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PubMed2006

Review article: safe amounts of gluten for patients with wheat allergy or coeliac disease.

For both wheat allergy and coeliac disease the dietary avoidance of wheat and other gluten-containing cereals is the only effective treatment. Estimation of the maximum tolerated amount of gluten for susceptible individuals would support effective management of their disease. Literature was reviewed to evaluate whether an upper limit for gluten content in food, which would be safe for sufferers from both diseases, could be identified. When setting gluten limits for coeliac disease sufferers, the overall potential daily intake should be considered, while for wheat allergy limits should be based on single servings. For coeliac disease sufferers this limit should lie between 10 and 100 mg daily intake. For wheat allergy, lowest eliciting doses for children lie in the lower milligram range, while for adults they are most significantly higher. Gliadins (part of the gluten proteins) not only trigger coeliac disease, but are also major allergens in wheat allergy. Therefore, measurement of gliadins with validated enzyme-linked immunosorbent assay methods provides an appropriate marker for assessing gluten and/or wheat protein contents in food. Available data suggest that a maximum gluten content for 'gluten-free' foods could be set, which protects both wheat allergy sufferers and coeliac patients.

Adult↗
PubMed2003

Avenin fails to induce a Th1 response in coeliac tissue following in vitro culture.

BACKGROUND: It is well established that the wheat protein gliadin triggers inflammation in coeliac patients. However, the potential toxicity of avenin, the equivalent protein in oats, is debated. AIM: To investigate the immunogenicity of avenin using the cytokines interferon gamma (IFN-gamma) and interleukin (IL)-2 as markers of immunological activity. METHODS: Duodenal biopsies from coeliac patients were cultured with 5 mg/ml of peptic tryptic (PT) gliadin (n=9) or 5 mg/ml of PT avenin (n=8) for four hours. Biopsies cultured with RPMI 1640 alone served as controls. Non-coeliac biopsies were also cultured with PT gliadin (n=8) and PT avenin (n=8). Total RNA was extracted from the tissue after culture. Cytokine mRNA was quantified by TaqMan polymerase chain reaction. Secreted cytokine protein was measured in the culture supernatant by enzyme linked immunosorbent assay. RESULTS: After culture with PT gliadin, an increase in IFN-gamma mRNA was observed in all nine patients with coeliac disease. Increased IFN-gamma protein was also found in four of these patients. Smaller increases in IL-2 mRNA were detected in six subjects with increased IL-2 protein found in two patients. In contrast with PT gliadin, there was no significant IFN-gamma or IL-2 response when coeliac biopsies were cultured with PT avenin. Similarly, biopsies from normal controls did not respond to PT gliadin or PT avenin stimulation. CONCLUSIONS: The findings of this study suggest that the immunogenic sequences in gliadin are not present in avenin. Moreover, they are in keeping with in vivo studies which report that oats are safe for consumption by coeliac patients.

Adult↗
PubMed2004

The molecular basis for oat intolerance in patients with celiac disease.

BACKGROUND: Celiac disease is a small intestinal inflammatory disorder characterized by malabsorption, nutrient deficiency, and a range of clinical manifestations. It is caused by an inappropriate immune response to dietary gluten and is treated with a gluten-free diet. Recent feeding studies have indicated oats to be safe for celiac disease patients, and oats are now often included in the celiac disease diet. This study aimed to investigate whether oat intolerance exists in celiac disease and to characterize the cells and processes underlying this intolerance. METHODS AND FINDINGS: We selected for study nine adults with celiac disease who had a history of oats exposure. Four of the patients had clinical symptoms on an oats-containing diet, and three of these four patients had intestinal inflammation typical of celiac disease at the time of oats exposure. We established oats-avenin-specific and -reactive intestinal T-cell lines from these three patients, as well as from two other patients who appeared to tolerate oats. The avenin-reactive T-cell lines recognized avenin peptides in the context of HLA-DQ2. These peptides have sequences rich in proline and glutamine residues closely resembling wheat gluten epitopes. Deamidation (glutamine-->glutamic acid conversion) by tissue transglutaminase was involved in the avenin epitope formation. CONCLUSIONS: We conclude that some celiac disease patients have avenin-reactive mucosal T-cells that can cause mucosal inflammation. Oat intolerance may be a reason for villous atrophy and inflammation in patients with celiac disease who are eating oats but otherwise are adhering to a strict gluten-free diet. Clinical follow-up of celiac disease patients eating oats is advisable.

Atrophy↗
PubMed2002

Celiac disease.

Clinically, celiac disease has always been regarded as a wasting, malabsorptive disorder due to disease of the small intestinal mucosa. It has been difficult for clinicians to recognize that this condition is primarily due to sensitization of mesenteric T lymphocytes to wheat protein (gluten) in genetically predisposed (DQ2+) individuals. On contact with dietary-derived gluten in the upper intestine, these sensitized T lymphocytes are activated leading to inflammation of and morphologically altered mucosal architecture: the latter reverts to normal with a gluten-free diet. The circulation of sensitized T lymphocytes to other parts of the intestinal mucosa explains why identical immunopathological inflammation can be induced in ileal and rectal mucosa. It appears, then, that in predisposed DQ2+ subjects, mesenteric T lymphocytes recognize gluten as foreign (non-self) antigen, thereby inducing mucosal pathology secondary to the initiating lymphocyte-protein interaction, analogously to the mucosal lesions that typify graft-vs-host reactions, or nematode or Giaraia infestations. Today, as this article describes, we recognize that celiac disease often exists in a subclinical, or "compensated-latent," form, or with symptoms that do not immediately suggest an origin in the gastrointestinal tract.

Celiac Disease↗
PubMed1992

Evidence for the translational control of storage protein gene expression in oat seeds.

We employed a rapid fractionation method coupled with a sensitive enzyme-linked immunosorbent assay to quantify the globulins and avenins in developing and mature oat seeds. On a molar basis, there is approximately 10-11 times as much globulin as avenin. Pulse labeling of endosperm proteins indicated that the rate of globulin synthesis is approximately nine times that of avenin. In addition, neither protein class showed any signs of degradation during this experiment. Analysis of the storage protein mRNAs indicates that both globulin and avenin transcripts are associated with membrane-bound polysomes and are found in similar concentrations within the membrane-bound polysome fraction. We found that avenin and globulin mRNAs are fully loaded with ribosomes, suggesting that initiation is not rate-limiting for translation of either protein. Rates of globulin and avenin synthesis were similar when synthetic storage protein mRNAs were translated in vitro. Translation of equimolar amounts of globulin and avenin mRNAs in the same reaction showed equivalent amounts of protein synthesized when compared with globulin and avenin mRNAs translated in separate reaction mixes. We propose that translation elongation or termination reactions are likely regulatory steps for controlling storage protein synthesis in oat endosperm.

Autoradiography↗
PubMed2005

Transglutaminases: a meeting point for wheat allergy, celiac disease, and food safety.

Wheat is the staple cereal in many countries and its uses in manufactured foods are ever growing due to the technological qualities of gluten proteins. Transglutaminases (TG) are ubiquitous enzymes with many functions. They are able to transform proteins by deamidation and/or transamidation. This last reaction can cross-link proteins together. Intestinal tissue TG has been shown to play an important role in two kinds of immune reactions to wheat: celiac disease and wheat-dependent exercise-induced anaphylaxis. In addition, new epitopes have been suspected in cases of anaphylaxis to wheat isolates, a food ingredient consisting mainly of deamidated gluten proteins. As a microbial TG is included in many food technological processes, its safe use should be checked. This assessment must cover not only the safety of the TG itself but also that of the deamidated/cross-linked proteins generated by this enzyme. This article aims at discussing the possible consequences of using TG in food industry in the light of today knowledge about immune reactions to wheat.

Adolescent↗
PubMedDate not supplied

Determination of the gluten content of foods.

Coeliac disease affects 1:1,500 people in Europe. Treatment of the condition involves a gluten-free diet with avoidance of foods containing wheat, rye, barley or oats. Evidence suggests that individuals should adhere strictly to the diet as this reduces the increased incidence of malignancy observed in the condition. A large number of gluten-free products are currently available. Immunological assays have been developed to assess their suitability for patients with coeliac disease. Quantitative assays, based on both polyclonal antisera and monoclonal antibodies, methods of extraction and problems associated with interfering substances are reviewed in this paper.

Celiac Disease↗
PubMed1990

Analysis of seed storage protein genes of oats.

We have isolated genomic clones encoding the two major classes of seed storage proteins in oats, the 12 S globulins and the avenins. The globulin genes encode glutamine-rich, sulfur-poor storage proteins that are highly conserved in sequence and structure. The globulin genes contain three short introns whose positions in the coding sequence are the same as in storage globulin genes in legumes and other dicots. The avenin genomic clone contains four tightly linked genes that belong to both of the two avenin gene subfamilies. The avenin genes encode glutamine-rich, lysine-poor proteins that vary in length due to differences in the number of peptide repeats. Although globulin and avenin genes are expressed coordinately during oat seed development, their promoter regions do not contain any conserved sequence elements that might determine developmental timing. Previous studies showed that there are roughly equal amounts of globulin and avenin mRNAs in developing oat seed, despite there being much more globulin than avenin in mature seed. Storage protein synthesis in oats must therefore be controlled partially by post-transcriptional mechanisms. Sequence analysis of globulin and avenin genes has provided several clues as to why globulin mRNAs may be translated more efficiently than avenin mRNAs.

Allergens↗