Reintroduction of Gluten Following Flour Transamidation in Adult Celiac Patients: A Randomized, Controlled Clinical Study
A lifelong gluten-free diet (GFD) is mandatory for celiac disease (CD) but has poor compliance, justifying novel strategies. We found that wheat flour transamidation inhibited IFN-γ secretion by intestinal T cells from CD patients. Herein, the primary endpoint was to evaluate the ability of transami...
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Wiley
2012-01-01
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| Series: | Clinical and Developmental Immunology |
| Online Access: | http://dx.doi.org/10.1155/2012/329150 |
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| author | Giuseppe Mazzarella Virginia M. Salvati Gaetano Iaquinto Rosita Stefanile Federica Capobianco Diomira Luongo Paolo Bergamo Francesco Maurano Nicola Giardullo Basilio Malamisura Mauro Rossi |
| author_facet | Giuseppe Mazzarella Virginia M. Salvati Gaetano Iaquinto Rosita Stefanile Federica Capobianco Diomira Luongo Paolo Bergamo Francesco Maurano Nicola Giardullo Basilio Malamisura Mauro Rossi |
| author_sort | Giuseppe Mazzarella |
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| description | A lifelong gluten-free diet (GFD) is mandatory for celiac disease (CD) but has poor compliance, justifying novel strategies. We found that wheat flour transamidation inhibited IFN-γ secretion by intestinal T cells from CD patients. Herein, the primary endpoint was to evaluate the ability of transamidated gluten to maintain GFD CD patients in clinical remission. Secondary endpoints were efficacy in prevention of the inflammatory response and safety at the kidney level, where reaction products are metabolized. In a randomized single blinded, controlled 90-day trial, 47 GFD CD patients received 3.7 g/day of gluten from nontransamidated (12) or transamidated (35) flour. On day 15, 75% and 37% of patients in the control and experimental groups, respectively, showed clinical relapse (𝑃=0.04) whereas intestinal permeability was mainly altered in the control group (50% versus 20%, 𝑃=0.06). On day 90, 0 controls and 14 patients in the experimental group completed the challenge with no variation of antitransglutaminase IgA (𝑃=0.63), Marsh-Oberhuber grading (𝑃=0.08), or intestinal IFN-γ mRNA (𝑃>0.05). Creatinine clearance did not vary after 90 days of treatment (𝑃=0.46). In conclusion, transamidated gluten reduced the number of clinical relapses in challenged patients with no changes of baseline values for serological/mucosal CD markers and an unaltered kidney function. |
| format | Article |
| id | doaj-art-2fd22a7e4c144eb2ba1dd5847c007b45 |
| institution | DOAJ |
| issn | 1740-2522 1740-2530 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
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| series | Clinical and Developmental Immunology |
| spelling | doaj-art-2fd22a7e4c144eb2ba1dd5847c007b452025-08-20T03:20:22ZengWileyClinical and Developmental Immunology1740-25221740-25302012-01-01201210.1155/2012/329150329150Reintroduction of Gluten Following Flour Transamidation in Adult Celiac Patients: A Randomized, Controlled Clinical StudyGiuseppe Mazzarella0Virginia M. Salvati1Gaetano Iaquinto2Rosita Stefanile3Federica Capobianco4Diomira Luongo5Paolo Bergamo6Francesco Maurano7Nicola Giardullo8Basilio Malamisura9Mauro Rossi10Institute of Food Sciences, CNR, 83100 Avellino, ItalyCenter for Coeliac Disease S. Maria dell'Olmo Hospital, 84013 Cava de' Tirreni Salerno, ItalyGastroenterology Department, San G. Moscati Hospital, 83100 Avellino, ItalyInstitute of Food Sciences, CNR, 83100 Avellino, ItalyIPALC Research & Development, 83040 Frigento, AV, ItalyInstitute of Food Sciences, CNR, 83100 Avellino, ItalyInstitute of Food Sciences, CNR, 83100 Avellino, ItalyInstitute of Food Sciences, CNR, 83100 Avellino, ItalyGastroenterology Department, San G. Moscati Hospital, 83100 Avellino, ItalyCenter for Coeliac Disease S. Maria dell'Olmo Hospital, 84013 Cava de' Tirreni Salerno, ItalyInstitute of Food Sciences, CNR, 83100 Avellino, ItalyA lifelong gluten-free diet (GFD) is mandatory for celiac disease (CD) but has poor compliance, justifying novel strategies. We found that wheat flour transamidation inhibited IFN-γ secretion by intestinal T cells from CD patients. Herein, the primary endpoint was to evaluate the ability of transamidated gluten to maintain GFD CD patients in clinical remission. Secondary endpoints were efficacy in prevention of the inflammatory response and safety at the kidney level, where reaction products are metabolized. In a randomized single blinded, controlled 90-day trial, 47 GFD CD patients received 3.7 g/day of gluten from nontransamidated (12) or transamidated (35) flour. On day 15, 75% and 37% of patients in the control and experimental groups, respectively, showed clinical relapse (𝑃=0.04) whereas intestinal permeability was mainly altered in the control group (50% versus 20%, 𝑃=0.06). On day 90, 0 controls and 14 patients in the experimental group completed the challenge with no variation of antitransglutaminase IgA (𝑃=0.63), Marsh-Oberhuber grading (𝑃=0.08), or intestinal IFN-γ mRNA (𝑃>0.05). Creatinine clearance did not vary after 90 days of treatment (𝑃=0.46). In conclusion, transamidated gluten reduced the number of clinical relapses in challenged patients with no changes of baseline values for serological/mucosal CD markers and an unaltered kidney function.http://dx.doi.org/10.1155/2012/329150 |
| spellingShingle | Giuseppe Mazzarella Virginia M. Salvati Gaetano Iaquinto Rosita Stefanile Federica Capobianco Diomira Luongo Paolo Bergamo Francesco Maurano Nicola Giardullo Basilio Malamisura Mauro Rossi Reintroduction of Gluten Following Flour Transamidation in Adult Celiac Patients: A Randomized, Controlled Clinical Study Clinical and Developmental Immunology |
| title | Reintroduction of Gluten Following Flour Transamidation in Adult
Celiac Patients: A Randomized, Controlled Clinical Study |
| title_full | Reintroduction of Gluten Following Flour Transamidation in Adult
Celiac Patients: A Randomized, Controlled Clinical Study |
| title_fullStr | Reintroduction of Gluten Following Flour Transamidation in Adult
Celiac Patients: A Randomized, Controlled Clinical Study |
| title_full_unstemmed | Reintroduction of Gluten Following Flour Transamidation in Adult
Celiac Patients: A Randomized, Controlled Clinical Study |
| title_short | Reintroduction of Gluten Following Flour Transamidation in Adult
Celiac Patients: A Randomized, Controlled Clinical Study |
| title_sort | reintroduction of gluten following flour transamidation in adult celiac patients a randomized controlled clinical study |
| url | http://dx.doi.org/10.1155/2012/329150 |
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