Gluten-Sensitivities - Will The Real Culprit Please Stand Up?
Thousands of years ago - we find that humans regularly ate breads that were baked with wheat, rye, barley, spelt and other grains. So why is there so much attention now being put upon gluten sensitivities? Why is celiac disease growing and why do many people say they feel better when they don’t eat gluten?
Barley. Wheat. Rye. Spelt. These are some of the oldest, most ancient grains, which have been eaten by humans for millions of years. Millions?
Yes, recent research from the University of Utah and other international teams of archeologists has determined that some of the oldest humanoids ate grains. This they have determined from analyzing the fossil teeth enamel. Their findings confirm that over two million years ago humans and their ancestors were eating a combination of tree fruits and grains, along with nuts, roots and other gathered foods.
In fact, many traditional societies have - many known for long life spans - have eaten gluten-containing grains as the cornerstone of their diet. This is the case for one of the most studied diets - known as one of the healthiest traditional diets - the Mediterranean Diet.
Along these same lines, some have presented research showing that among celiac patients, and even others, there are negative consequences from eating gluten-containing grains. What is going on here?
The culprits currently being identified are the glutenin and gliadin proteins. Research has shown that in some individuals, these proteins can produce an IgA, IgG or IgE antibody response, which can provoke inflammation in the body. This inflammation response - typically initiated with an interleukin-15 mediated response - may come in the form of an allergic response in some, or any number of other inflammatory tissue responses.
Is Gluten Really the Culprit?
Over the last decade, increasing research is establishing that perhaps gluten isn’t the problem. Evidence is showing the problem is related to problems within the intestinal tract. This was addressed by Italian researchers, who stated in a recent study:
"An overlap between the irritable bowel syndrome and non-celiac gluten sensitivity has been detected, requiring even more stringent diagnostic criteria."
In another study, researchers stated that even Celiac disease may be related to IBS:
"...there is a group of patients who, without having celiac disease, suffer gluten intolerance that cause them digestive symptoms similar to those of IBS."
Let’s get to the core of the matter. The internal tissues of the intestines and the bloodstream were never supposed to be confronted with the large glutenin and gliadin proteins in their macro (unbroken) polypeptide forms.
Rather, among healthy guts - and for millions of years - intestinal probiotics break down the glutenin and gliadin proteins into smaller peptides and amino acids, which the body can readily assimilate and utilize.
This lack of healthy intestinal bacteria - also called dysbiosis - also happens to increase inflammation within the intestines, which open gaps in the intestinal walls. These gaps - called intestinal permeability - allow these gliadins into the bloodstream, where they produce an inflammation response.
For many reasons, our intestinal probiotics help protect our intestines from irritation and inflammation. One is that they break down large proteins like gliadins and glutenins.
Let’s review some of the recent research confirming this combined scenario:
Researchers from the George Washington University School of Medicine - including two gastroenterology professors, Anita Bakshi, M.D.and Sindu Stephen, M.D. - found that probiotics regularly secret enzymes that break down gliadins
The research determined that undigested wheat gliadin proteins activate a CD4+ T-cell response among the intestinal cells. This response induces the secretion of a protein called zonulin. Zonulin stimulates an increase in the spaces in the tight junctions between the intestinal cells. This creates what is called intestinal permeability - which is also often referred to loosely (an inaccurately) as "leaky gut."
This permeability within the intestinal cells will then produce the antibody response referred to above, as the bloodstream immune system kicks into high gear. This initiated inflammatory response depends upon the type of immunoglobulin and the unique level of sensitivity - pro-inflammatory system or level of immunosuppression - that may exist within the body.
Clinical Research Confirms The Relationship Between Gluten and Probiotics
A number of clinical studies have shown these effects, illustrating that intestinal probiotics will curtail the entire mechanism by simply breaking down the glutenin and gliadin proteins through protease activity.
For example, Irish researchers found probiotic bacteria will produce prolyl endopeptidase and endoprotease B. These break down gliadin into basic amino acids and peptides, which the intestines can absorb and use as nutrients.
Another study from California’s Celiac Sprue Research Foundation, tested 20 celiac patients with small doses of gluten with or without pretreatment with prolyl endopeptidase, produced by probiotics.
After fourteen days, the researchers crossed-over the patients - allowing the pretreatment group to switch with the non-pretreatment group.
The majority of the celiac patients were able to prevent the typical gluten response - symptomized by the malabsorption of fats and carbohydrates.
Researchers from Finland’s University of Tampere Medical School found that probiotic strains Lactobacillus fermentum and Bifidobacterium lactis inhibited the inflammation response among sensitive intestinal (Caco-2) cells in patients. The researchers stated that:
"B. lactis inhibited the gliadin-induced increase dose-dependently in epithelial permeability, higher concentrations completely abolishing the gliadin-induced decrease in transepithelial resistance."
This dose-dependent response - a gold standard among medical research - provides the clarity that probiotics indeed not only break down glutenins and gliadins, but also prevent the inflammatory process that ends up opening up the intestinal walls to undigested proteins.
This of course isn’t only about gluten proteins. It is also about the so-many other proteins that can produce sensitivities and allergic responses, including those from nuts, peanuts, shellfish and other foods that cause inflammatory responses.
The UGW professors concluded after reviewing the research that:
"Inclusion of probiotics appears to be able to reduce the damage caused by eating gluten-contaminated foods and may even accelerate mucosal healing after the initiation of a gluten-free diet."
Researchers from the University of Buenos Aires gave a probiotic supplement or a placebo to 22 adults with celiac disease for three weeks.
Those who received the probiotic supplement suffered significantly less indigestion, constipation and other intestinal symptoms according to the Gastrointestinal Symptom Rating Scale. The probiotic group also had significantly lower levels of IgA antibodies to gluten.
The researchers stated simply:
"The study suggests that B. infantis may alleviate symptoms in untreated celiac disease."
Will Probiotic Supplementation Cure Celiac Disease?
Of course, celiac patients - who deal with heightened allergic response to gluten - are often contending with a particular genetic disposition. This doesn’t mean that many celiac patients may well be dealing with a probiotic dysfunction rather than a genetic situation. This possibility was indicated by Spanish researchers:
"...IBS and celiac disease symptoms may be indistinguishable, especially when diarrhea, bloating or abdominal pain predominate. In the last decade several studies have shown that the separation between CD and IBS is not so clear."
In fact, several microbiome studies have shown that our genes will often reflect our microbiome - the genetic composition of our intestinal probiotics.
This doesn’t mean that probiotic supplementation will necessarily cure a celiac patient. Their immune system may well be too entrained to completely reverse their particular antibody response - which may be triggered even by a short peptide sequence. But certainly these studies and others show that probiotics may help alleviate at least some of the inflammatory response in Celiac disease.
But it is those who have become sensitive to gluten that probiotics may help the most. Over decades of antibiotics, many have ruined much of their healthy intestinal probiotic colonies. Certainly they may face sensitivity to gluten proteins and/or other proteins, given the mechanism discussed above.
The University of George Washington Medical School professors concur:
"Supplementation with a variety of bacterial strains can help inhibit gluten/gliadin-induced damage in the small intestine."
Wheat and Other Grains are Prebiotics
A little known fact is that wheat and other grains actually are prebiotics for some of our intestinal probiotics. How symbiotic is that?
In research from the UK’s University of Reading, 55 healthy men and women were given different doses of wheat bran for three weeks. Those eating more wheat bran had a significant increase in healthy probiotic bifidobacteria. Another study by some of the same researchers tested 40 adults and came to the same conclusion.
The prebiotic polysaccharides - arabinoxylan-oligosaccharides - are a component of wheat bran. Arabinoxylan-oligosaccharide is critical for the health of our intestinal probiotics.
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Case Adams is a California Naturopath and holds a Ph.D. in Natural Health Sciences. His focus is upon science-based natural health solutions. He is the author of 25 books on natural health and numerous print and internet articles. A listing and description of many of his books can be found on Realnatural.org. His new video series on low back pain can be found at Healthy-back.net. Case appreciates feedback and questions at firstname.lastname@example.org.