For individuals with coeliac disease, strict adherence to a gluten-free diet is essential for managing symptoms and promoting intestinal healing.
However, some people may still experience ongoing symptoms despite eliminating gluten.
One possible explanation is cross-reactivity, where proteins from other foods mimic the structure of gluten and trigger an immune response.
Here, we will explore some food proteins that have been associated with cross-reactivity in coeliac disease.
Oats themselves are gluten-free, but some individuals with coeliac disease may experience cross-reactivity with avenin, a protein found in oats. Cross-contamination during processing or improper sourcing may also contribute to this cross-reactivity.
Casein is a protein found in milk and dairy products. Some individuals with coeliac disease may experience cross-reactivity between casein and gluten. Casein's structural similarities to gluten proteins may lead to an immune response in susceptible individuals. If ongoing symptoms persist despite strict adherence to a gluten-free diet, eliminating dairy products temporarily can help determine if casein cross-reactivity is a factor.
Cross-reactivity can occur when certain proteins from other foods share similar amino acid sequences or structures with gluten proteins.
This molecular mimicry can lead to immune reactions in individuals with coeliac disease.
While the extent and significance of cross-reactivity through molecular mimicry are still being studied, some potential cross-reactive proteins include:
It is important to note that the presence of molecular mimicry does not guarantee cross-reactivity in all individuals. Cross-reactivity is highly individual and may vary depending on the person's immune response and specific sensitivities.
While a strict gluten-free diet remains the primary treatment for coeliac disease, some individuals may experience cross-reactivity with proteins from other foods. Avenin in oats, casein in dairy, and proteins with molecular mimicry potential such as those found in rice, corn, millet, yeast, and coffee have been associated with cross-reactivity. However, the significance of these potential cross-reactions and their impact on symptom management vary among individuals.
Testing: Testing for cross-reactive food proteins in coeliac disease is possible with the Cyrex Array 4 test. This comprehensive panel identifies specific proteins that may trigger immune reactions similar to gluten.
If you suspect cross-reactivity or continue to experience symptoms despite a gluten-free diet, it is recommended to consult with a functional medicine practitioner knowledgeable in coeliac disease. They can provide personalisd guidance, help identify potential triggers, and support you in developing an appropriate dietary plan to achieve optimal symptom relief and overall well-being.