Review article: safe amounts of gluten for patients with wheat allergy or coeliac disease
C. Hischenhuber,R Crevel,B Jarry,Markku Mäki,D A Moneret-Vautrin,A Romano,R Troncone,R. Ward +7 more
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TLDR
Estimation of the maximum tolerated amount of gluten for susceptible individuals would support effective management of their disease.Abstract:
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.read more
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Diagnosis and management of adult coeliac disease: guidelines from the British Society of Gastroenterology
Jonas F. Ludvigsson,Jonas F. Ludvigsson,Julio C. Bai,Federico Biagi,Timothy R. Card,Carolina Ciacci,Paul J. Ciclitira,Peter H.R. Green,Marios Hadjivassiliou,Anne Holdoway,David A. van Heel,Katri Kaukinen,Daniel A. Leffler,Jonathan N. Leonard,Knut E.A. Lundin,Norma McGough,Mike Davidson,Joseph A. Murray,Gillian L Swift,Marjorie M. Walker,Fabiana Zingone,David S Sanders +21 more
TL;DR: A multidisciplinary panel of 18 physicians and 3 non-physicians from eight countries reviewed the literature on diagnosis and management of adult coeliac disease and the recommendations are presented.
Journal ArticleDOI
A prospective, double-blind, placebo-controlled trial to establish a safe gluten threshold for patients with celiac disease
Carlo Catassi,E Fabiani,Giuseppe Iacono,Cinzia D'Agate,Ruggiero Francavilla,Federico Biagi,Umberto Volta,Salvatore Accomando,Antonio Picarelli,Italo De Vitis,Giovanna Pianelli,Rosaria Gesuita,Flavia Carle,Alessandra Mandolesi,Italo Bearzi,Alessio Fasano +15 more
TL;DR: The ingestion of contaminating gluten should be kept lower than 50 mg/d in the treatment of CD, and no significant differences in the IEL count were found between the 3 groups.
Journal ArticleDOI
Allergens to wheat and related cereals
Arthur S. Tatham,Peter R. Shewry +1 more
TL;DR: Wheat is one of the major crops grown, processed and consumed by humankind and is associated with both intolerances (notably coeliac disease) and allergies.
Journal ArticleDOI
Scientific Opinion on the assessment of allergenicity of GM plants andmicroorganisms and derived food and feed
H. C. Andersson,Salvatore Arpaia,Detlef Bartsch,Josep M. Casacuberta,Howard V. Davies,P. du Jardin,Gerhard Flachowsky,Lieve Herman,Huw Jones,Sirpa Kärenlampi,Jozsef Kiss,Gijs Kleter,H. Kuiper,Antoine Messéan,K. M. Nielsen,Joe N. Perry,A. Pöting,Jeremy Sweet,Christoph Tebbe,Jean-Michel Wal +19 more
TL;DR: The weight-of-evidence, case-by-case approach is considered the most appropriate way of assessing the allergenicity of genetically modified (GM) food and feed, and various aspects to increase the strength and accuracy are discussed.
Journal ArticleDOI
Advances in celiac disease and gluten-free diet.
TL;DR: This review focuses in detail on the gluten-free diet and the importance of intense expert dietary counseling for all patients with celiac disease, which is becoming an increasingly recognized autoimmune enteropathy caused by a permanent intolerance to gluten.
References
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Identification of tissue transglutaminase as the autoantigen of celiac disease
Walburga Dieterich,Tobias Ehnis,Michael Bauer,Peter Donner,Umberto Volta,Ernst Otto Riecken,Detlef Schuppan +6 more
TL;DR: Tissue transglutaminase is identified as the unknown endomysial autoantigen of celiac disease, and gliadin is a preferred substrate for this enzyme, giving rise to novel antigenic epitopes.
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TL;DR: The results suggest that CD occurs frequently not only in patients with gastrointestinal symptoms, but also in first- and second-degree relatives and patients with numerous common disorders even in the absence of gastrointestinal symptoms.
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Structural Basis for Gluten Intolerance in Celiac Sprue
Lu Shan,Øyvind Molberg,Isabelle Parrot,Felix Hausch,Ferda Filiz,Gary M. Gray,Ludvig M. Sollid,Chaitan Khosla +7 more
TL;DR: A 33-mer peptide was identified that has several characteristics suggesting it is the primary initiator of the inflammatory response to gluten in Celiac Sprue patients, and could be detoxified in in vitro and in vivo assays by exposure to a bacterial prolyl endopeptidase, suggesting a strategy for oral peptidase supplement therapy for CeliacSprue.
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Utility of food-specific IgE concentrations in predicting symptomatic food allergy ☆ ☆☆
TL;DR: Quantification of food-specific IgE is a useful test for diagnosing symptomatic allergy to egg, milk, peanut, and fish in the pediatric population and could eliminate the need to perform double-blind, placebo-controlled food challenges in a significant number of children.
Journal ArticleDOI
Tissue transglutaminase selectively modifies gliadin peptides that are recognized by gut-derived T cells in celiac disease
Øyvind Molberg,Stephen N. McAdam,Roman Körner,Hanne Quarsten,Christel Kristiansen,Lars Madsen,Lars Fugger,Lars Fugger,Helge Scott,Ove Norén,Peter Roepstorff,Knut E.A. Lundin,Hans Sjöström,Ludvig M. Sollid +13 more
TL;DR: Evidence is provided for a new role of Transglutaminase in the common, HLA-DQ2 (and DQ8) associated celiac disease and it is demonstrated that TGase mediates its effect through an ordered and specific deamidation of gliadins.