Canadian Journal of Gastroenterology and Hepatology / 2016 / Article / Tab 2

Review Article

Celiac Disease and Gluten-Free Oats: A Canadian Position Based on a Literature Review

Table 2

Clinical studies of the effects of oats on adults with celiac disease from January 2008 to January 2015.

Reference authors, year of publicationNumber of subjects testedOats exposureAmount of oatsLab testsBiopsyDropout rateConclusion

Guttormsen et al., 2008, Norway [21]
82 subjects GFD with oat consumption
54 subjects GFD without oats
2 yearsMean = 24 g/day (minimum 6 months)Antiavenin IgA, anti-gliadin IgA, and TTG IgA No biopsyNot specifiedMost adult CD patients can tolerate oats Ingestion of oats does not cause increased levels of IgA oats in CD patients with GFD
Purity of oats not verified

Sey et al., 2011, Canada [22]3 months50 g/dayTTG IgADuodenal biopsies before and after oat challenge (Marsh score): histology scores did not significantly change during oat challengeOne relapse occurred in a patient who became noncompliant with GFDIgA TTG antibodies remained negative in all patients and the histology scores did not change. Support the safety of uncontaminated oats for patients with CD

Tuire et al., 2012, Finland [23]
96 (54%) with persistent IEL
74 (42%) normal small intestinal mucosa
7 (4%) villous atrophy
Mean = 11 yearsNot specifiedEndomysial IgA and TTG IgAConsumption of oats was the only factor contributing to the persistent IELDespite excellent villous recovery, persistent IEL was common among CD patients on a long-term GFD. Consumption of oats was associated with persistent IEL
Purity of oats not verified.

Kaukinen et al., 2013, Finland [24]
36 no oat in GFD
70 oats in GFD
Median = 5 years
Range = 0.5–8 years
Median = 20 g/day
Range = 1–100 g/day
Endomysial IgA and TTG IgASmall-bowel mucosal biopsies were normal in 103 patients
2 patients using oats and 1 patient not using oats had abnormal structure
NoneLong-term consumption of pure oats proved to be safe for CD patients. Long-term regular follow-up is recommended

Hardy et al., 2015 [25]
(3 sources of oats assessed)
3 days100 g/dayIn vivo avenin-specific T cells responsesNo biopsy4 subjects did not complete the full 3-day challenge34 patients reported no symptoms and 46 reported digestive symptoms.
Ingestion of 100 g of oats provides weak antigenic stimulation of blood avenin-specific T cells (<10% of CD patients) which is different from the antigenic stimulation observed with wheat, rye, and barley

Abs: antibodies; CD: celiac disease; GFD: gluten-free diet; IEL: intraepithelial lymphocytes; IgA: immunoglobulin A; IgG: immunoglobulin G; TTG: tissue transglutaminase; GFD-std: standard GFD without oats; GFD-oats: GFD with uncontaminated oats.