Multiple food intolerance or refractory celiac sprue?

Accomando, Salvatore; Albino, Claudia Accursia; Montaperto, Daniela; Amato, Giuseppe; Corsello, Giovanni

doi:10.1016/j.dld.2005.07.004

Cited by 6 publications

(5 citation statements)

References 8 publications

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“…It is used as alternative to elaborate gluten-free foodstuffs. Some celiac patients considered refractory to the treatment with a GFD improved when a corn-free diet was prescribed [32]. However, some studies have showed the certain maize prolamins (zeins) contain amino acid sequences that resemble the wheat gluten immunodominant peptides and their integrity after gastrointestinal proteolysis is unknown [33].…”

Section: Natural Varieties Of Cereal and Pseudocereals Suitable Fomentioning

confidence: 99%

The Gluten-Free Diet: Testing Alternative Cereals Tolerated by Celiac Patients

et al. 2013

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A strict gluten-free diet (GFD) is the only currently available therapeutic treatment for patients with celiac disease, an autoimmune disorder of the small intestine associated with a permanent intolerance to gluten proteins. The complete elimination of gluten proteins contained in cereals from the diet is the key to celiac disease management. However, this generates numerous social and economic repercussions due to the ubiquity of gluten in foods. The research presented in this review focuses on the current status of alternative cereals and pseudocereals and their derivatives obtained by natural selection, breeding programs and transgenic or enzymatic technology, potential tolerated by celiac people. Finally, we describe several strategies for detoxification of dietary gluten. These included enzymatic cleavage of gliadin fragment by Prolyl endopeptidases (PEPs) from different organisms, degradation of toxic peptides by germinating cereal enzymes and transamidation of cereal flours. This information can be used to search for and develop cereals with the baking and nutritional qualities of toxic cereals, but which do not exacerbate this condition.

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Section: Natural Varieties Of Cereal and Pseudocereals Suitable Fomentioning

confidence: 99%

The Gluten-Free Diet: Testing Alternative Cereals Tolerated by Celiac Patients

et al. 2013

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“…One of the more common wheat substitutes is maize as a principal ingredient for different gluten-free foodstuffs. However, some unexpected responses to maize proteins have been found in some CD patients after oral challenge (Accomando, Albino, Montaperto, Amato, & Corsello, 2006); as humoral IgA immunoreactivity (Cabrera-Chávez, Rouzaud-Sánchez, Sotelo-Cruz, & Calderón de la Barca, 2008); and other in vivo and in vitro findings previously reviewed (Ortiz-Sánchez, Cabrera-Chávez, & Calderón de la Barca, 2013). Hypothetically, maize prolamins could be harmful for a very small group of CD patients, especially those that are nonresponsive, and if it is confirmed, they should follow a gluten-free diet that also excludes maize foodstuffs.…”

Section: Introductionmentioning

confidence: 99%

Prolamins of maize and wheat differentially affect intestinal cells both in biopsies of celiac patients and CACO-2 cell line

Sánchez

Mata-Haro

Cabrera-Chávez

et al. 2015

Food and Agricultural Immunology

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We study the effect of maize zeins on cellular immune response as compared to that of wheat gliadins for exacerbating celiac disease due to a hypothetical similar response in some patients. In vitro activation of celiac duodenal mucosa with gliadin or zein immunoreactive peptides and pro-inflammatory response of CACO-2 cells to digested gliadin or zein fractions were evaluated as indicators of adaptive and innate response, respectively. In 3/5 biopsies, zein increased production of IFN-γ, whereas gliadin has done it in all the patient biopsies. In CACO-2 cells, two zein fractions (3-5 and 1-3 kDa), similar to gliadin fractions, stimulated the production of IL-8, p38 MAPK, COX2, and release of ZO-1 as compared to medium alone. The 3-5 kDa zein fraction increased permeability in cell monolayers, although less than gliadin. Zein peptides are immunogenic for some patients and induce a similar innate response, but to a lesser extent than gliadin peptides.

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“…For instance, they could be involved in inhibiting epithelial cell differentiation, augmenting epithelial cell proliferation, increasing epithelial and blood vessel permeability and affecting angiogenesis [28]. In some CD patients on a gluten-free diet, including maize-based foods, the anti-gliadin and anti-tTG antibody titers diminished, but the symptoms persisted [29,30]. Total symptom remission in these cases was achieved only with a gluten- and maize-free diet [30].…”

Section: Supporting Experimental Resultsmentioning

confidence: 99%

Maize Prolamins Could Induce a Gluten-Like Cellular Immune Response in Some Celiac Disease Patients

Ortiz-Sánchez

Cabrera-Chávez²,

Barca

2013

Nutrients

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Celiac disease (CD) is an autoimmune-mediated enteropathy triggered by dietary gluten in genetically prone individuals. The current treatment for CD is a strict lifelong gluten-free diet. However, in some CD patients following a strict gluten-free diet, the symptoms do not remit. These cases may be refractory CD or due to gluten contamination; however, the lack of response could be related to other dietary ingredients, such as maize, which is one of the most common alternatives to wheat used in the gluten-free diet. In some CD patients, as a rare event, peptides from maize prolamins could induce a celiac-like immune response by similar or alternative pathogenic mechanisms to those used by wheat gluten peptides. This is supported by several shared features between wheat and maize prolamins and by some experimental results. Given that gluten peptides induce an immune response of the intestinal mucosa both in vivo and in vitro, peptides from maize prolamins could also be tested to determine whether they also induce a cellular immune response. Hypothetically, maize prolamins could be harmful for a very limited subgroup of CD patients, especially those that are non-responsive, and if it is confirmed, they should follow, in addition to a gluten-free, a maize-free diet.

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Multiple food intolerance or refractory celiac sprue?

Cited by 6 publications

References 8 publications

The Gluten-Free Diet: Testing Alternative Cereals Tolerated by Celiac Patients

The Gluten-Free Diet: Testing Alternative Cereals Tolerated by Celiac Patients

Prolamins of maize and wheat differentially affect intestinal cells both in biopsies of celiac patients and CACO-2 cell line

Maize Prolamins Could Induce a Gluten-Like Cellular Immune Response in Some Celiac Disease Patients

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