Immunologic evidence of no harmful effect of oats in celiac disease

Picarelli, Antonio; Tola, Marco Di; Sabbatella, L.; Gabrielli, Fabiola; Cello, T. Di; Anania, M.C.; Mastracchio, Antonio; Silano, Marco; Vincenzi, Massimo De

doi:10.1093/ajcn/74.1.137

Cited by 68 publications

(41 citation statements)

References 21 publications

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“…Some patients may consume large quantities of oats in order to improve a restricted diet. The statement from earlier studies (Janatuinen et al, 1995(Janatuinen et al, , 2000(Janatuinen et al, , 2002Srinivasan et al, 1996;Hardman et al, 1997;Reunala et al, 1999;Picarelli et al, 2001) that a 'moderate quantity of oats is safe', may lead to misinterpretation and confusion. Results from this study on 20 adult coeliac patients in remission indicate that there is no reason to state that intake of uncontaminated oats in adults must be limited to small or moderate amounts.…”

Section: Discussionmentioning

confidence: 99%

“…Studies from the 1950s reported raised levels of faecal fat or reduced xylose excretion in a few patients who consumed large amounts of oats ( > 60 -70 g=day; Dicke et al, 1953;Moulton, 1959;Baker & Read, 1976). Recent research, however, suggests that moderate amounts of oats, ie about 50 g=day, can be safely consumed by adult coeliac patients as well as subjects with dermatitis herpetiformis (Janatuinen et al, 1995(Janatuinen et al, , 2000Srinivasan et al, 1996;Hardman et al, 1997;Reunala et al, 1998;Picarelli et al, 2001). …”

Section: Introductionmentioning

confidence: 99%

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Adult coeliac patients do tolerate large amounts of oats

et al. 2003

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Objective: The aim of the present study was to investigate whether adult patients with coeliac disease in remission could include large amounts of oats in their daily gluten-free diet for an extended period of time without adverse effects. Design, subjects and methods: Twenty adult coeliac patients in remission included large amounts of uncontaminated rolled oats in their daily diet for a prolonged period. The examinations, performed four times during the study period, included small bowel endoscopy with biopsies, blood samples (nutritional status, serological analysis), height and body weight, gastrointestinal symptoms and dietary records. Gastrointestinal symptoms and diet were also investigated through unannounced telephone interviews once a month during the study period. Results: No adverse effects of a large intake of oats were seen in small bowel histology, serology nor in nutritional status in the 15 subjects who completed the whole study period. Two of the subjects dropped out because of gastrointestinal symptoms and three for non-medical reasons. The median intake of oats was 93 g=day and the compliance to the oat diet was found to be good. Examinations of the patients after drop-out did not show any deterioration in small bowel histology or nutritional status nor raised levels of antibodies. Conclusion: Results from this study indicate that adult patients with coeliac disease in remission can include large amounts of controlled wheat-free rolled oats for an extended period of time without adverse effects.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Adult coeliac patients do tolerate large amounts of oats

et al. 2003

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“…were not present in avenin (Picarelli 2001). Kilamartin et al, showed that in vitro challenge with avenin did not induce production of EMA (Kilamartin 2003).…”

Section: Treatment Gfd: Now and Then-oatsmentioning

confidence: 99%

Demographics, clinical features and treatment of pediatric celiac disease

Tapsas¹

2015

Linköping University Medical Dissertations

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Celiac disease (CD) is a chronic small intestinal immune-mediated enteropathy triggered by ingestion of gluten-containing food in genetically predisposed subjects. The enteropathy is presented with a wide variety of clinical manifestations, which can occur even outside the gastrointestinal tract. In the majority of cases, the diagnosis of CD is based on a small intestinal biopsy showing mucosal alterations, i.e. intraepithelial lymphocytosis, crypt hyperplasia, and villous atrophy. The treatment, gluten-free diet (GFD), has recently been revised with the addition of gluten-free oats. Oats give a more diversified nutrition and increase the fibre content. The use of oats in CD is though still debated in some reports. A strict life-long adherence to the GFD can be problematic, especially for pediatric CD patients. Sweden reported of one of the highest observed CD prevalences worldwide, i.e. 3%, among 12-year-olds born during what has been described as "the Swedish celiac epidemic", 1984−1996.The aims of this thesis were to elucidate how pediatric CD has changed during a 41-year period in Sweden, i.e. 1973Sweden, i.e. −2013, in terms of clinical presentation, disease severity, incidence, and demographics. We also wanted to adress the compliance to the GFD, the use of oats in the GFD and the safety of oats inclusion in the diet by measuring urinary nitric oxide (NO) metabolites.Filed information provided data about 2856 pediatric patients investigated for suspected CD between 1973 and 2013; of which 1030 patients were diagnosed with CD. After the data analyses the mean age of CD patients was shown to increase after the celiac epidemic period.Currently, CD shows a less severe picture in terms of symptoms and intestinal pathology.Younger children suffer primarily from gastrointestinal symptoms and growth failure, whereas extra-intestinal manifestations are more often displayed among adolescents. viWe also reported an unusually high pediatric CD incidence rate and cumulative incidence, likely the highest reported worldwide. We hypothesised that the introduction of new antibody tests would affect the diagnostic activity and accuracy in performing small intestinal biopsies for CD investigation. However, the outcome of diagnostic activity and accuracy could not clearly be attributed to the use of antibody tests due to changes occurring in parallel during the 41-year study period, e.g. a different pattern of symptoms at presentation and improved knowledge of the disease among parents and health professionals.In a questionnaire-based study our patient group reported a high compliance to the GFD.Long duration of the GFD may, however, influence compliance negatively. Oats have been included to the GFD of our study population in most of the cases without reporting major complications related to their well-being.The urinary measurements of NO metabolites revealed two patient groups, one with high and one with low levels. The two populations did not differ regarding sex, age, compliance to the GFD or oats consumption. Fa...

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“…Rye and barley show some degree of 'toxicity' in CD, whereas rice and maize have generally been considered safe for celiac patients (Dicke et al 1953;Cornell and Townley 1974;Baker and Read 1976;Anand et al 1978). Furthermore, recent works have provided impressive results showing that oats is tolerated by CD patients, with the only exception of certain individuals possessing peculiar DQ2-restricted T cells (Picarelli et al 2001;Janatuinen et al 2002;Kilmartin et al 2003;Arentz-Hansen et al 2004). More interestingly, large differences in the harmfulness profile of prolamins have been found in the genus Triticum, which contains diploid, tetraploid and hexaploid species.…”

Section: Introductionmentioning

confidence: 99%

Variation in noxiousness of different wheat species for celiac patients

Pogna

Gazza

Vincentini

et al. 2008

Journal of Plant Interactions

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Peptic-tryptic (PT) digested prolamins from spelt wheat Triticum aestivum ssp. spelta and landraces ERSA 6 and ERSA 8 of farro wheat T. turgidum ssp. dicoccum were found to agglutinate K562(S) cells, and exert strong toxic effects on Caco-2/TC7 cells. Cytotoxicity of spelt prolamins against Caco-2/TC7 cells was greatly reduced by 10-mer peptide QQPQDAVQPF. By contrast, the PT digests from monoccum wheat (Triticum monococcum) and farro landraces Prometeo, L5563, L5540 and L5558 did not exhibit any negative effects on K562(S) and Caco-2/ TC7 cells. Toxic genotypes ERSA 6 and ERSA 8 were found to share the same gliadin pattern, which was absent in inactive landraces. Monococcum, farro and spelt wheats differed from each other in their responses to antibodies specific for 13-mer cytotoxic sequence FPGQQQPFPPQQP and 10-mer peptide QQPQDAVQPF. This latter sequence was found to occur in high amounts in common wheat line FG, Phaseoulus vulgaris, Ph. coccineus and Lens culinaria.

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Immunologic evidence of no harmful effect of oats in celiac disease

Abstract: Because the in vitro challenge with PT-avenin and its C fraction did not induce EMA production in treated celiac disease patients, it appears that oats have no harmful effect on celiac disease. Therefore, oats can be safely included in a gluten-free diet.

Cited by 68 publications

References 21 publications

Adult coeliac patients do tolerate large amounts of oats

Adult coeliac patients do tolerate large amounts of oats

Demographics, clinical features and treatment of pediatric celiac disease

Variation in noxiousness of different wheat species for celiac patients

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