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Review
. 2013 Oct 23;5(10):4250-68.
doi: 10.3390/nu5104250.

The gluten-free diet: testing alternative cereals tolerated by celiac patients

Affiliations
Review

The gluten-free diet: testing alternative cereals tolerated by celiac patients

Isabel Comino et al. Nutrients. .

Abstract

A strict gluten-free diet (GFD) is the only currently available therapeutic treatment for patients with celiac disease, an autoimmune disorder of the small intestine associated with a permanent intolerance to gluten proteins. The complete elimination of gluten proteins contained in cereals from the diet is the key to celiac disease management. However, this generates numerous social and economic repercussions due to the ubiquity of gluten in foods. The research presented in this review focuses on the current status of alternative cereals and pseudocereals and their derivatives obtained by natural selection, breeding programs and transgenic or enzymatic technology, potential tolerated by celiac people. Finally, we describe several strategies for detoxification of dietary gluten. These included enzymatic cleavage of gliadin fragment by Prolyl endopeptidases (PEPs) from different organisms, degradation of toxic peptides by germinating cereal enzymes and transamidation of cereal flours. This information can be used to search for and develop cereals with the baking and nutritional qualities of toxic cereals, but which do not exacerbate this condition.

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Figures

Figure 1
Figure 1
Diagram showing the evolutionary relationships among species of wheat and related species of Aegilops. The dotted line separates the wild and domesticated species of wheat. Ancestral or unknown species are surrounded by a double dashed rectangle. Ploidy level and the number of chromosomes are indicated. Nomenclature according to van Slageren [8].
Figure 2
Figure 2
Taxonomic relation of known non-toxic cereals, minor cereals and pseudocereals in the context of celiac disease.

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