Once considered a concern solely for the gut,gluten is now recognized as an important factor in the pathogenesis of metabolic dysfunction-associated steatotic liver disease.Studies estimate that 18%-40%of individuals ...Once considered a concern solely for the gut,gluten is now recognized as an important factor in the pathogenesis of metabolic dysfunction-associated steatotic liver disease.Studies estimate that 18%-40%of individuals with gluten-related diseases have elevated liver enzyme levels,with 9%of patients with unexplained hypertransaminasemia ultimately diagnosed with gluten sensitivity.Hepatic manifestations of gluten sensitivity range from mild transaminase elevations to autoimmune liver diseases,metabolic dysfunction-associated steatotic liver disease,and even cirrhosis.Up to 50%of untreated cases of gluten-induced liver dysfunction show significant hepatic injury,which can lead to liver failure in severe cases.The pathophysiology is multifaceted and involves increased intestinal permeability,immune dysregulation,and shared genetic risk factors.A gluten-free diet leads to normalized liver enzymes in 75%-90%of cases within 1 year.Long-term gluten-free diet adherence has been paradoxically linked to higher body mass index,insulin resistance and increased hepatic steatosis risk,which raise concerns about its metabolic impact.Our review dissects the gluten-liver axis,emphasizing a need for early recognition,targeted screening,and personalized dietary interventions.Ultimately,given the increasing global burden of metabolic and autoimmune liver diseases,understanding gluten’s role is essential for optimizing liver health and preventing progressive hepatic injury.展开更多
Currently,1% of the United States population holds a diagnosis for celiac disease(CD),however,a more recently recognized and possibly related condition,"non-celiac gluten sensitivity"(NCGS)has been suggested...Currently,1% of the United States population holds a diagnosis for celiac disease(CD),however,a more recently recognized and possibly related condition,"non-celiac gluten sensitivity"(NCGS)has been suggested to affect up to 6%of the United States public.While reliable clinical tests for CD exist,diagnosing individuals affected by NCGS is still complicated by the lack of reliable biomarkers and reliance upon a broad set of intestinal and extra intestinal symptoms possibly provoked by gluten.NCGS has been proposed to exhibit an innate immune response activated by gluten and several other wheat proteins.At present,an enormous food industry has developed to supply gluten-free products(GFP)with GFP sales in 2014 approaching$1 billion,with estimations projecting sales to reach$2 billion in the year 2020.The enormous demand for GFP also reflects a popular misconception among consumers that gluten avoidance is part of a healthy lifestyle choice.Features of NCGS and other gluten related disorders(e.g.,irritable bowel syndrome)call for a review of current distinctive diagnostic criteria that distinguish each,and identification of biomarkers selective or specific for NCGS.The aim of this paper is to review our current understanding of NCGS,highlighting the remaining challenges and questions which may improve its diagnosis and treatment.展开更多
While exerting their metabolic activities in the gastrointestinal milieu,probiotics impact the host well-being by boosting immunity,treating metabolic disorders,and modulating microbiota and metabolome.Due to the high...While exerting their metabolic activities in the gastrointestinal milieu,probiotics impact the host well-being by boosting immunity,treating metabolic disorders,and modulating microbiota and metabolome.Due to the high incidence of gluten-based disorders,the present work aims to deeply explore the metabolism of two selected microbial consortia(MCs)during gluten digestion under simulated gastrointestinal conditions.Featured by high protease and peptidase activity,both MCs accounted for different lactic acid bacteria and Bacillus strains that were combined with two commercial protease enzymes.Gluten substrates were used as purified extracts,white and whole wheat breads.Control samples,instead,relied onto the microbial enzyme lack.Twenty-four hours of simulated digestion were sufficient to completely hydrolyze gluten in one of the two MC-containing experimental sets,and the relative 48 h-digested extract did not alter the cytokine expression in duodenal biopsies from celiac disease(CeD)patients.When digested samples were assayed for antioxidant and phytase activities,microbial enzymes demonstrated to significantly improve both 2,2'-azinobis(3-ethylbenzothiazoline-6-sulfonic acid)(ABTS)and 1,1-diphenyl-2-picrylhydrazyl(DPPH)scavenging activity and to decrease the phytic acid concentration.The inspection of the free amino acid profiles allowed for distinguishing the two MCs,whereas the detection of a heterogeneous panel of volatile organic compounds supported the presence/activity of microbial enzymes without statistically significant differences between MCs.As functional contribution,digested extracts with MCs also proved to reduce the inflammatory cytokine concentrations in cell lines exposed to lipopolysaccharide trigger.Therefore,in line with studies exploring novel adjuvant therapies,the present innovative probiotic consortium featured by high gluten-hydrolyzing metabolism also showed the capability to improve various parameters usually found to be altered in patients affected by gluten-based disorders or CeD.展开更多
Cereal crops and cereal consumption have had a vital role in Mankind's history. In the recent years gluten ingestion has been linked with a range of clinical disorders. Gluten-related disorders have gradually emer...Cereal crops and cereal consumption have had a vital role in Mankind's history. In the recent years gluten ingestion has been linked with a range of clinical disorders. Gluten-related disorders have gradually emerged as an epidemiologically relevant phenomenon with an estimated global prevalence around 5%. Celiac disease, wheat allergy and non-celiac gluten sensitivity represent different gluten-related disorders. Similar clinical manifestations can be observed in these disorders, yet there are peculiar pathogenetic pathways involved in their development. Celiac disease and wheat allergy have been extensively studied, while non-celiac gluten sensitivity is a relatively novel clinical entity, believed to be closely related to other gastrointestinal functional syndromes. The diagnosis of celiac disease and wheat allergy is based on a combination of findings from the patient's clinical history and specific tests, including serology and duodenal biopsies in case of celiac disease, or laboratory and functional assays for wheat allergy. On the other hand, non-celiac gluten sensitivity is still mainly a diagnosis of exclusion, in the absence of clear-cut diagnostic criteria. A multimodal pragmatic approach combining findings from the clinical history, symptoms, serological and histological tests is required in order to reach an accurate diagnosis. A thorough knowledge of the differences and overlap in clinical presentation among gluten-related disorders, and between them and other gastrointestinal disorders, will help clinicians in the process of differential diagnosis.展开更多
[Objective] To investigate the optimal enzyme for the hydrolysis of corn gluten meal and the optimal hydrolysis conditions for the enzyme. [Method] Nine kinds of enzymes were used to hydrolyze the corn gluten meal, us...[Objective] To investigate the optimal enzyme for the hydrolysis of corn gluten meal and the optimal hydrolysis conditions for the enzyme. [Method] Nine kinds of enzymes were used to hydrolyze the corn gluten meal, using the formaldehyde titration method for the determination of hydrolysis degree, and orthogonal test was used to determine the optimal hydrolysis conditions for double enzymes hydrol- ysis of corn gluten meal. [Result] The optimal pretreatment condition for corn gluten meal is heating at 121 ~C for 30 min. The double enzyme hydrolysis for the pro- treated corn gluten meal using 2709 alkaline protease and flavourzyme showed that the degree of hydrolysis could reach 32.4% with enzyme addition amount of 4%, hy- drolysis time of 4 h at 45℃ and pH=7.0. [Conclusion] This study laid the foundation for the study on the preparation of bioactive peptides such as oligopeptide with high F value and antihypertensive peptides, further improving the corn intensive process- ing industrial chain.展开更多
Dissecting the genetic relationships among gluten-related traits is important for high quality wheat breeding. Quantita- tive trait loci （QTLs） analysis for gluten strength, as measured by sedimentation volume （SV...Dissecting the genetic relationships among gluten-related traits is important for high quality wheat breeding. Quantita- tive trait loci （QTLs） analysis for gluten strength, as measured by sedimentation volume （SV） and gluten index （GI）, was performed using the QTLNetwork 2.0 software. Recombinant inbred lines （RILs） derived from the winter wheat varieties Shannong 01-35xGaocheng 9411 were used for the study. A total of seven additive QTLs for gluten strength were identi- fied using an unconditional analysis. QGi1D-13 and QSv1D-14 were detected through unconditional and conditional QTLs mapping, which explained 9.15-45.08% of the phenotypic variation. QTLs only identified under conditional QTL mapping were located in three marker intervals： WPT-3743-GLU-D1 （1D）, WPT-7001-WMC258 （1B）, and WPT-8682-WPT-5562 （1B）. Six pairs of epistatic QTLs distributed nine chromosomes were identified. Of these, two main effect QTLs （QGi1D-13 and QSvlD-14） and 12 pairs of epistatic QTLs were involved in interactions with the environment. The results indicated that chromosomes 1B and 1D are important for the improvement of gluten strength in common wheat. The combination of conditional and unconditional QTLs mapping could be useful for a better understanding of the interdependence of different traits at the QTL molecular level.展开更多
Non celiac gluten sensitivity(NCGS) is a syndrome characterized by a cohort of symptoms related to the ingestion of gluten-containing food in subjects who are not affected by celiac disease(CD) or wheat allergy. The p...Non celiac gluten sensitivity(NCGS) is a syndrome characterized by a cohort of symptoms related to the ingestion of gluten-containing food in subjects who are not affected by celiac disease(CD) or wheat allergy. The possibility of systemic manifestations in this condition has been suggested by some reports. In most cases they are characterized by vague symptoms such as ‘foggy mind', headache, fatigue, joint and muscle pain, leg or arm numbness even if more specific complaints have been described. NCGS has an immune-related background. Indeed there is a strong evidence that a selective activation of innate immunity may be the trigger for NCGS inflammatory response. The most commonly autoimmune disorders associated to NCGS are Hashimoto thyroiditis, dermatitis herpetiformis, psoriasis and rheumatologic diseases. The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported; it could be a characteristic feature that could help the diagnosis and be simultaneously managed. A possible neurological involvement has been underlined by NCGS association with gluten ataxia, gluten neuropathy and gluten encephalopathy. NCGS patients may show even psychiatric diseases such as depression, anxiety and psychosis. Finally, a link with functional disorders(irritable bowel syndrome and fibromyalgia) is a topic under discussion. In conclusion, the novelty of this matter has generated an expansion of literature data with the unavoidable consequence that some reports are often based on low levels of evidence. Therefore, only studies performed on large samples with the inclusion of control groups will be able to clearly establish whether the large information from the literature regarding extra-intestinal NCGS manifestations could be supported by evidence-based agreements.展开更多
Gluten is one of the most abundant and widely distributed components of food in many areas. It can be included in wheat, barley, rye, and grains such as oats, barley, spelt, kamut, and triticale. Gluten-containinggrai...Gluten is one of the most abundant and widely distributed components of food in many areas. It can be included in wheat, barley, rye, and grains such as oats, barley, spelt, kamut, and triticale. Gluten-containinggrains are widely consumed; in particular, wheat is one of the world's primary sources of food, providing up to 50% of the caloric intake in both industrialized and developing countries. Until two decades ago, celiac disease(CD) and other gluten-related disorders were believed to be exceedingly rare outside of Europe and were relatively ignored by health professionals and the global media. In recent years, however, the discovery of important diagnostic and pathogenic milestones led CD from obscurity to global prominence. In addition, interestingly, people feeding themselves with glutenfree products greatly outnumber patients affected by CD, fuelling a global consumption of gluten-free foods with approximately $2.5 billion in United States sales each year. The acknowledgment of other medical conditions related to gluten that has arisen as health problems, providing a wide spectrum of gluten-related disorders. In February 2011, a new nomenclature for gluten-related disorders was created at a consensus conference in London. In this review, we analyse innovations in the field of research that emerged after the creation of the new classification, with particular attention to the new European Society for Paediatric Gastroenterology, Hepatology and Nutrition guidelines for CD and the most recent research about non-celiac gluten sensitivity.展开更多
AIM: To determine the prevalence of gluten sensitive enteropathy (GSE) in a large group of patients with iron deficiency anemia (IDA) of obscure origin. METHODS: In this cross-sectional study, patients with IDA of obs...AIM: To determine the prevalence of gluten sensitive enteropathy (GSE) in a large group of patients with iron deficiency anemia (IDA) of obscure origin. METHODS: In this cross-sectional study, patients with IDA of obscure origin were screened for GSE. Anti- endomysial antibody (EMA) and tissue transglutamin- ase antibody (tTG) levels were evaluated and duodenal biopsies were taken and scored according to the Marsh classification. The diagnosis of GSE was based on a positive serological test and abnormal duodenal histol- ogy. Gluten free diet (GFD) was advised for all the GSE patients. RESULTS: Of the 4120 IDA patients referred to our Hematology departments, 206 (95 male) patients were found to have IDA of obscure origin. Thirty out of 206 patients (14.6%) had GSE. The mean age of GSE pa- tients was 34.6 ± 17.03 (range 10-72 years). The female to male ratio was 1.3:1. Sixteen patients had Marsh 3,12 had Marsh 2, and 2 had Marsh 1 lesions. The sever- ity of anemia was in parallel with the severity of duode- nal lesions. Twenty-two GSE patients (73.3%) had no gastrointestinal symptoms. Fourteen GSE patients who adhered to GFD without receiving iron supplementation agreed to undergo follow up visits. After 6 mo of GFD, their mean hemoglobin levels (Hb) increased from 9.9 ± 1.6 to 12.8 ± 1.0 g/dL (P < 0.01). Interestingly, in 6 out of 14 patients who had Marsh 1/2 lesions (e.g. no villous atrophy) on duodenal biopsy, mean Hb increased from 11.0 ± 1.1 to 13.1 ± 1.0 g/dL (P < 0.01) while they did not receive any iron supplementation. CONCLUSION: There is a high prevalence (e.g. 14.6%) of GSE in patients with IDA of obscure origin. Gluten free diet can improve anemia in GSE patients who have mild duodenal lesions without villous atrophy.展开更多
In the last few years, a new nomenclature has been proposed for the disease induced by the ingestion of gluten, a protein present in wheat, rice, barley and oats. Besides celiac disease and wheat allergy, the most stu...In the last few years, a new nomenclature has been proposed for the disease induced by the ingestion of gluten, a protein present in wheat, rice, barley and oats. Besides celiac disease and wheat allergy, the most studied forms of gluten-related disorders characterized by an evident immune mechanism(autoimmune in celiac disease and Ig E-mediated in wheat allergy), a new entity has been included, apparently not driven by an aberrant immune response: the non-celiac gluten sensitivity(NCGS). NCGS is characterized by a heterogeneous clinical picture with intestinal and extraintestinal symptoms arising after gluten ingestion and rapidly improving after its withdrawal from the diet. The pathogenesis of NCGS is largely unknown, but a mixture of factors such as the stimulation of the innate immune system, the direct cytotoxic effects of gluten, and probably the synergy with other wheat molecules, are clues for the complicated puzzle. In addition, the diagnostic procedures still remain problematic due to the absence of efficient diagnostic markers; thus, diagnosis is based upon the symptomatic response to a gluten-free diet and the recurrence of symptoms after gluten reintroduction with the possibility of an important involvement of a placebo effect. The temporary withdrawal of gluten seems a reasonable therapy, but the timing of gluten reintroduction and the correct patient management approach are have not yet been determined.展开更多
AIM:To investigate all patients referred to our center with non-responsive celiac disease (NRCD),to establish a cause for their continued symptoms.METHODS:We assessed all patients referred to our center with non-respo...AIM:To investigate all patients referred to our center with non-responsive celiac disease (NRCD),to establish a cause for their continued symptoms.METHODS:We assessed all patients referred to our center with non-responsive celiac disease over an 18-mo period.These individuals were investigated to establish the eitiology of their continued symptoms.The patients were first seen in clinic where a thorough history and examination were performed with routine blood work including tissue transglutaminase antibody measurement.They were also referred to a specialist gastroenterology dietician to try to identift any lapses in the diet and sources of hidden gluten ingestion.A repeat small intestinal biopsy was also performed and compared to biopsies from the referring hospital where possible.Colonoscopy,lactulose hydrogen breath testing,pancreolauryl testing and computed tomography scan of the abdomen were undertaken if the symptoms persisted.Their clinical progress was followed over a minimum of 2 years.RESULTS:One hundred and twelve consecutive patients were referred with NRCD.Twelve were found not to have celiac disease (CD).Of the remaining 100 patients,45% were not adequately adhering to a strict gluten-free diet,with 24 (53%) found to be inadvertently ingesting gluten,and 21 (47%) admitting noncompliance.Microscopic colitis was diagnosed in 12% and small bowel bacterial overgrowth in 9%.Refractory CD was diagnosed in 9%.Three of these were diagnosed with intestinal lymphoma.After 2 years,78 patients remained well,eight had continuing symptoms,and four had died.CONCLUSION:In individuals with NRCD,a remediable cause can be found in 90%:with continued gluten ingestion as the leading cause.We propose an algorithm for investigation.展开更多
Celiac disease is a genetically-determined chronic inflammatory intestinal disease induced by gluten in wheat,barley,rye etc.Celiac disease affects approximately one percent of people in the world and strict gluten-fr...Celiac disease is a genetically-determined chronic inflammatory intestinal disease induced by gluten in wheat,barley,rye etc.Celiac disease affects approximately one percent of people in the world and strict gluten-free diet(GFD)for a lifetime is the only available treatment.As gluten-free products available in the market are known to have low nutritional quality as well as are more expensive than gluten-containing food products,there is a strong need to develop gluten-free products that are nutritionally complete as well as economical.This review focuses on the special considerations during developing gluten-free products viz.,finding an alternate non-gluten source,ensuring nutrition and sensory quality characteristics,compliance with the regulatory guidelines,economics and product.展开更多
BACKGROUND Life-long removal of gluten from the diet is currently the only way to manage celiac disease(CeD).Until now,no objective test has proven useful to objectively detect ingested gluten in clinical practice.Rec...BACKGROUND Life-long removal of gluten from the diet is currently the only way to manage celiac disease(CeD).Until now,no objective test has proven useful to objectively detect ingested gluten in clinical practice.Recently,tests that determine consumption of gluten by assessing excretion of gluten immunogenic peptides(GIP)in stool and urine have been developed.Their utility,in comparison with conventional dietary and analytical follow-up strategies,has not been fully established.AIM To assess the performance of enzyme-linked immunosorbent assay(ELISA)and point-of-care tests(PoCTs)for GIP excretion in CeD patients on gluten-free diet(GFD).METHODS We conducted an observational,prospective,cross-sectional study in patients following a GFD for at least two years.Using the Gastrointestinal Symptom Rating Scale questionnaire,patients were classified at enrollment as asymptomatic or symptomatic.Gluten consumption was assessed twice by 3-d dietary recall and GIP excretion(by ELISA in stool and PoCTs(commercial kits for stool and urine)in two consecutive samples.These samples and dietary reports were obtained 10 day apart one from the other.Patients were encouraged to follow their usual GFD during the study period.RESULTS Forty-four patients were enrolled,of which 19(43.2%)were symptomatic despite being on a GFD.Overall,83 sets of stool and/or urine samples were collected.Eleven out of 44 patients(25.0%)had at least one positive GIP test.The occurrence of at least one positive test was 32%in asymptomatic patients compared with 15.8%in symptomatic patients.GIP was concordant with dietary reports in 65.9%of cases(Cohen′s kappa:0.317).PoCT detected dietary indiscretions.Both ELISA and PoCT in stool were concordant(concomitantly positive or negative)in 67 out of 74(90.5%)samples.Excretion of GIP was detected in 7(8.4%)stool and/or urine samples from patients considered to be strictly compliant with the GFD by dietary reports.CONCLUSION GIP detects dietary transgressions in patients on long-term GFD,irrespective of the presence of symptoms.PoCT for GIP detection constitutes a simple homebased method for self-assessment of dietary indiscretions.展开更多
BACKGROUND Gluten is a complex mixture of proteins with immunogenic peptide sequences triggering the autoimmune activity in patients with celiac disease(CeD).Gluten immunogenic peptides(GIP)are resistant to gastrointe...BACKGROUND Gluten is a complex mixture of proteins with immunogenic peptide sequences triggering the autoimmune activity in patients with celiac disease(CeD).Gluten immunogenic peptides(GIP)are resistant to gastrointestinal digestion and are then excreted via the stool and urine.Most common detection methods applied in the follow-up visits for CeD patients such as serology tests,dietetic interviews,questionnaires,and duodenal biopsy have been proved to be inefficient,invasive,or inaccurate for evaluating gluten-free diet(GFD)compliance.Determination of excreted GIP in stool and urine has been developed as a non-invasive,direct,and specific test for GFD monitoring.AIM To summarize published literature about the clinical utility of GIP determination in comparison to the tools employed for GFD monitoring.METHODS PubMed and Web of Science searches were performed using the keywords“gluten immunogenic peptides”or“gluten immunogenic peptide”and a combination of the previous terms with“feces”,“stools”,“urine”,“celiac disease”,“gluten-free diet”,and“adherence”to identify relevant clinical studies published in English and Spanish between 2012 to January 2021.Reference lists from the articles were reviewed to identify additional pertinent articles.Published articles and abstracts reporting the clinical use of GIP determination in stool and/or urine for the follow-up of patients with CeD in comparison with other tools in use were included.Case reports,commentaries,reviews,conference papers,letters,and publications that did not focus on the aims of this review were excluded.RESULTS Total of 15 publications were found that involved the use of GIP determination in stool and/or urine to monitor the adherence to the GFD in comparison to other tools.Studies included both children and adults diagnosed with CeD and healthy volunteers.Overall,these preliminary studies indicated that this novel technique was highly sensitive for the detection of GFD transgressions and therefore could facilitate the follow-up of patients with CeD.Tools identified in this work included the CeD-specific serology,dietetic questionnaires,symptomatology,and the duodenal biopsy.Review of the literature revealed that the rates of GFD adherence may vary between 30%-93%using either stool or urine GIP determination,49%-96%by the serology,59%-94%using the dietetic questionnaires,56%-95%by the reported symptoms and 44%-76%with the duodenal biopsy.In addition,the association between the different methods and histological abnormalities(Marsh II-III)was found to be 33%-100%for GIP determination(stool and urine),25%-39%for CeD-specific serology,3%-50%for dietetic questionnaires,and 22%-28%for the symptomatology.CONCLUSION Excreted GIP detection is the precise approach for determining voluntary or involuntary gluten consumption in CeD patients preventing future complications arising from gluten exposure.展开更多
Significant correlations exist for the total sample between the dough viscoelastic properties and quality, but little information about these links is available. This study investigates the relationship between the gl...Significant correlations exist for the total sample between the dough viscoelastic properties and quality, but little information about these links is available. This study investigates the relationship between the gluten molecular conformation and the dough viscoelastic properties of the Zhengmai 379 wheat variety with different relative humidity(RH) values during storage.The results showed that protein extractability, free sulfhydryl(SH) groups, and wet gluten contents decreased to a certain degree during storage, while the glutenin quantity significantly varied. Significant negative correlation coefficients were found between the dough viscosity at 50% RH and the β-turn contents at 40% RH(-0.918) or 60% RH(-0.949)(P < 0.01), the dough viscosity at50% RH and the β-turn contents at 50% RH(-0.912)(P < 0.05), and the dough viscosity at 50% RH and the α-helix/β-sheet ratio at 40% RH(-0.875), 50% RH(-0.869), or 60% RH(-0.843)(P < 0.05). Significant correlation coefficients were further observed between the dough viscosity at 50% RH and the β-sheet contents at 60% RH(0.927)(P < 0.01) and between the dough viscosity at50% RH and the β-sheet contents at 40% RH(0.910) or 50% RH(0.908)(P < 0.05). A decrease in the free SH groups of gluten and an increase in the low-molecular weight contents suggested that gliadin was incorporated via SS crosslinking to the glutenin-like protein, which did not dissolve in ethanol.展开更多
Celiac Disease (CD) is an inherited, autoimmune disorder in which proteins from the grains wheat, rye and barley (collectively called gluten) damage the small intestine. The only treatment for CD is a strict, lifelong...Celiac Disease (CD) is an inherited, autoimmune disorder in which proteins from the grains wheat, rye and barley (collectively called gluten) damage the small intestine. The only treatment for CD is a strict, lifelong gluten-free diet. With a prevalence rate of about one in 100-133 people worldwide. Celiac disease is wide-spread across the globe. Unlike traditional allergies, which cause immediate reactions, gluten sensitivity is harder to pin down since it manifests gradually and in various forms like headaches, stomach cramps, bloating, anxiety, and depression. Due to complicated diagnosis procedure and lack of awareness, many cases are either misdiagnosed or not at all diagnosed in India and USA. In spite of high growth, gluten-free foods are facing problems to grain ground in Asian market, due to high price, lack of awareness about the products, large number of un-diagnosed cases and inefficient value chain for gluten-free products. One of the major issues in India and USA is very high prices of gluten-free foods as compared to regular food products. Globally, the market potential of gluten free products is estimated to be USD 4639.13 Million and USD 7594.43 Million in 2015 and 2020 respectively. The global gluten free food market is projected to grow with a CAGR between 9 percent and 10.2 percent during 2016-2022. The study on consumer preference of gluten-free foods would enable manufacturers of gluten-free foods to understand the current and evolving expectations of consumers and to design the products according. Study of two countries i.e., India and USA would enable manufacturers to understand the difference in choices and preferences related to gluten-free foods for both the nations. This study would help manufacturers of alternative wheat product to form the concrete marketing and product development strategy based on recent consumer behavior trends.展开更多
Gluten-sensitive enteropathy,also known as coeliac disease(CD),is an autoimmune disorder occurring in genetically susceptible individuals that damages the small intestine and interferes with the absorption of other nu...Gluten-sensitive enteropathy,also known as coeliac disease(CD),is an autoimmune disorder occurring in genetically susceptible individuals that damages the small intestine and interferes with the absorption of other nutrients.As it is triggered by dietary gluten and related prolamins present in wheat,rye and barley,the accepted treatment for CD is a strict gluten-free diet.However,a complete exclusion of gluten-containing cereals from the diet is often difficult,and new therapeutic strategies are urgently needed.A class of proteins that have already emerged as drug targets for other autoimmune diseases are the heat shock proteins(HSPs),which are highly conserved stress-induced chaperones that protect cells against harmful extracellular factors.HSPs are expressed in several tissues,including the gastrointestinal tract,and their levels are significantly increased under stress circumstances.HSPs exert immunomodulatory effects,and also play a crucial role in the maintenance of epithelial cell structure and function,as they are responsible for adequate protein folding,influence the degradation of proteins and cell repair processes after damage,and modulate cell signalling,cell proliferation and apoptosis.The present review discusses the involvement of HSPs in the pathophysiology of CD.Furthermore,HSPs may represent a useful therapeutic target for the treatment of CD due to the cytoprotective,immunomodulatory,and anti-apoptotic effects in the intestinal mucosal barrier.展开更多
Celiac disease, gluten-allergy or gluten-sensitivity is caused due to glutamine protein from the grains like wheat, rye and barley (collectively called gluten). This protein damages the small intestine and causes stom...Celiac disease, gluten-allergy or gluten-sensitivity is caused due to glutamine protein from the grains like wheat, rye and barley (collectively called gluten). This protein damages the small intestine and causes stomach pain, bloating, weakness etc. Celiac disease, gluten-allergy or gluten-sensitivity has never really been taken seriously in developing countries like India. However, in developed nations like UK, USA, Canada and other parts of Europe, gluten-free foods have become quite popular. With a prevalence rate of about one in 100 - 133 people worldwide, celiac disease is widespread across the globe and life-long consumption of gluten-free food is recommended treatment for this allergy. Apart from celiac-disease patients, gluten-free foods are also consumed by health conscious people for weight management and high protein diet and by the patients for diabetes, autism and food allergies. Apart from gluten-free flour, biscuits, cookies and snacks, product innovations like gluten-free beers are becoming very popular. Big data including online blogs, articles, and reviews have played a major role in increased sales of gluten-free foods. Thus, analysis of editorial and social media content becomes essential to understand the leading trends in gluten-free foods. This study provided deep insights about positive, negative and neutral sentiments related to gluten-free foods using the data from Perspectory Media Insights and Google Trends. This study also revealed that most of the consumers talked and expected product innovation in food sections like snacks, fast food (pizza, pasta and noodles) and desserts through comments on social and editorial media. Searches were divided into developed (e.g., U.S.A.) and developing nations (e.g., India) to get more details about the consumer preferences. This study would help manufacturers of gluten-free foods to develop food products according to the choices and preferences of consumers. The study is very unique in itself since it combines big data to niche food market of gluten-free foods to draw the valuable consumer preferences using online platforms.展开更多
Gluten ataxia and other central nervous system disorders could be linked to gluten enteropathy and related autoantibodies.In this narrative review,we focus on the various neuro-logical manifestations in patients with ...Gluten ataxia and other central nervous system disorders could be linked to gluten enteropathy and related autoantibodies.In this narrative review,we focus on the various neuro-logical manifestations in patients with gluten sensitivity/celiac disease,immunological and autoimmune mechanisms of ataxia in connection to gluten sensitivity and the autoantibodies that could be used as a biomarker for diagnosing and following.We focused on the anti-gliadin antibodies,antibodies to different isoforms of tissue transglutaminase(TG)(anti-TG2,3,and 6 antibodies),anti-glycine receptor antibodies,anti-glutamine acid decarboxylase antibodies,anti-deamidated gliadin peptides antibodies,etc.Most studies found a higher prevalence of these antibodies in patients with gluten sensitivity and neurological dysfunction,presented as different neurological disorders.We also discuss the role of a gluten-free diet on the clinical improvement of patients and also on imaging of these disorders.展开更多
This study investigated how a gluten-free diet affects hormones, with particular emphasis on cortisol, thyroid, insulin, and sex hormones. Background: For medical diseases such as non-celiac gluten sensitivity, wheat ...This study investigated how a gluten-free diet affects hormones, with particular emphasis on cortisol, thyroid, insulin, and sex hormones. Background: For medical diseases such as non-celiac gluten sensitivity, wheat allergy, and celiac disease, a gluten-free diet is important. The main area of concern for research is how a gluten-free diet can affect hormone levels and related health consequences. A review of the body of research on this topic, including studies on hormone regulation and the impact of dietary modifications, is a part of the methodology. These findings imply that a gluten-free diet may have an impact on hormone levels, which may affect metabolism, weight, and general health. These implications include the need for additional studies, particularly in those with autoimmune illnesses, to completely comprehend the relationship between a gluten-free diet and hormone regulation.展开更多
文摘Once considered a concern solely for the gut,gluten is now recognized as an important factor in the pathogenesis of metabolic dysfunction-associated steatotic liver disease.Studies estimate that 18%-40%of individuals with gluten-related diseases have elevated liver enzyme levels,with 9%of patients with unexplained hypertransaminasemia ultimately diagnosed with gluten sensitivity.Hepatic manifestations of gluten sensitivity range from mild transaminase elevations to autoimmune liver diseases,metabolic dysfunction-associated steatotic liver disease,and even cirrhosis.Up to 50%of untreated cases of gluten-induced liver dysfunction show significant hepatic injury,which can lead to liver failure in severe cases.The pathophysiology is multifaceted and involves increased intestinal permeability,immune dysregulation,and shared genetic risk factors.A gluten-free diet leads to normalized liver enzymes in 75%-90%of cases within 1 year.Long-term gluten-free diet adherence has been paradoxically linked to higher body mass index,insulin resistance and increased hepatic steatosis risk,which raise concerns about its metabolic impact.Our review dissects the gluten-liver axis,emphasizing a need for early recognition,targeted screening,and personalized dietary interventions.Ultimately,given the increasing global burden of metabolic and autoimmune liver diseases,understanding gluten’s role is essential for optimizing liver health and preventing progressive hepatic injury.
文摘Currently,1% of the United States population holds a diagnosis for celiac disease(CD),however,a more recently recognized and possibly related condition,"non-celiac gluten sensitivity"(NCGS)has been suggested to affect up to 6%of the United States public.While reliable clinical tests for CD exist,diagnosing individuals affected by NCGS is still complicated by the lack of reliable biomarkers and reliance upon a broad set of intestinal and extra intestinal symptoms possibly provoked by gluten.NCGS has been proposed to exhibit an innate immune response activated by gluten and several other wheat proteins.At present,an enormous food industry has developed to supply gluten-free products(GFP)with GFP sales in 2014 approaching$1 billion,with estimations projecting sales to reach$2 billion in the year 2020.The enormous demand for GFP also reflects a popular misconception among consumers that gluten avoidance is part of a healthy lifestyle choice.Features of NCGS and other gluten related disorders(e.g.,irritable bowel syndrome)call for a review of current distinctive diagnostic criteria that distinguish each,and identification of biomarkers selective or specific for NCGS.The aim of this paper is to review our current understanding of NCGS,highlighting the remaining challenges and questions which may improve its diagnosis and treatment.
文摘While exerting their metabolic activities in the gastrointestinal milieu,probiotics impact the host well-being by boosting immunity,treating metabolic disorders,and modulating microbiota and metabolome.Due to the high incidence of gluten-based disorders,the present work aims to deeply explore the metabolism of two selected microbial consortia(MCs)during gluten digestion under simulated gastrointestinal conditions.Featured by high protease and peptidase activity,both MCs accounted for different lactic acid bacteria and Bacillus strains that were combined with two commercial protease enzymes.Gluten substrates were used as purified extracts,white and whole wheat breads.Control samples,instead,relied onto the microbial enzyme lack.Twenty-four hours of simulated digestion were sufficient to completely hydrolyze gluten in one of the two MC-containing experimental sets,and the relative 48 h-digested extract did not alter the cytokine expression in duodenal biopsies from celiac disease(CeD)patients.When digested samples were assayed for antioxidant and phytase activities,microbial enzymes demonstrated to significantly improve both 2,2'-azinobis(3-ethylbenzothiazoline-6-sulfonic acid)(ABTS)and 1,1-diphenyl-2-picrylhydrazyl(DPPH)scavenging activity and to decrease the phytic acid concentration.The inspection of the free amino acid profiles allowed for distinguishing the two MCs,whereas the detection of a heterogeneous panel of volatile organic compounds supported the presence/activity of microbial enzymes without statistically significant differences between MCs.As functional contribution,digested extracts with MCs also proved to reduce the inflammatory cytokine concentrations in cell lines exposed to lipopolysaccharide trigger.Therefore,in line with studies exploring novel adjuvant therapies,the present innovative probiotic consortium featured by high gluten-hydrolyzing metabolism also showed the capability to improve various parameters usually found to be altered in patients affected by gluten-based disorders or CeD.
文摘Cereal crops and cereal consumption have had a vital role in Mankind's history. In the recent years gluten ingestion has been linked with a range of clinical disorders. Gluten-related disorders have gradually emerged as an epidemiologically relevant phenomenon with an estimated global prevalence around 5%. Celiac disease, wheat allergy and non-celiac gluten sensitivity represent different gluten-related disorders. Similar clinical manifestations can be observed in these disorders, yet there are peculiar pathogenetic pathways involved in their development. Celiac disease and wheat allergy have been extensively studied, while non-celiac gluten sensitivity is a relatively novel clinical entity, believed to be closely related to other gastrointestinal functional syndromes. The diagnosis of celiac disease and wheat allergy is based on a combination of findings from the patient's clinical history and specific tests, including serology and duodenal biopsies in case of celiac disease, or laboratory and functional assays for wheat allergy. On the other hand, non-celiac gluten sensitivity is still mainly a diagnosis of exclusion, in the absence of clear-cut diagnostic criteria. A multimodal pragmatic approach combining findings from the clinical history, symptoms, serological and histological tests is required in order to reach an accurate diagnosis. A thorough knowledge of the differences and overlap in clinical presentation among gluten-related disorders, and between them and other gastrointestinal disorders, will help clinicians in the process of differential diagnosis.
文摘[Objective] To investigate the optimal enzyme for the hydrolysis of corn gluten meal and the optimal hydrolysis conditions for the enzyme. [Method] Nine kinds of enzymes were used to hydrolyze the corn gluten meal, using the formaldehyde titration method for the determination of hydrolysis degree, and orthogonal test was used to determine the optimal hydrolysis conditions for double enzymes hydrol- ysis of corn gluten meal. [Result] The optimal pretreatment condition for corn gluten meal is heating at 121 ~C for 30 min. The double enzyme hydrolysis for the pro- treated corn gluten meal using 2709 alkaline protease and flavourzyme showed that the degree of hydrolysis could reach 32.4% with enzyme addition amount of 4%, hy- drolysis time of 4 h at 45℃ and pH=7.0. [Conclusion] This study laid the foundation for the study on the preparation of bioactive peptides such as oligopeptide with high F value and antihypertensive peptides, further improving the corn intensive process- ing industrial chain.
基金support from the Natural Science Foundation of Shandong Province,China (ZR2015CM036)the Molecular Foundation of Main Crop Quality,the Ministry of Science and Technology of China (2016YFD0100500)+1 种基金the Project of Science and Technology of Shandong “Wheat Breeding by Molecular Design”,China (2016LZGC023)the Research Fund for Agricultural Big Data Project,China
文摘Dissecting the genetic relationships among gluten-related traits is important for high quality wheat breeding. Quantita- tive trait loci （QTLs） analysis for gluten strength, as measured by sedimentation volume （SV） and gluten index （GI）, was performed using the QTLNetwork 2.0 software. Recombinant inbred lines （RILs） derived from the winter wheat varieties Shannong 01-35xGaocheng 9411 were used for the study. A total of seven additive QTLs for gluten strength were identi- fied using an unconditional analysis. QGi1D-13 and QSv1D-14 were detected through unconditional and conditional QTLs mapping, which explained 9.15-45.08% of the phenotypic variation. QTLs only identified under conditional QTL mapping were located in three marker intervals： WPT-3743-GLU-D1 （1D）, WPT-7001-WMC258 （1B）, and WPT-8682-WPT-5562 （1B）. Six pairs of epistatic QTLs distributed nine chromosomes were identified. Of these, two main effect QTLs （QGi1D-13 and QSvlD-14） and 12 pairs of epistatic QTLs were involved in interactions with the environment. The results indicated that chromosomes 1B and 1D are important for the improvement of gluten strength in common wheat. The combination of conditional and unconditional QTLs mapping could be useful for a better understanding of the interdependence of different traits at the QTL molecular level.
文摘Non celiac gluten sensitivity(NCGS) is a syndrome characterized by a cohort of symptoms related to the ingestion of gluten-containing food in subjects who are not affected by celiac disease(CD) or wheat allergy. The possibility of systemic manifestations in this condition has been suggested by some reports. In most cases they are characterized by vague symptoms such as ‘foggy mind', headache, fatigue, joint and muscle pain, leg or arm numbness even if more specific complaints have been described. NCGS has an immune-related background. Indeed there is a strong evidence that a selective activation of innate immunity may be the trigger for NCGS inflammatory response. The most commonly autoimmune disorders associated to NCGS are Hashimoto thyroiditis, dermatitis herpetiformis, psoriasis and rheumatologic diseases. The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported; it could be a characteristic feature that could help the diagnosis and be simultaneously managed. A possible neurological involvement has been underlined by NCGS association with gluten ataxia, gluten neuropathy and gluten encephalopathy. NCGS patients may show even psychiatric diseases such as depression, anxiety and psychosis. Finally, a link with functional disorders(irritable bowel syndrome and fibromyalgia) is a topic under discussion. In conclusion, the novelty of this matter has generated an expansion of literature data with the unavoidable consequence that some reports are often based on low levels of evidence. Therefore, only studies performed on large samples with the inclusion of control groups will be able to clearly establish whether the large information from the literature regarding extra-intestinal NCGS manifestations could be supported by evidence-based agreements.
文摘Gluten is one of the most abundant and widely distributed components of food in many areas. It can be included in wheat, barley, rye, and grains such as oats, barley, spelt, kamut, and triticale. Gluten-containinggrains are widely consumed; in particular, wheat is one of the world's primary sources of food, providing up to 50% of the caloric intake in both industrialized and developing countries. Until two decades ago, celiac disease(CD) and other gluten-related disorders were believed to be exceedingly rare outside of Europe and were relatively ignored by health professionals and the global media. In recent years, however, the discovery of important diagnostic and pathogenic milestones led CD from obscurity to global prominence. In addition, interestingly, people feeding themselves with glutenfree products greatly outnumber patients affected by CD, fuelling a global consumption of gluten-free foods with approximately $2.5 billion in United States sales each year. The acknowledgment of other medical conditions related to gluten that has arisen as health problems, providing a wide spectrum of gluten-related disorders. In February 2011, a new nomenclature for gluten-related disorders was created at a consensus conference in London. In this review, we analyse innovations in the field of research that emerged after the creation of the new classification, with particular attention to the new European Society for Paediatric Gastroenterology, Hepatology and Nutrition guidelines for CD and the most recent research about non-celiac gluten sensitivity.
基金Supported by Local funds from Digestive Disease Research Centre, University of Tehran and Gastrointestinal and Liver Disease Research Centre, Iran University of Medical Science
文摘AIM: To determine the prevalence of gluten sensitive enteropathy (GSE) in a large group of patients with iron deficiency anemia (IDA) of obscure origin. METHODS: In this cross-sectional study, patients with IDA of obscure origin were screened for GSE. Anti- endomysial antibody (EMA) and tissue transglutamin- ase antibody (tTG) levels were evaluated and duodenal biopsies were taken and scored according to the Marsh classification. The diagnosis of GSE was based on a positive serological test and abnormal duodenal histol- ogy. Gluten free diet (GFD) was advised for all the GSE patients. RESULTS: Of the 4120 IDA patients referred to our Hematology departments, 206 (95 male) patients were found to have IDA of obscure origin. Thirty out of 206 patients (14.6%) had GSE. The mean age of GSE pa- tients was 34.6 ± 17.03 (range 10-72 years). The female to male ratio was 1.3:1. Sixteen patients had Marsh 3,12 had Marsh 2, and 2 had Marsh 1 lesions. The sever- ity of anemia was in parallel with the severity of duode- nal lesions. Twenty-two GSE patients (73.3%) had no gastrointestinal symptoms. Fourteen GSE patients who adhered to GFD without receiving iron supplementation agreed to undergo follow up visits. After 6 mo of GFD, their mean hemoglobin levels (Hb) increased from 9.9 ± 1.6 to 12.8 ± 1.0 g/dL (P < 0.01). Interestingly, in 6 out of 14 patients who had Marsh 1/2 lesions (e.g. no villous atrophy) on duodenal biopsy, mean Hb increased from 11.0 ± 1.1 to 13.1 ± 1.0 g/dL (P < 0.01) while they did not receive any iron supplementation. CONCLUSION: There is a high prevalence (e.g. 14.6%) of GSE in patients with IDA of obscure origin. Gluten free diet can improve anemia in GSE patients who have mild duodenal lesions without villous atrophy.
文摘In the last few years, a new nomenclature has been proposed for the disease induced by the ingestion of gluten, a protein present in wheat, rice, barley and oats. Besides celiac disease and wheat allergy, the most studied forms of gluten-related disorders characterized by an evident immune mechanism(autoimmune in celiac disease and Ig E-mediated in wheat allergy), a new entity has been included, apparently not driven by an aberrant immune response: the non-celiac gluten sensitivity(NCGS). NCGS is characterized by a heterogeneous clinical picture with intestinal and extraintestinal symptoms arising after gluten ingestion and rapidly improving after its withdrawal from the diet. The pathogenesis of NCGS is largely unknown, but a mixture of factors such as the stimulation of the innate immune system, the direct cytotoxic effects of gluten, and probably the synergy with other wheat molecules, are clues for the complicated puzzle. In addition, the diagnostic procedures still remain problematic due to the absence of efficient diagnostic markers; thus, diagnosis is based upon the symptomatic response to a gluten-free diet and the recurrence of symptoms after gluten reintroduction with the possibility of an important involvement of a placebo effect. The temporary withdrawal of gluten seems a reasonable therapy, but the timing of gluten reintroduction and the correct patient management approach are have not yet been determined.
文摘AIM:To investigate all patients referred to our center with non-responsive celiac disease (NRCD),to establish a cause for their continued symptoms.METHODS:We assessed all patients referred to our center with non-responsive celiac disease over an 18-mo period.These individuals were investigated to establish the eitiology of their continued symptoms.The patients were first seen in clinic where a thorough history and examination were performed with routine blood work including tissue transglutaminase antibody measurement.They were also referred to a specialist gastroenterology dietician to try to identift any lapses in the diet and sources of hidden gluten ingestion.A repeat small intestinal biopsy was also performed and compared to biopsies from the referring hospital where possible.Colonoscopy,lactulose hydrogen breath testing,pancreolauryl testing and computed tomography scan of the abdomen were undertaken if the symptoms persisted.Their clinical progress was followed over a minimum of 2 years.RESULTS:One hundred and twelve consecutive patients were referred with NRCD.Twelve were found not to have celiac disease (CD).Of the remaining 100 patients,45% were not adequately adhering to a strict gluten-free diet,with 24 (53%) found to be inadvertently ingesting gluten,and 21 (47%) admitting noncompliance.Microscopic colitis was diagnosed in 12% and small bowel bacterial overgrowth in 9%.Refractory CD was diagnosed in 9%.Three of these were diagnosed with intestinal lymphoma.After 2 years,78 patients remained well,eight had continuing symptoms,and four had died.CONCLUSION:In individuals with NRCD,a remediable cause can be found in 90%:with continued gluten ingestion as the leading cause.We propose an algorithm for investigation.
文摘Celiac disease is a genetically-determined chronic inflammatory intestinal disease induced by gluten in wheat,barley,rye etc.Celiac disease affects approximately one percent of people in the world and strict gluten-free diet(GFD)for a lifetime is the only available treatment.As gluten-free products available in the market are known to have low nutritional quality as well as are more expensive than gluten-containing food products,there is a strong need to develop gluten-free products that are nutritionally complete as well as economical.This review focuses on the special considerations during developing gluten-free products viz.,finding an alternate non-gluten source,ensuring nutrition and sensory quality characteristics,compliance with the regulatory guidelines,economics and product.
文摘BACKGROUND Life-long removal of gluten from the diet is currently the only way to manage celiac disease(CeD).Until now,no objective test has proven useful to objectively detect ingested gluten in clinical practice.Recently,tests that determine consumption of gluten by assessing excretion of gluten immunogenic peptides(GIP)in stool and urine have been developed.Their utility,in comparison with conventional dietary and analytical follow-up strategies,has not been fully established.AIM To assess the performance of enzyme-linked immunosorbent assay(ELISA)and point-of-care tests(PoCTs)for GIP excretion in CeD patients on gluten-free diet(GFD).METHODS We conducted an observational,prospective,cross-sectional study in patients following a GFD for at least two years.Using the Gastrointestinal Symptom Rating Scale questionnaire,patients were classified at enrollment as asymptomatic or symptomatic.Gluten consumption was assessed twice by 3-d dietary recall and GIP excretion(by ELISA in stool and PoCTs(commercial kits for stool and urine)in two consecutive samples.These samples and dietary reports were obtained 10 day apart one from the other.Patients were encouraged to follow their usual GFD during the study period.RESULTS Forty-four patients were enrolled,of which 19(43.2%)were symptomatic despite being on a GFD.Overall,83 sets of stool and/or urine samples were collected.Eleven out of 44 patients(25.0%)had at least one positive GIP test.The occurrence of at least one positive test was 32%in asymptomatic patients compared with 15.8%in symptomatic patients.GIP was concordant with dietary reports in 65.9%of cases(Cohen′s kappa:0.317).PoCT detected dietary indiscretions.Both ELISA and PoCT in stool were concordant(concomitantly positive or negative)in 67 out of 74(90.5%)samples.Excretion of GIP was detected in 7(8.4%)stool and/or urine samples from patients considered to be strictly compliant with the GFD by dietary reports.CONCLUSION GIP detects dietary transgressions in patients on long-term GFD,irrespective of the presence of symptoms.PoCT for GIP detection constitutes a simple homebased method for self-assessment of dietary indiscretions.
基金Supported by Ministerio de Ciencia e Innovación,No.DI-16-08943 and No.DI-17-09627.
文摘BACKGROUND Gluten is a complex mixture of proteins with immunogenic peptide sequences triggering the autoimmune activity in patients with celiac disease(CeD).Gluten immunogenic peptides(GIP)are resistant to gastrointestinal digestion and are then excreted via the stool and urine.Most common detection methods applied in the follow-up visits for CeD patients such as serology tests,dietetic interviews,questionnaires,and duodenal biopsy have been proved to be inefficient,invasive,or inaccurate for evaluating gluten-free diet(GFD)compliance.Determination of excreted GIP in stool and urine has been developed as a non-invasive,direct,and specific test for GFD monitoring.AIM To summarize published literature about the clinical utility of GIP determination in comparison to the tools employed for GFD monitoring.METHODS PubMed and Web of Science searches were performed using the keywords“gluten immunogenic peptides”or“gluten immunogenic peptide”and a combination of the previous terms with“feces”,“stools”,“urine”,“celiac disease”,“gluten-free diet”,and“adherence”to identify relevant clinical studies published in English and Spanish between 2012 to January 2021.Reference lists from the articles were reviewed to identify additional pertinent articles.Published articles and abstracts reporting the clinical use of GIP determination in stool and/or urine for the follow-up of patients with CeD in comparison with other tools in use were included.Case reports,commentaries,reviews,conference papers,letters,and publications that did not focus on the aims of this review were excluded.RESULTS Total of 15 publications were found that involved the use of GIP determination in stool and/or urine to monitor the adherence to the GFD in comparison to other tools.Studies included both children and adults diagnosed with CeD and healthy volunteers.Overall,these preliminary studies indicated that this novel technique was highly sensitive for the detection of GFD transgressions and therefore could facilitate the follow-up of patients with CeD.Tools identified in this work included the CeD-specific serology,dietetic questionnaires,symptomatology,and the duodenal biopsy.Review of the literature revealed that the rates of GFD adherence may vary between 30%-93%using either stool or urine GIP determination,49%-96%by the serology,59%-94%using the dietetic questionnaires,56%-95%by the reported symptoms and 44%-76%with the duodenal biopsy.In addition,the association between the different methods and histological abnormalities(Marsh II-III)was found to be 33%-100%for GIP determination(stool and urine),25%-39%for CeD-specific serology,3%-50%for dietetic questionnaires,and 22%-28%for the symptomatology.CONCLUSION Excreted GIP detection is the precise approach for determining voluntary or involuntary gluten consumption in CeD patients preventing future complications arising from gluten exposure.
基金Supported by National Key Research and Development Program(2016YFD0400203)National Natural Science Foundation of China(31571780 and 31771897)+2 种基金General Science and Technology Research Projects of Zhengzhou(N2013G0077)Key Scientific Research Project of Universities in Henan Province(16A210018)the focus on Fostering Basic Research Fund of Henan University of Technology(2013JCYJ05)
文摘Significant correlations exist for the total sample between the dough viscoelastic properties and quality, but little information about these links is available. This study investigates the relationship between the gluten molecular conformation and the dough viscoelastic properties of the Zhengmai 379 wheat variety with different relative humidity(RH) values during storage.The results showed that protein extractability, free sulfhydryl(SH) groups, and wet gluten contents decreased to a certain degree during storage, while the glutenin quantity significantly varied. Significant negative correlation coefficients were found between the dough viscosity at 50% RH and the β-turn contents at 40% RH(-0.918) or 60% RH(-0.949)(P < 0.01), the dough viscosity at50% RH and the β-turn contents at 50% RH(-0.912)(P < 0.05), and the dough viscosity at 50% RH and the α-helix/β-sheet ratio at 40% RH(-0.875), 50% RH(-0.869), or 60% RH(-0.843)(P < 0.05). Significant correlation coefficients were further observed between the dough viscosity at 50% RH and the β-sheet contents at 60% RH(0.927)(P < 0.01) and between the dough viscosity at50% RH and the β-sheet contents at 40% RH(0.910) or 50% RH(0.908)(P < 0.05). A decrease in the free SH groups of gluten and an increase in the low-molecular weight contents suggested that gliadin was incorporated via SS crosslinking to the glutenin-like protein, which did not dissolve in ethanol.
文摘Celiac Disease (CD) is an inherited, autoimmune disorder in which proteins from the grains wheat, rye and barley (collectively called gluten) damage the small intestine. The only treatment for CD is a strict, lifelong gluten-free diet. With a prevalence rate of about one in 100-133 people worldwide. Celiac disease is wide-spread across the globe. Unlike traditional allergies, which cause immediate reactions, gluten sensitivity is harder to pin down since it manifests gradually and in various forms like headaches, stomach cramps, bloating, anxiety, and depression. Due to complicated diagnosis procedure and lack of awareness, many cases are either misdiagnosed or not at all diagnosed in India and USA. In spite of high growth, gluten-free foods are facing problems to grain ground in Asian market, due to high price, lack of awareness about the products, large number of un-diagnosed cases and inefficient value chain for gluten-free products. One of the major issues in India and USA is very high prices of gluten-free foods as compared to regular food products. Globally, the market potential of gluten free products is estimated to be USD 4639.13 Million and USD 7594.43 Million in 2015 and 2020 respectively. The global gluten free food market is projected to grow with a CAGR between 9 percent and 10.2 percent during 2016-2022. The study on consumer preference of gluten-free foods would enable manufacturers of gluten-free foods to understand the current and evolving expectations of consumers and to design the products according. Study of two countries i.e., India and USA would enable manufacturers to understand the difference in choices and preferences related to gluten-free foods for both the nations. This study would help manufacturers of alternative wheat product to form the concrete marketing and product development strategy based on recent consumer behavior trends.
基金Supported by OTKA-84087/2010,-K81117,-K105530,-PD83431,-PD105361,"Lendulet"Research Grant LP2011-008,2011 and KMR_12-1-2012-0074Vannayáand Veres G are holders of the János Bolyai Research Grant by János Bolyai Research Scholarship of the Hungarian Academy of Sciences
文摘Gluten-sensitive enteropathy,also known as coeliac disease(CD),is an autoimmune disorder occurring in genetically susceptible individuals that damages the small intestine and interferes with the absorption of other nutrients.As it is triggered by dietary gluten and related prolamins present in wheat,rye and barley,the accepted treatment for CD is a strict gluten-free diet.However,a complete exclusion of gluten-containing cereals from the diet is often difficult,and new therapeutic strategies are urgently needed.A class of proteins that have already emerged as drug targets for other autoimmune diseases are the heat shock proteins(HSPs),which are highly conserved stress-induced chaperones that protect cells against harmful extracellular factors.HSPs are expressed in several tissues,including the gastrointestinal tract,and their levels are significantly increased under stress circumstances.HSPs exert immunomodulatory effects,and also play a crucial role in the maintenance of epithelial cell structure and function,as they are responsible for adequate protein folding,influence the degradation of proteins and cell repair processes after damage,and modulate cell signalling,cell proliferation and apoptosis.The present review discusses the involvement of HSPs in the pathophysiology of CD.Furthermore,HSPs may represent a useful therapeutic target for the treatment of CD due to the cytoprotective,immunomodulatory,and anti-apoptotic effects in the intestinal mucosal barrier.
文摘Celiac disease, gluten-allergy or gluten-sensitivity is caused due to glutamine protein from the grains like wheat, rye and barley (collectively called gluten). This protein damages the small intestine and causes stomach pain, bloating, weakness etc. Celiac disease, gluten-allergy or gluten-sensitivity has never really been taken seriously in developing countries like India. However, in developed nations like UK, USA, Canada and other parts of Europe, gluten-free foods have become quite popular. With a prevalence rate of about one in 100 - 133 people worldwide, celiac disease is widespread across the globe and life-long consumption of gluten-free food is recommended treatment for this allergy. Apart from celiac-disease patients, gluten-free foods are also consumed by health conscious people for weight management and high protein diet and by the patients for diabetes, autism and food allergies. Apart from gluten-free flour, biscuits, cookies and snacks, product innovations like gluten-free beers are becoming very popular. Big data including online blogs, articles, and reviews have played a major role in increased sales of gluten-free foods. Thus, analysis of editorial and social media content becomes essential to understand the leading trends in gluten-free foods. This study provided deep insights about positive, negative and neutral sentiments related to gluten-free foods using the data from Perspectory Media Insights and Google Trends. This study also revealed that most of the consumers talked and expected product innovation in food sections like snacks, fast food (pizza, pasta and noodles) and desserts through comments on social and editorial media. Searches were divided into developed (e.g., U.S.A.) and developing nations (e.g., India) to get more details about the consumer preferences. This study would help manufacturers of gluten-free foods to develop food products according to the choices and preferences of consumers. The study is very unique in itself since it combines big data to niche food market of gluten-free foods to draw the valuable consumer preferences using online platforms.
基金Supported by The European Union-NextGenerationEU,Through The National Recov-ery and Resilience Plan of the Republic of Bulgaria,No.BG-RRP-2.004-0008。
文摘Gluten ataxia and other central nervous system disorders could be linked to gluten enteropathy and related autoantibodies.In this narrative review,we focus on the various neuro-logical manifestations in patients with gluten sensitivity/celiac disease,immunological and autoimmune mechanisms of ataxia in connection to gluten sensitivity and the autoantibodies that could be used as a biomarker for diagnosing and following.We focused on the anti-gliadin antibodies,antibodies to different isoforms of tissue transglutaminase(TG)(anti-TG2,3,and 6 antibodies),anti-glycine receptor antibodies,anti-glutamine acid decarboxylase antibodies,anti-deamidated gliadin peptides antibodies,etc.Most studies found a higher prevalence of these antibodies in patients with gluten sensitivity and neurological dysfunction,presented as different neurological disorders.We also discuss the role of a gluten-free diet on the clinical improvement of patients and also on imaging of these disorders.
文摘This study investigated how a gluten-free diet affects hormones, with particular emphasis on cortisol, thyroid, insulin, and sex hormones. Background: For medical diseases such as non-celiac gluten sensitivity, wheat allergy, and celiac disease, a gluten-free diet is important. The main area of concern for research is how a gluten-free diet can affect hormone levels and related health consequences. A review of the body of research on this topic, including studies on hormone regulation and the impact of dietary modifications, is a part of the methodology. These findings imply that a gluten-free diet may have an impact on hormone levels, which may affect metabolism, weight, and general health. These implications include the need for additional studies, particularly in those with autoimmune illnesses, to completely comprehend the relationship between a gluten-free diet and hormone regulation.
