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Wheat starch-containing gluten-free flour products in the treatment of coeliac disease and dermatitis herpetiformis. A long-term follow-up study.
Scand J Gastroenterol 1999; 34(2):163-9SJ

Abstract

BACKGROUND

We investigated whether wheat starch-based gluten-free products are safe in the treatment of gluten intolerance.

METHODS

The study involved 41 children and adults with coeliac disease and 11 adults with dermatitis herpetiformis adhering to a gluten-free diet for 8 years on average. Thirty-five newly diagnosed coeliac patients at diagnosis and 6 to 24 months after the start of a gluten-free diet and 27 non-coeliac patients with dyspepsia were investigated for comparison. Daily dietary gluten and wheat starch intake were calculated. Small-bowel mucosal villous architecture, CD3+, alphabeta+, and gammadelta+ intraepithelial lymphocytes, mucosal HLA-DR expression, and serum endomysial, reticulin, and gliadin antibodies were investigated.

RESULTS

Forty of 52 long-term-treated patients adhered to a strict wheat starch-based diet and 6 to a strict naturally gluten-free diet; 6 patients had dietary lapses. In the 46 patients on a strict diet the villous architecture, enterocyte height, and density of alphabeta+ intraepithelial lymphocytes were similar to those in non-coeliac subjects and better than in short-term-treated coeliac patients. The density of gammadelta(+)cells was higher, but they seemed to decrease over time with the gluten-free diet. Wheat starch-based gluten-free flour products did not cause aberrant upregulation of mucosal HLA-DR. The mucosal integrity was not dependent on the daily intake of wheat starch in all patients on a strict diet, whereas two of the six patients with dietary lapses had villous atrophy and positive serology.

CONCLUSION

Wheat starch-based gluten-free flour products were not harmful in the treatment of coeliac disease and dermatitis herpetiformis.

Authors+Show Affiliations

Dept. of Medicine, Tampere University Hospital, Finland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10192194

Citation

Kaukinen, K, et al. "Wheat Starch-containing Gluten-free Flour Products in the Treatment of Coeliac Disease and Dermatitis Herpetiformis. a Long-term Follow-up Study." Scandinavian Journal of Gastroenterology, vol. 34, no. 2, 1999, pp. 163-9.
Kaukinen K, Collin P, Holm K, et al. Wheat starch-containing gluten-free flour products in the treatment of coeliac disease and dermatitis herpetiformis. A long-term follow-up study. Scand J Gastroenterol. 1999;34(2):163-9.
Kaukinen, K., Collin, P., Holm, K., Rantala, I., Vuolteenaho, N., Reunala, T., & Mäki, M. (1999). Wheat starch-containing gluten-free flour products in the treatment of coeliac disease and dermatitis herpetiformis. A long-term follow-up study. Scandinavian Journal of Gastroenterology, 34(2), pp. 163-9.
Kaukinen K, et al. Wheat Starch-containing Gluten-free Flour Products in the Treatment of Coeliac Disease and Dermatitis Herpetiformis. a Long-term Follow-up Study. Scand J Gastroenterol. 1999;34(2):163-9. PubMed PMID: 10192194.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Wheat starch-containing gluten-free flour products in the treatment of coeliac disease and dermatitis herpetiformis. A long-term follow-up study. AU - Kaukinen,K, AU - Collin,P, AU - Holm,K, AU - Rantala,I, AU - Vuolteenaho,N, AU - Reunala,T, AU - Mäki,M, PY - 1999/4/7/pubmed PY - 1999/4/7/medline PY - 1999/4/7/entrez SP - 163 EP - 9 JF - Scandinavian journal of gastroenterology JO - Scand. J. Gastroenterol. VL - 34 IS - 2 N2 - BACKGROUND: We investigated whether wheat starch-based gluten-free products are safe in the treatment of gluten intolerance. METHODS: The study involved 41 children and adults with coeliac disease and 11 adults with dermatitis herpetiformis adhering to a gluten-free diet for 8 years on average. Thirty-five newly diagnosed coeliac patients at diagnosis and 6 to 24 months after the start of a gluten-free diet and 27 non-coeliac patients with dyspepsia were investigated for comparison. Daily dietary gluten and wheat starch intake were calculated. Small-bowel mucosal villous architecture, CD3+, alphabeta+, and gammadelta+ intraepithelial lymphocytes, mucosal HLA-DR expression, and serum endomysial, reticulin, and gliadin antibodies were investigated. RESULTS: Forty of 52 long-term-treated patients adhered to a strict wheat starch-based diet and 6 to a strict naturally gluten-free diet; 6 patients had dietary lapses. In the 46 patients on a strict diet the villous architecture, enterocyte height, and density of alphabeta+ intraepithelial lymphocytes were similar to those in non-coeliac subjects and better than in short-term-treated coeliac patients. The density of gammadelta(+)cells was higher, but they seemed to decrease over time with the gluten-free diet. Wheat starch-based gluten-free flour products did not cause aberrant upregulation of mucosal HLA-DR. The mucosal integrity was not dependent on the daily intake of wheat starch in all patients on a strict diet, whereas two of the six patients with dietary lapses had villous atrophy and positive serology. CONCLUSION: Wheat starch-based gluten-free flour products were not harmful in the treatment of coeliac disease and dermatitis herpetiformis. SN - 0036-5521 UR - https://www.unboundmedicine.com/medline/citation/10192194/Wheat_starch_containing_gluten_free_flour_products_in_the_treatment_of_coeliac_disease_and_dermatitis_herpetiformis__A_long_term_follow_up_study_ L2 - http://www.tandfonline.com/doi/full/10.1080/00365529950173023 DB - PRIME DP - Unbound Medicine ER -