Celiac.com 03/26/2008 - According to the results of a recent study, adults with diet-treated celiac disease show no elevation in anti-avenin IgA by oats. Celiac disease is effectively treated with a gluten-free diet that is free of wheat, rye, barley and related grains. While it is well known that wheat, rye and barley trigger the disease, for decades there has been controversy about the safety of oats.

Recent evidence from a number of studies has supported the idea that oats are safe for people with celiac disease. In several countries, oats are now on the list of safe foods for people with celiac disease. The studies on oats and celiac disease have had various designs, but most have been small, and often with high patient drop-out rates. To date, there has only been a single randomized and double-blinded study measuring the effects of oats on celiac patients. The studies have been nearly unanimous in concluding that consumption of oats is safe to celiac disease patients.

Most of these clinical studies have assessed blood histology in reaction to oats, or measured normalization after patients had been diagnosed with celiac disease and were already following gluten-free diets. Three large studies from Finland have investigated the effect of dietary oats and their influence on antibody levels to wheat gluten and to tissue transglutaminase. Previous studies have shown that people with untreated celiac disease show elevated IgA antibodies in reaction oat avenins. However, only one study on treated celiac disease patients has investigated IgA antibodies to oats.

Researchers know of just three confirmed cases of active celiac disease flaring up again in adults after these people ingested oats, which indicates that intolerance to oats among celiacs may be rare, but also may in fact have some role to play in celiac disease. It also points to the need for clinical monitoring of celiac disease patients who eat oats.

A research team made up of Vigdis Guttormsen, Astrid Løvik, Asta Bye; Jorunn Bratlie, Lars Mørkrid, and Knut E. A. Lundin recently conducted a small study to determine whether treated adult celiac disease patients who ate oats showed elevated levels if IgA. The research team compared blood samples of 136 adult patients with treated celiac disease against 139 controls. The team used ELISA to test the blood samples to measure IgA against oats avenin, wheat gliadin and tissue trans-glutaminase.

Eighty-two of the celiac disease patients had been eating oats as part of their gluten-free diet for 6 months or more.  Both the oats-eating and non-oats-eating celiac disease patients showed no significant differences in IgA against oats. However, both groups did show elevated levels of IgA against wheat, oats and tissue tTG compared to healthy controls. The groups also showed a significant positive correlation between anti-avenin and antigliadin IgA (pB0.0001), and between anti-avenin and anti-tissue transglutaminase IgA (p 0.0012).

The researchers concluded that eating oats does not cause increased levels of IgA in adult celiac disease patients on a gluten-free diet. The findings support the notion that most adult celiac disease patients can tolerate oats.

Scandinavian Journal of Gastroenterology, 43:2, 161 - 165.
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