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Oats Not Safe For All & Psoriasis Linked to CD
Oats have seemed to be safe and tolerated by most, but not all, celiacs in
past studies. However, this new study in Public Library of Science
Medicine confirms that some celiacs are intolerant to oats. Below are a
Reuters Health story (free Medscape registration may be required) and the
original PLoS Medicine articles including free full text of the study.
Also below, a PubMed abstract of a study showing a closer link between
celiac disease and psoriasis.
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Oats Not Safe for All Celiac Disease Patients
NEW YORK (Reuters Health) Oct 19 - Some patients with celiac disease cannot
tolerate oats in their diet, a European team reports.
http://www.medscape.com/viewarticle/491638
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Oats Intolerance in Celiac Disease
DOI: 10.1371/journal.pmed.0010023
PLoS Medicine
Published October 19, 2004
Copyright: © 2004 Public Library of Science. This is an open-access article
distributed under the terms of the Creative Commons Public Domain
Declaration, which stipulates that, once placed in the public domain, this
work may be freely reproduced, distributed, transmitted, modified, built
upon, or otherwise used by anyone for any lawful purpose.
Table of Contents:
http://medicine.plosjournals.org
http://medicine.plosjournals.org/perlserv/?request=index-html&issn=1549-1676
Free Full HTML text -
(Paste address together or select article from Table Of Contents):
The Molecular Basis for Oat Intolerance
http://medicine.plosjournals.org/perlserv/?request=get-
document&doi=10.1371/journal.pmed.0010001
SYNOPSIS
Most patients with celiac disease can eliminate their symptoms--at a price:
life-long adherence to a gluten-free diet. This means no wheat, rye,
barley, and, until recently, no oats. Then some recent studies suggested
that oats did not cause the intestinal inflammation characteristic of the
disease, and thus oats are now often included in the celiac disease diet.
This is good news for patients coping with severe restrictions on what they
can and must not eat, but a study by Ludvig Sollid and colleagues in this
issue of PLoS Medicine suggests that oats are not safe in all cases.
Like other chronic inflammatory diseases, celiac disease is caused by a
complex interplay between genetic and environmental factors, but it is
better understood than most. Long believed to be a relatively rare
disorder, it is now thought to affect about one in 250 people worldwide.
Clinical symptoms are present in less than half of patients and vary
considerably. Genetically, almost all patients have one of two predisposing
HLA molecules, which determine the context in which their immune system
encounters foreign antigens, including gluten proteins found in wheat and
other cereals. In individuals with celiac disease, the immune system mounts
an abnormal response to gluten, which is characterized by gluten-reactive
intestinal T cells and by inflammation and compromised function of the
small intestine.
Ludvig Sollid and colleagues applied the current understanding of celiac
disease and a range of molecular pathology tools to studying the response
to oats of nine patients with celiac disease. The nine patients were not a
random sample: all of them had been eating oats, and four of them had shown
clinical symptoms after oats ingestion. The goal of the study was to
characterize the intestinal T cell response to oats in these patients, and
to relate it to clinical symptoms and intestinal biopsy results. All
patients were on a gluten-free diet and ate oats that were free of
contamination by other cereals.
Three of the four patients who had reported problems after eating oats
showed intestinal inflammation typical of celiac disease, and Sollid and
colleagues studied intestinal T cells from these three patients. Two of the
five patients who seemed to tolerate oats also had oats-reactive intestinal
T cells. Functional study of these T cells showed that they were restricted
to celiac-disease-associated HLA molecules and that they recognized two
peptides derived from oat avenin that are very similar to peptides of
gluten.
Taken together, the findings show that intolerance to oats exists at least
in some patients with celiac disease, and that those patients have the same
molecular reaction to oats that other patients have to wheat, barley, or
rye. However, identical reactions were also seen in two of the patients who
were clinically tolerant to oats. The authors suggest that these reactions
could develop into symptomatic disease after some time delay, but there is
no proof that the presence of oats-reactive T cells is an indicator of
future symptoms or even of enhanced susceptibility to clinical oats
intolerance.
Oats are not safe for all patients with celiac disease, but future studies
are needed to determine the frequency of oats intolerance.
---
PLoS Medicine is an open-access journal published by the nonprofit
organization Public Library of Science.
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Br J Dermatol. 2004 Oct;151(4):891-4
Coeliac disease-associated antibodies correlate with psoriasis activity.
Woo WK, McMillan SA, Watson RG, McCluggage WG, Sloan JM, McMillan JC.
Department of Dermatology, Belfast City Hospital, Belfast, U.K.
Summary Background Antigliadin antibodies (AGA) have been reported in
patients with psoriasis. Objectives To determine if AGA and other coeliac
disease (CD)-associated antibodies correlate with clinical features and
activity in patients with psoriasis. Methods Patients with psoriasis (n =
130) were investigated for serum IgG and IgA AGA, IgA antitransglutaminase
antibody and IgA antiendomysial antibody. Disease characteristics and
associated bowel and joint symptoms were determined. All patients were
invited to undertake endoscopy with duodenal biopsy. Results A
significantly higher proportion of patients with elevated CD-associated
antibody levels was currently on or had previously required systemic
immunosuppressants (methotrexate, ciclosporin or etretinate; P = 0.04) or
psoralen plus ultraviolet A phototherapy (P = 0.03). One case of CD was
diagnosed. Conclusions The presence of CD-associated antibodies in
psoriasis patients correlates with greater disease activity.
PMID: 15491433 [PubMed - in process]
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