El gluten: Su historia y efectos en la enfermedad celíaca

Abstract

History of gluten and its effects on celiac disease The global prevalence of celiac disease is of one person per 250 inhabitants. The disease is induced by gluten, a peptide contained in wheat, rye and barley that during small intestinal digestion generates smaller peptides. Some of these are resistant to hydrolysis and cross through the epithelium into the mucosa, inducing a cascade of immune reactions leading to the appearance of the disease in susceptible individuals. Gluten appeared as a consequence of agricultural practices initiated 10000 years ago in the Fertile Crescent of southwest Asia. Celiac disease epidemiology is complicated since consumption of gluten differs depending on the origin of populations. Treatment of celiac disease consists of withdrawing gluten from the diet, a task that becomes difficult in the long term. The concept of gluten-free food has changed along time. This article updates the concept of celiac disease, the history of gluten consumption in the world, the characteristics of a gluten free diet and the difficulties to adhere to it.

Celiac disease: understanding the gluten-free diet

“…Because wheat is a hexaploid species and some of the genes coding for gluten proteins originate from duplicate loci, one variety of wheat may contain several hundred different gluten proteins. Being a protein of low nutritional value, gluten is massively used by food industries because of its ability to retain air in the protein matrix, facilitating baking and improving several characteristics of ultra-processed products [35]. Among the several attempts that intend to establish new therapeutics for CD, the use of less immunogenic wheat is being currently assessed.…”

Desarrollo de neoplasias en pacientes con mal manejo de la enfermedad celíaca en Latinoamérica.

“…En el segundo grupo se incluyeron dos artículos que analizan los factores de riesgo desde el punto de vista genético de la enfermedad celíaca (22,23). Como tercer grupo se distinguen diez artículos que dirigieron su estudio hacia los métodos de diagnóstico de la enfermedad celíaca (24)(25)(26)(27)(28)(29)(30)(31)(32)(33), un cuarto grupo de nueve artículos estudió el tratamiento en base a la dieta libre de gluten y (Tabla 1). De los cuales se pudo evidenciar que el país con más estudios publicados acerca de enfermedad celíaca es Chile con 14 artículos publicados en: Revista Chilena de Pediatría, Revista Médica de Chile y Revista Chilena de Nutrición; seguido de España con 12 artículos publicados en las revistas Nutrición Hospitalaria, Revista Clínica de Medicina Familiar y Revista Española de enfermedades digestivas; Colombia con dos artículos y Cuba y Uruguay con 1 artículo respectivamente.…”

Mediterranean Gluten-Free Diet: Is It a Fair Bet for the Treatment of Gluten-Related Disorders?

“…Is a cohesive and visco-elastic material present in the alcohol-soluble fraction of gliadin and glutenins, widely consumed in customary Western diets (17,18). The food industry extensively uses gluten due to its capacity to preserve the air in the protein matrices, improving the baking process, and enhancing properties of the processed foods (19,20). Still, today GFD is also the treatment of patients with other gluten-related disorders, including NCGS and WA (18,21).…”