Dietetics, National Institute of Nutrition (ICMR), Hyderabad, India
| | - Thappatla Deepika
- Department of Dietetics, National Institute of Nutrition (ICMR), Hyderabad, India
| | | | - S Devindra
- Department of Dietetics, National Institute of Nutrition (ICMR), Hyderabad, India
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12
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García-García A, Madrid R, Sohrabi H, de la Cruz S, García T, Martín R, González I. A sensitive and specific real-time PCR targeting DNA from wheat, barley and rye to track gluten contamination in marketed foods. Lebensm Wiss Technol 2019. [DOI: 10.1016/j.lwt.2019.108378] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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13
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Hoffmanová I, Sánchez D, Szczepanková A, Tlaskalová-Hogenová H. The Pros and Cons of Using Oat in a Gluten-Free Diet for Celiac Patients. Nutrients 2019; 11:nu11102345. [PMID: 31581722 PMCID: PMC6835965 DOI: 10.3390/nu11102345] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 09/12/2019] [Accepted: 09/25/2019] [Indexed: 02/07/2023] Open
Abstract
A therapeutic gluten-free diet often has nutritional limitations. Nutritional qualities such as high protein content, the presence of biologically active and beneficial substances (fiber, beta-glucans, polyunsaturated fatty acids, essential amino acids, antioxidants, vitamins, and minerals), and tolerance by the majority of celiac patients make oat popular for use in gluten-free diet. The health risk of long-time consumption of oat by celiac patients is a matter of debate. The introduction of oat into the diet is only recommended for celiac patients in remission. Furthermore, not every variety of oat is also appropriate for a gluten-free diet. The risk of sensitization and an adverse immunologically mediated reaction is a real threat in some celiac patients. Several unsolved issues still exist which include the following: (1) determination of the susceptibility markers for the subgroup of celiac patients who are at risk because they do not tolerate dietary oat, (2) identification of suitable varieties of oat and estimating the safe dose of oat for the diet, and (3) optimization of methods for detecting the gliadin contamination in raw oat used in a gluten-free diet.
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Affiliation(s)
- Iva Hoffmanová
- 2nd Department of Internal Medicine, University Hospital Královské Vinohrady and Third Faculty of Medicine, Charles University, Ruská 87, 10000 Prague, Czech Republic.
| | - Daniel Sánchez
- Laboratory of Cellular and Molecular Immunology, Institute of Microbiology of the Czech Academy of Sciences, Vídeňská 1083, 14220 Prague, Czech Republic.
| | - Adéla Szczepanková
- Laboratory of Cellular and Molecular Immunology, Institute of Microbiology of the Czech Academy of Sciences, Vídeňská 1083, 14220 Prague, Czech Republic.
- First Faculty of Medicine, Charles University, Kateřinská 1660/32, 121 08 Prague, Czech Republic.
| | - Helena Tlaskalová-Hogenová
- Laboratory of Cellular and Molecular Immunology, Institute of Microbiology of the Czech Academy of Sciences, Vídeňská 1083, 14220 Prague, Czech Republic.
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14
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Bascuñán KA, Roncoroni L, Branchi F, Doneda L, Scricciolo A, Ferretti F, Araya M, Elli L. The 5 Ws of a gluten challenge for gluten-related disorders. Nutr Rev 2019; 76:79-87. [PMID: 29325090 DOI: 10.1093/nutrit/nux068] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Gluten-related disorders (GRDs) are gradually emerging as epidemiologically relevant diseases, with a global prevalence estimated to be approximately 5% in the population. Conditions related to gluten ingestion include celiac disease (CD), wheat allergy (WA), and nonceliac gluten sensitivity (NCGS). Although mediated by different pathogenic pathways, these 3 conditions share similar clinical manifestations and can present a difficult differential diagnosis. The gluten challenge (GC) is an important diagnostic tool for GRDs, but there is great variability in regards to deciding which patients should be challenged, what amount of gluten should be used, what the GC duration should be, when and where the GC should occur, and, sometimes, why to conduct a GC. This review summarizes the current knowledge about the desirable characteristics of GCs in the 3 main GRDs following a 5 Ws approach-that is, the 5 main journalistic questions: who, what, when, where, why. The answers will help to determine the correct use of the GC in diagnosing GRDs.
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Affiliation(s)
- Karla A Bascuñán
- Department of Nutrition, School of Medicine, University of Chile, Santiago, Chile
| | - Leda Roncoroni
- Center for Prevention and Diagnosis of Celiac Disease, Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and Università degli Studi di Milano, Milan, Italy.,Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milano, Italy
| | - Federica Branchi
- Center for Prevention and Diagnosis of Celiac Disease, Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and Università degli Studi di Milano, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Luisa Doneda
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milano, Italy
| | - Alice Scricciolo
- Center for Prevention and Diagnosis of Celiac Disease, Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and Università degli Studi di Milano, Milan, Italy
| | - Francesca Ferretti
- Center for Prevention and Diagnosis of Celiac Disease, Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and Università degli Studi di Milano, Milan, Italy
| | - Magdalena Araya
- Institute of Nutrition and Food Technology, INTA, University of Chile, Santiago, Chile
| | - Luca Elli
- Center for Prevention and Diagnosis of Celiac Disease, Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and Università degli Studi di Milano, Milan, Italy
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15
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Spector Cohen I, Day AS, Shaoul R. To Be Oats or Not to Be? An Update on the Ongoing Debate on Oats for Patients With Celiac Disease. Front Pediatr 2019; 7:384. [PMID: 31616650 PMCID: PMC6775206 DOI: 10.3389/fped.2019.00384] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 09/05/2019] [Indexed: 12/12/2022] Open
Abstract
To date, the only known effective treatment for celiac disease (CD) is a strict gluten-free diet (GFD) for life. Patients with CD often find it difficult to adhere to strict GFD. Oats, compared with wheat, barley, and rye, contain less amounts of prolamins. Inclusion of oats in a GFD might be valuable due to their nutritional and health benefits and increase of food variety. Therefore, they may potentially improve feeding diversity for these children and improve taste and satiety. We reviewed the literature to evaluate the safety of oats in CD patients. We have searched PUBMED, societal guidelines and national health authorities' recommendations. The following aspects were reviewed: gastrointestinal symptoms, malabsorption, serology including specific avenin antibodies, mucosal changes, avenin toxicity, immunogenicity of oats, and quality of life. We also referred to wheat contamination of oat products, the safe amount of oats for CD patients and the type of oats recommended. Data support that pure oats are well-tolerated by most CD patients, at moderate amounts (20-25 g/day dry rolled oats for children; 50-70 g/day for adults). Nevertheless, since the potential for sensitivity/toxicity exists, oats should be added with caution to a GFD, only after all CD symptoms including weight loss and growth disturbances have resolved, after at least 6 months of conventional GFD and probably also after normalization of serology. The need for pre exposure biopsy is unclear and should be considered on an individual basis.
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Affiliation(s)
- Inna Spector Cohen
- Pediatric Gastroenterology and Nutrition Institute, Ruth Children's Hospital of Haifa, Rambam Medical Center, Faculty of Medicine, Technion, Haifa, Israel
| | - Andrew S Day
- Department of Paediatrics, University of Otago, Christchurch, New Zealand
| | - Ron Shaoul
- Pediatric Gastroenterology and Nutrition Institute, Ruth Children's Hospital of Haifa, Rambam Medical Center, Faculty of Medicine, Technion, Haifa, Israel
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Ross GMS, Bremer MGEG, Nielen MWF. Consumer-friendly food allergen detection: moving towards smartphone-based immunoassays. Anal Bioanal Chem 2018; 410:5353-5371. [PMID: 29582120 PMCID: PMC6096701 DOI: 10.1007/s00216-018-0989-7] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 02/14/2018] [Accepted: 02/26/2018] [Indexed: 12/28/2022]
Abstract
In this critical review, we provide a comprehensive overview of immunochemical food allergen assays and detectors in the context of their user-friendliness, through their connection to smartphones. Smartphone-based analysis is centered around citizen science, putting analysis into the hands of the consumer. Food allergies represent a significant worldwide health concern and consumers should be able to analyze their foods, whenever and wherever they are, for allergen presence. Owing to the need for a scientific background, traditional laboratory-based detection methods are generally unsuitable for the consumer. Therefore, it is important to develop simple, safe, and rapid assays that can be linked with smartphones as detectors to improve user accessibility. Smartphones make excellent detection systems because of their cameras, embedded flash functions, portability, connectivity, and affordability. Therefore, this review has summarized traditional laboratory-based methods for food allergen detection such as enzyme-linked-immunosorbent assay, flow cytometry, and surface plasmon resonance, and the potential to modernize these methods by interfacing them with a smartphone readout system, based on the aforementioned smartphone characteristics. This is the first review focusing on smartphone-based food-allergen detection methods designed with the intention of being consumer-friendly. Graphical abstract A smartphone-based food allergen detection system in three easy steps (1) sample preparation, (2) allergen detection on a smartphone using antibodies, which then transmits the data wirelessly, (3) analytical results sent straight to smartphone.
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Affiliation(s)
- Georgina M S Ross
- RIKILT, Wageningen University and Research, P.O Box 230, 6700 AE, Wageningen, The Netherlands.
| | - Monique G E G Bremer
- RIKILT, Wageningen University and Research, P.O Box 230, 6700 AE, Wageningen, The Netherlands
| | - Michel W F Nielen
- RIKILT, Wageningen University and Research, P.O Box 230, 6700 AE, Wageningen, The Netherlands
- Laboratory of Organic Chemistry, Wageningen University, Helix Building 124, Stippeng 4, 6708 WE, Wageningen, The Netherlands
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17
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Naik RD, Seidner DL, Adams DW. Nutritional Consideration in Celiac Disease and Nonceliac Gluten Sensitivity. Gastroenterol Clin North Am 2018; 47:139-154. [PMID: 29413009 DOI: 10.1016/j.gtc.2017.09.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Celiac disease is an autoimmune disorder due to the inflammatory response to gluten in genetically predisposed individuals. It causes an enteropathy associated with several nutritional complications. Strict compliance to a gluten-free diet (GFD) is the current primary therapy. Nonceliac gluten sensitivity (NCGS) is a condition in which gluten ingestion leads to systemic symptoms but is not associated with small bowel atrophy or abnormal celiac serologies. A GFD heals celiac disease enteropathy and improves symptoms in NCGS. However, a long-term GFD can be associated with nutritional deficiencies and requires monitoring and guidance.
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Affiliation(s)
- Rishi D Naik
- Division of Gastroenterology, Hepatology, and Nutrition, Center for Nutrition, Vanderbilt University Medical Center, 1211 21st Avenue South, Suite 514, Nashville, TN 37232, USA
| | - Douglas L Seidner
- Division of Gastroenterology, Hepatology, and Nutrition, Center for Nutrition, Vanderbilt University Medical Center, 1211 21st Avenue South, Suite 514, Nashville, TN 37232, USA
| | - Dawn Wiese Adams
- Division of Gastroenterology, Hepatology, and Nutrition, Center for Nutrition, Vanderbilt University Medical Center, 1211 21st Avenue South, Suite 514, Nashville, TN 37232, USA.
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18
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Abstract
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.
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Affiliation(s)
- J Rainer Poley
- a Eastern Virginia Medical School , Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics EVMS, and Childrens' Hospital of the King's Daughters , Norfolk , Virginia, (ret).,b Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, Brody School of Medicine , East Carolina University , Greenville , North Carolina (ret)
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Kerpes R, Fischer S, Becker T. The production of gluten-free beer: Degradation of hordeins during malting and brewing and the application of modern process technology focusing on endogenous malt peptidases. Trends Food Sci Technol 2017. [DOI: 10.1016/j.tifs.2017.07.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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20
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Pinto-Sánchez MI, Causada-Calo N, Bercik P, Ford AC, Murray JA, Armstrong D, Semrad C, Kupfer SS, Alaedini A, Moayyedi P, Leffler DA, Verdú EF, Green P. Safety of Adding Oats to a Gluten-Free Diet for Patients With Celiac Disease: Systematic Review and Meta-analysis of Clinical and Observational Studies. Gastroenterology 2017; 153:395-409.e3. [PMID: 28431885 DOI: 10.1053/j.gastro.2017.04.009] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 03/28/2017] [Accepted: 04/06/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND & AIMS Patients with celiac disease should maintain a gluten-free diet (GFD), excluding wheat, rye, and barley. Oats might increase the nutritional value of a GFD, but their inclusion is controversial. We performed a systematic review and meta-analysis to evaluate the safety of oats as part of a GFD in patients with celiac disease. METHODS We searched the Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE databases for clinical trials and observational studies of the effects of including oats in GFD of patients with celiac disease. The studies reported patients' symptoms, results from serology tests, and findings from histologic analyses. We used the GRADE approach to assess the quality of evidence. RESULTS We identified 433 studies; 28 were eligible for analysis. Of these, 6 were randomized and 2 were not randomized controlled trials comprising a total of 661 patients-the remaining studies were observational. All randomized controlled trials used pure/uncontaminated oats. Oat consumption for 12 months did not affect symptoms (standardized mean difference: reduction in symptom scores in patients who did and did not consume oats, -0.22; 95% CI, -0.56 to 0.13; P = .22), histologic scores (relative risk for histologic findings in patients who consumed oats, 0.24; 95% CI, 0.01-4.8; P = .35), intraepithelial lymphocyte counts (standardized mean difference, 0.21; 95% CI, reduction of 1.44 to increase in 1.86), or results from serologic tests. Subgroup analyses of adults vs children did not reveal differences. The overall quality of evidence was low. CONCLUSIONS In a systematic review and meta-analysis, we found no evidence that addition of oats to a GFD affects symptoms, histology, immunity, or serologic features of patients with celiac disease. However, there were few studies for many endpoints, as well as limited geographic distribution and low quality of evidence. Rigorous double-blind, placebo-controlled, randomized controlled trials, using commonly available oats sourced from different regions, are needed.
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Affiliation(s)
- María Inés Pinto-Sánchez
- Department of Medicine, Farncombe Family Digestive Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Natalia Causada-Calo
- Department of Medicine, Farncombe Family Digestive Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Premysl Bercik
- Department of Medicine, Farncombe Family Digestive Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Alexander C Ford
- Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, United Kingdom; Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, United Kingdom
| | - Joseph A Murray
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - David Armstrong
- Department of Medicine, Farncombe Family Digestive Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Carol Semrad
- Celiac Disease Center at University of Chicago Medicine, Chicago, Illinois
| | - Sonia S Kupfer
- Celiac Disease Center at University of Chicago Medicine, Chicago, Illinois
| | - Armin Alaedini
- Celiac Disease Center at Columbia University, New York, New York
| | - Paul Moayyedi
- Department of Medicine, Farncombe Family Digestive Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Daniel A Leffler
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Elena F Verdú
- Department of Medicine, Farncombe Family Digestive Research Institute, McMaster University, Hamilton, Ontario, Canada.
| | - Peter Green
- Celiac Disease Center at Columbia University, New York, New York
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21
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Abstract
Celiac disease (CD) is an autoimmune enteropathy that occurs in response to gluten ingestion in predisposed individuals. The autoimmune response results in villous atrophy in the small intestine, the primary site of nutrient absorption. Consequently, micronutrient deficiencies may occur in undiagnosed CD. Deficiencies in calcium, vitamin D, iron, folate, vitamin B12, and zinc have all been demonstrated in children with CD. Complications as a result of these nutrient deficiencies may affect a child’s growth, development, and overall well-being. The gluten-free diet (GFD) is the only known treatment for CD. Compliance with the diet is vital in correcting and preventing future micronutrient deficiencies. The purpose of this article is to give a background on CD and to present research that has shown micronutrient deficiencies in the pediatric population. The article will also focus on the crucial role of the health care team in both the recognition and management of pediatric patients with CD.
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Affiliation(s)
- Amy Friedman
- Columbia University School of Nursing, New York, New York
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22
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Giménez MJ, Real A, García-Molina MD, Sousa C, Barro F. Characterization of celiac disease related oat proteins: bases for the development of high quality oat varieties suitable for celiac patients. Sci Rep 2017; 7:42588. [PMID: 28209962 PMCID: PMC5314403 DOI: 10.1038/srep42588] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 01/11/2017] [Indexed: 12/16/2022] Open
Abstract
Some studies have suggested that the immunogenicity of oats depends on the cultivar. RP-HPLC has been proposed as a useful technique to select varieties of oats with reduced immunogenicity. The aim of this study was to identify both the avenin protein patterns associated with low gluten content and the available variability for the development of new non-toxic oat cultivars. The peaks of alcohol-soluble avenins of a collection of landraces and cultivars of oats have been characterized based on the RP-HPLC elution times. The immunotoxicity of oat varieties for patients with celiac disease (CD) has been tested using a competitive ELISA based on G12 monoclonal antibody. The oat lines show, on average, seven avenin peaks giving profiles with certain similarities. Based on this similarity, most of the accessions have been grouped into avenin patterns. The variability of RP-HPLC profiles of the collection is great, but not sufficient to uniquely identify the different varieties of the set. Overall, the immunogenicity of the collection is less than 20 ppm. However, there is a different distribution of toxicity ranges between the different peak patterns. We conclude that the RP-HPLC technique is useful to establish groups of varieties differing in degree of toxicity for CD patients.
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Affiliation(s)
| | - Ana Real
- INSERM U1218 "ACTION", Bordeaux University, Bordeaux Cedex, France
| | | | - Carolina Sousa
- Departamento de Microbiología y Parasitología, Facultad de Farmacia, Universidad de Sevilla, Sevilla, Spain
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23
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Nomenclature and diagnosis of gluten-related disorders: A position statement by the Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO). Dig Liver Dis 2017; 49:138-146. [PMID: 27887897 DOI: 10.1016/j.dld.2016.10.016] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 10/03/2016] [Accepted: 10/25/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND "Gluten-related disorders" is a term that encompasses different diseases induced by the ingestion of gluten-containing food. Because of their incidence the scientific community has been intensively studying them. AIM To support gastroenterologists with a correct nomenclature and diagnostic approach to gluten-related disorders in adulthood. METHODS The Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO) commissioned a panel of experts to prepare a position statement clarifying the nomenclature and diagnosis of gluten-related disorders, focusing on those of gastroenterological interest. Each member was assigned a task and levels of evidence/recommendation have been proposed. RESULTS The panel identified celiac disease, wheat allergy and non-celiac gluten sensitivity as the gluten-related disorders of gastroenterological interest. Celiac disease has an autoimmune nature, wheat allergy is IgE-mediated while the pathogenesis of non-celiac gluten sensitivity is still unknown as is the case of non-IgE mediated allergy. Diagnosis should start with the serological screening for celiac disease and wheat allergy. In case of normal values, the response to a gluten-free diet should be evaluated and a confirmatory blind food challenge carried out. CONCLUSIONS Gluten-related disorders are clinically heterogeneous. Patients should be carefully managed and specific protocols applied for a correct differential diagnosis in gastroenterological setting.
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24
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The starch-bound alpha-amylase/trypsin-inhibitors in Avena. Mol Genet Genomics 2016; 291:2043-2054. [PMID: 27495179 DOI: 10.1007/s00438-016-1238-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 07/29/2016] [Indexed: 12/15/2022]
Abstract
Oat kernels exhibit an extra-soft texture, a trait recently demonstrated to be largely modulated by starch-bound tryptophan-rich 2S proteins, the vromindolines. In this study, fractionation by two-dimensional electrophoresis of starch-bound proteins in 25 oat (Avena sativa) cultivars and 11 diploid or tetraploid Avena species revealed novel 2S proteins called Avena α-amylase/trypsin-inhibitors (AATI) because of their sequence similarity with wheat α-amylase/trypsin inhibitors. Thirty-seven AATI polypeptides, about 14 kDa in size, were split into three families named AATI-1, AATI-2, and AATI-3 with different primary structures and isoelectric points. AATI-1 and AATI-2 proteins showed 55.5-60.0 % sequence similarity with wheat α-amylase inhibitors CM1, CM2, and CM16, which have been found to cause innate immunity responses in celiac disease and non-celiac gluten sensitivity. Diploid A-genome and tetraploid AC-genome oat species possess three and five genes encoding for the AATI proteins, respectively, whereas hexaploid A. sativa exhibits 12 genes dispersed over the A-, C-, and D-genomes. Some AATI proteins expressed in hexaploid oats were assigned to the A-genome based on similarity to their counterparts in diploid species, contributing to further clarify the genetic origin of hexaploid oats. Moreover, AATI may interact with starch-bound vromindolines in determining the extra-soft texture of oat kernels and, due to their balanced amino acid compositions, may contribute to the biological value of oat proteins in a positive manner.
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de Souza MCP, Deschênes ME, Laurencelle S, Godet P, Roy CC, Djilali-Saiah I. Pure Oats as Part of the Canadian Gluten-Free Diet in Celiac Disease: The Need to Revisit the Issue. Can J Gastroenterol Hepatol 2016; 2016:1576360. [PMID: 27446824 PMCID: PMC4904650 DOI: 10.1155/2016/1576360] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 10/15/2015] [Indexed: 11/17/2022] Open
Abstract
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.
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Affiliation(s)
| | - Marie-Eve Deschênes
- Fondation Québécoise de la Maladie Cœliaque (FQMC), Montréal, QC, Canada H2J 3E6
| | - Suzanne Laurencelle
- Fondation Québécoise de la Maladie Cœliaque (FQMC), Montréal, QC, Canada H2J 3E6
| | - Patrick Godet
- Fondation Québécoise de la Maladie Cœliaque (FQMC), Montréal, QC, Canada H2J 3E6
- Clinique de Gastroentérologie, Centre Hospitalier Lasalle, Lasalle, QC, Canada H8N 1X7
| | - Claude C. Roy
- Fondation Québécoise de la Maladie Cœliaque (FQMC), Montréal, QC, Canada H2J 3E6
- Service de Gastroentérologie, Hépatologie et Nutrition, CHU Sainte-Justine, Montréal, QC, Canada H3T 1C5
| | - Idriss Djilali-Saiah
- Fondation Québécoise de la Maladie Cœliaque (FQMC), Montréal, QC, Canada H2J 3E6
- Service de Gastroentérologie, Hépatologie et Nutrition, CHU Sainte-Justine, Montréal, QC, Canada H3T 1C5
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26
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Comino I, Bernardo D, Bancel E, de Lourdes Moreno M, Sánchez B, Barro F, Šuligoj T, Ciclitira PJ, Cebolla Á, Knight SC, Branlard G, Sousa C. Identification and molecular characterization of oat peptides implicated on coeliac immune response. Food Nutr Res 2016; 60:30324. [PMID: 26853779 PMCID: PMC4744869 DOI: 10.3402/fnr.v60.30324] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Revised: 12/06/2015] [Accepted: 12/07/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Oats provide important nutritional and pharmacological properties, although their safety in coeliac patients remains controversial. Previous studies have confirmed that the reactivity of the anti-33-mer monoclonal antibody with different oat varieties is proportional to the immune responses in terms of T-cell proliferation. Although the impact of these varieties on the adaptive response has been studied, the role of the dendritic cells (DC) is still poorly understood. The aim of this study is to characterize different oat fractions and to study their effect on DC from coeliac patients. METHODS AND RESULTS Protein fractions were isolated from oat grains and analyzed by SDS-PAGE. Several proteins were characterized in the prolamin fraction using immunological and proteomic tools, and by Nano-LC-MS/MS. These proteins, analogous to α- and γ-gliadin-like, showed reactive sequences to anti-33-mer antibody suggesting their immunogenic potential. That was further confirmed as some of the newly identified oat peptides had a differential stimulatory capacity on circulating DC from coeliac patients compared with healthy controls. CONCLUSIONS This is the first time, to our knowledge, where newly identified oat peptides have been shown to elicit a differential stimulatory capacity on circulating DC obtained from coeliac patients, potentially identifying immunogenic properties of these oat peptides.
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Affiliation(s)
- Isabel Comino
- Departamento de Microbiología y Parasitología, Facultad de Farmacia, Universidad de Sevilla, Sevilla, Spain
| | - David Bernardo
- Gastroenterology Unit, Antigen Presentation Research Group, Imperial College London & St Mark's Hospital, Harrow, United Kingdom.,Hospital Universitario de La Princesa and Instituto de Investigación Sanitaria Princesa (IIS-IP), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
| | | | - María de Lourdes Moreno
- Departamento de Microbiología y Parasitología, Facultad de Farmacia, Universidad de Sevilla, Sevilla, Spain
| | - Borja Sánchez
- Nutrition and Bromatology Group, Department of Analytical and Food Chemistry, Food Science and Technology Faculty, University of Vigo-Ourense Campus, Ourense, Spain
| | | | - Tanja Šuligoj
- Division of Diabetes and Nutritional Sciences, King's College London, Gastroenterology, The Rayne Institute, St Thomas' Hospital, London, United Kingdom
| | - Paul J Ciclitira
- Division of Diabetes and Nutritional Sciences, King's College London, Gastroenterology, The Rayne Institute, St Thomas' Hospital, London, United Kingdom
| | | | - Stella C Knight
- Gastroenterology Unit, Antigen Presentation Research Group, Imperial College London & St Mark's Hospital, Harrow, United Kingdom
| | | | - Carolina Sousa
- Departamento de Microbiología y Parasitología, Facultad de Farmacia, Universidad de Sevilla, Sevilla, Spain;
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27
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Celiac Disease and Gluten-Free Oats: A Canadian Position Based on a Literature Review. Can J Gastroenterol Hepatol 2016; 2016:1870305. [PMID: 27446825 PMCID: PMC4904695 DOI: 10.1155/2016/1870305] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 08/22/2015] [Indexed: 12/14/2022] Open
Abstract
This paper provides an overview of the latest scientific data related to the safety of uncontaminated oats (<20 ppm of gluten) in the diet of individuals with celiac disease (CD). It updates the previous Health Canada position posted on the Health Canada website in 2007 and a related paper published in 2009. It considers a number of recent studies published between January 2008 and January 2015. While recognizing that a few people with celiac disease seem to be clinically intolerant to oats, this review concludes that oats uncontaminated by gluten-containing cereals (wheat, rye, and barley) can be safely ingested by most patients with celiac disease and that there is no conclusive evidence that the consumption of uncontaminated or specially produced oats containing no greater than 20 ppm gluten by patients with celiac disease should be limited to a specific daily amount. However, individuals with CD should observe a stabilization phase before introducing uncontaminated oats to the gluten-free diet (GFD). Oats uncontaminated with gluten should only be introduced after all symptoms of celiac disease have resolved and the individual has been on a GFD for a minimum of 6 months. Long-term regular medical follow-up of these patients is recommended but this is no different recommendation to celiac individuals on a GFD without oats.
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28
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Cho S, Yoon SH, Min J, Lee S, Tokar T, Lee SO, Seo HS. Variations in U.S. Consumers' Acceptability of Korean Rice Cake, Seolgitteok, with respect to Sensory Attributes and Nonsensory Factors. J Food Sci 2015; 81:S199-207. [PMID: 26641741 DOI: 10.1111/1750-3841.13153] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 10/16/2015] [Indexed: 11/30/2022]
Abstract
Because the Korean rice cake, Seolgitteok, is mainly prepared with rice flour containing no gluten-protein associated with celiac disease, it can be considered for inclusion in a gluten-free diet. However, Western consumers may be unlikely to enjoy the plain flavor and chewy texture of Seolgitteok. This study aimed to determine both sensory and nonsensory factors that might affect U.S. consumers' acceptability of Seolgitteok. A total of 119 U.S. consumers rated 5 Seolgitteok samples, differentiated by descriptive sensory analysis, with respect to hedonic impression and just-about-right aspects of sensory attributes. Nonsensory factors such as demographic profile, innovativeness, social representation, sensation-seeking, and personality traits were also assessed. Addition levels of brown rice flour (0% to 100%) and sugar (5% to 20%) not only enriched flavor, but also lessened chewiness of Seolgitteok, thereby increasing an overall hedonic impression. Moreover, consumer acceptability of Seolgitteok varied with respect to nonsensory factors. Seolgitteok was more appreciated by males, sensation seekers, and individuals constrained by social desirability than by other groups. In conclusion, these findings demonstrate that U.S. consumers' acceptability of Seolgitteok varies not only by sensory attributes such as rice flavor, sweetness, and chewiness, but also by nonsensory factors such as gender, sensation-seeking characteristics, and personality traits.
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Affiliation(s)
- Sungeun Cho
- Dept. of Food Science, Univ. of Arkansas, 2650 North Young Ave., Fayetteville, AR 72704, U.S.A
| | - Suk Hoo Yoon
- Korea Food Research Inst, 1201-62 Anyangpangyo-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463746, Republic of Korea.,Dept. of Food Science and Biotechnology, College of Food Science, Woosuk Univ, Wanju, Jeonbuk, 565701, Republic of Korea
| | - Jieun Min
- Dept. of Food Science, Univ. of Arkansas, 2650 North Young Ave., Fayetteville, AR 72704, U.S.A
| | - Suji Lee
- Dept. of Food Science, Univ. of Arkansas, 2650 North Young Ave., Fayetteville, AR 72704, U.S.A
| | - Tonya Tokar
- Dept. of Food Science, Univ. of Arkansas, 2650 North Young Ave., Fayetteville, AR 72704, U.S.A
| | - Sun-Ok Lee
- Dept. of Food Science, Univ. of Arkansas, 2650 North Young Ave., Fayetteville, AR 72704, U.S.A
| | - Han-Seok Seo
- Dept. of Food Science, Univ. of Arkansas, 2650 North Young Ave., Fayetteville, AR 72704, U.S.A
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29
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Comino I, Moreno MDL, Sousa C. Role of oats in celiac disease. World J Gastroenterol 2015; 21:11825-11831. [PMID: 26557006 PMCID: PMC4631980 DOI: 10.3748/wjg.v21.i41.11825] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Revised: 09/02/2015] [Accepted: 09/15/2015] [Indexed: 02/06/2023] Open
Abstract
A gluten-free diet is currently the only effective means of treating individuals with celiac disease. Such a diet enables celiac patients to control their symptoms and avoid various complications associated with this condition. However, while the quality of gluten-free foods has significantly improved during recent decades, maintenance of a gluten-free diet does not necessarily ensure adequate nutritional intake. Because oats are an important source of proteins, lipids, vitamins, minerals, and fibre, their inclusion in a gluten-free diet might improve the nutritional status of a celiac patient. Although oats are included in the list of gluten-free ingredients specified in European regulations, their safety when consumed by celiac patients remains debatable. Some studies claim that pure oats are safe for most celiac people, and contamination with other cereal sources is the main problem facing people with this disease. However, it is necessary to consider that oats include many varieties, containing various amino acid sequences and showing different immunoreactivities associated with toxic prolamins. As a result, several studies have shown that the immunogenicity of oats varies depending on the cultivar consumed. Thus, it is essential to thoroughly study the variety of oats used in a food ingredient before including it in a gluten-free diet.
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Değirmencioğlu N, Gürbüz O, Herken EN, Yıldız AY. The impact of drying techniques on phenolic compound, total phenolic content and antioxidant capacity of oat flour tarhana. Food Chem 2015; 194:587-94. [PMID: 26471596 DOI: 10.1016/j.foodchem.2015.08.065] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 08/12/2015] [Accepted: 08/18/2015] [Indexed: 01/22/2023]
Abstract
In this study, the changes in phenolic composition, total phenolic content, and antioxidant capacity of tarhanas supplemented with oat flour (OF) at the levels of 20-100% (w/w) after three drying treatments (sun-, oven-, and microwave drying) were investigated. A total of seventeen phenolic standards have been screened in tarhanas, and the most abundant flavonol and phenolic acid compounds were kaempferol (23.62mg/g) and 3-hydroxy-4-metoxy cinnamic acid (9.60mg/g). The total phenolic content amount gradually increased with the addition of OF to tarhana, but decidedly higher total phenolic content was found in samples oven dried at 55°C as compared with other methods. The microwave- and oven dried tarhana samples showed higher TEACDPPH and TEACABTS values than those dried with the other methods, respectively, in higher OF amounts. Consequently, oven- and microwave-drying can be recommended to retain the highest for phenolic compounds as well as maximal antioxidant capacity in OF supplemented tarhana samples.
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Affiliation(s)
- Nurcan Değirmencioğlu
- Department of Food Technology, Bandırma Vocational High School, Bandırma Onyedi Eylül University, Balıkesir, Turkey.
| | - Ozan Gürbüz
- Department of Food Engineering, Agricultural Faculty, Uludag University, Bursa, Turkey.
| | - Emine Nur Herken
- Department of Food Engineering, Engineering Faculty, Pamukkale University, Denizli, Turkey.
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Amaya-González S, de-Los-Santos-Álvarez N, Miranda-Ordieres AJ, Lobo-Castañón MJ. Sensitive gluten determination in gluten-free foods by an electrochemical aptamer-based assay. Anal Bioanal Chem 2015; 407:6021-9. [PMID: 26048055 DOI: 10.1007/s00216-015-8771-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 04/29/2015] [Accepted: 05/07/2015] [Indexed: 12/26/2022]
Abstract
Enzyme immunoassays are currently the methods of choice for gluten control in foods labelled as gluten free, providing a mechanism for assessing food safety for consumption by coeliac and other allergic patients. However, their limitations, many of them associated to the reactivity of the different antibodies used and their degree of specificity, have prevented the establishment of a standardised method of analysis. We explore new methods for quantitatively determining gluten content in foods based on the use of two recently described aptamers, raised against a 33-mer peptide recognised as the immunodominant fragment from α2-gliadin. The assays use the target peptide immobilised onto streptavidin-coated magnetic beads in combination with a limited amount of biotin-aptamer in a competitive format, followed by streptavidin-peroxidase labelling of the aptamer that remains bound to the magnetic beads. The enzyme activity onto the beads, measured by chronoamperometry in disposable screen-printed electrodes, is inversely related to the target concentration in the test solution. We find that while the assay using the aptamer with the highest affinity towards the target (Gli 4) achieves low detection limits (~0.5 ppm) and excellent analytical performance, when challenged in samples containing the intact protein, gliadin, it fails in detecting the peptide in solution. This problem is circumvented by employing another aptamer (Gli 1), the most abundant one in the SELEX pool, as a receptor. The proposed assays allow the convenient detection of the allergen in different kinds of food samples, including heat-treated and hydrolysed ones. The obtained results correlate with those of commercially available antibody-based assays, providing an alternative for ensuring the safety and quality of nominally gluten-free foods. Graphical Abstract Electrochemical magnetoassay for gluten determination using biotin-aptamers as receptors.
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Affiliation(s)
- Sonia Amaya-González
- Departamento de Química Física y Analítica, Universidad de Oviedo, Julián Clavería 8, 33006, Oviedo, Spain
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Abstract
Dermatitis herpetiformis (DH) is an inflammatory cutaneous disease with a chronic relapsing course, pruritic polymorphic lesions, and typical histopathological and immunopathological findings. According to several evidences, DH is considered the specific cutaneous manifestation of celiac disease, and the most recent guidelines of celiac disease have stated that, in celiac patients with a proven DH, a duodenal biopsy is unnecessary for the diagnosis. In this review, the most recent data about the diagnosis and the management of DH have been reported and discussed. In particular, in patients with clinical and/or histopathological findings suggestive for DH, the finding of granular IgA deposits along the dermal–epidermal junction or at the papillary tips by direct immunofluorescence (DIF) assay, together with positive results for anti-tissue transglutaminase antibody testing, allows the diagnosis. Thereafter, a gluten-free diet should be started in association with drugs, such as dapsone, that are able to control the skin manifestations during the first phases of the diet. In conclusion, although DH is a rare autoimmune disease with specific immunopathological alterations at the skin level, its importance goes beyond the skin itself and may have a big impact on the general health status and the quality of life of the patients.
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Affiliation(s)
- Emiliano Antiga
- Department of Surgery and Translational Medicine, Section of Dermatology, University of Florence, Florence, Italy
| | - Marzia Caproni
- Department of Surgery and Translational Medicine, Section of Dermatology, University of Florence, Florence, Italy
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Ciacci C, Ciclitira P, Hadjivassiliou M, Kaukinen K, Ludvigsson JF, McGough N, Sanders DS, Woodward J, Leonard JN, Swift GL. The gluten-free diet and its current application in coeliac disease and dermatitis herpetiformis. United European Gastroenterol J 2015; 3:121-35. [PMID: 25922672 PMCID: PMC4406897 DOI: 10.1177/2050640614559263] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 10/17/2014] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND A gluten-free diet (GFD) is currently the only available therapy for coeliac disease (CD). OBJECTIVES We aim to review the literature on the GFD, the gluten content in naturally gluten-free (GF) and commercially available GF food, standards and legislation concerning the gluten content of foods, and the vitamins and mineral content of a GFD. METHODS We carried out a PubMed search for the following terms: Gluten, GFD and food, education, vitamins, minerals, calcium, Codex wheat starch and oats. Relevant papers were reviewed and for each topic a consensus among the authors was obtained. CONCLUSION Patients with CD should avoid gluten and maintain a balanced diet to ensure an adequate intake of nutrients, vitamins, fibre and calcium. A GFD improves symptoms in most patients with CD. The practicalities of this however, are difficult, as (i) many processed foods are contaminated with gluten, (ii) staple GF foods are not widely available, and (iii) the GF substitutes are often expensive. Furthermore, (iv) the restrictions of the diet may adversely affect social interactions and quality of life. The inclusion of oats and wheat starch in the diet remains controversial.
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Affiliation(s)
- Carolina Ciacci
- Department of Medicine and Surgery, Gastroenterology, University of Salerno, Italy
| | - Paul Ciclitira
- Department of Gastroenterology, Division of Diabetes and Nutritional Sciences, Kings College London; The Rayne Institute, St Thomas Hospital, London, UK
| | - Marios Hadjivassiliou
- Academic Department of Neurosciences, Sheffield Teaching Hospitals NHS Trust; Royal Hallamshire Hospital, Sheffield, UK
| | - Katri Kaukinen
- School of Medicine, University of Tampere and Department of Internal Medicine, Tampere University Hospital and Department of Internal Medicine, Seinäjoki Central Hospital, Finland
| | - Jonas F Ludvigsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet and Department of Pediatrics, Örebro University Hospital, Sweden
| | | | - David S Sanders
- Gastroenterology and Liver Unit, Royal Hallamshire Hospital & University of Sheffield, Sheffield, UK
| | - Jeremy Woodward
- Cambridge Intestinal Unit, Addenbrooke’s Hospital, Cambridge, UK
| | - Jonathan N Leonard
- Department of Dermatology, St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Gillian L Swift
- Department of Gastroenterology, University Hospital Llandough, Cardiff, UK
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Ercili-Cura D, Miyamoto A, Paananen A, Yoshii H, Poutanen K, Partanen R. Adsorption of oat proteins to air–water interface in relation to their colloidal state. Food Hydrocoll 2015. [DOI: 10.1016/j.foodhyd.2014.09.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Cho S, Yoon SH, Min J, Lee S, Tokar T, Lee SO, Seo HS. Sensory Characteristics of S
eolgitteok
(Korean Rice Cake) in Relation to the Added Levels of Brown Rice Flour and Sugar. J SENS STUD 2014. [DOI: 10.1111/joss.12118] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Sungeun Cho
- Department of Food Science; University of Arkansas; 2650 North Young Avenue Fayetteville AR 72704
| | - Suk Hoo Yoon
- Korea Food Research Institute; 1201-62 Anyangpangyo-ro, Bundang-gu Seongnam-si Gyeonggi-do 463746 Korea
- Department of Food Science and Biotechnology; College of Food Science; Woosuk University; Wanju Jeonbuk 565701 Korea
| | - Jieun Min
- Department of Food Science; University of Arkansas; 2650 North Young Avenue Fayetteville AR 72704
| | - Suji Lee
- Department of Food Science; University of Arkansas; 2650 North Young Avenue Fayetteville AR 72704
| | - Tonya Tokar
- Department of Food Science; University of Arkansas; 2650 North Young Avenue Fayetteville AR 72704
| | - Sun-Ok Lee
- Department of Food Science; University of Arkansas; 2650 North Young Avenue Fayetteville AR 72704
| | - Han-Seok Seo
- Department of Food Science; University of Arkansas; 2650 North Young Avenue Fayetteville AR 72704
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Sjöberg V, Hollén E, Pietz G, Magnusson KE, Fälth-Magnusson K, Sundström M, Holmgren Peterson K, Sandström O, Hernell O, Hammarström S, Högberg L, Hammarström ML. Noncontaminated dietary oats may hamper normalization of the intestinal immune status in childhood celiac disease. Clin Transl Gastroenterol 2014; 5:e58. [PMID: 24964993 PMCID: PMC4077043 DOI: 10.1038/ctg.2014.9] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 04/23/2014] [Accepted: 05/01/2014] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES: Life-long, strict gluten-free diet (GFD) is the only treatment for celiac disease (CD). Because there is still uncertainty regarding the safety of oats for CD patients, the aim was to investigate whether dietary oats influence the immune status of their intestinal mucosa. METHODS: Paired small intestinal biopsies, before and after >11 months on a GFD, were collected from children with CD who were enrolled in a randomized, double-blind intervention trial to either of two diets: standard GFD (GFD-std; n=13) and noncontaminated oat-containing GFD (GFD-oats; n=15). Expression levels of mRNAs for 22 different immune effector molecules and tight junction proteins were determined by quantitative reverse transcriptase (RT)-PCR. RESULTS: The number of mRNAs that remained elevated was higher in the GFD-oats group (P=0.05). In particular, mRNAs for the regulatory T cell (Treg) signature molecules interleukin-10 (IL-10) and transforming growth factor-β1 (TGF-β1), the cytotoxicity-activating natural killer (NK) receptors KLRC2/NKG2C and KLRC3/NKG2E, and the tight junction protein claudin-4 remained elevated. Between the two groups, most significant differences were seen for claudin-4 (P=0.003) and KLRC3/NKG2E (P=0.04). CONCLUSIONS: A substantial fraction of pediatric CD patients seem to not tolerate oats. In these patients, dietary oats influence the immune status of the intestinal mucosa with an mRNA profile suggesting presence of activated cytotoxic lymphocytes and Tregs and a stressed epithelium with affected tight junctions. Assessment of changes in levels of mRNA for claudin-4 and KLC3/NKG2E from onset to after a year on oats containing GFD shows promise to identify these CD patients.
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Affiliation(s)
- Veronika Sjöberg
- Department of Clinical Microbiology, Immunology, Umeå University, Umeå, Sweden
| | - Elisabet Hollén
- Department of Clinical and Experimental Medicine, Medical Microbiology, Linköping University, Linköping, Sweden
| | - Grzegorz Pietz
- Department of Clinical Microbiology, Immunology, Umeå University, Umeå, Sweden
| | - Karl-Eric Magnusson
- Department of Clinical and Experimental Medicine, Medical Microbiology, Linköping University, Linköping, Sweden
| | - Karin Fälth-Magnusson
- 1] Department of Clinical and Experimental Medicine, Division of Pediatrics, Linköping University, Linköping, Sweden [2] Division of Pediatrics in Linköping, County Council of Östergötland, Linköping, Sweden
| | - Mia Sundström
- Department of Clinical Microbiology, Immunology, Umeå University, Umeå, Sweden
| | - Kajsa Holmgren Peterson
- Department of Clinical and Experimental Medicine, Medical Microbiology, Linköping University, Linköping, Sweden
| | - Olof Sandström
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
| | - Olle Hernell
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
| | - Sten Hammarström
- Department of Clinical Microbiology, Immunology, Umeå University, Umeå, Sweden
| | - Lotta Högberg
- 1] Department of Clinical and Experimental Medicine, Division of Pediatrics, Linköping University, Linköping, Sweden [2] Division of Pediatrics in Norrköping, County Council of Östergötland, Norrköping, Sweden
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Sziksz E, Pap D, Veres G, Fekete A, Tulassay T, Vannay &A. Involvement of heat shock proteins in gluten-sensitive enteropathy. World J Gastroenterol 2014; 20:6495-6503. [PMID: 24914370 PMCID: PMC4047334 DOI: 10.3748/wjg.v20.i21.6495] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Revised: 02/12/2014] [Accepted: 03/10/2014] [Indexed: 02/06/2023] Open
Abstract
Gluten-sensitive enteropathy, also known as coeliac disease (CD), is an autoimmune disorder occurring in genetically susceptible individuals that damages the small intestine and interferes with the absorption of other nutrients. As it is triggered by dietary gluten and related prolamins present in wheat, rye and barley, the accepted treatment for CD is a strict gluten-free diet. However, a complete exclusion of gluten-containing cereals from the diet is often difficult, and new therapeutic strategies are urgently needed. A class of proteins that have already emerged as drug targets for other autoimmune diseases are the heat shock proteins (HSPs), which are highly conserved stress-induced chaperones that protect cells against harmful extracellular factors. HSPs are expressed in several tissues, including the gastrointestinal tract, and their levels are significantly increased under stress circumstances. HSPs exert immunomodulatory effects, and also play a crucial role in the maintenance of epithelial cell structure and function, as they are responsible for adequate protein folding, influence the degradation of proteins and cell repair processes after damage, and modulate cell signalling, cell proliferation and apoptosis. The present review discusses the involvement of HSPs in the pathophysiology of CD. Furthermore, HSPs may represent a useful therapeutic target for the treatment of CD due to the cytoprotective, immunomodulatory, and anti-apoptotic effects in the intestinal mucosal barrier.
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38
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Tjellström B, Stenhammar L, Sundqvist T, Fälth-Magnusson K, Hollén E, Magnusson KE, Norin E, Midtvedt T, Högberg L. The effects of oats on the function of gut microflora in children with coeliac disease. Aliment Pharmacol Ther 2014; 39:1156-60. [PMID: 24661128 DOI: 10.1111/apt.12707] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 01/07/2014] [Accepted: 02/25/2014] [Indexed: 12/18/2022]
Abstract
BACKGROUND Faecal short chain fatty acids (SCFAs) are produced by the gut microflora. We have previously reported high faecal SCFA levels in children with coeliac disease (CD), indicating alteration in gut microfloral metabolism. Data accumulated over recent decades by us and others suggest that wheat-free oats can safely be included in a gluten-free diet (GFD). However, concerns have been raised with respect to the safety of oats in a subset of coeliacs. AIM To describe faecal SCFA patterns in children with newly diagnosed CD treated for 1 year with a GFD with or without oats. METHODS This report is part of a randomised, double-blind study on the effect of a GFD containing oats (GFD-oats) vs. a standard GFD (GFD-std). Faecal samples were received from 34 children in the GFD-oats group and 37 in the GFD-std group at initial diagnosis and/or after 1 year on a GFD. Faecal SCFAs were analysed. RESULTS The GFD-std group had a significantly lower total faecal SCFA concentration at 12 months compared with 0 months (P < 0.05). In contrast, total SCFA in the GFD-oats group remained high after 1 year on the GFD. The children in the GFD-oats group had significantly higher acetic acid (P < 0.05), n-butyric acid (P < 0.05) and total SCFA concentration (P < 0.01) after 1-year diet treatment compared to the GFD-std group. CONCLUSIONS Our results indicate that oats do affect the gut microflora function, and that some coeliac children receiving oats may develop gut mucosal inflammation, that may present a risk for future complications.
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Affiliation(s)
- B Tjellström
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institute, Stockholm, Sweden; Department of Paediatrics, Norrköping Hospital, County Council of Östergötland, Norrköping, Sweden
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Kaukinen K, Collin P, Huhtala H, Mäki M. Long-term consumption of oats in adult celiac disease patients. Nutrients 2013; 5:4380-9. [PMID: 24201240 PMCID: PMC3847736 DOI: 10.3390/nu5114380] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 10/21/2013] [Accepted: 10/25/2013] [Indexed: 01/29/2023] Open
Abstract
Many celiac disease patients tolerate oats, but limited data are available on its long-term consumption. This was evaluated in the present study, focusing on small-bowel mucosal histology and gastrointestinal symptoms in celiac adults maintaining a strict gluten-free diet with or without oats. Altogether 106 long-term treated celiac adults were enrolled for this cross-sectional follow-up study. Daily consumption of oats and fiber was assessed, and small-bowel mucosal morphology and densities of CD3+, αβ+ and γσ+ intraepithelial lymphocytes determined. Gastrointestinal symptoms were assessed by a validated Gastrointestinal Symptom Rating Scale questionnaire. Seventy (66%) out of the 106 treated celiac disease patients had consumed a median of 20 g of oats (range 1–100 g) per day for up to eight years; all consumed oat products bought from general stores. Daily intake and long-term consumption of oats did not result in small-bowel mucosal villous damage, inflammation, or gastrointestinal symptoms. Oat-consumers had a significantly higher daily intake of fiber than those who did not use oats. Two thirds of celiac disease patients preferred to use oats in their daily diet. Even long-term ingestion of oats had no harmful effects.
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Affiliation(s)
- Katri Kaukinen
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere FIN-33521, Finland; E-Mail:
- School of Medicine, University of Tampere, Tampere FIN-33014, Finland
- Department of Medicine, Seinäjoki Central Hospital, Seinäjoki FIN-60220, Finland
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +358-50-318-6343; Fax: +358-3-364-1369
| | - Pekka Collin
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere FIN-33521, Finland; E-Mail:
- School of Medicine, University of Tampere, Tampere FIN-33014, Finland
| | - Heini Huhtala
- School of Health Sciences, University of Tampere, Tampere FIN-33014, Finland; E-Mail:
| | - Markku Mäki
- Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere FIN-33014, Finland; E-Mail:
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Makovicky P, Rimarova K, Boor A, Makovicky P, Vodicka P, Samasca G, Kruzliak P. Correlation between antibodies and histology in celiac disease: incidence of celiac disease is higher than expected in the pediatric population. Mol Med Rep 2013; 8:1079-83. [PMID: 23942815 DOI: 10.3892/mmr.2013.1627] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 07/23/2013] [Indexed: 12/21/2022] Open
Abstract
The present study aims to report on the correlation between the degree of negativity of anti-endomysial antibodies and anti-tissue transglutaminase antibodies in the IgA and IgG classes with regard to histological grade, in 44 newly diagnosed children with celiac disease (CD). Samples with negative antibodies, but a positive histology from a 5-year program searching for CD in the pediatric population were collected. A total of 4247 biopsy samples were used in this study. We documented that certain pediatric patients are seronegative, while the disease is active and the incidence of CD is higher than expected in the pediatric population. This is an important finding, which demonstrates the lack of association between autoantibodies and lesions, and justifies the use of biopsies for an accurate CD diagnosis and the importance of revising the diagnostic criteria in a clinical, endoscopic and serological context. We recommend a more active search for incidences of the disease in the pediatric population. Serological markers are not the main method for the diagnosis of CD as they are considered to only have a supporting role clinically. Biopsies of the small intestine are always necessary for the diagnosis of CD in these patients.
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Affiliation(s)
- Peter Makovicky
- Department of Veterinary Sciences, Czech University of Life Sciences in Prague, CZ-165 21 Prague, Czech Republic.
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41
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Les grains de céréales : diversité et compositions nutritionnelles. CAHIERS DE NUTRITION ET DE DIETETIQUE 2012. [DOI: 10.1016/s0007-9960(12)70292-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Tokár M, Buksa K, Gambuś H, Bojňanská T, Ivanišová E. Molecular properties of selected polysaccharides determined by sec chromatography and their impact on water absorption of wheat flour. POTRAVINARSTVO 2012. [DOI: 10.5219/173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Chemical composition and solubility in water of selected polysaccharides as β-glucan, arabinoxylan and inulin preparation were determined. All these preparation were of good purity, they consist of at least 71% of polysaccharide of intrest. Solubility in water was the highest in the case of inulin and the lowest in the case of β-glucan. Molecular properties of examined preparations were determined by SEC chromatography. β-glucan and arabinoxylan were of much higher molecular mass than inulin. Molecular mass of examined polysacharides was corelated with increase of water absorption of the flour caused by 2% addition of each polysaccharide.
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