Glutenlightgrani con glutine leggero e tollerabile
Header Image - Gluten Light
Gluten LightMagazine & Library
Gallery

Magazine

Gluten and intestinal inflammation

by luciano

gluten induces intestinal inflammation not only in celiac individuals but also in healthy ones

Intestinal inflammation is a condition of the gastro-intestinal system that affects a very large and constantly increasing number of people (1). This condition represents for the individual not only a state of disconfort that affects the quality of life but can – if underestimated or neglected – promote the onset or aggravation of serious illnesses.
An important role but still to be fully explored is played by gluten as it is pro-inflammatory.
The study ” The Role of Gluten in Gastrointestinal Disorders: A Review. Sabrina Cenni. Gastrointestinal Disorders: A Review. Nutrients 2023” provides a useful overview of its effectiveness in the prevention and management of these disorderes.

“Abstract: Gluten is only partially digested by intestinal enzymes and can generate peptides that can
alter intestinal permeability, facilitating bacterial translocation, thus affecting the immune system. Few studies addressed the role of diet with gluten in the development of intestinal inflammation and in other gastrointestinal disorders. The aim of this narrative review was to analyse the role of gluten in several gastrointestinal diseases so as to give a useful overview of its effectiveness in the prevention and management of these disorders.”

“Introduction. Gluten is a protein mass made of a complex network of gliadins and glutenins, which are proteins rich in glutamines and prolines found in most grains, such as barley, wheat, and rye [1 ,2]. Due to its high-water binding capacity and its consequent malleability and elasticity, gluten induces the formation of viscoelastic membranes, thus determining the proper consistency of dough, which allows it to be processed in bread and other foods [ 3– 5]. The high content of glutamines and prolines in gliadins make them difficult to cleave, making them able to escape degradation from gastric, pancreatic, and intestinal proteolytic enzymes [3, 4]. Therefore, gluten is what remains after the removal of starch, water-soluble proteins, and albumins [1]. In Western countries, the gluten dietary intake is approximately 5 to 20 g per day [3 , 4]. In the last decades, the literature reports an increased number of reactions following a widespread exposure to gluten [ 6]. Gluten-related diseases affect up to 10% of the general population and can be classified as three different disorders: IgE-mediated wheat allergy, Celiac disease (CD), and non-celiac gluten sensitivity (NCGS) [2, 6]. However, there is increasing evidence that gluten can trigger an innate and adaptative immune response responsible for intestinal inflammation [7]. Notably, along with other dietary elements, gluten may contribute to the development of inflammatory intestinal disorders, such as inflammatory bowel disease (IBD), as well as functional gastrointestinal disorders (FGIDs) and concur in symptom exacerbation, although its exact role is still under investigation.”

Gluten and intestinal inflammation. “Inflammation is the natural response of the innate immune system to external stimuli, such as microbial pathogens and injuries [8 ]. When the trigger persists and the immune cells are constantly activated, the inflammatory response may become chronic and self-sustainable [8]. The aetiology of inflammation is clear and easily detectable in some health conditions, while in others it can be difficult to identify [ 8]. The pathogenesis of inflammation is multifactorial. Nevertheless, genetic vulnerability, psychological stress, environmental factors, and some dietary patterns have been described as potentially implicated in the development of inflammatory phenotypes [ 8]. There are at least 50 different types of gliadin epitopes that can have an immunomodulatory and cytotoxic role or that can impact the gut permeating activities [ 8 ]; in fact, some of these can stimulate a pro-inflammatory innate immune response and others can activate specific T cells [8]. Gliadins immune cells’ activation is not only observed in celiac patients, as described by Lammers et al. [9, 10]. Indeed, their study concluded that gliadin induced an inflammatory response and, in particular, an important production of pro-inflammatory cytokines (IL-6, IL- 13, and interferon-gamma) both in Celiac patients and in healthy controls, even if proinflammatory cytokine levels were higher in Celiac patients [9, 10]. Similarly, Harris et al. showed that incubated peripheral blood mononuclear cells (PMBC) obtained from healthy HLA-DQ2 positive individuals produced proinflammatory cytokines, such as IL-23, IL-1beta, and TNF-α, when exposed to gliadin peptides [ 8, 11]. These cytokines’ production was significantly higher in Celiac patients compared to healthy controls [8,11]. Accordingly, Cinova et al., in their case-control study, demonstrated that gliadin could stimulate a substantial TNF-α and IL-8 production by monocytes, principally in celiac patients, but also, to a lesser extent, in healthy control individuals [12]. Gliadin also has an important role in modifying intestinal permeability through the reorganization of actin filaments and the modified expression of junctional complex proteins [ 8,13 ]. As demonstrated by Drago et al. and Lammers et al., gliadin’s binding to the chemokine receptor CXCR3 determines a release of zonulin, an active protein, which compromises the integrity of the intestinal barrier through the rearrangements of actin filaments, ultimately leading to an altered intestinal permeability both in Celiac and non-Celiac patients [ 9, 10, 14 ]. In conclusion, Ziegler et al. and Junker et al. reported that amylase trypsin inhibitors, found in gluten-containing cereals, have the capacity to activate toll-like receptors, thus stimulating the release of inflammatory cytokines and inducing a T-cell immune response in both celiac and non-celiac patients [15,16]”.

Einkorn wheat is the exception in relation to gluten-induced intestinal inflammation

A – Einkorn bread evidenced an anti-inflammatory effect. Integrated Evaluation of the Potential Health Benefits of Einkorn-Based Breads A. Gobetti et al. 2017.

B – Protective effects of ID331 Triticum monococcum. Protective effects of ID331 Triticum monococcum gliadin on in vitro models of the intestinal epithelium. Giuseppe Iacomino et al. (PMID: 27374565 DOI: 10.1016/j.foodchem.2016.06.014 ).

Keywords: gluten; inflammatory bowel disease; functional gastrointestinal disorders; celiac disease

Note

1 – Worldwide Prevalence and Burden of Functional Gastrointestinal Disorders, Results of Rome Foundation Global Study

BACKGROUND & AIMS: Although functional gastrointestinal disorders (FGIDs), now called disorders of gut-brain interaction, have major economic effects on health care systems and adversely affect quality of life, little is known about their global prevalence and distribution. We investigated the prevalence of and factors associated with 22 FGIDs, in 33 countries on 6 continents. METHODS: Data were collected via the Internet in 24 countries, personal interviews in 7 countries, and both in 2 countries, using the Rome IV diagnostic questionnaire, Rome III irritable bowel syndrome questions, and 80 items to identify variables associated with FGIDs. Data collection methods differed for Internet and household groups, so data analyses were conducted and reported separately. RESULTS: Among the 73,076 adult respondents (49.5% women), diagnostic criteria were met for at least 1 FGID by 40.3% persons who completed the Internet surveys (95% confidence interval [CI], 39.9–40.7) and 20.7% of persons who completed the household surveys (95% CI, 20.2–21.3). FGIDs were more prevalent among women than men, based on responses to the Internet survey (odds ratio, 1.7; 95% CI, 1.6–1.7) and household survey (odds ratio, 1.3; 95% CI, 1.3–1.4). FGIDs were associated with lower quality of life and more frequent doctor visits. Proportions of subjects with irritable bowel syndrome were lower when the Rome IV criteria were used, compared with the Rome III criteria, in the Internet survey (4.1% vs 10.1%) and household survey (1.5% vs 3.5%). CONCLUSIONS: In a large-scale multinational study, we found that more than 40% of persons worldwide have FGIDs, which affect quality of life and health care use. Although the absolute prevalence was higher among Internet respondents, similar trends and relative distributions were found in people who completed Internet vs personal interviews. Worldwide Prevalence and Burden of Functional Gastrointestinal Disorders, Results of Rome Foundation Global Study. Ami D. Sperber et al. Gastroenterology 2021;160:99–114

 

Gluten from some wheat varieties: a comparative study

by luciano

Knowledge of the gluten composition of soft, durum and spelt wheat is relevant for the success of final baked products (especially salty baked product) and/or for the production of pasta. The characteristics of gluten are also fundamental if the aim is to create products suitable for people genetically predisposed to celiac disease, for those who are sensitive to gluten without celiac disease and, extensively, for those who suffer from intestinal inflammation. For all these people it is important to make products that are as digestible and tolerable as possible. Of all the known grains, einkorn wheat is the one that is considered the most suitable for this purpose.
The study “Comparative Study on Gluten Protein Composition of Ancient (Einkorn, Emmer and Spelt) and Modern Wheat Species (Durum and Common Wheat). Sabrina Geisslitz et al. Published: 12 September 2019 in Foods (MDPI)” analyzes some characteristics of the gluten of some grains (300) highlighting the differences; it also analyzes the effect on them of the use of nitrogenous fertilizers in cultivation.

The reason for the interest in the search for varieties of einkorn, emmer and spelt:
The “ancient” wheats einkorn (Triticum monococcum L., diploid), emmer (T. dicoccum L., tetraploid) and spelt (T. aestivum ssp. spelta, hexaploid) have been cultivated in very low amounts compared to the “modern” wheat species common wheat (T. aestivum L., hexaploid) and durum wheat (T. durum L., tetraploid) in the 20th century. The reasons for the low cultivation of ancient wheats are 30–60% lower grain yields, the presence of husks and poor baking properties compared to common wheat [1]. Nevertheless, ancient wheats have been rediscovered in the last 20 years, because a growing number of consumers associate their consumption with sensory and health benefits due to their comparatively higher contents of e.g., ferulic acid, vitamins, alkylresorcinols and lutein [2–8].
Common wheat is most suitable for bread making, because the flour forms a viscoelastic dough with a high gas holding capacity when it is mixed with water. In contrast, flours of ancient wheats yield softer dough with low elasticity and high extensibility because of their poor gluten quality [1,9–11].
This latter feature translates into a less “strong”[A] and therefore more digestible gluten. In addition, einkorn and emmer do not contain the gluten fraction (33mer” : Quantitation of the immunodominant 33-mer peptide from α-gliadin in wheat flours by liquid chromatography tandem mass spectrometry. Kathrin Schalk et al. 2017. Scientific Reports.) which is considered the one that most activates the immune response in celiac subjects as well as being among the least digestible. This last feature makes these grains, especially einkorn[B], the main candidates for decreasing exposure to celiac disease in genetically predisposed subjects.

Featured in the study:
The total protein content was equally influenced by location and wheat species, however, gliadin, glutenin and gluten contents were influenced more strongly by wheat species than location. Einkorn, emmer and spelt had higher protein and gluten contents than common wheat at all four locations. However, common wheat had higher glutenin contents than einkorn, emmer and spelt resulting in increasing ratios of gliadins to glutenins from common wheat (< 3.8) to spelt, emmer and einkorn (up to 12.1). With the knowledge that glutenin contents are suitable predictors for high baking volume, cultivars of einkorn, emmer and spelt with good predicted baking performance were identified. Finally, spelt, emmer and einkorn were found to have a higher nitrogen partial factor productivity than common and durum wheat making them promising crops for a more sustainable agriculture.

….omissis.
It is generally accepted that gluten proteins are one of the most important factors determining the baking quality of wheat flours. Gluten proteins are storage proteins and classified into gliadins (GLIA) soluble in aqueous alcohol and glutenins (GLUT) soluble in aqueous alcohol only after reduction of disulfide bonds. Not only the amount, but the ratio between GLIA and GLUT (GLIA/GLUT) has been shown to be responsible for good baking quality. GLIA/GLUT of common wheat is typically 1.5–3.1 [12,13], but a recent study showed that the GLIA/GLUT of ancient wheats was much higher (spelt: 2.8–4.0; emmer: 3.6–6.7; einkorn: 4.2–12.0)
Quantitation of GLIA, GLUT, Gluten and Total Protein Contents

Integrated Evaluation of the Potential Health Benefits of Einkorn-Based Breads: anti-inflammatory effect

by luciano

Einkorn-Based Breads: anti-inflammatory effect. (Fabiana Antognoni et al. Nutrients 11-11-2017)

Abstract: Nowadays the high nutritional value of whole grains is recognized, and there is an increasing interest in the ancient varieties for producing wholegrain food products with enhanced nutritional characteristics. Among ancient crops, einkorn could represent a valid alternative. In this work, einkorn flours were analyzed for their content in carotenoids and in free and bound phenolic acids, and compared to wheat flours. The most promising flours were used to produce conventional and sourdough fermented breads. Breads were in vitro digested, and characterized before and after digestion. The four breads having the best characteristics were selected, and the product of their digestion was used to evaluate their anti-inflammatory effect using Caco-2 cells. Our results confirm the higher carotenoid levels in einkorn than in modern wheats, and the effectiveness of sourdough fermentation in maintaining these levels, despite the longer exposure to atmospheric oxygen. Moreover, in cultured cells einkorn bread evidenced an anti-inflammatory effect, although masked by the effect of digestive fluid. This study represents the first integrated evaluation of the potential health benefit of einkorn-based bakery products compared to wheat-based ones, and contributes to our knowledge of ancient grains.

Several studies have shown a clear correlation between the consumption of wholegrain and a reduced risk of cardiovascular diseases [1,2], diabetes [3], and some types of cancer [4]. The beneficial properties of wholegrain are mainly ascribed to their micronutrient and phytochemical content [5–7]. Cereals are among the richest food in phenolic acids, their content being comparable with or even higher than that found in berries, fruits, and vegetables [8]. In addition, some cereals are rich in lutein and zeaxanthin [9,10]. Micronutrients and phytochemicals are chiefly concentrated in the outer layers of grains [11], and this could explain the preventive effects associated with high wholegrain consumption [12]. Nowadays, the higher nutritional value of wholegrain compared to refined ones is recognized [13], and there is an increasing interest in ancient crops as source of wholegrain flours [14].

Einkorn (Triticum monococcum L. ssp. monococcum) is an ancient crop. Compared to polyploid wheats it has a higher content of proteins, polyunsaturated fatty acids, fructans, and phytochemicals as tocols, carotenoids, alkylresorcinols, phytosterols, and a lower α-, β-amylase and lipoxygenase activities [15]. In addition, einkorn expresses very few T-cell stimulatory gluten peptides [16]. Einkorn could represent a valid alternative for producing functional baked products.
In bakery, processing could contribute to functionality [17,18]. Sourdough fermentation, involving the inter-relation between microbial metabolism and cereal enzymes, has been shown to greatly affect the functional features of leavened baked goods [19]. This type of fermentation may produce new nutritionally active molecules such as functional peptides and amino acid derivatives [20,21], deriving from either the bacterial hydrolytic activity [20] or from their own synthetic pathways [22]. To exert a positive action in the human body, bioactive compounds must be hydrolyzed from the food matrix, and be absorbed in the intestine. The bioaccessibility of bioactive compounds, i.e., the percentage released from the food matrix and made available for uptake by the intestinal mucosa, is an important parameter that can be influenced by many different factors including the food matrix and the food processing [23,24]. Fermentation by lactic acid bacteria may improve nutrient bioaccessibility and produce compounds with anti-oxidant and anti-inflammatory activity [19]. Sourdough lactic acid bacteria have been reported to release or synthesize antioxidant and anti-inflammatory peptides during fermentation of cereal flours [20].
In this work, different wheat and einkorn flours were analyzed for their content in carotenoids and phenolic acids. The richest in these functional compounds were selected, and used to bake breads with two different fermentation procedures (conventional and sourdough).
Breads were digested in vitro using a dynamic gastro-intestinal digestor, and characterized before and after digestion. Based on integrated results, four breads were selected, and the product of their intestinal digestion was supplemented to Caco-2 intestinal cells. Cells were exposed to inflammatory stress, and the effect of supplementation on different inflammation markers was assessed.
Overall, this study has evaluated how the type of flour and the type of fermentation can influence the nutritional features of bread, and the bioaccessibility and anti-inflammatory effects of its functional compounds. The combination of different results provides an integrated vision supporting the possible health benefits of einkorn-based bread.

References

1. Zong, G.; Gao, A.; Hu, F.B.; Sun, Q. Whole grain intake and mortality from all causes, cardiovascular disease, and cancer: A meta-analysis of prospective cohort studies. Circulation 2016, 133, 2370–2380. [CrossRef] [PubMed]

2. Aune, D.; Keum, N.; Giovannucci, E.; Fadnes, L.T.; Boffetta, P.; Greenwood, D.C.; Tonstad, S.; Vatten, L.J.; Riboli, E.; Norat, T. Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: Systematic review and dose-response meta-analysis of prospective studies. BMJ 2016, 353, i2716. [CrossRef] [PubMed]

3. Ye, E.Q.; Chacko, S.A.; Chou, E.L.; Kugizaki, M.; Liu, S. Greater whole-grain intake is associated with lower risk of type 2 diabetes, cardiovascular disease, and weight gain. J. Nutr. 2012, 142, 1304–1313. [CrossRef] [PubMed]

4. Kyrø, C.; Skeie, G.; Loft, S.; Landberg, R.; Christensen, J.; Lund, E.; Nilsson, L.M.; Palmqvist, R.; Tjønneland, A.; Olsen, A. Intake of whole grains from different cereal and food sources and incidence of colorectal cancer in the Scandinavian HELGA cohort. Cancer Causes Control 2013, 24, 1363–1374. [CrossRef] [PubMed]

5. Adom, K.K.; Liu, R.H. Antioxidant activity of grains. J. Agric. Food Chem. 2002, 50, 6182–6187. [CrossRef] [PubMed]

6. Adom, K.K.; Sorrells, M.E.; Liu, R.H. Phytochemical profiles and antioxidant activity of wheat varieties.

J. Agric. Food Chem. 2003, 51, 7825–7834. [CrossRef] [PubMed]

7. Abdel-Aal, E.S.M.; Young, J.C.; Rabalski, I.; Hucl, P.; Frégeau-Reid, J. Identification and quantification of seed carotenoids in selected wheat species. J. Agric. Food Chem. 2007, 55, 787–794. [CrossRef] [PubMed]

8. Perez-Jimenez, J.; Neveu, V.; Vos, F.; Scalbert, A. Systematic analysis of the content of 502 polyphenols in 452 foods and beverages: An application of the Phenol−Explorer database. J. Agric. Food Chem. 2010, 58, 4959–4969. [CrossRef] [PubMed]

9. Abdel-Aal, E.S.M.; Young, J.C.; Wood, P.J.; Rabalski, I.; Hucl, P.; Fregeau-Reid, J. Einkorn: A potential candidate for developing high lutein wheat. Cereal Chem. 2002, 79, 455–457. [CrossRef]

10. Humphries, J.M.; Khachik, F. Distribution of lutein, zeaxanthin and related geometrical isomers in fruit, vegetables, wheat and pasta products. J. Agric. Food Chem. 2003, 51, 1322–1327. [CrossRef] [PubMed]

11. Sosulski, F.; Krygier, K.; Hogge, L. Free, esterified, and insoluble-bound phenolic acids. 3. Composition of phenolic acids in cereal and potato flour. J. Agric. Food Chem. 1982, 30, 337–340. [CrossRef]

12. Poutanen, K.; Shepherd, R.; Shewry, P.R.; Delcour, J.A.; Bjorck, I.; Van Der Kamp, J.W. Beyond whole grain:

The European HEALTH GRAIN project aims at healthier cereal foods. Cereal Foods World 2008, 53, 32–35. [CrossRef]

13. Slavin, J. Why whole grains are protective: Biological mechanisms. Proc. Nutr. Soc. 2003, 62, 129–134.

[CrossRef] [PubMed]

14. Bordoni, A.; Danesi, F.; Di Nunzio, M.; Taccari, A.; Valli, V. Ancient wheat and health: A legend or the reality?

A review on KAMUT khorasan wheat. Int. J. Food Sci. Nutr. 2016, 28, 1–9. [CrossRef] [PubMed]

15. Hidalgo, A.; Brandolini, A. Nutritional properties of einkorn wheat (Triticum monococcum L.). J. Sci. Food Agric.

2014, 94, 601–612. [CrossRef] [PubMed] Nutrients 2017, 9, 1232

15 of 17

16. Molberg, Ø.; Uhlen, A.K.; Jensen, T.; Flæte, N.S.; Fleckenstein, B.; Arentz-Hansen, H.; Raki, M.; Lundin, K.E.A.; Sollid, L.M. Mapping of gluten T-cell epitopes in the bread wheat ancestors: Implication for celiac disease. Gastroenterology 2005, 128, 393–401. [CrossRef] [PubMed]

17. Sánchez-Pardo, M.E.; Blancas-Nápoles, J.A.; Vázquez-Landaverde, P.A.; Nari, A.; Taglieri, I.; Ortiz-Moreno, A.; Mayorga-Reyes, L.; Sanmartin, C.; Bermúdez-Humarán, L.G.; Torres-Maravilla, E. The use of Mexican xaxtle as leavening agent in Italian straight dough bread making to produce pulque bread. Agrochimica 2016, 60, 329–342.

18. Venturi, F.; Sanmartin, C.; Taglieri, I.; Nari, A.; Andrich, G.; Zinnai, A. Effect of the baking process on artisanal sourdough bread-making: A technological and sensory evaluation. Agrochimica 2016, 60, 222–234.

19. Ganzle, M.G. Enzymatic and bacterial conversions during sourdough fermentation. Food Microbiol. 2014, 37, 2–10. [CrossRef] [PubMed]

20. Gobbetti, M.; Rizzello, G.C.; Di Cagno, R.; De Angelis, M. How the sourdough may affect the functional features of leavened baked goods. Food Microbiol. 2014, 37, 30–40. [CrossRef] [PubMed]

 

Natural Variation in Toxicity of Wheat

by luciano

Natural Variation in Toxicity of Wheat: Potential for Selection of Nontoxic Varieties for Celiac Disease Patients (and useful for disease prevention in individuals at risk)
Liesbeth Dekking, Harry Jonker et al. Article in Gastroenterology · October 2005. DOI: 10.1053/j.gastro.2005.06.017 · Source: PubMed

“Background & Aims: Celiac disease (CD) is an intestinal disorder caused by T-cell responses to peptides derived from the gluten proteins present in wheat. Such peptides have been found both in the gliadin and glutenin proteins in gluten. The only cure for CD is a lifelong gluten-free diet. It is unknown, however, if all wheat varieties are equally harmful for patients. We investigated whether wheat varieties exist with a nat- ural low number of T-cell–stimulatory epitopes. Methods: Gluten proteins present in public databases were analyzed for the presence of T-cell–stimulatory sequences. In addition, wheat accessions from diploid (AA, SS/BB, and DD genomes), tetraploid (AABB), and hexaploid (AABBDD) Triticum species were tested for the presence of T-cell–stimulatory epitopes in gliadins and glutenins by both T-cell and monoclonal anti-body–based assays. Results: The database analysis readily identified gluten proteins that lack 1 or more of the known T-cell–stimulatory sequences. Moreover, both the T-cell– and antibody-based assays showed that a large variation exists in the amount of T-cell– stimulatory peptides present in the wheat accessions. Conclusions: Sufficient genetic variation is present to endeavor the selection of wheat accessions that con- tain low amounts of T-cell–stimulatory sequences. Such materials may be used to select and breed wheat varieties suitable for consumption by CD patients, contributing to a well-balanced diet and an increase in their quality of life. Such varieties also may be useful for disease prevention in individuals at risk.”

The study also recalls the influence of gluten intake on early childhood nutrition:

“It is known that early exposure to gluten and a double HLA-DQ2 gene dose both promote CD development. In Sweden the addition of gluten to infant food led to a 5-fold increase in the occurrence of CD in the 1980s,and HLA-DQ2 homozygous individuals have a 5-fold increased risk for developing CD com pared with HLA-DQ2 heterozygous individuals. A large repertoire of abundant immunogenic gluten peptides in the diet, together with a high copy number of HLA-DQ2, thus favors the breaking of oral tolerance. In present-day practice, gluten is introduced into the diet of infants at 6–7 months of age. Because there is no restriction in the amount of gluten given, gluten intake at age 12 months is between 6 and 9 g/day, whereas gluten-specific T cells of CD patients are known to respond to microgram amounts. The sudden introduction of grams of gluten thus may play an important role in the breaking of oral tolerance. As we have suggested previously, the current understand- ing of the development of the disease may call for a more gradual and/or reduced intake of gluten in infants. The breeding of wheat varieties with a lower amount of T-cell–stimulatory gluten peptides potentially could aid in reaching that goal.”

….omissis “Wheat gluten is a group of proteins that can be partitioned into 2 protein families: the glutenins and the gliadins. The glutenins can be subdivided further into high molecular weight (HMW) and low molecular weight (LMW) glutenins and the gliadins can be divided into α, γ and ω gliadins. At present, many gluten- derived T-cell–stimulatory peptides are known and they originate from the α, and γ-gliadins, and the HMW and LMW glutenins. Homologue sequences are found in the secalins of rye, the hordeins of barley, and the avenins of oats. Gluten and gluten-like molecules thus contain many immunogenic peptides. Moreover, the unique food-industrial properties of gluten are in part related to a very high proline content that renders gluten relatively resistant to enzymatic degradation in the gastrointestinal tract. Hence, many of the immunogenic gluten peptides are likely to survive for extended periods in the intestine, increasing the probability of triggering a T-cell response. Thus, the unique properties of gluten are linked tightly to their disease- inducing potential in CD patients”.

Deepening
Celiac disease is a prevalent disorder characterized by a chronic intestinal inflammation driven by HLA-DQ2 or -DQ8-restricted T cells specific for ingested wheat gluten peptides. The dominant T-cell responses are to epitopes that cluster within a stable 33mer fragment formed by physiologic digestion of distinct alpha-gliadins. Celiac disease is treated by excluding all gluten proteins from the diet. Conceivably, a diet based on baking-quality gluten from a wheat species that expresses no or few T-cell stimulatory gluten peptides should be equally well tolerated by the celiac patients and, importantly, also be beneficial for disease prevention. To identify baking quality, harmless wheat, we followed the evolution of the wheat back to the species that most likely have contributed the AA, BB, and DD genomes to the bread wheat. Gluten were extracted from a large collection of these ancient wheat species and screened for T-cell stimulatory gluten peptides. Distinct differences in the intestinal T-cell responses to the diploid species were identified. Interestingly, we found that the fragments identical or equivalent to the immunodominant 33mer fragment are encoded by alpha-gliadin genes on the wheat chromosome 6D and thus absent from gluten of diploid einkorn (AA) and even certain cultivars of the tetraploid (AABB) pasta wheat. These findings have implications for celiac disease because they raise the prospect of identifying or producing by breeding wheat species with low or absent levels of harmful gluten proteins.
Mapping of Gluten T-Cell Epitopes in the Bread Wheat Ancestors: Implications for Celiac Disease. Tore Jensen et al. March 2005 Gastroenterology 128(2):393-401; DOI:10.1053/j.gastro.2004.11.003

Cutaneous Manifestations of Non-Celiac Gluten Sensitivity

by luciano

Cutaneous Manifestations of Non-Celiac Gluten Sensitivity: Clinical Histological and Immunopathological Features
Veronica Bonciolini, Beatrice Bianchi, Elena Del Bianco, Alice Verdelli, and Marzia Caproni
“Abstract
Background: The dermatological manifestations associated with intestinal diseases are becoming more frequent, especially now when new clinical entities, such as Non-Celiac Gluten Sensitivity (NCGS), are identified. The existence of this new entity is still debated. However, many patients with diagnosed NCGS that present intestinal manifestations have skin lesions that need appropriate characterization. Methods: We involved 17 patients affected by NCGS with non-specific cutaneous manifestations who got much better after a gluten free diet. For a histopathological and immunopathological evaluation, two skin samples from each patient and their clinical data were collected. Results: The median age of the 17 enrolled patients affected by NCGS was 36 years and 76% of them were females. On the extensor surfaces of upper and lower limbs in particular, they all presented very itchy dermatological manifestations morphologically similar to eczema, psoriasis or dermatitis herpetiformis. This similarity was also confirmed histologically, but the immunopathological analysis showed the prevalence of deposits of C3 along the dermo-epidermal junction with a microgranular/granular pattern (82%). Conclusions: The exact characterization of new clinical entities such as Cutaneous Gluten Sensitivity and NCGS is an important objective both for diagnostic and therapeutic purposes, since these are patients who actually benefit from a GFD (Gluten Free Diet) and who do not adopt it only for fashion.
….omissis: 5.

Conclusions
At the moment, the results of our study do not allow the exact characterization of a new skin disease related to NCGS. The skin lesions observed were similar both to eczema and psoriasis and did not show a specific histological pattern. Furthermore, no serological marker was useful to identify these patients. The only data common to most of these patients affected by NCGS associated to non-specific skin manifestations are:
1. the itching;
2. the presence of C3 at the dermoepidermal junction;
3. a rapid resolution of lesions when adopting the gluten free diet.”

From: Nutrients. 2015 Sep; 7(9): 7798–7805. Published online 2015 Sep 15. doi:10.3390/nu7095368