No sign of gliadin immunoreactivity indu ced by hydrolyzed wheat flour in celiac disease children after a short oral challenge
MetadataShow full item record
Background: Many efforts are going on to find new strategies to detoxify wheat flour in order to make it suitable for the diet of celiac disease (CD) patients. Fermentation of wheat flour with sourdough lactobacilli and fungal proteases has already been demonstrated to reduce gluten-induced inflammatory effects in celiac patients. Aim: In this study, we evaluated the effect of detoxified flour on peripheral blood immune response after a brief oral challenge in subjects with treated CD. Methods: Four CD patients on a gluten-free diet from at least 2 years were voluntarily enrolled in the study. They ate for 3 days bread made of fermented flour (12 g gluten/die). Immune reactivity to gliadin, either from detoxified or toxic wheat, was analyzed on peripheral blood cells by detecting INF-γ releasing cells before and 6 days after the challenge. Results: No INF-γ secreting CD4+ T cells reactive to hydrolyzed gliadin with sourdough lactobacilli and fungal proteases were detected on day 6 of the challenge in any of 4 patients tested, instead of a consistent mobilization of T cells reactive to a pepsin-trypsin gliadin observed in celiac patients on a gluten-free diet consuming toxic wheat flour. Conclusion: This in vivo challenge confirms that fermentation of wheat with sourdough lactobacilli and fungal proteases reduces gluten-specific immunoreactivity in PBMCs. Moreover, our data demonstrate that the in vivo procedure can be a good method to test new therapeutics approach in the future.