No Harm of Oats in the Diet of Children With Newly or Previously Diagnosed Coeliac Disease (Cd)

52 This study was aimed to evaluate whether coeliac children are able to use oats in their diet without damaging their duodenal mucosa or causing antibody responses. The oats challenge group of thirteen over 7 years old CD children diagnosed at least 2 years earlier, eating a strict gluten-free diet (GFD) and having normal small bowel mucosal morphology, started taking 50 grams of oats per day. The control group was composed of 10 CD children undergoing postpubertal gluten challenge (PGC). Also 9 newly diagnosed CD children started oats beside conventional GFD. All patients were examined at the beginning of the study and at 1, 3, and 6 months. Control biopsies were performed at 6 months. Clinical, serological (serum IgA and IgG class gliadin, reticulin and IgA class endomysial antibody tests), morphometrical (villous height (VH), crypt depth(CrD) measures, villous height/crypt depth ratio (VH/CrD) and intraepithelial lymphocyte (IEL) counts) immunohistochemical (intraepithelial density of CD3+, α/β+, γ/δ+ T cells and HLA-DR staining intensity) and nutritional evaluations were performed. In the oats challenge group 10 out of 13 patients did not develop any antibody responses under the 6 months follow up time and all biopsy specimens were normal as studied by morphometrical and immunohistochemical methods. Two of the 13 patients in the oats challenge group had symptoms of vomiting and diarrhoea only after 2-3 hours of the first meal with oats without any morphological or immunohistochemical signs of inflammation. One patient did not follow the GFD and showed the lowest positive reticulin and endomysial antibody test value at 3 months. All the CD patients undergoing the PGC had positive serological tests at 1-3 months and developed flat mucosa within 6 months. All the 9 newly diagnosed CD patients showed a clear decline in their antibody levels and normalisation of the mucosa after 6 months despite of oats ingestion (mean VH 356μm and CrD 131μm, VH/CrD 2.7). Intraepithelial CD3+ and α/β+ T cell densities had decreased significantly. Our study shows that coeliac children on a GFD and newly diagnosed patients are able to ingest even high amounts of oats without harmful effects on the jejunal mucosal architecture, intraepithelial lymphocyte counts, antibody levels or clinical symptoms.