<<Disclaimer: Verify this information before applying it to your situation.>>
 
Comments on the letter from Charlie in The Big Apple about the possibility
that cigarettes might incorporate a glue made from gluten.
 
from:  Don Kasarda, Albany, CA
 
First, of all, it would be helpful to me to know how Charlie was diagnosed
as having celiac disease and if the diagnosis was solid.  Secondly, I would
like to know if it was definitely licking the envelope that caused him
intestinal distess.  It is possible, I think, for people to make the
unwarranted jump from, "I licked the envelope" and "I got sick" to "licking
the envelope made me sick."
 
If, in fact, Charlie is that sensitive to gluten, however, I will predict
that either he does not have celiac disease, but rather a Type I immediate
hypersensitivity to gluten, one probably mediated by IgE antibodies, or that
he has both the Type I sensitivity and a Type IV delayed hypersensitivity--
the latter being considered characteristic of celiac disease and determined
primarily by a cellular response (involving T cells) rather than an antibody
response.  There may be a semantic problem or an arbitrary difference in
classification terminologies, but some immunologists (e.  g., Janeway and
Travers, Immunobiology 1994) would consider both Type I and Type IV reactions
as coming under the general heading of "allergy," whereas I have tended to
consider (possibly incorrectly because I am not an immunologist) that only
Type I responses are true "allergic" reactions.
 
I suspect that anyone who reacts with strong symptoms within a couple of
hours of eating gluten has the Type I response, which may or may not be
accompanied by their having true celiac disease.  A Type I response could,
in theory, be caused by proteins found in wheat that are not gluten proteins
and do not initiate the processes in celiac patients that ultimately damage
the absorptive surface of the small intestine.
 
I have discussed this question of IgE antibodies with Vijay Kumar and he has
offered to try to obtain some test results for IgE antibodies that might
shed some light on my proposal.
 
I suspect that Charlie is unlikely to suffer any harm (at least, harm related
to celiac disease) from smoking a cigarette with a glue containing gluten in
it unless he is concerned about touching the glue with his mouth--in which
case, he might try getting himself a cigarette holder.  I would guess that
any gluten peptides are unlikely to carry through in the cigarette smoke.
They should be degraded in the burning.  If, in fact, Charlie had a
gluten-like reaction from cigarette smoke while using a cigarette holder,
that would be an interesting case--one worthy of description in the
scientific literature as it would indicate that the gluten peptides can
survive in truly trace amounts when a cigarette burns as detected by a truly
hypersensitive individual.
 
This is my personal opinion and it should not be considered medical advice
in any legal sense.