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      Frequently Asked Questions About Celiac Disease   04/07/2018

      This Celiac.com FAQ on celiac disease will guide you to all of the basic information you will need to know about the disease, its diagnosis, testing methods, a gluten-free diet, etc.   Subscribe to Celiac.com's FREE weekly eNewsletter   What are the major symptoms of celiac disease? Celiac Disease Symptoms What testing is available for celiac disease?  Celiac Disease Screening Interpretation of Celiac Disease Blood Test Results Can I be tested even though I am eating gluten free? How long must gluten be taken for the serological tests to be meaningful? The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-Free Is celiac inherited? Should my children be tested? Ten Facts About Celiac Disease Genetic Testing Is there a link between celiac and other autoimmune diseases? Celiac Disease Research: Associated Diseases and Disorders Is there a list of gluten foods to avoid? Unsafe Gluten-Free Food List (Unsafe Ingredients) Is there a list of gluten free foods? Safe Gluten-Free Food List (Safe Ingredients) Gluten-Free Alcoholic Beverages Distilled Spirits (Grain Alcohols) and Vinegar: Are they Gluten-Free? Where does gluten hide? Additional Things to Beware of to Maintain a 100% Gluten-Free Diet What if my doctor won't listen to me? An Open Letter to Skeptical Health Care Practitioners Gluten-Free recipes: Gluten-Free Recipes
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    CAN SCIENTISTS FIND ACCEPTANCE FOR GMO GLUTEN-FREE WHEAT?


    Jefferson Adams


    • Will people buy GMO gluten-free wheat? The people developing it think so.


    Celiac.com 01/08/2018 - Imagine gluten-free wheat. Well, actually you don't have to imagine it, because a group of scientists has used a gene-editing technique called CRISPR/Cas9 to cut selected genes from a wheat genome, and presto, gluten-free wheat is a thing.


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    As people in numerous countries debate genetically modified crops, some countries, including France and Germany, have passed laws to prohibit their cultivation.

    Remember, we're not talking about hybridization here, which is based on natural selection and works by interbreeding plant strains. Researchers have used hybridization to develop strains of wheat that are low in gluten, but so far no one has made a strain that is entirely free of gluten.

    In this case, we're talking about genetic modification; changing the basic genetic structure of the plant. The greatest objections around GMO practices have been focused on the insertion of DNA from one species into another species, says Francisco Barro, a plant biotechnologist at the Institute for Sustainable Agriculture in Spain.

    To steer clear of this genetic process, Barro and his team used the gene-editing technique CRISPR/Cas9 to remove certain genes from a wheat genome. Their team focused on alpha-gliadins, gluten proteins that are thought to be the trigger for immune system reactions in people with celiac disease and gluten sensitivity.

    To accomplish their goal of removing the culprit gene(s), the research team used the scissorlike Cas9 protein to cut out 35 of the 45 alpha-gliadin genes. Lab tests showed that the new wheat strain reduced the immune response by 85 percent, the team reported.

    Far from being any kind of decisive breakthrough though, this is just one “really important step in maybe producing something that is going to be incredibly useful,” says Wendy Harwood, a crop geneticist at the John Innes Center in England.

    Meanwhile, Barro says his team is working on targeting more gluten-triggered genes to develop a completely safe strain of wheat for celiac patients.

    Source:


    Image Caption: Photo: CC--Brad Higham
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    Guest Michael

    Posted

    Once again, I have to point out the overwhelming ignorance of "scientists". Dr. Tom O'Bryan has switched from talking about "gluten sensitivity" to "wheat sensitivity" after researchers at Columbia University have identified five more categories of proteins in wheat that celiacs react to, in addition to prolamins and glutelins as gliadin and glutenin. My diagnosing physician has told me that someone born with celiac disease but not diagnosed until late in adulthood will react to every part of wheat and many things that the patient ate with wheat. She said that there is a "Pavlov's dog" effect on the immune system. And in view of the mistake at the General Mills factory of using wheat flour in Cheerios, how can anybody trust that gluten-free wheat will be used instead of regular wheat. And how can you think that gluten-free wheat will not be cross-pollinated by regular wheat? And what good will gluten-free wheat be to anyone? It will just be gross cardboard dust.

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    Guest CJ Russell

    Posted

    My father was a chemist and one of my brother's worked with scientists who were developing GMO grains 30 years ago. I don't have the 'GMOs are dangerous and scary' mindset. I am totally in favor of science finding solutions to my health issues. It is true that "gluten sensitivity", "gluten allergy", and "wheat sensitivity" are different things, so this particular breakthrough may not help every gluten sensitive person, but I believe that it is a step in the right direction.

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    Guest Liz

    Posted

    Thanks for this article. I think we're wasting the potential of GMO foods on things like Roundup Ready Corn. I would be in favor of gluten-free wheat, but this article says it reduces the response by 85%. That may not be enough for those who already have it. It might be better as a preventative to reduce the incidence of celiac disease in those who haven't developed it yet. If it were adopted as the wheat used in processed foods, then it could potentially do a world of good to everyone by not exposing them and not sensitizing them in the first place. I think that for me, I am too far gone to be helped, but I'd love to imagine a future for my family in which they have never heard of celiac. To do that, it will also be necessary to make gluten-free barley and rye, and possibly oats. Oats are still in the gray area of gluten-free because some people react to avenin. If embraced, this could really give us a better future.

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    Guest Pau

    Posted

    And what exactly would be the use of gluten-free wheat? Without gluten, it won't be any better in making bread and pastry than any other naturally gluten-free grains. Try making bread with wheat strains that only contain 3% of gluten and you will see for yourself, and I assume that is still way more gluten than the gluten-free would have. Another issue will be to keep the crop uncontaminated because it will probably look the same as regular wheat, maybe adding a gene to make it resistant to some herbicide will solve that? Yummy. Not worth the effort.

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  • Related Articles

    Jefferson Adams
    Celiac.com 05/04/2015 - Kansas farmers grow a lot of wheat. People with celiac disease avoid wheat like the plague. Not only are people with celiac disease avoiding wheat, but the vast majority of people who avoid wheat now do so for non-medical reasons.
    With celiac disease rates on the rise, and millions of non-celiacs now avoiding gluten for non-medical reasons, the gluten-free food industry is worth nearly a billion dollars a year in the U.S. alone.
    This reality has wheat farmers and researchers scrambling to develop wheat strains and products that are safe for consumption by people who follow gluten-free diets.
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    Read more at AP.
     

    Jefferson Adams
    Celiac.com 03/22/2017 - A new study published in the journal Food Chemistry shows that even the ancient varieties of wheat that have not been subject to hybridization, contain toxic epitopes that trigger adverse autoimmune response in celiac patients.
    What makes gluten toxic to people with celiac disease? Also, what is the relationship between various kinds of wheat and their celiac toxicity?
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    Jefferson Adams
    Celiac.com 06/01/2017 - With low prices and slim margins, life is tough for people who trade in wheat, corn and soybeans these days. So much so that some traders are turning to obscure commodities like desert-grown tomatoes and chickpeas to turn a profit.
    Over the last several years, as farmers have produced far more of these crops than the marker can handle, margins for handling major grain crops have sunk. That has led some trading firms to seek higher margins in niche markets, such as tomatoes and organic grains, while other firms are looking to organic grains, and markets for costlier processed food ingredients or gluten-free products.
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    Source:
    ESMMagazine.com

    Jefferson Adams
    Celiac.com 10/25/2017 - For people with celiac disease, eating gluten proteins from wheat, barley, and rye triggers an auto-immune response, and the accompanying physical symptoms.
    A team of researchers recently set out to engineer low-gluten wheat strains that also have low-reactivity for people with celiac disease. To meet their goals, the team designed two sgRNAs to target a conserved region adjacent to the coding sequence for the 33-mer in the -gliadin genes. They then sought to evaluate the results.
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    Connie Sarros
    Celiac.com 04/21/2018 - Dear Friends and Readers,
    I have been writing articles for Scott Adams since the 2002 Summer Issue of the Scott-Free Press. The Scott-Free Press evolved into the Journal of Gluten Sensitivity. I felt honored when Scott asked me ten years ago to contribute to his quarterly journal and it's been a privilege to write articles for his publication ever since.
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    Source:
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    Jefferson Adams
    Celiac.com 04/18/2018 - To the relief of many bewildered passengers and crew, no more comfort turkeys, geese, possums or other questionable pets will be flying on Delta or United without meeting the airlines' strict new requirements for service animals.
    If you’ve flown anywhere lately, you may have seen them. People flying with their designated “emotional support” animals. We’re not talking genuine service animals, like seeing eye dogs, or hearing ear dogs, or even the Belgian Malinois that alerts its owner when there is gluten in food that may trigger her celiac disease.
    Now, to be honest, some of those animals in question do perform a genuine service for those who need emotional support dogs, like veterans with PTSD.
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    Now the major airlines are taking note and introducing stringent requirements for service animals.
    Delta was the first to strike. As reported by the New York Times on January 19: “Effective March 1, Delta, the second largest US airline by passenger traffic, said it will require passengers seeking to fly with pets to present additional documents outlining the passenger’s need for the animal and proof of its training and vaccinations, 48 hours prior to the flight.… This comes in response to what the carrier said was a 150 percent increase in service and support animals — pets, often dogs, that accompany people with disabilities — carried onboard since 2015.… Delta said that it flies some 700 service animals a day. Among them, customers have attempted to fly with comfort turkeys, gliding possums, snakes, spiders, and other unusual pets.”
    Fresh from an unsavory incident with an “emotional support” peacock incident, United Airlines has followed Delta’s lead and set stricter rules for emotional support animals. United’s rules also took effect March 1, 2018.
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    cnbc.com

    admin
    WHAT IS CELIAC DISEASE?
    Celiac disease is an autoimmune condition that affects around 1% of the population. People with celiac disease suffer an autoimmune reaction when they consume wheat, rye or barley. The immune reaction is triggered by certain proteins in the wheat, rye, or barley, and, left untreated, causes damage to the small, finger-like structures, called villi, that line the gut. The damage occurs as shortening and villous flattening in the lamina propria and crypt regions of the intestines. The damage to these villi then leads to numerous other issues that commonly plague people with untreated celiac disease, including poor nutritional uptake, fatigue, and myriad other problems.
    Celiac disease mostly affects people of Northern European descent, but recent studies show that it also affects large numbers of people in Italy, China, Iran, India, and numerous other places thought to have few or no cases.
    Celiac disease is most often uncovered because people experience symptoms that lead them to get tests for antibodies to gluten. If these tests are positive, then the people usually get biopsy confirmation of their celiac disease. Once they adopt a gluten-free diet, they usually see gut healing, and major improvements in their symptoms. 
    CLASSIC CELIAC DISEASE SYMPTOMS
    Symptoms of celiac disease can range from the classic features, such as diarrhea, upset stomach, bloating, gas, weight loss, and malnutrition, among others.
    LESS OBVIOUS SYMPTOMS
    Celiac disease can often less obvious symptoms, such fatigue, vitamin and nutrient deficiencies, anemia, to name a few. Often, these symptoms are regarded as less obvious because they are not gastrointestinal in nature. You got that right, it is not uncommon for people with celiac disease to have few or no gastrointestinal symptoms. That makes spotting and connecting these seemingly unrelated and unclear celiac symptoms so important.
    NO SYMPTOMS
    Currently, most people diagnosed with celiac disease do not show symptoms, but are diagnosed on the basis of referral for elevated risk factors. 

    CELIAC DISEASE VS. GLUTEN INTOLERANCE
    Gluten intolerance is a generic term for people who have some sort of sensitivity to gluten. These people may or may not have celiac disease. Researchers generally agree that there is a condition called non-celiac gluten sensitivity. That term has largely replaced the term gluten-intolerance. What’s the difference between celiac disease and non-celiac gluten-sensitivity? 
    CELIAC DISEASE VS. NON-CELIAC GLUTEN SENSITIVITY (NCGS)
    Gluten triggers symptoms and immune reactions in people with celiac disease. Gluten can also trigger symptoms in some people with NCGS, but the similarities largely end there.

    There are four main differences between celiac disease and non-celiac gluten sensitivity:
    No Hereditary Link in NCGS
    Researchers know for certain that genetic heredity plays a major role in celiac disease. If a first-degree relative has celiac disease, then you have a statistically higher risk of carrying genetic markers DQ2 and/or DQ8, and of developing celiac disease yourself. NCGS is not known to be hereditary. Some research has shown certain genetic associations, such as some NCGS patients, but there is no proof that NCGS is hereditary. No Connection with Celiac-related Disorders
    Unlike celiac disease, NCGS is so far not associated with malabsorption, nutritional deficiencies, or a higher risk of autoimmune disorders or intestinal malignancies. No Immunological or Serological Markers
    People with celiac disease nearly always test positive for antibodies to gluten proteins. Researchers have, as yet, identified no such antobodies or serologic markers for NCGS. That means that, unlike with celiac disease, there are no telltale screening tests that can point to NCGS. Absence of Celiac Disease or Wheat Allergy
    Doctors diagnose NCGS only by excluding both celiac disease, an IgE-mediated allergy to wheat, and by the noting ongoing adverse symptoms associated with gluten consumption. WHAT ABOUT IRRITABLE BOWEL SYNDROME (IBS) AND IRRITABLE BOWEL DISEASE (IBD)?
    IBS and IBD are usually diagnosed in part by ruling out celiac disease. Many patients with irritable bowel syndrome are sensitive to gluten. Many experience celiac disease-like symptoms in reaction to wheat. However, patients with IBS generally show no gut damage, and do not test positive for antibodies to gliadin and other proteins as do people with celiac disease. Some IBS patients also suffer from NCGS.

    To add more confusion, many cases of IBS are, in fact, celiac disease in disguise.

    That said, people with IBS generally react to more than just wheat. People with NCGS generally react to wheat and not to other things, but that’s not always the case. Doctors generally try to rule out celiac disease before making a diagnosis of IBS or NCGS. 
    Crohn’s Disease and celiac disease share many common symptoms, though causes are different.  In Crohn’s disease, the immune system can cause disruption anywhere along the gastrointestinal tract, and a diagnosis of Crohn’s disease typically requires more diagnostic testing than does a celiac diagnosis.  
    Crohn’s treatment consists of changes to diet and possible surgery.  Up to 10% of Crohn's patients can have both of conditions, which suggests a genetic connection, and researchers continue to examine that connection.
    Is There a Connection Between Celiac Disease, Non-Celiac Gluten Sensitivity and Irritable Bowel Syndrome? Large Number of Irritable Bowel Syndrome Patients Sensitive To Gluten Some IBD Patients also Suffer from Non-Celiac Gluten Sensitivity Many Cases of IBS and Fibromyalgia Actually Celiac Disease in Disguise CELIAC DISEASE DIAGNOSIS
    Diagnosis of celiac disease can be difficult. 

    Perhaps because celiac disease presents clinically in such a variety of ways, proper diagnosis often takes years. A positive serological test for antibodies against tissue transglutaminase is considered a very strong diagnostic indicator, and a duodenal biopsy revealing villous atrophy is still considered by many to be the diagnostic gold standard. 
    But this idea is being questioned; some think the biopsy is unnecessary in the face of clear serological tests and obvious symptoms. Also, researchers are developing accurate and reliable ways to test for celiac disease even when patients are already avoiding wheat. In the past, patients needed to be consuming wheat to get an accurate test result. 
    Celiac disease can have numerous vague, or confusing symptoms that can make diagnosis difficult.  Celiac disease is commonly misdiagnosed by doctors. Read a Personal Story About Celiac Disease Diagnosis from the Founder of Celiac.com Currently, testing and biopsy still form the cornerstone of celiac diagnosis.
    TESTING
    There are several serologic (blood) tests available that screen for celiac disease antibodies, but the most commonly used is called a tTG-IgA test. If blood test results suggest celiac disease, your physician will recommend a biopsy of your small intestine to confirm the diagnosis.
    Testing is fairly simple and involves screening the patients blood for antigliadin (AGA) and endomysium antibodies (EmA), and/or doing a biopsy on the areas of the intestines mentioned above, which is still the standard for a formal diagnosis. Also, it is now possible to test people for celiac disease without making them concume wheat products.

    BIOPSY
    Until recently, biopsy confirmation of a positive gluten antibody test was the gold standard for celiac diagnosis. It still is, but things are changing fairly quickly. Children can now be accurately diagnosed for celiac disease without biopsy. Diagnosis based on level of TGA-IgA 10-fold or more the ULN, a positive result from the EMA tests in a second blood sample, and the presence of at least 1 symptom could avoid risks and costs of endoscopy for more than half the children with celiac disease worldwide.

    WHY A GLUTEN-FREE DIET?
    Currently the only effective, medically approved treatment for celiac disease is a strict gluten-free diet. Following a gluten-free diet relieves symptoms, promotes gut healing, and prevents nearly all celiac-related complications. 
    A gluten-free diet means avoiding all products that contain wheat, rye and barley, or any of their derivatives. This is a difficult task as there are many hidden sources of gluten found in the ingredients of many processed foods. Still, with effort, most people with celiac disease manage to make the transition. The vast majority of celiac disease patients who follow a gluten-free diet see symptom relief and experience gut healing within two years.
    For these reasons, a gluten-free diet remains the only effective, medically proven treatment for celiac disease.
    WHAT ABOUT ENZYMES, VACCINES, ETC.?
    There is currently no enzyme or vaccine that can replace a gluten-free diet for people with celiac disease.
    There are enzyme supplements currently available, such as AN-PEP, Latiglutetenase, GluteGuard, and KumaMax, which may help to mitigate accidental gluten ingestion by celiacs. KumaMax, has been shown to survive the stomach, and to break down gluten in the small intestine. Latiglutenase, formerly known as ALV003, is an enzyme therapy designed to be taken with meals. GluteGuard has been shown to significantly protect celiac patients from the serious symptoms they would normally experience after gluten ingestion. There are other enzymes, including those based on papaya enzymes.

    Additionally, there are many celiac disease drugs, enzymes, and therapies in various stages of development by pharmaceutical companies, including at least one vaccine that has received financial backing. At some point in the not too distant future there will likely be new treatments available for those who seek an alternative to a lifelong gluten-free diet. 

    For now though, there are no products on the market that can take the place of a gluten-free diet. Any enzyme or other treatment for celiac disease is intended to be used in conjunction with a gluten-free diet, not as a replacement.

    ASSOCIATED DISEASES
    The most common disorders associated with celiac disease are thyroid disease and Type 1 Diabetes, however, celiac disease is associated with many other conditions, including but not limited to the following autoimmune conditions:
    Type 1 Diabetes Mellitus: 2.4-16.4% Multiple Sclerosis (MS): 11% Hashimoto’s thyroiditis: 4-6% Autoimmune hepatitis: 6-15% Addison disease: 6% Arthritis: 1.5-7.5% Sjögren’s syndrome: 2-15% Idiopathic dilated cardiomyopathy: 5.7% IgA Nephropathy (Berger’s Disease): 3.6% Other celiac co-morditities include:
    Crohn’s Disease; Inflammatory Bowel Disease Chronic Pancreatitis Down Syndrome Irritable Bowel Syndrome (IBS) Lupus Multiple Sclerosis Primary Biliary Cirrhosis Primary Sclerosing Cholangitis Psoriasis Rheumatoid Arthritis Scleroderma Turner Syndrome Ulcerative Colitis; Inflammatory Bowel Disease Williams Syndrome Cancers:
    Non-Hodgkin lymphoma (intestinal and extra-intestinal, T- and B-cell types) Small intestinal adenocarcinoma Esophageal carcinoma Papillary thyroid cancer Melanoma CELIAC DISEASE REFERENCES:
    Celiac Disease Center, Columbia University
    Gluten Intolerance Group
    National Institutes of Health
    U.S. National Library of Medicine
    Mayo Clinic
    University of Chicago Celiac Disease Center