Immunologic evidence of no harmful effect of oats in celiac disease.
BACKGROUND
It was recently shown that antiendomysial antibodies (EMAs), which are highly sensitive and specific for celiac disease, are produced by intestinal mucosa. Furthermore, EMAs were detected previously in supernatant fluid from cultured duodenal mucosa specimens collected from untreated celiac disease patients and in culture media of biopsy specimens collected from treated celiac disease patients after an in vitro challenge with gliadin. Moreover, it was recently shown in vivo that oats are not toxic to celiac disease patients, suggesting the safety of oats in a gluten free-diet.


OBJECTIVE
The objective was to better define the controversial role of oats in celiac disease to determine whether oats can be safely included in a gluten-free diet.


METHODS
We used an in vitro model to test whether oats induce EMA production in supernatant fluid from cultured duodenal mucosa specimens collected from 13 treated celiac disease patients. The biopsy specimens were cultured with and without peptic-tryptic digest (PT) of gliadin and avenin (from oats) and in medium alone. Samples from 5 of the 13 patients were cultured with the C fraction of PT-avenin. Indirect immunofluorescence was used to detect EMAs.


RESULTS
EMAs were detected in specimens from all 13 patients after the challenge with gliadin but not after culture in medium alone. By contrast, no EMAs were detected in any of the specimens cultured with PT-avenin and its C fraction.


CONCLUSIONS
Because the in vitro challenge with PT-avenin and its C fraction did not induce EMA production in treated celiac disease patients, it appears that oats have no harmful effect on celiac disease. Therefore, oats can be safely included in a gluten-free diet.
Picarelli
A
A
Department of Clinical Sciences, University of Rome "La Sapienza", Italy. a.picarelli@flashnet.it
Di Tola
M
M
Sabbatella
L
L
Gabrielli
F
F
Di Cello
T
T
Anania
M C
MC
Mastracchio
A
A
Silano
M
M
De Vincenzi
M
M
D000293:Adolescent; D000328:Adult; D000917:Antibody Formation; D018554:Avena / Q000009:adverse effects*; D001706:Biopsy; D016022:Case-Control Studies; D002446:Celiac Disease / Q000178:diet therapy / Q000276:immunology*; D003470:Culture Media; D046508:Culture Techniques; D004386:Duodenum / Q000276:immunology*; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D005903:Gliadin / Q000276:immunology; D005983:Glutens; D006801:Humans; D007413:Intestinal Mucosa / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D010940:Plant Proteins / Q000276:immunology; D055315:Prolamins; D012449:Safety
D003470:Culture Media; D010940:Plant Proteins; D055315:Prolamins; D005983:Glutens; D005903:Gliadin