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Introducción: el tratamiento de la enfermedad celiaca es la dieta sin gluten, la cual requiere para ser realizada de conocimientos, destrezas y actitudes de los afectados, además de un entorno social propicio. El objetivo fue determinar las circunstancias que facilitan y dificultan la dieta sin gluten en los sujetos con enfermedad celiaca del Paraguay en 2021. Material y métodos: se realizó un estudio exploratorio descriptivo. Se aplicó una encuesta telemática a los adultos, adolescentes y padres de niños con enfermedad celiaca que aceptaban participar voluntariamente. Se midieron variables demográficas, clínicas y 17 aspectos que se presumen son factores facilitadores o barreras para la dieta sin gluten. El estudio fue aprobado por el Comité de Ética de la Universidad Privada del Este, Paraguay. Resultados: se incluyeron 364 encuestas, siendo 85% de adultos. Las circunstancias identificadas como facilitadores fueron los conocimientos propios y los impartidos por el personal de salud sobre la celiaquía, además del poco miedo a la opinión de los demás y los escasos sentimientos de vergüenza por la restricción dietética. En contraste, los factores considerados como barreras fueron el escaso conocimiento de la sociedad sobre las exigencias alimentarias, la poca participación de los encuestados en los grupos de autoayuda y el costo elevado de los alimentos sin gluten. Conclusión: se describen las circunstancias que pueden facilitar y obstaculizar la dieta sin gluten en los portadores de enfermedad celiaca del Paraguay. Se sugieren estudios analíticos para evaluar la influencia exacta de los mismos y aplicar medidas correctivas para disminuir las barreras para la adherencia esta dieta.

Peptides from several plant food proteins not only maintain the nutritional values of the original protein and decrease the environmental impact of animal agriculture, but also exert biological activities with significant health-beneficial effects. Wheat is the most important food grain source in the world. However, negative attention on wheat-based products has arose due to the role of gluten in celiac disease. A controlled enzymatic hydrolysis could reduce the antigenicity of wheat gluten protein hydrolysates (WGPHs). Therefore, the aims of the present study were to evaluate the effects of the in vitro administration of Alcalase-generated WGPHs on the immunological and antioxidant responses of human peripheral blood mononuclear cells (PBMCs) from 39 healthy subjects. WGPH treatment reduced cell proliferation and the production of the Type 1 T helper (Th1) and Th17 pro-inflammatory cytokines IFN-γ and IL-17, respectively. WPGHs also improved the cellular anti-inflammatory microenvironment, increasing Th2/Th1 and Th2/Th17 balances. Additionally, WGPHs improved global antioxidant capacity, increased levels of the reduced form of glutathione and reduced nitric oxide production. These findings, not previously reported, highlight the beneficial capacity of these vegetable protein hydrolysates, which might represent an effective alternative in functional food generation., This work was supported by the Spanish Government, Ministerio de Economía y Competitividad (AGL2012-40247-C02-01 and AGL2012-40247-C02-02) the Andalusian Government Ministry of Health (PC-0111-2016-0111) and the PAIDI Program from the Andalusian Government (CTS160). I.C.-C. was supported by Ministerio de Economía y Competitividad (AGL2012-40247-C02-02) and by a FPU grant from the Spanish Ministerio de Educación, Cultura y Deporte (FPU13/01210). N.Á.-S. was supported by Instituto de Salud Carlos III, Ministerio de Economía y Competitividad (RD06/0013/0001 and RD12/0043/0012). G.S.-S. was supported by a FPU grant from the Spanish Ministerio de Educación, Cultura y Deporte (FPU16/02339). I.B. was supported by the VI Program of Inner Initiative for Research and Transfer of University of Seville (VI PPIT-US).

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License.-- et al., [Objectives]: Treatment for celiac disease (CD) is a lifelong strict gluten-free diet (GFD). Patients should be followed-up with dietary interviews and serology as CD markers to ensure adherence to the diet. However, none of these methods offer an accurate measure of dietary compliance. Our aim was to evaluate the measurement of gluten immunogenic peptides (GIP) in stools as a marker of GFD adherence in CD patients and compare it with traditional methods of GFD monitoring. [Methods]: We performed a prospective, nonrandomized, multicenter study including 188 CD patients on GFD and 84 healthy controls. Subjects were given a dietary questionnaire and fecal GIP quantified by enzyme-linked immunosorbent assay (ELISA). Serological anti-tissue transglutaminase (anti-tTG) IgA and anti-deamidated gliadin peptide (anti-DGP) IgA antibodies were measured simultaneously. [Results]: Of the 188 celiac patients, 56 (29.8%) had detectable GIP levels in stools. There was significant association between age and GIP in stools that revealed increasing dietary transgressions with advancing age (39.2% in subjects ≥13 years old) and with gender in certain age groups (60% in men ≥13 years old). No association was found between fecal GIP and dietary questionnaire or anti-tTG antibodies. However, association was detected between GIP and anti-DGP antibodies, although 46 of the 53 GIP stool-positive patients were negative for anti-DGP. [Conclusions]: Detection of gluten peptides in stools reveals limitations of traditional methods for monitoring GFD in celiac patients. The GIP ELISA enables direct and quantitative assessment of gluten exposure early after ingestion and could aid in the diagnosis and clinical management of nonresponsive CD and refractory CD. Trial registration number NCT02711397., This work was supported by grants from Ministerio de Ciencia e Innovación and FEDER funds (DELIAC, IPT-2011-0952-900000), and Corporación Tecnológica de Andalucía (SINGLUCHECK, 1737/0118).

Real, Ana et al., A strict gluten-free diet (GFD) is the only currently available therapeutic treatment for patients with celiac disease (CD). Traditionally, treatment with a GFD has excluded wheat, barley and rye, while the presence of oats is a subject of debate. The most-recent research indicates that some cultivars of oats can be a safe part of a GFD. In order to elucidate the toxicity of the prolamins from oat varieties with low, medium, and high CD toxicity, the avenin genes of these varieties were cloned and sequenced, and their expression quantified throughout the grain development. At the protein level, we have accomplished an exhaustive characterization and quantification of avenins by RP-HPLC and an analysis of immunogenicity of peptides present in prolamins of different oat cultivars. Avenin sequences were classified into three different groups, which have homology with S-rich prolamins of Triticeae. Avenin proteins presented a lower proline content than that of wheat gliadin; this may contribute to the low toxicity shown by oat avenins. The expression of avenin genes throughout the development stages has shown a pattern similar to that of prolamins of wheat and barley. RP-HPLC chromatograms showed protein peaks in the alcohol-soluble and reduced-soluble fractions. Therefore, oat grains had both monomeric and polymeric avenins, termed in this paper gliadin- and glutenin-like avenins. We found a direct correlation between the immunogenicity of the different oat varieties and the presence of the specific peptides with a higher/lower potential immunotoxicity. The specific peptides from the oat variety with the highest toxicity have shown a higher potential immunotoxicity. These results suggest that there is wide range of variation of potential immunotoxicity of oat cultivars that could be due to differences in the degree of immunogenicity in their sequences. © 2012 Real et al., This work was supported by the Spanish Ministerio de Economía y Competitividad (MINECO,Programa INNPACTO, IPT-2011-1321-010000) and the European Regional Development Fund (FEDER). FP is supported by a Ramón y Cajal research contract from the MINECO (RYC-2010-07345).