A gluten-free diet is currently the only reliable therapeutic strategy that is approved for celiac disease.
For many patients, however, compliance remains inadequate.
Dr Gianfrani and from Italy investigated the immunogenicity of wheat flour that was pre-treated with selected lactobacilli and fungal proteases (hydrolyzed wheat gluten) in celiac patients.
The immunogenicity of hydrolyzed wheat gluten was evaluated both in vitro in intestinal T cell lines, and in vivo in treated celiac disease patients after a short-term gluten challenge.
The researchers enrolled 20 treated celiac disease patients, and equally randomized the patients into 2 groups.
|Consumption of natural wheat gluten mobilized interferon secreting cells in the blood|
|Annals of Internal Medicine|
The patients ate bread that was prepared with hydrolyzed wheat flour or natural wheat flour.
The team assessed the interferon responses to natural gliadin and a 33-mer peptide by the enzyme-linked immunospot (ELISPOT) assay on peripheral blood mononuclear cells both before and 6 days after the start of the challenge.
The researchers found that hydrolyzed wheat was not able to activate the T cell lines from the celiac intestinal mucosa.
Consistent with the in vitro results, no significant increase in interferon secretion was observed in patients who consumed hydrolyzed wheat flour.
The researchers found that the consumption of natural wheat gluten mobilized interferon secreting cells in the blood.
Dr Gianfrani's team concludes, "We confirm that fermentation of wheat flour with sourdough lactobacilli and fungal proteases is capable of abolishing the T cell immunogenicity of gluten in celiac patients."
"Our data also validate the short-term oral challenge as a useful tool for testing the efficacy of novel therapeutic approaches."