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On 7th December 2023, the European Food Safety Authority (EFSA) released the results of its exploration into how Europe can safeguard coeliac disease patients.
EFSA researchers have investigated the causes of coeliac disease and developed a tool for screening proteins in food products and ingredients that might cause coeliac symptoms in patients. The discovery of these tools opens up opportunities for manufacturers to develop others and has the potential for use in various food safety areas.
Advancing coeliac disease understanding
Coeliac disease is caused by an immune reaction prompted by gluten and proteins in foods containing wheat, barley or rye. While symptoms vary considerably between people with coeliac disease, they typically include stomach ache, diarrhoea, malnutrition, iron deficiency (anaemia) and osteoporosis.
Studies indicate that approximately 0.7% of the population in the European Union (EU) suffers from coeliac disease, but many cases go unreported. Symptom detection and diagnoses are vital as the only therapy for coeliac disease is currently a permanent gluten-free diet. Adherence to a gluten-free diet requires considerable patient education, motivation and follow-up, a 2019 research study confirmed.
Coeliac disease patients all share one or two molecules called HLA-DQ2 and HLA-DQ8, which are receptors that efficiently bind fragments of gluten proteins. “This binding allows recognition of the gluten fragment by the immune system, triggering coeliac disease,” Professor Koning stated, who has investigated how coeliac disease develops and behaves and is a member of the EFSA working group that helps to assess the allergenicity of genetically modified (GM) plants.
“EFSA’s new tool provides a practical application for predicting whether ingredients in foods may pose a risk for coeliac disease patients,” a spokesperson for EFSA told FoodNavigator. “Anyone can use the tool to screen primary amino acid sequences in proteins to predict health risks,” added the spokesperson.
Food safety tests
The tool aims to progress the food industry’s understanding of coeliac disease. It is based on a model, EFSA’s spokesperson said, “which allows a rapid evaluation of proteins from plants, animals or microorganisms used in food”.
EFSA’s tool, preDQ uses a mathematical model and application to predict how gluten from food binds to the HLA-DQ2 and HLA-DQ8 receptors, called ‘peptide binding’. The tool enables the researchers to evaluate plant, animal or microorganism proteins used in consumers’ food before they are allowed in their diets. “We use the tool to screen the primary amino acid sequence of the protein to predict whether or not binding of fragments of the protein will take place. If it predicts binding, the protein may pose a risk for coeliac disease patients,” Professor Frits Koning stated.
Potential for the wider food industry
EFSA’s scientific teams are now using the preDQ tool in its GM plant assessments after the discovery. In the future, it could be used to screen any proteins, for example, those in novel foods, food/feed enzymes, contaminants, and GM food or feed. The tool could also be used outside the EFSA by producers to screen crop plants made by plant breeding techniques.
“I am pleased that over a decade later, my research and the work of the scientific community is helping to protect European coeliac disease patients from being exposed to harmful food products,” Professor Koning said.
The tool serves to help coeliac sufferers identify symptoms and the presence of the condition, which, in turn, encourages manufacturers to develop more gluten-free products. However, new research presented in The Association of European Coeliac Societies (AOECS)’s Scientific Research eBook detailed that many people with coeliac continue to experience persistent gastrointestinal symptoms despite strict adherence to a gluten-free diet.
Medication to help people avoid accidental gluten exposure may be the answer and will be in place by the end of the decade. Clinical phase two tests are taking place on a drug to improve intestinal damage in Europe.
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