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Celiacs may benefit from antioxidant supplements

By Stephen Daniells , 15-Sep-2009

Sufferers of celiac disease have significantly reduced antioxidant capacity, says a new study, and could need natural antioxidants and appropriate dietary supplements.

According to findings published in the Clinical Biochemistry, the major reduction in their antioxidant levels is due to a reduction in levels of the antioxidant glutathione.

“As glutathione could be regenerated by other antioxidants, a diet rich in natural antioxidants, as well as appropriate dietary supplements, could be important complements to the classic therapy of celiac disease,” wrote the researchers, led by Vesna Stojiljkovic from the University of Belgrade.

Celiac disease, a condition characterized by an intolerance to gluten in wheat, is reported to affect up to 1 per cent of children and 1.2 per cent of adults, according to a study in the BMJ’s Gut journal. The only therapy for celiac patients is to adhere to a life-long gluten-free diet.

“It is generally accepted that the activation of immune system by gluten peptides is responsible for pathogenesis and progression of celiac disease,” explained Stojiljkovic and her co-workers.

“In the last decade the results of several investigations showed that gluten corrupts the pro-oxidant-antioxidant balance in intestinal mucosa, probably by an overproduction of free radicals. Nevertheless, the data concerning antioxidant status of celiac patients are scarce,” they added.

The researchers therefore set about studying the role of oxidative stress and antioxidant status in the pathogenesis of celiac disease.

Stojiljkovic and her co-workers recruited 39 children with different forms of celiac disease and 19 celiac-free children. Intestinal biopsies showed that the activities of antioxidant enzymes, such as superoxide dismutase, were increased in children with active and silent celiac disease. This would be in response to the higher levels of reactive oxygen species.

“In this study we found decreased glutathione concentrations in intestinal mucosa of the patients with active and silent celiac disease in comparison to the controls,” wrote Stojiljkovic and her co-workers. “This is followed by a decrease in the activity of glutathione peroxidase, a key enzyme in lipid peroxide elimination.”

“Since the activity of glutathione peroxidase, a main scavenger of hydrogen peroxide in gastrointestinal tissue was significantly decreased in active and silent group, the misbalance between hydrogen peroxide production and scavenging causes a pro-oxidant shift,” wrote the researchers. “[This] results in increased lipid peroxidation and higher lipid peroxide concentration.

“In these patients lipid peroxide concentration was 80 to 100 per cent higher than in the control group,” they added.

These observations, along with knowledge that glutathione could be regenerated by other antioxidants, led the researchers to note that consumption of an antioxidant-rich diet and “appropriate dietary supplements”, may complement the normal gluten-free diet.

The study funded by the Serbian Ministry of Science and Technological Development.

Source: Clinical Biochemistry
September 2009, Volume 42, Issues 13-14, Pages 1431-1437
“Antioxidant status and lipid peroxidation in small intestinal mucosa of children with celiac disease”
Authors: V. Stojiljkovic, A. Todorovic, S. Pejic, J. Kasapovic, Z.S. Saicic, N. Radlovic, S.B. Pajovic

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