Celiac disease, also known as celiac sprue or gluten-sensitive enteropathy, is a genetically linked autoimmune disorder that can affect both children and adults. In people with celiac disease, eating certain types of grain-based products sets off an immune mediated response that causes measurable damage to the small intestine. This, in turn, interferes with the small intestine’s ability to absorb nutrients in food, leading to malnutrition and a variety of other complications. The offending amino acid sequences are collectively called “gluten” and are found in wheat, barley, rye, and to a lesser extent, oats* (WBRO). Related proteins are found in triticale, spelt, and Kamut®. Refer to the grains and flours glossary for a more extensive classification of grains.
In people with celiac disease, eating certain types of protein fractions, collectively called gluten, set off an immune mediated response at the site of the epithelial cells. The condition is caused by an abnormal or dysregulated, cellular level immune activity can affect all organs. See Symptoms.
The term "gluten" is, in a sense, a generic term for the storage proteins that are found in grains. In reality, each type of protein - glutenin and gliadin in wheat, secalin in rye, hordein in barley, avenin in oats, zein in corn and oryzenin in rice - is slightly different from the others. The "gluten" in wheat, rye, barley, and in a much lower amount, oats, contains particular amino acid sequences that are harmful to persons with celiac disease.
The damaging proteins are particularly rich in proline and glutamine (especially the amino acid sequences which are in the following orders: Pro-Ser-Gln-Gln and Gln-Gln-Gln-Pro). As peptides, some such as 33-MER, cannot be broken down any further in the body. In people with celiac disease, 33-MER stimulates T-cells to produce antibodies. Sequences containing as few as 7 amino acids can be toxic to those with celiac disease. The antibodies, in turn, attack the villi in the small intestine, reducing the surface able to absorb nutrients. The damage may be patchy.
It is important to note that these amino acid or protein sequences are NOT found in the proteins of corn and rice.
The Nature of the Injury
The damage to the small intestine (the jejunum) is very slow to develop and is insidious.
Celiac disease cannot be "caught," but rather the potential for celiac disease is in the body from birth. Its onset is not confined to a particular age range or gender, although more women are diagnosed than men. It is not known exactly what activates the disease, however three things are required for a person to develop celiac disease:
Celiac disease is a life-long disease managed by lifestyle and generally without medication. There is no cure. The only known treatment is strict adherence to a gluten-free lifestyle. The complexity of the disease makes any other safe therapeutic option years away. Oats are not recommended during the first year after diagnosis. Oats can be a choice for many after the first year. There is no way to determine in advance whether or not a person will be able to tolerate uncontaminated oats. Uncontaminated oats and oat products may qualify for the CSA Recognition Seal for Innovative products if absent G12 antibody below 5 ppm of gluten. Call or email the Celiac Support Association home office at 1-877-CSA-4CSA for assistance and guidance on beginning a gluten-free lifestyle.
There is no animal model. The National Health and Nutrition Examination Survey (NHANES) is a program of studies designed to assess the health and nutritional status of adults and children in the United States. The survey is unique in that it combines interviews and physical examinations. Two questions were added to include celiac disease for two years. MCQ082 - Ever been told you have celiac disease? MCQ086 - Are you on a gluten-free diet? NHANES Statement.
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