The gluten-free diet: testing alternative cereals tolerated by celiac patients

Nutrients. 2013 Oct 23;5(10):4250-68. doi: 10.3390/nu5104250.

Abstract

A strict gluten-free diet (GFD) is the only currently available therapeutic treatment for patients with celiac disease, an autoimmune disorder of the small intestine associated with a permanent intolerance to gluten proteins. The complete elimination of gluten proteins contained in cereals from the diet is the key to celiac disease management. However, this generates numerous social and economic repercussions due to the ubiquity of gluten in foods. The research presented in this review focuses on the current status of alternative cereals and pseudocereals and their derivatives obtained by natural selection, breeding programs and transgenic or enzymatic technology, potential tolerated by celiac people. Finally, we describe several strategies for detoxification of dietary gluten. These included enzymatic cleavage of gliadin fragment by Prolyl endopeptidases (PEPs) from different organisms, degradation of toxic peptides by germinating cereal enzymes and transamidation of cereal flours. This information can be used to search for and develop cereals with the baking and nutritional qualities of toxic cereals, but which do not exacerbate this condition.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Celiac Disease / diet therapy*
  • Diet, Gluten-Free*
  • Edible Grain / chemistry*
  • Gliadin / metabolism
  • Humans
  • Intestine, Small / drug effects
  • Intestine, Small / pathology
  • Prolyl Oligopeptidases
  • Serine Endopeptidases / metabolism

Substances

  • Gliadin
  • Serine Endopeptidases
  • PREPL protein, human
  • Prolyl Oligopeptidases