The Molecular Basis for Oat Intolerance in Patients with Celiac Disease

BACKGROUND: Celiac disease is a small intestinal inflammatory disorder characterized by malabsorption, nutrient deficiency, and a range of clinical manifestations. It is caused by an inappropriate immune response to dietary gluten and is treated with a gluten-free diet. Recent feeding studies have indicated oats to be safe for celiac disease patients, and oats are now often included in the celiac disease diet. This study aimed to investigate whether oat intolerance exists in celiac disease and to characterize the cells and processes underlying this intolerance. METHODS AND FINDINGS: We selected for study nine adults with celiac disease who had a history of oats exposure. Four of the patients had clinical symptoms on an oats-containing diet, and three of these four patients had intestinal inflammation typical of celiac disease at the time of oats exposure. We established oats-avenin-specific and -reactive intestinal T-cell lines from these three patients, as well as from two other patients who appeared to tolerate oats. The avenin-reactive T-cell lines recognized avenin peptides in the context of HLA-DQ2. These peptides have sequences rich in proline and glutamine residues closely resembling wheat gluten epitopes. Deamidation (glutamine→glutamic acid conversion) by tissue transglutaminase was involved in the avenin epitope formation. CONCLUSIONS: We conclude that some celiac disease patients have avenin-reactive mucosal T-cells that can cause mucosal inflammation. Oat intolerance may be a reason for villous atrophy and inflammation in patients with celiac disease who are eating oats but otherwise are adhering to a strict gluten-free diet. Clinical follow-up of celiac disease patients eating oats is advisable

Spectrum of gluten-related disorders: consensus on new nomenclature and classification

A decade ago celiac disease was considered extremely rare outside Europe and, therefore, was almost completely ignored by health care professionals. In only 10 years, key milestones have moved celiac disease from obscurity into the popular spotlight worldwide. Now we are observing another interesting phenomenon that is generating great confusion among health care professionals. The number of individuals embracing a gluten-free diet (GFD) appears much higher than the projected number of celiac disease patients, fueling a global market of gluten-free products approaching $2.5 billion (US) in global sales in 2010. This trend is supported by the notion that, along with celiac disease, other conditions related to the ingestion of gluten have emerged as health care concerns. This review will summarize our current knowledge about the three main forms of gluten reactions: allergic (wheat allergy), autoimmune (celiac disease, dermatitis herpetiformis and gluten ataxia) and possibly immune-mediated (gluten sensitivity), and also outline pathogenic, clinical and epidemiological differences and propose new nomenclature and classifications

Safety of Adding Oats to a Gluten-free Diet for Patients with Celiac Disease: Systematic Review and Meta-analysis of Clinical and Observational Studies

Background & Aims: Patients with celiac disease should maintain a gluten-free diet (GFD), excluding wheat, rye, and barley. Oats might increase the nutritional value of a GFD, but their inclusion is controversial. We performed a systematic review and meta-analysis to evaluate the safety of oats as part of a GFD in patients with celiac disease. Methods: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE databases for clinical trials and observational studies of the effects of including oats in GFD of patients with celiac disease. The studies reported patients’ symptoms, results from serology tests, and findings from histologic analyses. We used the GRADE approach to assess the quality of evidence. Results: We identified 433 studies; 28 were eligible for analysis. Of these, 6 were randomized and 2 were not randomized controlled trials comprising a total of 661 patients—the remaining studies were observational. All randomized controlled trials used pure/uncontaminated oats. Oat consumption for 12 months did not affect symptoms (standardized mean difference: reduction in symptom scores in patients who did and did not consume oats, −0.22; 95% CI, −0.56 to 0.13; P = .22), histologic scores (relative risk for histologic findings in patients who consumed oats, 0.24; 95% CI, 0.01–4.8; P = .35), intraepithelial lymphocyte counts (standardized mean difference, 0.21; 95% CI, reduction of 1.44 to increase in 1.86), or results from serologic tests. Subgroup analyses of adults vs children did not reveal differences. The overall quality of evidence was low. Conclusions: In a systematic review and meta-analysis, we found no evidence that addition of oats to a GFD affects symptoms, histology, immunity, or serologic features of patients with celiac disease. However, there were few studies for many endpoints, as well as limited geographic distribution and low quality of evidence. Rigorous double-blind, placebo-controlled, randomized controlled trials, using commonly available oats sourced from different regions, are needed

An empire on display: English, Indian, and Australian exhibitions from the Crystal Palace to the Great War

The grand exhibitions of the Victorian and Edwardian eras are the lens through which Peter Hoffenberg examines the economic, cultural, and social forces that helped define Britain and the British Empire. He focuses on major exhibitions in England, Australia, and India between the Great Exhibition of 1851 and the Festival of Empire sixty years later, taking special interest in the interactive nature of the exhibition experience, the long-term consequences for the participants and host societies, and the ways in which such popular gatherings revealed dissent as well as celebration. Hoffenberg shows how exhibitions shaped culture and society within and across borders in the transnational working of the British Empire. The exhibitions were central to establishing and developing a participatory imperial world, and each polity in that world provided distinctive information, visitors, and exhibits. Among the displays were commercial goods, working machines, and ethnographic scenes. Exhibits were intended to promote external commonwealth and internal nationalism. The imperial overlay did not erase significant differences but explained and used them in economic and cultural terms. The exhibitions in cities such as London, Sydney, and Calcutta were living and active public inventories of the Empire and its national political communities. The process of building and consuming such inventories persists today in the cultural bureaucracies, museums, and festivals of modern nation-states, the appeal to tradition and social order, and the actions of transnational bodies

World Expositions. Tra Nation-Building e processi di globalizzazione. Interventi di Robert W. Rydell, Christiane Demeulenaere-Douye\u300re, Peter H. Hoffenberg, Luis A\u301ngel Sa\u301nchez-Go\u301mez, Anna Pellegrino, Iain Chambers

This forum addresses some of the key issues regarding the historical analysis of the great world expositions: how did the great expositions developed over a 150 years history and how was it attempted to regulate them ? have world fairs a future ? how did expositions reflect a reality of conflicts much more than of cosmopolitan integration ? which is the Future of Exhibition Studies ? which was the the participation of Christian Churches at the colonial and international Exhibitions, 1851-1958 ? how did the expositions work as a socially inclusive device ? and finally, what was the meaning of exhibiting Humanity ? These are questions put by the coordinator of the forum and which some internaitonal specialists answer to trying to make the point to an extrenmely update subject, awaiting the opening of Expo 2015 in Mila