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måndag 19 maj 2014

W.K. Dicke havaitsi vuonna 1950, että keliakiaa triggeröi vehnäproteiinin syöminen. joillain yksilöillä

Wheat and its close relatives, rye and barley
Since the discovery by W. K. Dicke in 1950 that wheat was a key environmental factor that triggered celiac disease in susceptible individuals, the relationship of the disease to ingestion of wheat gluten proteins has become an essential part of the definition. By and large, if wheat doesn’t trigger enteropathy (or at least, changes in the mucosa that presage enteropathy), it isn’t celiac disease. Most reviews of celiac disease tend to avoid the question of toxicity, or lack thereof, in grains, seeds, or foods other than wheat—possibly because studies are lacking or inadequate. This may be reasonable from a scientific standpoint, but patients, dietitians, and primary care physicians would like something more. Only wheat and, in recent years, oats have been extensively studied with modern approaches (such as measurement of intraepithelial lymphocyte infiltration and cytokine production) for their toxicity in celiac disease—with wheat obviously being toxic, whereas evidence for the lack of toxicity of oats has now become quite strong (see below). Rye and barley have many identical or nearly identical storage proteins to those in wheat. Although testing is rather minimal, these strong protein sequence similarities, combined with the experience of celiac patients over many years with these grains and what scientific investigations have been carried out, are supportive of some degree of toxicity for these grains in celiac disease. It is very difficult to quantify the toxicity of any given grain, but I think it is at least possible that the lack of a-type gliadins (one of the most studied fractions in wheat) in rye and barley results in lesser toxicity for these two grains in comparison with wheat, as does the generally lower protein percentages of rye and barley grain.

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