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Oats do not induce systemic or mucosal autoantibody response in children with coeliac disease.
J Pediatr Gastroenterol Nutr. 2009 May; 48(5):559-65.JP

Abstract

OBJECTIVES

A gluten-free diet omitting wheat, rye, and barley is the only effective treatment for coeliac disease. The necessity of excluding oats from the diet has remained controversial. We studied the toxicity of oats in children with coeliac disease during a 2-year follow-up by investigating jejunal transglutaminase 2 (TG2)-targeted IgA-class autoantibody deposits, a potentially more sensitive disease marker than serum antibodies or conventional histology.

PATIENTS AND METHODS

Twenty-three coeliac children in remission were randomized to undergo oat or gluten challenge with wheat, rye, barley, and oats. When jejunal histological relapse was evident after gluten challenge, patients excluded wheat, rye, and barley but continued with oats. Mucosal morphology and TG2-targeted autoantibody deposits were studied in jejunal biopsies taken at baseline and after 6 and 24 months. Furthermore, serum IgA-class TG2 antibodies were measured.

RESULTS

At baseline, serum TG2 antibodies were negative in all 23 patients, but 7 of them had minor mucosal deposits. In the oats group, there was no significant change in the intensity of the deposits within 2 years. In contrast, during the gluten challenge, the intensity of the deposits clearly increased and decreased again when wheat, rye, and barley were excluded but consumption of oats was continued; this was in line with serum autoantibodies. The intensity of the mucosal deposits correlated well with both villous morphology and serum autoantibody levels.

CONCLUSIONS

Consumption of oats does not induce TG2 autoantibody production at mucosal level in children with coeliac disease. Measurement of small-intestinal mucosal autoantibody deposits is suitable for monitoring treatment in coeliac patients.

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Authors+Show Affiliations

Koskinen O
Paediatric Research Centre, University of Tampere, Tampere, Finland.
Villanen M
No affiliation info available
Korponay-Szabo I
No affiliation info available
Lindfors K
No affiliation info available
Mäki M
No affiliation info available
Kaukinen K
No affiliation info available

MeSH

AdolescentAutoantibodiesAvenaCeliac DiseaseChildDiet, Gluten-FreeEdible GrainFemaleFollow-Up StudiesGTP-Binding ProteinsHumansImmunoglobulin AIntestinal MucosaJejunumMalePlant ProteinsSeedsTransglutaminasesTreatment Outcome

Pub Type(s)

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

Language

eng

PubMed ID

19412007

Citation

Koskinen, Outi, et al. "Oats Do Not Induce Systemic or Mucosal Autoantibody Response in Children With Coeliac Disease." Journal of Pediatric Gastroenterology and Nutrition, vol. 48, no. 5, 2009, pp. 559-65.
Koskinen O, Villanen M, Korponay-Szabo I, et al. Oats do not induce systemic or mucosal autoantibody response in children with coeliac disease. J Pediatr Gastroenterol Nutr. 2009;48(5):559-65.
Koskinen, O., Villanen, M., Korponay-Szabo, I., Lindfors, K., Mäki, M., & Kaukinen, K. (2009). Oats do not induce systemic or mucosal autoantibody response in children with coeliac disease. Journal of Pediatric Gastroenterology and Nutrition, 48(5), 559-65. https://doi.org/10.1097/MPG.0b013e3181668635
Koskinen O, et al. Oats Do Not Induce Systemic or Mucosal Autoantibody Response in Children With Coeliac Disease. J Pediatr Gastroenterol Nutr. 2009;48(5):559-65. PubMed PMID: 19412007.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Oats do not induce systemic or mucosal autoantibody response in children with coeliac disease. AU - Koskinen,Outi, AU - Villanen,Mikko, AU - Korponay-Szabo,Ilma, AU - Lindfors,Katri, AU - Mäki,Markku, AU - Kaukinen,Katri, PY - 2009/5/5/entrez PY - 2009/5/5/pubmed PY - 2009/7/25/medline SP - 559 EP - 65 JF - Journal of pediatric gastroenterology and nutrition JO - J Pediatr Gastroenterol Nutr VL - 48 IS - 5 N2 - OBJECTIVES: A gluten-free diet omitting wheat, rye, and barley is the only effective treatment for coeliac disease. The necessity of excluding oats from the diet has remained controversial. We studied the toxicity of oats in children with coeliac disease during a 2-year follow-up by investigating jejunal transglutaminase 2 (TG2)-targeted IgA-class autoantibody deposits, a potentially more sensitive disease marker than serum antibodies or conventional histology. PATIENTS AND METHODS: Twenty-three coeliac children in remission were randomized to undergo oat or gluten challenge with wheat, rye, barley, and oats. When jejunal histological relapse was evident after gluten challenge, patients excluded wheat, rye, and barley but continued with oats. Mucosal morphology and TG2-targeted autoantibody deposits were studied in jejunal biopsies taken at baseline and after 6 and 24 months. Furthermore, serum IgA-class TG2 antibodies were measured. RESULTS: At baseline, serum TG2 antibodies were negative in all 23 patients, but 7 of them had minor mucosal deposits. In the oats group, there was no significant change in the intensity of the deposits within 2 years. In contrast, during the gluten challenge, the intensity of the deposits clearly increased and decreased again when wheat, rye, and barley were excluded but consumption of oats was continued; this was in line with serum autoantibodies. The intensity of the mucosal deposits correlated well with both villous morphology and serum autoantibody levels. CONCLUSIONS: Consumption of oats does not induce TG2 autoantibody production at mucosal level in children with coeliac disease. Measurement of small-intestinal mucosal autoantibody deposits is suitable for monitoring treatment in coeliac patients. SN - 1536-4801 UR - https://www.unboundmedicine.com/medline/citation/19412007/Oats_do_not_induce_systemic_or_mucosal_autoantibody_response_in_children_with_coeliac_disease_ L2 - https://doi.org/10.1097/MPG.0b013e3181668635 DB - PRIME DP - Unbound Medicine ER -