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Scott Adams posted an article in Additional Celiac Disease ConcernsCeliac.com 08/14/2015 – Recently I took a last minute, end of Summer road trip with my family and on one of our pit stops I was delighted to discover the often rumored, highly elusive and possibly "Holy Grail" of gluten-free food: Subway's gluten-free sub rolls! Yes, I am here to tell you that they do indeed exist, even though I almost couldn't believe it even when I saw them—but there they were...a whole stack of six inch long gluten-free Subway rolls—sitting right in front of me in tidy, individually wrapped cellophane packages. I had to rub my eyes and look twice to make sure that I wasn't dreaming because I, like many people, believed that Subway had discontinued them after a temporary Oregon-only trial run, and had decided against a permanent gluten-free roll out. Apparently though, in Oregon at least (and perhaps in other states?), they are still going strong many months after their rumored demise. To top this off, they even offered a gluten-free brownie for dessert! Rather than getting stuck with a chopped Subway salad again I was finally able to order a real submarine sandwich—just like everyone else. So, I immediately honed in on an old favorite and decided to try their Spicy Italian sub on a gluten-free roll. What...no bewildered look on their faces when I asked for gluten-free? They seemed to know exactly what I wanted, and the employee who prepared my sandwich seemed to follow a carefully prepared script—she first cleaned off the prep counter, then changed into a new pair of clean gloves, and finally pulled out a new, clean sheet of paper onto which she set the packaged roll. The roll was pre-cut, thus she didn't have to use the bread knife to cut it, which was likely contaminated. While making the sandwich I was offered the option of having it toasted (some sensitive celiacs may want to skip the toaster oven part), and I noticed that when she toasted mine she made sure that it went into the oven solo, so that it would not touch other sandwiches (it was also on its original sheet of clean paper when it went in). At this point you are probably wondering how it tasted, right? It was simply fantastic! Why can't other companies make gluten-free bread taste like this? It was soft, strong and slightly chewy. It wasn't at all dry, and seemed very fresh. My wife wanted me to ask them if they were sold separately so that I could take some home with me, which I didn't do, but you get the idea—they were really good and tasted very fresh. I was so excited about the prospect of being able to once again eat Subway sandwiches that I ended up stopping at Subway several times during our road trip. Each time I visited a Subway in Oregon I noticed that other people were also ordering or eating gluten-free subs, and in each case the staff seemed to follow their gluten-free script perfectly. It is difficult to estimate the exact ratio of gluten-free customers from such a small sampling, but it seemed to me that around 10-20% of total visitors ordered the gluten-free roll. Most companies would do almost anything to grow their business by 10-20%, but in this case the opposite could be the case—businesses should be willing to offer gluten-free options so they don't lose 10-20% of their business! I certainly hope that Subway's Oregon test bed is going well, and that Subway has learned that offering gluten-free sub rolls is great for business. And now for the $64,000 question: Will Subway roll out their gluten-free rolls to other states, and if so, when? It's time for Subway to share the gluten-free love beyond just Oregon! Of course with the P.F. Chang's litigation still ongoing, they are likely now in a holding pattern to see how that case turns out. Have you seen gluten-free Subway rolls outside of Oregon? Please let us know below.
Jefferson Adams posted an article in Crohn's Disease and Celiac DiseaseCeliac.com 02/18/2011 - In their search for a deeper understanding of the connections between celiac disease and Crohn’s disease, scientists have begun to focus on genetic variants that trigger inflammation in the gut. A research team examining associations between celiac disease and Crohn’s disease has now confirmed four common genetic variations between the two diseases. Their discovery may help to explain why people with celiac disease suffer Crohn’s disease at higher rates than the general population. Better understanding the genetic connections will likely pave the way for new treatments for symptoms common to both conditions, such as inflammation. The study used a new method of analysis called a genome-wide association study, or GWAS. This allows researchers to look at hundreds of thousands of genetic variations, called single nucleotide polymorphisms, or SNPs, that may be involved in any one disease. The research team compared 471,504 SNPs, representing the genomes of about 10,000 people, some of whom had Crohn’s disease, some of whom had celiac disease, and others who were healthy. They found four genes that seemed to raise the risk for both diseases. Two of these genes, IL18RAP and PTPN2, had already been associated with each disease. Another, called TAGAP, had previously been identified as a risk factor in celiac disease, but was newly associated with Crohn’s disease. The fourth gene, PUS10, had been previously been tied to Crohn’s disease, celiac disease, and ulcerative colitis. Three of the four genes seem to influence immune system response to perceived threats. “The first three we can say are involved in T-lymphocyte function,” Rioux says. “They seem to have a role to play in how these cells respond to a given stimulus.” In celiac disease, gluten-induced intestinal inflammation causes damage that prevents the intestine from absorbing nutrients in food. This can cause a wide range of problems, from anemia to osteoporosis to lactose intolerance. In Crohn’s disease, inflammation of the digestive tract often causes the bowel to empty frequently, resulting in diarrhea, among other problems. Some research shows that people with one condition are more likely to have the other. One study, for example, found that more than 18.5% of people with Crohn’s disease also have celiac disease. The study has “completely changed the way we can identify genetic risk factors,” says study co-author John D. Rioux, PhD, an associate professor of medicine at the University of Montreal, in Quebec, Canada. “There are sequence differences at the genetic level that get translated down to the protein levels,” Rioux notes. “And these differences may really nudge a person toward inflammation." He adds that "we’re just in the beginning, but we hope they may elucidate a common pathway and one day help us discover treatments that correct the underlying genetic changes.” Source: Jan. 27 issue of PLoS Genetics
Jefferson Adams posted an article in Diabetes and Celiac DiseaseCeliac.com 12/12/2008 - For some time now scientists have been working to better understand the connection between celiac disease and diabetes. About 10% of children and 2% of adults with Type 1 diabetes also have celiac disease, as compared to just 1% of the general population. Moreover, celiac disease and diabetes are known to have a common genetic susceptibility locus in the HLA system, specifically, HLA class II alleles on chromosome six. The primary susceptibility genes for type-1 diabetes are HLA-DQB1 and HLA-DRB1, but they act in combination with non-immune system genes as well as environmental factors that are still undiscovered. Celiac disease also has a major susceptibility gene in the HLA system — HLA-DQB1 — as well as locations outside the HLA complex. Recently, a research team led by John Todd, Ph.D., of the University of Cambridge, set out to better understand the connection between the two diseases, and to determine if they shared any non-HLA regions. They discovered another seven regions outside of the HLA system that are tied to both celiac disease and diabetes. One of those regions is the 32-base pair insertion-deletion variant on chromosome three that leads to a non-functional CCR5 receptor on T cells. People who carry both pairs of these genes enjoy some protection against HIV infection, and its role in both celiac disease and diabetes indicates that lymphocytes are a key factor in both diseases. Carriers of these genes also face a greater risk of developing either celiac disease or diabetes, or both conditions in their lifetimes. In genome-wide association studies, eight loci outside the HLA system have been associated with celiac disease. Similarly, 15 non-HLA loci have been linked with Type 1 diabetes. Dr. Todd and colleagues genotyped single nucleotide polymorphisms (SNPs)—single letter variations in the genetic code—in the eight celiac loci and in the 15 diabetes loci. They then screened DNA samples from 9,339 control subjects, 2,560 subjects with celiac disease, and 8,064 subjects with diabetes. They also tested the diabetic children, along with both biological parents in 2,828 families. The overall statistical significance was P<1.00Ã—10âˆ’4. At the same level of significance, three celiac disease locations—RGS1 on chromosome one, IL18RAP on chromosome two, and TAGAP on chromosome six—were also associated with Type 1 diabetes. The minor alleles of IL18RAP and TAGAP were associated with some protection from in Type 1 diabetes, but were associated with susceptibility in celiac disease. The CCR5 variant on chromosome three was newly tied to Type 1 diabetes (at P=1.81Ã—10âˆ’8) and was also tied with celiac disease, together with PTPN2 on chromosome 18 and CTLA4 on chromosome two. Counting SH2B3 on chromosome 12, which already known to be a shared locus—the number of non-HLA areas strongly tied to both celiac disease and diabetes stands at seven. Dr. Todd and colleagues said it's possible that a common genetic background with respect to autoimmunity and inflammation—combined with disease-specific variation at HLA and non-HLA genes as well as non-genetic factors -- might lead to different clinical outcomes. It is possible that dietary exposure to gluten in the form of cereal grains might play a role in the pathogenesis of Type 1 diabetes. These findings offer support a growing scientific view that many common diseases share genetic risk factors, and indicate that celiac and diabetes may in fact have common biological causes, and that the two disorders may be more closely linked than previously understood. More research is needed to determine which shared risk factors might reveal previously unexpected biologic connections between diseases. New England Journal of Medicine 2008; 359: 2767-77, 2837-2838