Abstract
PurposeDetermination of Gluten Immunogenic Peptides (GIP) in feces is a direct tool for gluten exposure detection. The sensitivity of GIP detection methods for cases of unintentional low gluten intakes is unknown. We studied the interindividual variability in the kinetic of excretion under homogeneously controlled dietary conditions, and the sensitivity of fecal GIP tests after low amounts of punctual gluten ingestions.MethodsParticipants (n = 20) followed the same gluten-free menu for 12 days in which two separated doses of gluten (50 mg and 2 g) were ingested and all the depositions were collected. GIP from stool samples were analyzed by ELISA and lateral flow immunoassay (LFIA) tests.ResultsMost participants had detectable GIP after 50 mg and 2 g gluten ingestions using ELISA test (72.2% and 95%, respectively), whereas the LFIA test showed less sensitivity (22.2% and 80%, respectively). GIP were detected at higher either frequency or concentration in the range of 12–36 h after 50 mg intake, and 12–84 h after 2 g consumption. Considering this period, diagnostic sensitivity of GIP detection after a single 50 mg ingestion may be significatively increased analyzing three stool samples per individual. High variability among participants was found in the time and amount of GIP excretion; however, some individuals showed common patterns for both gluten intakes.ConclusionSporadic gluten exposure detection may require several fecal samples to achieve level of sensitivity above 90%. Interindividual variability in the dynamic of GIP excretion may suggest patterns of gluten metabolism.
Highlights
Celiac disease (CD) is a chronic, multiorgan autoimmune disease that occurs in genetically predisposed individuals with well-known genetic components such as human leukocyte antigen (HLA-DQ2 and HLA-DQ8), an auto-antigen, and gluten [1]
We describe the dynamics of human fecal gluten immunogenic peptides (GIP) excretion in conditions simulating occasional gluten exposure under controlled dietary conditions to study individual variability
This is the first study collecting samples of all the following defecations after gluten intake and controlling diet variables to determine the range of individual variability in the excretion of fecal GIP
Summary
Celiac disease (CD) is a chronic, multiorgan autoimmune disease that occurs in genetically predisposed individuals with well-known genetic components such as human leukocyte antigen (HLA-DQ2 and HLA-DQ8), an auto-antigen (tissue trans-glutaminase), and gluten [1]. Human Nutrition and Food Science Doctoral Program, University of Granada, 18011 Granada, Spain. Gluten is a water-insoluble polymorphic mixture of storage proteins, which are mainly categorized as alcohol-soluble prolamins and the alcohol-insoluble glutelins. Cereal grains such as wheat, rye, and barley contain high quantities of gluten, whereas oats show much lower content [10]. Prolamins impart specific functional properties such as viscoelasticity to food product; these cereals are used in European Journal of Nutrition a broad range of foodstuffs [11]. Prolamins are structurally characterized by unique repetitive amino acid sequences, rich in glutamine and proline; they are not digested by gastric and pancreatic enzymes [10]
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