Randomised trial · International immunopharmacology · 2017Abstract only

Modified wheat gluten in people with celiac disease

What it found

In a small trial in people with celiac disease, those who ate wheat flour treated with an enzyme had fewer signs of immune reaction and gut damage than those who ate untreated flour.

The authors say larger trials are needed to confirm this.

What they found

Studies in people

Immune blood markers

At the end, 2 of 7 people eating the treated rusks and 4 of 7 eating untreated rusks had positive anti-tTG and EMA blood results. All had been negative at the start.

Gut damage

Villous atrophy was found in 1 of 7 people eating treated rusks and 4 of 7 eating untreated rusks.

Antibody levels

In the untreated group, anti-actin antibody levels rose significantly, and duodenal anti-tTG levels were higher than in the treated group.

Symptoms

Abdominal swelling, bloating and nausea were more severe in people eating untreated rusks than in those eating treated rusks.

Kidney marker

Creatinine levels did not change.

What the authors conclude

“Our results may support larger clinical trials to confirm the enzymatic treatment of wheat flour as an alternative to GFD.”
Marino M, Casale R, Borghini R, et al, 2017

Also in their conclusions

  • They say their results may support larger clinical trials to confirm the enzymatic treatment of wheat flour as an alternative to a gluten-free diet.

How it was done

Celiac disease is treated with a gluten-free diet, but other approaches have been suggested. Treating gliadin peptides with microbial transglutaminase stops them triggering an immune response in lab tests.

Twenty-one people with celiac disease in remission were randomly assigned to eat rusks made from wheat flour treated with microbial transglutaminase (11 people) or untreated flour (10 people), without knowing which they got. They filled in symptom questionnaires every month, had blood tests, and had an endoscopy at the start and after 90 days.

What it can’t tell you

  • We summarised it from the abstract only.
  • This was a small trial, with only 7 people in each group finishing it. Larger trials are needed to confirm the findings.

The paper

Title
The effects of modified versus unmodified wheat gluten administration in patients with celiac disease
Type
Randomised controlled trial
Evidence
Studies in people
Summarised from
Abstract only
Cite
Marino M, Casale R, Borghini R, et al (2017). The effects of modified versus unmodified wheat gluten administration in patients with celiac disease. International immunopharmacology. doi:10.1016/j.intimp.2017.03.012PubMed 28343108DOI

Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error