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  • Jefferson Adams

    Have Researchers Found a Safe Way for Celiac Patients to Consume Wheat?

    Jefferson Adams

    Reviewed and edited by a celiac disease expert.

    Celiac.com 05/18/2015 - It is well known that fermenting wheat flour with sourdough lactobacilli and fungal proteases reduces the amount of gluten. A team of researchers recently assessed whether patients with celiac disease can safely consume baked goods made from this hydrolyzed kind of wheat flour.

    Photo: Christina D. C. HoeppnerThe research team included Luigi Greco, Marco Gobbetti, Renata Auricchio, Raffaella Di Mase, Francesca Landolfo, Francesco Papro, Raffaella Di Cagno, Maria De Angelis, Carlo Giusseppi Rizzello, Angela Cassone, Gaetano Terrone, Laura Timpone, Martina D’Aniello, Maria Maglio, Riccardo Troncone, and Salvatore Auricchio.

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    They are variously affiliated with the Department of Pediatrics and European Laboratory for the Study of Food Induced Diseases at the University of Naples, Federico II in Naples, and with the Department of Plant Protection and Applied Microbiology at the University of Bari in Bari, Italy.

    For their study, the team randomly assigned patients to receive 200 grams per day of natural flour baked goods (NFBG) (80,127 ppm gluten; n 6), extensively hydrolyzed flour baked goods (S1BG) (2480 ppm residual gluten; n 2), or fully hydrolyzed baked goods (S2BG) (8 ppm residual gluten; n 5) for 60 days.

    Two of the 6 patients who consumed natural flour baked goods discontinued the challenge due to adverse symptoms; all patients showed increased levels of anti–tissue transglutaminase (tTG) antibodies and mucosal damage to the small bowel.

    • The 2 patients who ate the S1BG goods had no complaints and showed no symptoms, but developed subtotal atrophy.
    • The 5 patients who ate the S2BG had no clinical symptoms or complaints. They showed no increase in anti-tTG antibodies, and their Marsh grades indicated no damage to small intestinal mucosa.
    • The results showed that a 60-day diet of baked goods made from hydrolyzed wheat flour, manufactured with sourdough lactobacilli and fungal proteases, was not toxic to patients with celiac disease.

    Obviously further study is needed, along with a combined analysis of serologic, morphometric, and immunohistochemical parameters, which is the most accurate way to assess new celiac therapies.

    However, hydrolyzing wheat flour and treating it with sourdough lactobacilli and fungal proteases is not especially complicated. If these results stand, researchers may have developed the first wheat products that are safe for people with celiac disease.

    What do you think? Exciting news? Or one more thing to be skeptical about? Share your comments below.


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    Very interesting. I would like to see the study replicated in the U.S. with a larger test group. I believe U.S. wheat is very different than Italian wheat because of genetic modifications in the U.S. I have a friend who shows severe allergy symptoms when eating wheat in the U.S., but can eat all the bread and pasta in Italy with no symptoms.

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    While the findings were interesting regarding the fully hydrolyzed wheat, I was shocked and appalled to read that the researchers gave normal bread (w/ over 80,000 ppm gluten!) to six people with celiac disease. Evidence showing that gluten causes long term damage and possibly severe health outcomes to celiacs patients has been well documented. As such, I think this study was completely unethical in its design. Biomedical research ethics require that the subjects should not be exposed to excess harm, which is exactly what happened here. The authors, the funders, and the journal editor that published this article should be ashamed.

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    This would, of course, be a blessing for all of us with this disease. Though I nearly died of my disease (lost more than 60 percent of my body weight in 2 months), I am not particularly sensitive to wheat contamination in the short term now that I am being treated. So, this might really be a possibility for me.

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  • About Me

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,500 articles on celiac disease. His coursework includes studies in science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. He previously served as SF Health News Examiner for Examiner.com, and devised 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 "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

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