Skip to main content
PMC home page
Gut logoLink to Gut
. 1988 Nov;29(11):1564–1568. doi: 10.1136/gut.29.11.1564

Low gluten diet in the treatment of adult coeliac disease: effect on jejunal morphology and serum anti-gluten antibodies.

A M Montgomery 1, A K Goka 1, P J Kumar 1, M J Farthing 1, M L Clark 1
PMCID: PMC1433820  PMID: 3209114

Abstract

Treatment of patients with coeliac disease with a low gluten containing diet (LGD) remains controversial. We have studied jejunal morphology and antigluten (AG) antibody titres by ELISA in patients on a LGD of 2.5-5 g/day for three to 14 months (median six months) and compared results with patients on a strict gluten free diet (GFD) for six to 27 months (median 13 months). We found no significant difference in villous height or crypt depth (eight LGD v 10 GFD patients) or serum AG-IgA, -IgG, and IgM titres (13 LGD v 12 GFD patients). there was however, a significant increase (p less than 0.05) in intra-epithelial lymphocytes in those patients on a LGD. We conclude that adult coeliac patients can tolerate a LGD without gross morphological change and without initiating significant AG antibody responses.

Full text

PDF
1564

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson C. M., Gracey M., Burke V. Coeliac disease. Some still controversial aspects. Arch Dis Child. 1972 Apr;47(252):292–298. doi: 10.1136/adc.47.252.292. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Baker P. G., Barry R. E., Read A. E. Detection of continuing gluten ingestion in treated coeliac patients. Br Med J. 1975 Mar 1;1(5956):486–488. doi: 10.1136/bmj.1.5956.486. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Ciclitira P. J., Ellis H. J., Richards D., Kemeny D. M. Gliadin IgG subclass antibodies in patients with coeliac disease. Int Arch Allergy Appl Immunol. 1986;80(3):258–261. doi: 10.1159/000234062. [DOI] [PubMed] [Google Scholar]
  4. Eterman K. P., Feltkamp T. E. Antibodies to gluten and reticulin in gastrointestinal diseases. Clin Exp Immunol. 1978 Jan;31(1):92–99. [PMC free article] [PubMed] [Google Scholar]
  5. Ferguson A., Murray D. Quantitation of intraepithelial lymphocytes in human jejunum. Gut. 1971 Dec;12(12):988–994. doi: 10.1136/gut.12.12.988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Friis S. U., Gudmand-Høyer E. Screening for coeliac disease in adults by simultaneous determination of IgA and IgG gliadin antibodies. Scand J Gastroenterol. 1986 Nov;21(9):1058–1062. doi: 10.3109/00365528608996420. [DOI] [PubMed] [Google Scholar]
  7. Gliadin antibody levels in screening tests for coeliac disease. Br Med J (Clin Res Ed) 1984 Jan 7;288(6410):69–71. doi: 10.1136/bmj.288.6410.69-b. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Goka A. K., Farthing M. J. The use of 3,3',5,5'-tetramethylbenzidine as a peroxidase substrate in microplate enzyme-linked immunosorbent assay. J Immunoassay. 1987;8(1):29–41. doi: 10.1080/01971528708063053. [DOI] [PubMed] [Google Scholar]
  9. Hamilton J. R., McNeill L. K. Childhood celiac disease: response of treated patients to a small uniform daily dose of wheat gluten. J Pediatr. 1972 Nov;81(5):885–893. doi: 10.1016/s0022-3476(72)80538-9. [DOI] [PubMed] [Google Scholar]
  10. Jackson P. T., Glasgow J. F., Thom R. Parents' understanding of coeliac disease and diet. Arch Dis Child. 1985 Jul;60(7):672–674. doi: 10.1136/adc.60.7.672. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Juto P., Fredrikzon B., Hernell O. Gliadin-specific serum immunoglobulins A, E, G, and M in childhood: relation to small intestine mucosal morphology. J Pediatr Gastroenterol Nutr. 1985 Oct;4(5):723–729. doi: 10.1097/00005176-198510000-00007. [DOI] [PubMed] [Google Scholar]
  12. Kieffer M., Frazier P. J., Daniels N. W., Coombs R. R. Wheat gliadin fractions and other cereal antigens reactive with antibodies in the sera of coeliac patients. Clin Exp Immunol. 1982 Dec;50(3):651–660. [PMC free article] [PubMed] [Google Scholar]
  13. Kumar P. J., O'Donoghue D. P., Stenson K., Dawson A. M. Reintroduction of gluten in adults and children with treated coeliac disease. Gut. 1979 Sep;20(9):743–749. doi: 10.1136/gut.20.9.743. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Leigh R. J., Marsh M. N., Crowe P., Kelly C., Garner V., Gordon D. Studies of intestinal lymphoid tissue. IX. Dose-dependent, gluten-induced lymphoid infiltration of coeliac jejunal epithelium. Scand J Gastroenterol. 1985 Aug;20(6):715–719. doi: 10.3109/00365528509089201. [DOI] [PubMed] [Google Scholar]
  15. Mattison D. R., Thorgeirsson S. S. Smoking and industrial pollution, and their effects on menopause and ovarian cancer. Lancet. 1978 Jan 28;1(8057):187–188. doi: 10.1016/s0140-6736(78)90617-7. [DOI] [PubMed] [Google Scholar]
  16. O'Farrelly C., Kelly J., Hekkens W., Bradley B., Thompson A., Feighery C., Weir D. G. Alpha gliadin antibody levels: a serological test for coeliac disease. Br Med J (Clin Res Ed) 1983 Jun 25;286(6383):2007–2010. doi: 10.1136/bmj.286.6383.2007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Savilahti E., Viander M., Perkkiö M., Vainio E., Kalimo K., Reunala T. IgA antigliadin antibodies: a marker of mucosal damage in childhood coeliac disease. Lancet. 1983 Feb 12;1(8320):320–322. doi: 10.1016/s0140-6736(83)91627-6. [DOI] [PubMed] [Google Scholar]
  18. Scott H., Ek J., Brandtzaeg P. Changes of serum antibody activities to various dietary antigens related to gluten withdrawal or challenge in children with coeliac disease. Int Arch Allergy Appl Immunol. 1985;76(2):138–144. doi: 10.1159/000233680. [DOI] [PubMed] [Google Scholar]
  19. Sheldon W. Prognosis in early adult life of coeliac children treated with a gluten-free diet. Br Med J. 1969 May 17;2(5654):401–404. doi: 10.1136/bmj.2.5654.401. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Unsworth D. J., Kieffer M., Holborow E. J., Coombs R. R., Walker-Smith J. A. IgA anti-gliadin antibodies in coeliac disease. Clin Exp Immunol. 1981 Nov;46(2):286–293. [PMC free article] [PubMed] [Google Scholar]
  21. Visakorpi J. K., Kuitunen P., Savilahti E. Frequency and nature of relapses in children suffering from the malabsorption syndrome with gluten intolerance. Acta Paediatr Scand. 1970 Sep;59(5):481–486. doi: 10.1111/j.1651-2227.1970.tb16795.x. [DOI] [PubMed] [Google Scholar]
  22. Volta U., Lenzi M., Lazzari R., Cassani F., Collina A., Bianchi F. B., Pisi E. Antibodies to gliadin detected by immunofluorescence and a micro-ELISA method: markers of active childhood and adult coeliac disease. Gut. 1985 Jul;26(7):667–671. doi: 10.1136/gut.26.7.667. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Young W. F., Pringle E. M. 110 children with coeliac disease, 1950-1969. Arch Dis Child. 1971 Aug;46(248):421–436. doi: 10.1136/adc.46.248.421. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES