Correspondence

The Ethiopian Cereal Tef in Celiac Disease

N Engl J Med 2005; 353:1748-1749October 20, 2005

Article

To the Editor:

Celiac disease is caused by aberrant T-cell responses to wheat gluten and the gluten-like proteins in barley and rye.1 The only cure for the disease is a lifelong gluten-free diet. Although consumption of oats is generally considered safe for patients with celiac disease,2 recent studies indicate that the grain does contain T-cell–stimulatory epitopes1,3 and that symptoms of celiac disease develop in some patients after the consumption of oats.4 A cereal lacking T-cell–stimulatory peptides would thus be of great value to patients with celiac disease. Tef (Eragrostis tef) is a cereal traditionally grown in Ethiopia and used to make injera, or flat bread. Tef flour can substitute for wheat flour in almost all applications, and the nutritional value of tef is similar to that of wheat (www.ipgri.cgiar.org/publications/pdf/279.pdf). Since tef is only distantly related phylogenetically to wheat, barley, and rye, we have investigated the potential safety of tef for consumption by patients with celiac disease.

For this purpose, pepsin and trypsin digests were prepared of 14 varieties of tef (provided by Soil and Crop, Assen, the Netherlands) and of wheat, barley, rye, triticale, oats, maize, and rice as controls. These digests were analyzed for the presence of T-cell–stimulatory epitopes of α-gliadin (Figure 1AFigure 1Analyses Showing an Absence of Gluten-Derived T-Cell Epitopes in Tef.), γ-gliadin, and low- and high-molecular-weight glutenin (not shown) by T-cell and antibody-based assays.5 In addition, extracted proteins of one tef variety were separated by two-dimensional gel electrophoresis and analyzed by Western blotting and mass spectrometry. Although T-cell–stimulatory epitopes were detected in protein digests of known gluten-containing cereals, all tef varieties lacked these epitopes (Figure 1A). In a similar manner, with monoclonal antibodies specific for T-cell–stimulatory gluten peptides, comparable results with the various control preparations were obtained, whereas 12 of the 14 tef preparations tested negative (Figure 1B). With two tef varieties, weak antibody responses were found, even though Western blot and mass spectrometric analysis detected no gluten-like proteins (which were readily detected in barley, rye, and oats) (not shown). Therefore, this response was probably based on antibody cross-reactivity to nongluten molecules.

In conclusion, within the limits of the currently available methods, no gluten or gluten homologues could be detected in the tef varieties tested. This finding indicates that tef may be suitable for use in the diet of patients with celiac disease. Ultimately, the study of tef consumption by patients with celiac disease in remission will be needed in order to determine whether tef is safe for these patients.

Liesbeth Spaenij-Dekking, Ph.D.
Yvonne Kooy-Winkelaar
Frits Koning, Ph.D.
Leiden University Medical Center, 2300 RC Leiden, the Netherlands

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Citing Articles (15)

Citing Articles

1. 1

   Sander H. van Delden, Jan Vos, Tjeerd-Jan Stomph, Gerard Brouwer, Paul C. Struik. (2012) Photoperiodism in Eragrostis tef: Analysis of ontogeny and morphology in response to photoperiod. European Journal of Agronomy 37:1, 105-114
   CrossRef

2. 2

   M. Zeid, K. Assefa, A. Haddis, S. Chanyalew, M.E. Sorrells. (2012) Genetic diversity in tef (Eragrostis tef) germplasm using SSR markers. Field Crops Research 127, 64-70
   CrossRef

3. 3

   Paolo Bergamo, Francesco Maurano, Giuseppe Mazzarella, Gaetano Iaquinto, Immacolata Vocca, Anna Rita Rivelli, Enrica De Falco, Carmen Gianfrani, Mauro Rossi. (2011) Immunological evaluation of the alcohol-soluble protein fraction from gluten-free grains in relation to celiac disease. Molecular Nutrition & Food Research 55:8, 1266-1270
   CrossRef

4. 4

   A. Araya, Leo Stroosnijder, G. Girmay, S.D. Keesstra. (2011) Crop coefficient, yield response to water stress and water productivity of teff (Eragrostis tef (Zucc.). Agricultural Water Management 98:5, 775-783
   CrossRef

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   K. Assefa, J.-K. Yu, M. Zeid, G. Belay, H. Tefera, M. E. Sorrells. (2011) Breeding tef [Eragrostis tef (Zucc.) trotter]: conventional and molecular approaches. Plant Breeding 130:1, 1-9
   CrossRef

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   Gianfranco Mamone, Gianluca Picariello, Francesco Addeo, Pasquale Ferranti. (2011) Proteomic analysis in allergy and intolerance to wheat products. Expert Review of Proteomics 8:1, 95-115
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   M. Zeid, G. Belay, S. Mulkey, J. Poland, M. E. Sorrells. (2011) QTL mapping for yield and lodging resistance in an enhanced SSR-based map for tef. Theoretical and Applied Genetics 122:1, 77-93
   CrossRef

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   S. H. Van Delden, J. Vos, A. R. Ennos, T. J. Stomph. (2010) Analysing lodging of the panicle bearing cereal teff (Eragrostis tef). New Phytologist 186:3, 696-707
   CrossRef

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   Mukadder Ayşe Selimoğlu, Hamza Karabiber. (2010) Celiac Disease. Journal of Clinical Gastroenterology 44:1, 4-8
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    S. Evert, S. Staggenborg, B. L. S. Olson. (2009) Soil Temperature and Planting Depth Effects on Tef Emergence. Journal of Agronomy and Crop Science 195:3, 232-236
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