All authors contributed equally to this study.
Review article: safe amounts of gluten for patients with wheat allergy or coeliac disease
Version of Record online: 14 FEB 2006
Alimentary Pharmacology & Therapeutics
Volume 23, Issue 5, pages 559–575, March 2006
How to Cite
HISCHENHUBER, C., CREVEL, R., JARRY, B., MÄKI, M., MONERET-VAUTRIN, D. A., ROMANO, A., TRONCONE, R. and WARD, R. (2006), Review article: safe amounts of gluten for patients with wheat allergy or coeliac disease. Alimentary Pharmacology & Therapeutics, 23: 559–575. doi: 10.1111/j.1365-2036.2006.02768.x
- Issue online: 14 FEB 2006
- Version of Record online: 14 FEB 2006
- Publication data Submitted 23 May 2005 First decision 15 June 2005 Resubmitted 16 November 2005 Accepted 16 November 2005
For both wheat allergy and coeliac disease the dietary avoidance of wheat and other gluten-containing cereals is the only effective treatment. Estimation of the maximum tolerated amount of gluten for susceptible individuals would support effective management of their disease.
Literature was reviewed to evaluate whether an upper limit for gluten content in food, which would be safe for sufferers from both diseases, could be identified.
When setting gluten limits for coeliac disease sufferers, the overall potential daily intake should be considered, while for wheat allergy limits should be based on single servings. For coeliac disease sufferers this limit should lie between 10 and 100 mg daily intake. For wheat allergy, lowest eliciting doses for children lie in the lower milligram range, while for adults they are most significantly higher.
Gliadins (part of the gluten proteins) not only trigger coeliac disease, but are also major allergens in wheat allergy. Therefore, measurement of gliadins with validated enzyme-linked immunosorbent assay methods provides an appropriate marker for assessing gluten and/or wheat protein contents in food. Available data suggest that a maximum gluten content for ‘gluten-free’ foods could be set, which protects both wheat allergy sufferers and coeliac patients.