Minireviews
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 26, 2019; 7(8): 917-927
Published online Apr 26, 2019. doi: 10.12998/wjcc.v7.i8.917
Food additives can act as triggering factors in celiac disease: Current knowledge based on a critical review of the literature
Clara Mancuso, Donatella Barisani
Clara Mancuso, Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, Monza 20900, Italy
Donatella Barisani, Department of Medicine and Surgery, University of Milano-Bicocca, Monza 20900, Italy
Author contributions: All authors equally contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Conflict-of-interest statement: There are no conflicts of interest arising from this work.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Donatella Barisani, MD, Associate Professor, Department of Medicine and Surgery, University of Milano-Bicocca, Building U-8, Via Cadore 48, Monza 20900, Italy. donatella.barisani@unimib.it
Telephone: +39-02-64488304
Received: January 13, 2019
Peer-review started: January 14, 2019
First decision: January 30, 2019
Revised: March 11, 2019
Accepted: March 16, 2019
Article in press: March 16, 2019
Published online: April 26, 2019
Abstract

Celiac disease (CeD) is an autoimmune disorder, mainly affecting the small intestine, triggered by the ingestion of gluten with the diet in subjects with a specific genetic status. The passage of gluten peptides through the intestinal barrier, the uptake by antigen presenting cells and their presentation to T cells represent essential steps in the pathogenesis of the disease. CeD prevalence varies in different populations, but a tendency to increase has been observed in various studies in recent years. A higher amount of gluten in modern grains could explain this increased frequency, but also food processing could play a role in this phenomenon. In particular, the common use of preservatives such as nanoparticles could intervene in the pathogenesis of CeD, due to their possible effect on the integrity of the intestinal barrier, immune response or microbiota. In fact, these alterations have been reported after exposure to metal nanoparticles, which are commonly used as preservatives or to improve food texture, consistency and color. This review will focus on the interactions between several food additives and the intestine, taking into account data obtained in vitro and in vivo, and analyzing their effect in respect to the development of CeD in genetically predisposed individuals.

Keywords: Celiac disease, Food additives, Metallic nanoparticles, Gluten, Intestine, Immune system

Core tip: Celiac disease (CeD) is a common autoimmune disorder caused by the ingestion of gluten. Its frequency has been increasing, and several factors have been analyzed as possible triggers; among them also food additives should be taken into account. Several nanoparticles are used as food additives or preservatives, and they can interact with the intestine or the immune system, increasing, in theory, the immune response towards gluten. The scope of this review is to analyze the data present in the literature with respect to the pathogenetic mechanisms involved in the development of CeD.