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Celiac Disease Research Honors Experience Dan Geiser Nov 8th-Dec 2nd What is Celiac Disease? • • • Celiac Disease is a life-long genetically based auto-immune disease triggered by gluten from the diet It is said to cause painful, “inflammation of the proximal small intestine in response to ingested gluten from wheat, rye, and barley (Escott).” Auto-immune responses can occur at any age or at any time. Sometimes people that have Celiac’s don’t experience symptoms until later in life (Van Walleghen). – – Therefore a very elusive disease Between 1-100 to 1-130 people have it or go undiagnosed (Van Walleghen). What’s going on physiologically? • Auto-Immune – Bodies own cells attack itself • Upon gliadin and glutenin release (gluten proteins) – T-Cells responsible for all immune responses attack inappropriately at intestinal absorption sites. • This causes villous atrophy (unintended villi growth – uncomfortable) • Inflammation • Decreased villi numbers • Decreased absorptive power due to elongated crypts causing malabsorption (Escott) Main antigen presenter for CD: Tissue Transglutaminase - In high quantities in tissue and blood this would be the main calling card for CD diagnosis Structure of Gluten • • • • 33-mer – made from gliadins and glutenins “Structurally, it is relatively poorly digested due to high level of proline and glutamine residues (Guandalini).” Main amino acid sequences that cause damage in wheat ( – Pro-Ser-Gln-Gln – Gln-Gln-Gln-Pro Can be highly resistant to break down in the intestines – No Proteolytic Cleavage: No activation so the structure sits in the gut – Might contribute with the Immune response that Celiac suffers experience Signs and Symptoms Only 0.5%-1.0% of the United States Population has CD (Fellstone) Asymptomatic – Sometimes does not show symptoms or shows later in life - Can be spurred on by environmental factors (Van Walleghen) • Diarrhea • Flatulence • Bloating like IBS • Steatorrhea – Excess of fat in feces • Weight Loss • Stomatitis – inflammation of the mouth and lips • Anemia Pain experienced is relatively individual – “For me I know when I eat something that has gluten immediately. Afterwards it takes me at least five days or less to recover. It takes all of the energy out of me (Van Walleghen).” Celiac Awareness • Mainstream Diet and Condition – “Contains gluten” on food labels in many countries has become mandatory (Fellstone). - FDA labeling mandatory for all allergies in food production facilities - Mandatory allergen clean outs – 1st gluten-free diet appeared in 1963 by Willem-Karel Dicke • Proved certain types of flour can cause CD relapse - “Gluten-free products are easier to find due to fad diets. In the past finding reliable products was hard (Van Walleghen).” Celiac Awareness Cont. • Things to look out for! • Products must contain gluten level of less than or equal to 20 parts/million – – Level at which wont cause damage to intestines Depends on how much you eat though! • (Van Walleghen) • Not all products are 100% glutenfree – • Do research- Check if production facility uses the same equipment for making GF products and GC products In restaurants have cooks switch gloves! – Cross-contamination can occur if not! Making CD Sufferers Lives Easier • Gluten-Free Beer – • Breweries such as “Bard’s Brewery” has been making sensory pleasing sorghum-based beer. This beer is both please to CD suffers and nonsufferers. Gluten-Free Bread – Possible– but has it’s sensory flaws for good looking bread. One flaw present is that gluten-free flower is wheat based. This unavoidable flaw can affect the health of those with CD • • • • Thoughts of using gluten-imitating ingredients in bread is/are highly considered. Use of many gluten-free flours will provide the visoelastic function of real gluten in bread (Fellstone) Gluten Tests You Can Buy • Tests for gliadin content, crosscontamination etc. • $100 or less • User error possible? (Van Walleghen) Why Do I Care? • Undergrad research opportunities within Dietetics programs are few and far between – This project was/is a chance to learn about a popular health problem and topic while making a product in which those with CD can enjoy • Gluten-Free Beer • The field of Food Science and the food industry is always looking for innovations of already existing products. – Finding new ways to make products better in terms of nutrition and taste – Expanding the availability of a product to other people – Market products in different ways • By doing research on CD and making Gluten-Free Beer I’m doing all of these things • Passion and Education Combo – Brewing and Nutrition intertwine within this project. Taking my passion and education and combining them makes a great experience! Why I Care Cont. • Food For All – I believe that everyone should be able to enjoy the same food and drink as everybody else. Food/Drink is just as much an experience as it is sustenance and everybody should take part in that social gathering. • i.e. – Beer should be made available to those with gluten intolerances. The beer should be acceptable in taste and quality and be able to be enjoyed by all. This way everyone (gluten stricken or not) can enjoy a beer! • Possible Career Move? – Brewing is a huge passion of mine. If I can create innovative products hopefully others will take notice and want to invest in me. I hope one day to work in a brewery and make great beer! References • • • Escott-Stump, Sylvia. "Celiac Disease." Nutrition and Diagnosis-related Care. Seventh ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2008. 414-19. Print. Fellstone, Diane S. Gluten Properties, Modifications and Dietary Intolerance. New York: Nova Science, 2011. Print. Guandalini, Stefano, and Mala Setty. "Celiac Disease." University of Chicago - Gastroenterology Section (2008): 707-12. Pub Med. Web. 10 Oct. 2014. • Lafiandra, D., S. Masci, and R. D'Ovidio. "Effects of Rye and Barley on Coeliac Disease." The Gluten Proteins. Cambridge, UK: Royal Society of Chemistry, 2004. 398-401. Print. • Van Walleghen, Emily, Dr. "Van Walleghen Celiac Disease Interview." Personal interview. 31 Oct. 2014.