Abstract

Aims: Gliadine contains a superpeptide, 33-mer, not digestible by human intestinal enzymes. This peptide activates a specific T-cells toxic response which produces the characteristic intestinal mucosal lesions in celiac patients. The 33-mer is hydrolyzed by a prolil-endopeptidase from Flavobacterium meningosepticum. We isolated an endopeptidase from selected Lactobacilli, which is capable to hydrolyze such peptides. The aim of the study is to evaluate the short term toxicity of gluten pre-digested with this endopeptidase in celiac subjects. Methods: Twenty Celiac patients, negative for Anti-Transglutaminase antibodies on a strict gluten-free diet were admitted. After a baseline permeability test, patients were allocated randomly to the ingestion of one single biscuit containing either 2 g of raw gluten or 2 g of gluten digested for 24 hours with the Lactobacilli peptidases. Fasting patients ingested one single biscuit and the permeability test was started after 5 hours. Intestinal permeability was evaluated by a 5 hour urine collection after a load of Rhamnose 1 gr, Lactulose 7,5 g and Sucrose 40 g. Trisilyl derivatives were prepared to assay the sugars by Gas Chromatography according to Dutton. Results: Of the 20 patients: 3 were excluded because they had ingested gluten after the recruitment; 13 showed a marked increase of the gastrointestinal permeability after the ingestion of the raw gluten biscuit and a much lower value (not significantly different from the basal value) after the ingestion of a biscuit with the same dose of gluten pre-digested with Lattobacilli; three patients showed pathological values of intestinal permeability with both kind of biscuits, while one patient showed no alteration after the raw gluten ingestion. Conclusions: We suggest that it is possible to reduce short term gluten toxicity by prolonged hydrolysis of raw gluten with Endopeptidase from bacteria normally used in food production, for the ‘super-dough’. Not all patients show the same sensitivity to gluten and individual variations cannot be excluded. We are now running a long-term tolerance study.

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