Gluten sensitivity
From Wikipedia, the free encyclopedia
Gluten sensitivity (GS) encompasses a collection of medical conditions in which gluten has an adverse effect. For individuals with gluten-sensitive enteropathy, removal of gluten generally results in the restoration of villus architecture[1] or lower lymphocyte densities in the intestine.[2] With some sensitivities, improvements may be seen in the neurological state, but a clinical finding may not be clear.[3][4] GS also can affect blood chemistry,[5] treatability of certain autoimmune diseases,[6] and/or an untreated improvement in autoimmune conditions.[7][8][9]
Gluten is composed of the sticky, storage proteins found in wheat. Gluten-sensitive enteropathy (GSE) can range from mild inflammation of the mucosa of the small intestine to severe coeliac disease. The term gluten-sensitive is applicable when a probable diagnosis of GSE based on conditions such as dermatitis herpetiformis. However, GS may be used in ambiguous situations when other conditions may be possible. For example, wheat allergies to gluten can result in anaphylaxis while others may be difficult to diagnose because of some of the cryptic inflammatory properties of wheat proteins. The term 'gluten sensitivity' is typically applied when diagnostic testing is not done because of prolonged gluten-free diet and/or refusal of gluten-challenge prior to biopsy. The gluten-sensitive designation may not be appropriate in all cases, as wheat allergies are often directed toward albumins or globulins of wheat, or the person may have a sensitivity to proteins commonly found with wheat products (e.g. fungal amylase or bread-yeast mannins). Therefore diagnostic criteria are preferred. The relationship between gluten and these various sensitivities is complex. For gluten enteropathy, T-cell reactivity is almost entirely restricted to prolamin-glutelin/species within the grass tribe Triticeae, and especially α-gliadins of wheat.[10][11] For a tiny minority of GSE, inflammatory responses may extend to cover oats.[12] Gluten allergies may extend over wide taxa or may be specific to certain wheat proteins and allergies may include oats.
Gluten sensitivity should have a defined cause, although not apparent always with first examination, affected individuals should eventually fall into GSE or wheat allergy. Only rarely should gluten sensitivity be idiopathic. Idiopathic gluten sensitivity (IGS) arises "spontaneously or from an obscure or unknown cause" and may involve neuropathy, myopathy, dermal, or intestinal abnormalities. Anti-gliadin antibodies are the primary link between gluten and idiopathic sensitivity in instances in which enteropathy or allergy are not clearly involved.[13] This form of gluten sensitivity is controversial at the moment.
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Coeliac disease
From Wikipedia, the free encyclopedia
| Coeliac disease | |
|---|---|
| Classification and external resources | |
 Biopsy of small bowel showing coeliac disease manifested by blunting of villi, crypt hyperplasia, and lymphocyte infiltration of crypts | |
| ICD-10 | K90.0 |
| ICD-9 | 579.0 |
| OMIM | 212750 |
| DiseasesDB | 2922 |
| MedlinePlus | 000233 |
| eMedicine | med/308 ped/2146 radio/652 |
| MeSH | [1] |
Coeliac disease (pronounced /ˈsiːli.æk/; spelled celiac disease in North America[1]) is an autoimmune disorder of the small intestine that occurs in genetically predisposed people of all ages from middle infancy on up. Symptoms include chronic diarrhoea, failure to thrive (in children), and fatigue, but these may be absent, and symptoms in other organ systems have been described. A growing portion of diagnoses are being made in asymptomatic persons as a result of increased screening.[2]
Coeliac disease is caused by a reaction to gliadin, a gluten protein found in wheat (and similar proteins of the tribe Triticeae, which includes other cultivars such as barley and rye). Upon exposure to gliadin, the enzyme tissue transglutaminase modifies the protein, and the immune system cross-reacts with the small-bowel tissue, causing an inflammatory reaction. That leads to a truncating of the villi lining the small intestine (called villous atrophy). This interferes with the absorption of nutrients, because the intestinal villi are responsible for absorption. The only known effective treatment is a lifelong gluten-free diet. While the disease is caused by a reaction to wheat proteins, it is not the same as wheat allergy.
This condition has several other names, including: cœliac disease (with œ ligature), c(o)eliac sprue, non-tropical sprue, endemic sprue, gluten enteropathy or gluten-sensitive enteropathy, and gluten intolerance. The term coeliac derives from the Greek κοιλιακός (koiliakόs, "abdominal"), and was introduced in the 19th century in a translation of what is generally regarded as an ancient Greek description of the disease by Aretaeus of Cappadocia.
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http://en.wikipedia.org/wiki/Coeliac_Disease#Signs_and_symptoms
Gluten
From Wikipedia, the free encyclopedia
Gluten is a composite of the proteins gliadin and glutenin. These exist, conjoined with starch, in the endosperms of some grass-related grains, notably wheat, rye, and barley. Gliadin and glutenin comprise about 80% of the protein contained in wheat seed. Being insoluble in water, they can be purified by washing away the associated starch. Worldwide, gluten is an important source of nutritional protein, both in foods prepared directly from sources containing it, and as an additive to foods otherwise low in protein.[citation needed]
The seeds of most flowering plants have endosperms with stored protein to nourish embryonic plants during germination, but true gluten, with gliadin and glutenin, is limited to certain members of the grass family. The stored proteins of maize and rice are sometimes called glutens, but their proteins differ from wheat gluten by lacking gliadin. The glutenin in wheat flour gives kneaded dough its elasticity, allows leavening and contributes chewiness to baked products like bagels.
Although wheat supplies much of the world's dietary protein and food supply, as much as 0.5% to 1% of the population of the United States has celiac disease, a condition which results from an adverse immune system response to gluten.[1][2] The manifestations of celiac disease range from no symptoms to malabsorption of nutrients with involvement of multiple organ systems. The only effective treatment is a lifelong gluten-free diet.
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http://en.wikipedia.org/wiki/Gluten
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