Stanford pediatric gastroenterologist responds to your questions on celiac disease

One hopeful approach is aglutenase therapya where an enzyme could break down the gluten and render it non-toxic. Other working ideas include: blocking the immune reaction (i.e., auto-antibodies) through an ingestible polymeric resin, adesensitizinga the bodyas immune system response to gluten via serial protein-based injections and developing a celiac vaccine. Looking ahead, it is conceivable that celiac patients will one day be able to eat gluten-containing foods, but definitive alternatives to gluten avoidance are not yet ready for general consumer use. Antonio Ruben Murcia Prieto asks: What aboutAoats for celiac disease? The topic of oats is very much an evolving discussion among celiac experts. Generally, oats are an excellent source of good nutrients, including vitamins, minerals and antioxidants, and dietary fiber, such as soluble beta-glucans. They are high in protein, and are even thought to help maintain steady insulin levels. The working idea is that the biochemical nature of oats is gluten-free, but the manufacturing process of oats contaminates it with a common cereal protein called prolamins , which are found in wheat, barley and rye containing seeds that celiac patients have to avoid. One group of investigators analyzed 134 oat grains from various manufacturers in the U.S., Canada, and Europe, and they found that only 25 samples were uncontaminated by prolamins, and the majority of samples tested exceeded the threshold for what would be considered gluten-free. Unfortunately, results from clinical studies have been mixed. Also, even if the cross-contamination problem is resolved, the scientific community seems to agree that some celiac patients may be able to tolerate oats without any health consequences, while a subgroup of celiac patients simply cannot tolerate any oats. For now, the Celiac Sprue Association says it best with this formal recommendation: aOat products, grown, processed and packaged to be free of contamination with wheat, barley or rye appear to be suitable for some people with celiac disease, but not ALL peoplea Oats is not a risk-free choice for those on a gluten-free diet.

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