# Oats Not Safe for All Celiac Disease Patients



## eric (Jul 8, 1999)

FYIOats Not Safe for All Celiac Disease Patients NEW YORK (Reuters Health) Oct 19 - Some patients with celiac disease cannot tolerate oats in their diet, a European team reports. As reported in the October issue of the Public Library of Science Medicine, the protein in oats may lead to villous atrophy and intestinal inflammation in those consuming an otherwise gluten-free diet.The results of recent studies have suggested that oats are safe for patients with celiac disease (see Reuters Health reports, February 12, 2002 and April 26, 2004). However, patient drop-out rates were high in some of these studies, senior author Dr. Ludvig M. Sollid, at the University of Oslo, Norway, and associates point out in their current report, which could have masked cases of oat intolerance.They therefore evaluated nine adults with celiac disease with a history of exposure to oats, taking small intestinal biopsies from the duodenum. Three subjects had intestinal inflammation in response to oats.Biopsy specimens from the three patients who were oat intolerant and from two of those who appeared to safely consume oats yielded T cells reactive to avenin, a protein similar to the gluten protein of wheat, the report indicates."Our data indicate that avenin can drive mucosal inflammation in that the incubation of the intestinal biopsies with avenin enriches for activated, avenin-reactive T-cells," Dr. Sollid's team states.The investigators observed that there were at least two distinct peptides of avenin that elicited mucosal T-cell responses, in regions of the protein rich in proline and glutamine residues. In wheat gliadin peptides, it is the glutamine and proline residues that are immunogenic, they note.Not knowing how frequently oat intolerance occurs in celiac disease, Dr. Sollid's group advises monitoring T cell responses to avenin epitomes to identify such individuals."Until the prevalence of oat intolerance in celiac disease patients is established, clinical follow-up of celiac disease patients eating oats is advisable," they conclude.PLoS Medicine 2004;1:e1.


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