--- title: "Gluten challenge celiac sprue: malabsorp & antibody response | Sutter Health" description: "Short-term gluten challenge in asymptomatic adult celiac patients produces carbohydrate and fat malabsorption but does not increase transglutaminase and antigliadin antibody titers." url: "https://www.sutterhealth.org/research/publications/gluten-challge-celiac-sprue-response-1055312499" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Gluten challenge celiac sprue: malabsorp & antibody response # Low-dose gluten challenge in celiac sprue: malabsorptive and antibody responses. Pyle GG, Paaso B, Anderson BE, Allen D, Marti T, Khosla C, & Gray GM. _Clin Gastroenterol Hepatol. 3(7):679-86._ 2005-07-01 ## Abstract BACKGROUND & AIMS: Undiagnosed patients with symptoms of celiac sprue often present to physicians after establishing dietary gluten exclusion. Although they must resume a gluten-containing diet for evaluation, there are no guidelines regarding duration of the gluten challenge, gluten dose, or monitoring parameters. We investigated the effects of a short-term gluten challenge in asymptomatic treated adult celiac patients on intestinal absorption and celiac antibody tests. METHODS: Eight adult asymptomatic celiac patients consumed either 5 or 10 g of partially hydrolyzed gluten per day in an orange juice mixture for 21 days while maintaining their usual gluten-free diet. A symptom questionnaire, serum antibodies (antigliadin immunoglobulin \[Ig\]A and antitransglutaminase IgA and IgG), D-xylose urine excretion test, and 72-hour quantitative fecal fat test were monitored. RESULTS: Two patients (25%) had at least 1 abnormal celiac antibody test at baseline. There was no increase in antibodies during gluten exposure compared with baseline for any of the patients (P > .05). At baseline, 1 patient had abnormal urine xylose excretion, and 3 patients had abnormal fecal fat values. At day 15 of gluten challenge, all patients had reduced xylose absorption compared with baseline (P = .0019), and 5 of 8 participants (63%) reduced their xylose excretion to the abnormal range. Seven of 8 patients (88%) had increased fecal fat excretion at day 15 (P = .026), and 6 of these (75%) had steatorrhea by day 15. CONCLUSIONS: Short-term gluten challenge in asymptomatic adult celiac patients produces carbohydrate and fat malabsorption but does not increase transglutaminase and antigliadin antibody titers. [PubMed abstract](http://www.ncbi.nlm.nih.gov/pubmed/16206501) ## Research topics - [Digestive Disorders](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Digestive+Disorders%5C%22%22) - [Disease Management](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Disease+Management%5C%22%22) - [Food and Nutrition](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Food+and+Nutrition%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Effect of pretreatment of food gluten with prolyl endopeptidase on gluten-induced malabsorption in celiac sprue.](https://www.sutterhealth.org/research/publications/prolyl-endopeptidase-gluten-malabsorp-celiac-sprue-1055312496) Pyle GG, Paaso B, Anderson BE, Allen DD, Marti T, Li Q, Siegel M, Khosla C, Gray GM. Clin Gastroenterol Hepatol. 3(7):687-94. 2005 Jul 01 - Publication ### [Dietary pattern change and acculturation of Chinese Americans in Pennsylvania.](https://www.sutterhealth.org/research/publications/diet-changes-and-acculturation-chinese-ams-in-pa-1055312864) Lv N, Cason KL. J Am Diet Assoc. 104(5):771-8. 2004 May 01 - Publication ### [Potential hazards of submucosal injection of methylene blue.](https://www.sutterhealth.org/research/publications/hazards-submucosal-injection-methylene-blue-1055312987) Chan EP, Kaltenbach T, Rouse RV, Soetikno R. Am J Gastroenterol. 107(4):633-4. doi: 10.1038/ajg.2011.462. 2012 Apr 01 - Publication ### [Festival foods in the immigrant diet.](https://www.sutterhealth.org/research/publications/festival-foods-in-the-immigrant-diet-1055312568) Azar KM, Chen E, Holland AT, Palaniappan LP J Immigr Minor Health. 15(5):953-60. doi: 10.1007/s10903-012-9705-4 2013 Oct 15 - Publication ### [Nutrition myths and healthy dietary advice in clinical practice.](https://www.sutterhealth.org/research/publications/nutrition-myths-dietary-advice-clinical-practice-1055312828) Lesser LI, Mazza MC, Lucan SC. Am Fam Physician. 91(9):634-8. 2015 May 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/gluten-challge-celiac-sprue-response-1055312499#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Gluten challenge celiac sprue: malabsorp & antibody response"}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/gluten-challge-celiac-sprue-response-1055312499#medicalscholarlyarticle","name":"Low-dose gluten challenge in celiac sprue: malabsorptive and antibody responses.","headline":"Gluten challenge celiac sprue: malabsorp & antibody response","abstract":"BACKGROUND & AIMS: Undiagnosed patients with symptoms of celiac sprue often present to physicians after establishing dietary gluten exclusion. Although they must resume a gluten-containing diet for evaluation, there are no guidelines regarding duration of the gluten challenge, gluten dose, or monitoring parameters. We investigated the effects of a short-term gluten challenge in asymptomatic treated adult celiac patients on intestinal absorption and celiac antibody tests. METHODS: Eight adult asymptomatic celiac patients consumed either 5 or 10 g of partially hydrolyzed gluten per day in an orange juice mixture for 21 days while maintaining their usual gluten-free diet. A symptom questionnaire, serum antibodies (antigliadin immunoglobulin [Ig]A and antitransglutaminase IgA and IgG), D-xylose urine excretion test, and 72-hour quantitative fecal fat test were monitored. RESULTS: Two patients (25%) had at least 1 abnormal celiac antibody test at baseline. There was no increase in antibodies during gluten exposure compared with baseline for any of the patients (P > .05). At baseline, 1 patient had abnormal urine xylose excretion, and 3 patients had abnormal fecal fat values. At day 15 of gluten challenge, all patients had reduced xylose absorption compared with baseline (P = .0019), and 5 of 8 participants (63%) reduced their xylose excretion to the abnormal range. Seven of 8 patients (88%) had increased fecal fat excretion at day 15 (P = .026), and 6 of these (75%) had steatorrhea by day 15. CONCLUSIONS: Short-term gluten challenge in asymptomatic adult celiac patients produces carbohydrate and fat malabsorption but does not increase transglutaminase and antigliadin antibody titers.","description":"Short-term gluten challenge in asymptomatic adult celiac patients produces carbohydrate and fat malabsorption but does not increase transglutaminase and antigliadin antibody titers.","keywords":["Digestive Disorders","Disease Management","Food and Nutrition"],"datePublished":"2005-07-01","url":"https://www.sutterhealth.org/research/publications/gluten-challge-celiac-sprue-response-1055312499","inLanguage":"en-US","identifier":[{"@type":"PropertyValue","propertyID":"PMID","value":"16206501"}],"sameAs":["https://pubmed.ncbi.nlm.nih.gov/16206501/"],"isPartOf":{"@type":"Periodical","name":"Clin Gastroenterol Hepatol"},"author":[{"@type":"Person","name":"Pyle GG"},{"@type":"Person","name":"Paaso B"},{"@type":"Person","name":"Anderson BE"},{"@type":"Person","name":"Allen D"},{"@type":"Person","name":"Marti T"},{"@type":"Person","name":"Khosla C"},{"@type":"Person","name":"Gray GM"}],"sourceOrganization":{"@type":"MedicalOrganization","name":"Palo Alto Medical Foundation Research Institute"},"about":[{"@type":"DefinedTerm","name":"Digestive Disorders","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Digestive+Disorders%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Disease Management","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Disease+Management%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Food and Nutrition","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Food+and+Nutrition%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/gluten-challge-celiac-sprue-response-1055312499","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/gluten-challge-celiac-sprue-response-1055312499#breadcrumblist"}}} ```