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  • About Me

    Jefferson Adams earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in biology, anatomy, medicine, and science. He previously served as Health News Examiner for Examiner.com, and provided health and medical content for Sharecare.com.

    Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book Dangerous Grains by James Braly, MD and Ron Hoggan, MA.

  • Related Articles

    Jefferson Adams
    Enzyme Quickly Breaks Down Wheat Protein
    Celiac.com 05/23/2007 - The results of a study recently published in the journal Gut suggest that the enzyme prolyl endoprotease from Aspergillus niger (AN-PEP) taken along with meals might allow patients with celiac disease to safely consume gluten on occasion.
    The negative effects of celiac disease are due in large part to an immune response to gluten.
    Because proline-rich gluten proteins resist the digestive enzymes of the gastro-intestinal tract, they are very likely suspects in the generation of this immune response.
    A team of doctors in the Netherlands set out to assess the abilities of a post-proline cutting enzyme, prolyl endoprotease from Aspergillus niger (AN-PEP) in breaking down gluten. The research team was made up of doctors Cristina Mitea (1), Robert Havenaar (2), Jan Wouter Drijfhout (1), Luppo Edens (3), Liesbeth Dekking (1)* and Frits Koning (1).
    The study was not performed on actual celiac patients, but used a dynamic system that mimics the human gastrointestinal tract (TIM system). Using the TIM system, the team performed two experiments. The first used the TIM-system to process a slice of bread with and without the presence of AN-PEP. The second experiment used the TIM-system to process standard fast food items, again both with and without the presence of AN-PEP.
    Samples of the digesting food were taken from the TIM systems stomach, duodenum, jejunum and ileum compartments from zero to four hours after the beginning of the experiment. These samples were evaluated for levels of immunogenic peptides from gliadins and glutenins by monoclonal antibody based competition assays, Western blot analysis and proliferation T-cell assays.
    Results of both experiments showed that AN-PEP broke down gluten in the stomach so effectively that almost no gluten reached the duodenum compartment. Because these results show that AN-PEP is capable of speeding the breakdown of gluten in a gastrointestinal system that closely mimics live digestion, the team concluded that AN-PEP might offer celiac patients an opportunity to stray from their strict gluten free diets from time to time.
    Participating Institutions:
    1 Dept of Immunohematology and Blood Transfusion,
    Leiden University Medical Center, Leiden, Netherlands.
    2 TNO Quality of Life, Zeist, Netherlands
    3 DSM Food Specialties, Delft, Netherlands
    Gut. Published Online First: 9 May 2007. doi:10.1136/gut.2006.111609
    health writer who lives in San Francisco and is a frequent author of articles for Celiac.com.

    Jefferson Adams
    Celiac.com 04/16/2010 - In most adults with celiac disease, clinical symptoms disappear with a gluten-free diet. However, the exact effects of a gluten-free diet on rates of mucosal recovery in adults with celiac disease is less certain.
    A group of clinicians recently set out to estimate the rate of mucosal recovery under a gluten-free diet in adult subjects with celiac disease, and to gauge the clinical prospects of ongoing mucosal damage in celiac patients following a gluten-free diet.
    The study group included: Alberto Rubio-Tapia, MD; Mussarat W. Rahim, MBBS; Jacalyn A. See , MS , RD, LD; Brian D. Lahr , MS; Tsung-Teh Wu, MD; and Joseph A. Murray, MD.
    Each patient in the study had biopsy-proven celiac disease, and was assessed at the Mayo Clinic. Also, each patient received duodenal biopsies at diagnosis. After beginning a gluten-free diet, each patient had at least one follow-up intestinal biopsy to assess mucosal recovery.
    The study team focused on mucosal recovery and overall mortality. Of 381 adult patients with biopsy-proven celiac disease, a total of 241 (175 women - 73%) had both a diagnostic and follow-up biopsy available for re-review.
    Using the Kaplan–Meier rate of confirmed mucosal recovery on these 241 patients, the study group found that 34% of patients enjoyed mucosal recovery at 2 years following diagnosis  (95% with a confidence interval (CI): 27–40 % ), and 66% of patients enjoyed mucosal recovery at 5 years (95% CI: 58–74 % ).
    More than 80% of patients showed some clinical response to the gluten-free diet, but clinical response was not a reliable marker of mucosal recovery ( P = 0.7). Serological response was, by far, the best marker for confirmed mucosal recovery ( P = 0.01).
    Patients who complied poorly with a gluten-free diet ( P < 0.01), those with severe celiac disease defined by diarrhea and weight loss ( P < 0.001), and those with total villous atrophy at diagnosis ( P < 0.001) had high rates of persistent mucosal damage.
    With adjustments for gender and age, patients who experienced confirmed mucosal recovery had lower mortality rates overall (hazard ratio = 0.13, 95 % CI: 0.02 – 1.06, P = 0.06).
    One of the most important findings from this study was that a large number of adults with celiac disease see no mucosal recovery, even after treatment with a GFD.
    Compared to those patients who suffered persistent damage, patients who experienced confirmed mucosal recovery had lower rates of mortality independent of age and gender.
    The group notes that systematic follow-up via intestinal biopsies may be advisable in patients diagnosed with celiac disease as adults.

    SOURCE: Am J Gastroenterol. 9 February 2010; doi: 10.1038/ajg.2010.10


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