Publication details
Does antibody reactivity to avenin in childhood celiac disease patients predict an oat-based personalized gluten-free diet?
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| Year of publication | 2025 |
| Type | Conference abstract |
| Citation | |
| Description | Objectives and Study: A lifelong gluten-free diet is the only therapeutic regimen for celiac disease (CD). Strict avoidance of wheat, rye, and barley is recommended. Current evidence suggests that most CD patients do not induce an autoimmune reaction to oats. Reactivity to avenin, an oat prolamin, however, may in some patients trigger an immune response similar to that of gliadin, a wheat prolamin. In this prospective study, we evaluate oat reactivity in pediatric CD patients. Based on the results, we aim to identify nonreactive individuals who may safely consume oats immediately after their initial diagnosis. This straightforward comparative analysis seeks to address the ongoing controversy regarding whether oats can be safely incorporated into the diet of CD patients, particularly given the persistent debate over their safety. Methods: Quantification of IgA, IgG, and IgE antibodies (and their respective subclasses) binding to both native and recombinant avenins and gliadins was performed using multiplexed fluorescent ELISA (FLISA) and mass spectrometry (LC-MS/MS) in parallel. Statistical analysis of 100 serum samples from CD patients obtained at a time of initial diagnosis and 50 samples from healthy controls. Results: A subset of CD patients revealed significant reactivity to avenin, potentially limiting their ability to tolerate oats. FLISA and MS helped in identifying patients with low or no reactivity who may safely include oats into their diets. Antibody reactivity was analyzed together with comprehensive clinical data (human leukocyte antigen [HLA] typing, Marsh classification, symptoms, etc.) with the aim of patient risk stratification and predictor modelling. Detailed results and comprehensive clinical data will be presented at the conference. Conclusions: This study aims to enhance our understanding of immunological tolerance to oat products in CD patients and provide a foundation for personalized dietary recommendations. |