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Saturday, October 12, 2013

In a startling paper discussing treatment alternatives for celiac
disease, research from George Washington University School of Medicine
finds that probiotics provide a viable solution for gluten digestion and
intestinal health – and likely their absence provides the smoking gun
for the cause of gluten sensitivities.

Celiac disease – an inflammatory immune response to the gliadin
protein in gluten – has been increasing over the past few years, and
research is illustrating that celiac disease is more prevalent than
previously considered.

Gluten sensitivities also appear to be increasing, with more and more
people in western countries – especially in the U.S. – opting for
gluten-free diets. This typically comes from a sense many have had that
the gluten foods in their diet produce intestinal irritations, including
bloating and indigestion. For this reason, the term “gluten-free” has
become ubiquitous among health food stores and consumers.

Meanwhile, we find that grain-based foods have been part of the human
diet for thousands of years, and some of the healthiest diets –
including the Mediterranean Diet – contain gracious quantities of wheat
and other whole grains. This is not to mention of course the fiber
content among whole grains and the research that has shown foods rich in
fiber reduce heart disease and other metabolic disorders.

And many traditional societies – producing the diets of a majority of
the world’s population, many of which are known for long lifespans –
have grains as the cornerstone of their diet. These cultures also come
with an absence of a history of intestinal problems.

This leads to the logical question: Has humanity really been
poisoning itself with wheat and other gluten-containing grains
(including barley, rye and others)? Or could there be something else
going on?

The gluten mystery is solved

The mystery appears to have been solved, as significant research
focus and several teams of investigators have confirmed that the
inflammatory response to gliadin – initiated with an interleukin-15
mediated response – is inhibited by healthy intestinal probiotics.

A 2012 paper by three medical school professors studied the various
means by which the effects of celiac disease may be mitigated – by
inhibiting the inflammatory response. The paper’s authors include two
professors who are gastroenterology professors at George Washington
University School of Medicine, Anita Bakshi, M.D.and Sindu Stephen, M.D.
Two other clinical M.D.s co-authored the research.

The researchers focused first upon the mechanisms of wheat gliadin
protein upon the intestinal cells – which produce inflammation and
intestinal permeability. These include the activation of a CD4+ T-cell
response among the intestinal cells – which induces the secretion of a
protein called zonulin. Zonulin then stimulates an increase in the
spaces in the tight junctions between the intestinal cells, creating gut
permeability.

This opening between intestinal cells is accompanied by an even
greater inflammatory response as the immune system responds to larger
proteins having potential contact with the bloodstream.
While there are a number of studies that have shown these effects,
the researchers singled out a few studies that clearly and specifically
illustrated how intestinal probiotics in a healthy body will inhibit
this process by breaking down gluten through protease (enzyme) activity.
In one of these, Irish researchers found that two enzymes produced
from probiotic bacteria – prolyl endopeptidase and endoprotease B – were
able to break down gluten into non-reactive elements, completely
sidestepping the possible intestinal response.

This research was confirmed in a clinical setting by scientists at
the Celiac Sprue Research Foundation in Palo Alto, California. Here 20
celiac patients were given small doses of gluten with and without
(double-blind, randomized, cross-over) being pretreated with one of
these probiotic-produced enzymes – prolyl endopeptidase. The cross-over
study utilized two 14-day treatment periods in total, in a staged
format.

The pretreatment with the enzyme allowed a majority of the celiac
patients to avoid malabsorption of carbohydrates and fats – a typical
symptom of celiac sprue response.
The researchers concluded that:

“Pretreatment of gluten with prolyl endopeptidase
avoided the development of fat or carbohydrate malabsorption in the
majority of those patients who developed fat or carbohydrate
malabsorption after a 2-week gluten challenge.”

In a series of studies from Finland’s University of Tampere Medical
School, researchers tested the probiotics strains Lactobacillus
fermentum and Bifidobacterium lactis with gluten digestion and the
inflammatory effects of gliadin.

They found that these live probiotics were both able to inhibit the
inflammation response among sensitive intestinal (Caco-2) cells. In both
instances the probiotics prevented the inflammatory response as well as
prevented the formation of “membrane ruffles.”

This of course means the probiotics reduced the amount of intestinal
damage caused by the inflammatory response related to the gluten
ingestion.
And in their conclusion, the researchers stated:

“We conclude thus that live B. lactis bacteria can
counteract directly the harmful effects exerted by coeliac-toxic gliadin
and would clearly warrant further studies of its potential as a novel
dietary supplement in the treatment of coeliac disease.”

While the inflammatory response in celiac sprue is typically
described as being the result of a genetic abnormality, intestinal
irritation and indigestion to gluten in non-celiac people provokes
similar mechanisms of inflammation – though not as vigorous – and not
linked with genetic abnormality (yet).

The UGW researchers 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.”

These results have been confirmed by other research. In a study from
earlier this year, researchers from Argentina’s University of Buenos
Aires tested a probiotic supplement with 22 adults with celiac disease.
The patients were given either capsules with the probiotic
Bifidobacterium infantis or a placebo for 3 weeks.

Those taking the probiotic supplement had significantly lower levels
of indigestion, constipation and other intestinal symptoms as gauged by
the Gastrointestinal Symptom Rating Scale. Levels of IgA antibodies to
gluten were also lower among the probiotic group.
The researchers stated:

How celiac research applies to gluten intolerance

Certainly adult celiac patients are dealing with a dramatically
heightened genetic response to the gluten protein, which is
significantly greater than what is experienced by those even with some
gluten sensitivity. And we cannot necessarily suggest that the the
inflammatory immune response of a celiac sprue patient can be completely
eliminated by gliadin enzymes released by probiotics, which break down
those gliadin proteins. This is because the gliadin genetic imprint may
still be recognized by the immune system – producing the antibody-driven
inflammatory response.

However, the non-genetic immune response that produces some bloating
and/or indigestion for non-celiac people sensitive to gluten has many
of the same mechanisms – especially when it comes to creating intestinal
permeability. And the research is showing that even among celiac
patients, symptoms of gluten intolerance are reduced. So it would only
be logical to conclude – as have many researchers – that gluten
sensitivities outside of celiac disease may be alleviated with healthy
intestinal flora.

We also have only been looking through a narrow beam of research
investigating only a few enzymes and probiotics. A healthy human
intestine is a microcosm of thousands of strains of probiotic bacteria
which produce a myriad of enzymes that assist our body with the
digestion of nature’s foods. So we are merely scratching the surface,
yet the surface truly reveals the culprits involved.

After reviewing the research (before this last study), the GW medical professors supported this conclusion by stating:

“Supplementation with a variety of bacterial strains can help inhibit gluten/gliadin-induced damage in the small intestine.”

The ‘smoking gun’ for growing gluten sensitivities is identified

The research clearly identifies the smoking gun for the growth of
intestinal irritability and gluten insensitivity: The steady and growing
destruction of healthy probiotics within our intestines through an
unbridled use of antibiotics and antiseptics.

When we examine the evidence: The fact that gluten sensitivities have
been growing as the use of antibiotics and antiseptics have become
increasingly utilized together with the findings that enzymes produced
by probiotics break down gluten and gliadin into non-toxic constituents,
we can only arrive at the conclusion that our gut microflora has
everything to do with wheat and other gluten sensitivities.

And with this conclusion, avoiding all forms of gluten in our diets
can not only be an arduous and close to impossible task – but it may
become unnecessary if we learn to maintain healthy intestinal
probiotics.

Wheat and grains are necessary for healthy intestinal probiotics

In fact, research from UK researchers has determined that gluten
grains – and wheat in particular – also provide critical nourishment
(prebiotics) for our intestinal probiotics. This has now been
established in a number of laboratory and human clinical studies over
the past couple of years.
For example, in research led by Professor of Food Microbial Sciences
at the UK’s University of Reading, Dr. Glenn Gibson, 55 healthy men and
women were given different doses of a wheat bran for three weeks. Those
eating more wheat bran showed an increase in healthy probiotic
bifidobacteria in their intestines and colons.

Another study led by Dr. Gibson tested 40 adults, and found the same
conclusion: A polysaccharide named arabino-xylan-oligosaccharide – a
component of wheat bran – was found to be the prebiotic. After many
additional studies, it has been confirmed that
arabino-xylan-oligosaccharide is critical for the health of our
intestinal probiotics – and this nutrient is now considered a prebiotic.

About the Author

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.