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Gluten-Free Diet

by luciano

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-Omissis…….GFD implied a reduction in bacterial populations generally regarded as beneficial for human health such as Bifidobacterium and Lactobacillus, and an increase in those of opportunistic pathogens such as Escherichia coli and total Enterobacteriaceae.
-Omissis…Hansen et al. showed that minimal amounts of gluten are sufficient to affect the microbiota population, lowering the Bifidobacteria count in patients adhering to a low-gluten regimen.
-Omissis…Some changes in the abundance of 8 families of bacteria were observed during the GFD period: Veillonellaceae, Ruminococcus bromii and Roseburia faecis, decreased, whereas Victivallaceae, Clostridiaceae, ML615J-28, Slackia and Coriobacteriaceae increased during GFD. Veillonellaceae, a pro-inflammatory family of Gram-negative bacteria known for lactate fermentation, increase in diseases such as IBD, irritable bowel syndrome and liver cirrhosis.
-Omissis.…This review appraised the current knowledge about the gut microbiota in health as well as CD and NCG/WS and the related effects evoked by GFD in these two most common conditions. The evidence so far acquired has demonstrated that diseases are often characterized by an imbalance in the microbial intestinal population composition, leading to dysbiosis, a condition promoting inflammation and metabolic impairment.

Research reviewed

1 – Effects of a gluten-free diet on gut microbiota and immune function in healthy adult human subjects. Published online by Cambridge University Press: 18 May 2009. Giada De Palma , Inmaculada Nadal , Maria Carmen Collado and Yolanda Sanz
…omissis. “Therefore, introduction of a GFD implied a reduction in bacterial populations generally regarded as beneficial for human health such as Bifidobacterium and Lactobacillus, and an increase in those of opportunistic pathogens such as Escherichia coli and total Enterobacteriaceae. These changes could be related to reductions in polysaccharide intake, since these dietary compounds usually reach the distal part of the colon partially undigested, and constitute one of the main energy sources for beneficial components of the gut microbiota(Reference De Graaf and Venema27). In addition, reductions in Bifidobacterium and Lactobacillus populations relative to Gram-negative bacteria (Bacteroides and Escherichia coli) were previously detected in untreated CD children and particularly in treated CD patients with a GFD(Reference Nadal, Donat and Ribes-Koninckx7). These findings indicate that this dietary therapy may contribute to reduce beneficial bacterial group counts and increase enterobacterial counts, which are microbial features associated with the active phase of CD(Reference Nadal, Donat and Ribes-Koninckx7, Reference Collado, Donat and Ribes-Koninckx28) and, therefore, it would not favour completely the normalisation of the gut ecosystem in treated CD patients”.

2 – Effect of Gluten-Free Diet on Gut Microbiota Composition in Patients with Celiac Disease and Non-Celiac Gluten/Wheat Sensitivity. Giacomo Caio, Lisa Lungaro, Nicola Segata, Matteo Guarino, Giorgio Zoli, Umberto Volta, and Roberto De Giorgio. Nutrients. 2020 Jun; 12(6): 1832. Published online 2020 Jun 19. doi:10.3390/nu12061832

“Celiac disease (CD) and non-celiac gluten/wheat sensitivity (NCG/WS) are the two most frequent conditions belonging to gluten-related disorders (GRDs). Both these diseases are triggered and worsened by gluten proteins ingestion, although other components, such as amylase/trypsin inhibitors (ATI) and fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs), seem to be involved in the NCG/WS onset. Therefore, the only effective treatment to date is the long-life adherence to a strictly gluten-free diet. Recently, increasing attention has been paid to the intestinal barrier, a dynamic system comprising various components, which regulate the delicate crosstalk between metabolic, motor, neuroendocrine and immunological functions. Among the elements characterizing the intestinal barrier, the microbiota plays a key role, modulating the gut integrity maintenance, the immune response and the inflammation process, linked to the CD and NCG/WS outbreak. This narrative review addresses the most recent findings on the gut microbiota modulation induced by the gluten-free diet (GFD) in healthy, CD and NCG/WS patients”.
Omissis…..7. Gluten-Free Diet Effects on Healthy Human Microbiota.
The overall literature search on databases including the terms “gluten free diet”, “GFD”, “gluten free diet AND healthy”, “microbiota”, “microbiome”, “microbiome AND healthy patients”, “microbiota AND healthy patients” produced 2775 results. Of these, excluding duplicates, three fulfilled our inclusion criteria. In 2009, De Palma et al. [101] explored whether a month of GFD affects the microbiota composition of ten healthy subjects. Enumeration of fecal bacteria by fluorescence in situ hybridization (FISH) using 16S rRNA-targeted oligonucleotide probes showed that GFD causes a decrease in the count of Bifidobacterium, Clostridium lituseburense and Faecalibacterium prausnitzii. Quantitative PCR (qPCR) characterization of fecal microbes following GFD revealed a reduction in the number of Bifidobacterium, Lactobacillus and Bifidobacterium longum and an increase in the Enterobacteriaceae and Escherichia coli counts. They propose that the depletion in Bifidobacterium and Lactobacillus, generally considered as probiotics, could be caused by the reduced availability of polysaccharides introduced with the GFD that serve as a substrate for gut microbiota. Moreover, the reduction in Faecalibacterium prausnitzii, along with the concomitant increase in the opportunistic pathogens Enterobacteriaceae and Escherichia coli in the fecal mucus of active Crohn’s disease patients was found to trigger the inflammatory insult [89,102,103]. Moreover, Hansen et al. showed that minimal amounts of gluten are sufficient to affect the microbiota population, lowering the Bifidobacteria count in patients adhering to a low-gluten regimen [104]. Indeed, the authors performed a randomized, controlled, cross-over trial study involving 60 non-CD Danish adults who followed a low-gluten diet (2 g gluten per day) for eight weeks and then switched to a high-gluten diet (18 g gluten per day) for another eight weeks, including a washout period of at least six weeks of normal diet (12 g gluten per day) between the two diets. Notably, GFD was associated with an increase of unclassified species of Clostridiales and an unclassified species of Lachnospiraceae, whereas E. hallii and A. hadrus (both butyrate-producers), Dorea (hydrogen producer) and the hydrogen-consumer and acetate-producer Blautia, in addition to two species of the Lachnospiraceae and four species of Bifidobacterium, were found to decrease. These microbial changes could be ascribed to the low-gluten diet availability of arabinoxylan and arabinoxylan-oligosaccharides, as these food components are abundant non-starch polysaccharides of cereal grains, which serve as energy substrates for the bacterial species mentioned above [105,106,107,108,109,110]. Bonder et al. [111] investigated the gut microbiota of 21 healthy volunteers on a GFD for four weeks, tested with a total of 9 stool samples for each person (one at baseline, four during the GFD and four when they returned to their usual diet). The microbiome profile was then characterized using 16 sRNA sequencing and investigated for taxonomic and implied functional compositions. Overall, the bacterial profile remained relatively stable in healthy individuals on GFD. However, some changes in the abundance of 8 families of bacteria were observed during the GFD period: Veillonellaceae, Ruminococcus bromii and Roseburia faecis, decreased, whereas Victivallaceae, Clostridiaceae, ML615J-28, Slackia and Coriobacteriaceae increased during GFD. Veillonellaceae, a pro-inflammatory family of Gram-negative bacteria known for lactate fermentation, increase in diseases such as IBD, irritable bowel syndrome and liver cirrhosis [88,112,113], while they decrease in autistic patients [114]. Compared to a normal diet, the abundance of Ruminococcus bromii, known to degrade the resistant starch in the human colon [115] and the cellulose, producing short chain fatty acids (SCFA) and hydrogen gas [116], was affected by the different starch composition of GFD. Coriobacteriaceae (Slackia genus in particular) and Clostridiaceae were associated with CD, IBD and colorectal cancer [117,118,119]. Thus, gluten withdrawal alters mostly bacterial species, utilizing carbohydrate and starch as energy substrates. The effects of GFD on the abundance of bacterial populations in healthy patients are illustrated in Figure 1.

……omissis. Growing evidence indicates that the interplay between gut microbiota and intestinal epithelial barrier function play a critical role in priming and maintaining a competent immune system. All together, these factors generate a gastrointestinal ecosystem, which, in concert with the classic repertoire of gut physiology, prevent the detrimental effect of various noxae. Offending foods belongs to those harmful substances able to perturb the gastrointestinal ecosystem, thereby leading to disease states. In this wide research area that is still far from being clarified, even classic dietary factors, such as wheat and related gluten and amylase trypsin inhibitors, can play a role in symptom generation in genetically susceptible or sensitive patients. This review appraised the current knowledge about the gut microbiota in health as well as CD and NCG/WS and the related effects evoked by GFD in these two most common conditions. The evidence so far acquired has demonstrated that diseases are often characterized by an imbalance in the microbial intestinal population composition, leading to dysbiosis, a condition promoting inflammation and metabolic impairment. In CD, the depletion of probiotic species, i.e., Lactobacillus and Bifidobacteria and the relative increase of pro-inflammatory bacteria, e.g., Veillonaceae genus, represent microbiota fingerprints likely contributing to disease onset, which is common to CD patients. In all the groups analyzed, GFD was shown to reduce bacterial richness while affecting gut microbiota composition in a different manner depending on health (asymptomatic subjects) and disease state (CD and NCG/WS). Indeed, in healthy subjects, GFD causes the depletion of beneficial species, e.g., Bifidobacteria, in favour of opportunistic pathogens, e.g., Enterobacteriaceae and Escherichia coli. Conversely, in CD and NCG/WS, GFD evoked a positive effect on gastrointestinal symptoms by helping to restore the microbiota population and by lowering pro-inflammatory species. In conclusion, these studies shed light on the complex interactions occurring between diet, gut barrier and gut microbiota. Multiple aspects are still to be explored along the microbiome-diet axis, including investigations into the yet-to-be-defined species that constitute large fractions of the microbiome [84], as well as the role of strain-specific microbial determinants and the difficulties in capturing detailed dietary information in large diverse metagenomics cohorts. In addition to general investigations of the complex link between diet, microbiome and health, further studies are particularly needed to specifically improve our knowledge of the effects that GFD could exert on the bacterial species involved within CD and NCG/WS”.

3 – The influence of a short-term gluten-free diet on the human gut microbiome. Marc Jan Bonder et al. Genome Medicine (2016)

“Abstract.

Background: A gluten-free diet (GFD) is the most commonly adopted special diet worldwide. It is an effective treatment for coeliac disease and is also often followed by individuals to alleviate gastrointestinal complaints. It is known there is an important link between diet and the gut microbiome, but it is largely unknown how a switch to a GFD affects the human gut microbiome.

Methods: We studied changes in the gut microbiomes of 21 healthy volunteers who followed a GFD for four weeks. We collected nine stool samples from each participant: one at baseline, four during the GFD period, and four when they returned to their habitual diet (HD), making a total of 189 samples. We determined microbiome profiles using 16S rRNA sequencing and then processed the samples for taxonomic and imputed functional composition. Additionally, in all 189 samples, six gut health-related biomarkers were measured.

Results: Inter-individual variation in the gut microbiota remained stable during this short-term GFD intervention. A number of taxon-specific differences were seen during the GFD: the most striking shift was seen for the family Veillonellaceae (class Clostridia), which was significantly reduced during the intervention (p = 2.81 × 10−05 ). Seven other taxa also showed significant changes; the majority of them are known to play a role in starch metabolism. We saw stronger differences in pathway activities: 21 predicted pathway activity scores showed significant association to the change in diet. We observed strong relations between the predicted activity of pathways and biomarker measurements.

Conclusions: A GFD changes the gut microbiome composition and alters the activity of microbial pathways”.

Key words: gut, microbiota, Free-Diet, Lactobacillus, Bifidobacteria, pro-inflammatory bacteria, opportunistic pathogens, Enterobacteriaceae, Escherichia coli

Lactis LLGKC18 caused degradation of the main gluten allergenic proteins

by luciano

The research “Fermentation of Gluten by Lactococcus lactis LLGKC18 Reduces its Antigenicity and Allergenicity” highlighted “ A significant decrease of the gliadins, glutenins, and ATI antigenicity was observed after fermentation of gluten by Lc. lactis LLGKC18”

Abstract: “Wheat is a worldwide staple food, yet some people suffer from strong immunological reactions after ingesting wheat-based products. Lactic acid bacteria (LAB) constitute a promising approach to reduce wheat allergenicity because of their proteolytic system. In this study, 172 LAB strains were screened for their proteolytic activity on gluten proteins and α-amylase inhibitors (ATIs) by SDS-PAGE and RP-HPLC. Gliadins, glutenins, and ATI antigenicity and allergenicity were assessed by Western blot/Dot blot and by degranulation assay using RBL-SX38 cells. The screening resulted in selecting 9 high gluten proteolytic strains belonging to two species: Enterococcus faecalis and Lactococcus lactis. Proteomic analysis showed that one of selected strains, Lc. lactis LLGKC18, caused degradation of the main gluten allergenic proteins. A significant decrease of the gliadins, glutenins, and ATI antigenicity was observed after fermentation of gluten by Lc. lactis LLGKC18, regardless the antibody used in the tests. Also, the allergenicity as measured by the RBL-SX38 cell degranulation test was significantly reduced. These results indicate that Lc. lactis LLGKC18 gluten fermentation can be deeply explored for its capability to hydrolyze the epitopes responsible for wheat allergy.” Kamel El Mecherfi et al. Probiotics and Antimicrobial Proteins volume 14, pages 779–791 (2022) Cite this article Published: 03 June 2021

Einkorn Wheat and Intestinal Microbiota

by luciano

The state and health of the intestinal microbiota is at the center of many studies aimed at studying the role of the microbiota in diseases and how to intervene for preventive or curative purposes.
The set of microorganisms that populate our digestive system (microbiota) includes good bacterial strains but harmful ones can sometimes also be present. Indigenous strains (those that characterize our microbiota) hinder the colonization of the intestine by new microbes, including pathogenic ones. Vitamin K, for example, is synthesized by good bacteria present. Indigenous bacteria digest and ferment the favonoids contained in fruits and vegetables, promoting the production of substances that have protective effects on cardiovascular health. An essential function that our bacteria perform is to produce short-chain fatty acids, especially butyric acid. These acids protect the intestine from inflammation and the onset of tumors.
La ricerca “In Vivo Effects of Einkorn Wheat (Triticum monococcum) Bread on the Intestinal Microbiota, Metabolome, and on the Glycemic and Insulinemic Response in the Pig Model” ha questo tema come focus.
Highlighted:
Abstract: “Einkorn wheat (Triticum monococcum) is characterized by high content of proteins, bioactive compounds, such as polyunsaturated fatty acids, fructans, tocols, carotenoids, alkylresorcinols, and phytosterols, and lower α-, β -amylase and lipoxygenase activities compared to polyploid wheat. These features make einkorn flour a good candidate to provide healthier foods. In the present study, we investigated the effects of einkorn bread (EB) on the intestinal physiology and metabolism of the pig model by characterizing the glycemic and insulinemic response, and the microbiota and metabolome profiles. Sixteen commercial hybrid pigs were enrolled in the study; four pigs were used to characterize postprandial glycemic and insulinemic responses and twelve pigs underwent a 30-day dietary intervention to assess microbiota and metabolome changes after EB or standard wheat bread (WB) consumption. The postprandial insulin rise after an EB meal was characterized by a lower absolute level, and, as also observed for glucose, by a biphasic shape in contrast to that in response to a WB meal. The consumption of EB led to enrichment in short-chain fatty acid producers (e.g., Blautia, Faecalibacterium, and Oscillospira) in the gut microbiota and to higher metabolic diversity with lower content of succinate, probably related to improved absorption and therefore promoting intestinal gluconeogenesis. The observed changes, at both a compositional and metabolic scale, strongly suggest that EB consumption may support a health-promoting configuration of the intestinal ecosystem.”

omissis……

“Einkorn wheat (Triticum monococcum) was one of the first crops domesticated approximately 12,000 years ago in the Near East, alongside emmer wheat (Triticum dicoccum). Typically, einkorn was cultivated on marginal agricultural land, being able to survive in harsh environments and poor soils where other types of wheat could not survive. Spelt wheat (Triticum spelta) represents a hexaploid series of the Triticum genome constitution, which is characterized by great adaptation to a wider range of environments [1]. When compared to polyploid wheats, it has a higher content of proteins and some well recognised bioactive compounds, such as polyunsaturated fatty acids, fructans, tocols, carotenoids, alkylresorcinols, phytosterols, and lower α-, β -amylase and lipoxygenase activities [2]. These compositional traits make einkorn flour a good candidate to provide healthier foods. Specifically, the presence of antioxidant compounds and the protein profile are expected to be related to reduced cardiovascular disease and hypoallergenic effects, respectively. In particular, einkorn was shown to express few T-cell stimulatory gluten peptides, with important implications for celiac disease [3]. In vitro digested einkorn breads evidenced their higher carotenoid level as compared to modern wheats and showed a greater anti-inflammatory effect than the control (wheat bread) in Caco-2 intestinal epithelial cells [4]. Given the crucial role of the gut microbiota in the metabolism of dietary compounds, including the bio-activation of plant polyphenols into health-promoting metabolites and the production of short-chain fatty acids (SCFAs, mainly acetate, propionate, and butyrate) from fiber fermentation, as major orchestrators of the host physiology [5].”

omissis….

“Specifically, for einkorn, one of the most representative ancient grains, in vitro results evidenced a good healthy potential because of its effects on blood concentrations of glucose and insulin with a view to using einkorn-based foods in metabolic diseases [7,8], but none has considered changes in the microbiota structure as well as in the intestinal repertoire of metabolites, potentially influencing multiple metabolic and immunological pathways that are relevant to host health. In an attempt to bridge this gap, here we explored the gut microbiota and metabolome of pigs fed with an einkorn versus wheat-based bread. “

omissis……

Conclusions. “In summary, through the pig model we demonstrated a beneficial impact of EB on several aspects of the host physiology, including insulin release, fecal consistency, and microbiota and metabolome profiles, both in feces and intestinal contents. According to our findings, the consumption of EB could reduce the AUC of the first insulin peak, thus prolonging the sense of satiety. Moreover, it could modulate the intestinal ecosystem, at both the compositional and metabolic scale, towards a configuration specifically enriched in health-promoting bacteria and showing distinct metabolic signatures potentially contributing to maintaining the host homeostasis. The use of the pig model allowed, unlike in clinical human trials, the sampling of the mucosa and the content of the small intestine, thus widening the knowledge on the complexity of the food-microbiota-host interaction along the gastrointestinal tracts. The observed positive effects could be driven by the synergistic interaction of many factors, including, inter alia, the fermentation process, the food matrix, and the flour components, which result in gut-mediated effects. The evaluation of the beneficial effects of a real food is far more complex than using purified compounds, as a direct cause-effect relationship can seldom be ascribed to a single component. It is indeed foods, and not the single components, which create the diet, and exploring their complexity can better reflect their overall role on health. Although further studies and clinical trials are needed, the results that are herein reported represent a first contribution to unravel the anti-inflammatory potential of einkorn-based foods.”

“In Vivo Effects of Einkorn Wheat (Triticum monococcum) Bread on the Intestinal Microbiota, Metabolome, and on the Glycemic and Insulinemic Response in the Pig Model”. Francesca Barone et al. Nutrients 2019, 11, 16; doi:10.3390/nu11010016

Note:
A – Pigs have significant anatomical and physiological similarities with humans, particularly with regard to the intestinal structure, with comparable transit time and analogous digestive and absorptive processes [9,10]. Furthermore, like humans, they are true omnivores, unlike other potential mammalian models, such as dogs, cats, ruminants, rabbits, and rodents, which have evolutionarily developed alternative digestive strategies. Finally, both pigs and humans are colon fermenters and have similar colonic microbiota composition. All of these features make the pig one of the most important models in the field of nutrition [11,12]. Through the pig model, in the present study we investigated the impact of a 30-day nutritional intervention with einkorn or wheat bread on the intestinal ecosystem, by means of next-generation sequencing of the 16S rRNA gene and metabolomics of fecal samples, as well as samples from ileal and colonic compartments. The effects of einkorn vs. wheat bread on animal physiology, blood parameters, postprandial glycemia, and insulin response were also evaluated.

B – The metabolome refers to the complete set of small-molecule chemicals found within a biological sample. The biological sample can be a cell, a cellular organelle, an organ, a tissue, a tissue extract, a biofluid or an entire organism. The small molecule chemicals found in a given metabolome may include both endogenous metabolites that are naturally produced by an organism (such as amino acids, organic acids, nucleic acids, fatty acids, amines, sugars, vitamins, co-factors, pigments, antibiotics, etc.) as well as exogenous chemicals (such as drugs, environmental contaminants, food additives, toxins and other xenobiotics) that are not naturally produced by an organism.
The metabolome refers to the complete set of small-molecule chemicals found within a biological sample. The biological sample can be a cell, a cellular organelle, an organ, a tissue, a tissue extract, a biofluid or an entire organism. The small molecule chemicals found in a given metabolome may include both endogenous metabolites that are naturally produced by an organism (such as amino acids, organic acids, nucleic acids, fatty acids, amines, sugars, vitamins, co-factors, pigments, antibiotics, etc.) as well as exogenous chemicals (such as drugs, environmental contaminants, food additives, toxins and other xenobiotics) that are not naturally produced by an organism.

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