Celiac disease is believed to be a permanent intolerance to gluten.
The team found a number of patients, however, discontinue the gluten-free diet without developing symptoms or signs.
|2 patients that developed tolerance to gluten|
|European Journal of Gastroenterology & Hepatology|
Dr Erica Hopman and colleagues investigated whether celiac disease patients are capable of developing tolerance to gluten.
The team invited all 77 adult patients from their hospital known to have biopsy-proven celiac disease for more than 10 years to participate.
The team investigated symptoms, gluten consumption, antibodies for celiac disease and other autoimmunity.
The research also performed human leukocyte antigen-typing, small bowel biopsies, and measured bone mineral density.
Tolerance was defined as no immunological or histological signs of celiac disease while consuming gluten.
The researchers reported that 66 patients accepted participation, but after review of the diagnostic biopsies 53 were found to have true celiac disease.The team found that 23% of patients had a gluten-containing diet, 15% admitted gluten transgression and 62% followed the gluten-free diet.
Patients on a gluten-free diet had significantly more osteoporosis.
The team found normal small bowel mucosa in 4 of 8 on gluten-containing diet, and in 4 of 4 with gluten transgression.
The research team identified 2 patients that developed tolerance to gluten, of which 1 was human leukocyte antigen-DQ2/DQ8 negative.
Dr Hopman‘s team concluded, "Development of tolerance to gluten seems possible in some patients with celiac disease."
"Further follow-up will show whether this tolerance is permanent or only a long-term return to latency."
"This feature may be associated with genetic characteristics, especially with human leukocyte antigen genotypes that differ from DQ2 or DQ8."
"More insight into the mechanisms of the development of gluten tolerance may help to distinguish those celiac disease patients that might not require life-long gluten-free diet."