A randomised, double-blind, cross-over trial to evaluate bread, in which gluten has been pre-digested by prolyl endoprotease treatment, in subjects self-reporting benefits of adopting a gluten-free or low-gluten diet

Br J Nutr. 2018 Mar;119(5):496-506. doi: 10.1017/S0007114517003749.

Abstract

The aim of the present study was to determine if the enzyme Aspergillus niger prolyl endoprotease (ANPEP), which degrades the immunogenic proline-rich residues in gluten peptides, can be used in the development of new wheat products, suitable for gluten-sensitive (GS) individuals. We have carried out a double-blind, randomised, cross-over trial with two groups of adults; subjects, self-reporting benefits of adopting a gluten-free or low-gluten diet (GS, n 16) and a control non-GS group (n 12). For the trial, volunteers consumed four wheat breads: normal bread, bread treated with 0·8 or 1 % ANPEP and low-protein bread made from biscuit flour. Compared with controls, GS subjects had a favourable cardiovascular lipid profile - lower LDL (4·0 (sem 0·3) v. 2·8 (sem 0·2) mmol/l; P=0·008) and LDL:HDL ratio (3·2 (sem 0·4) v. 1·8 (sem 0·2); P=0·005) and modified haematological profile. The majority of the GS subjects followed a low-gluten lifestyle, which helps to reduce the gastrointestinal (GI) symptoms severity. The low-gluten lifestyle does not have any effect on the quality of life, fatigue or mental state of this population. Consumption of normal wheat bread increased GI symptoms in GS subjects compared with their habitual diet. ANPEP lowered the immunogenic gluten in the treated bread by approximately 40 %. However, when compared with the control bread for inducing GI symptoms, no treatment effects were apparent. ANPEP can be applied in the production of bread with taste, texture and appearance comparable with standard bread.

Trial registration: ClinicalTrials.gov NCT02308397.

Keywords: Aspergillus niger prolyl endoprotease; ANPEP Aspergillus niger prolyl endoprotease; CD coeliac disease; Di-; FODMAP Fermentable; GFD gluten-free diet; GI gastrointestinal; GS gluten sensitive; Mono-saccharides and Polyols; NCGS non-coeliac gluten sensitive; Oligo-; SF-36 36-Item Short Form Health Survey; VAS visual analogue scale; Enzymes; Gastrointestinal symptoms; Gluten sensitivity; Lipid profile.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aspergillus niger / enzymology*
  • Bread / analysis*
  • Cardiovascular Diseases / blood
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Cross-Over Studies
  • Diet, Gluten-Free*
  • Digestion*
  • Double-Blind Method
  • Feeding Behavior
  • Female
  • Flour / analysis
  • Food Intolerance / complications
  • Food Intolerance / diet therapy*
  • Fungal Proteins / metabolism
  • Gastrointestinal Diseases / etiology
  • Gastrointestinal Diseases / prevention & control
  • Glutens* / administration & dosage
  • Glutens* / adverse effects
  • Glutens* / metabolism
  • Hematology
  • Humans
  • Male
  • Middle Aged
  • Prolyl Oligopeptidases
  • Serine Endopeptidases / metabolism*
  • Triticum / chemistry

Substances

  • Cholesterol, HDL
  • Cholesterol, LDL
  • Fungal Proteins
  • Glutens
  • Serine Endopeptidases
  • PREPL protein, human
  • Prolyl Oligopeptidases

Associated data

  • ClinicalTrials.gov/NCT02308397