Patologías relacionadas con el gluten: un auténtico desafío para la seguridad alimentaria.
DOI:
https://doi.org/10.12873/444garciaPalabras clave:
Celiac disease, Gluten-free dietResumen
El gluten se define como la fracción proteica obtenida en extractos etanólicos de granos de endospermos de cereales como trigo, cebada, centeno, espelta y kamut. Es ampliamente utilizado en la industria alimentaria, sin embargo, este componente puede causar reacciones adversas en personas sensibles.
Las patologías relacionadas con el gluten se dividen en tres grupos según su etiopatología. El primer grupo se corresponde con patologías de causa alérgica. El segundo incluye enfermedades de tipo autoinmune, dónde destaca la enfermedad celíaca, con una prevalencia global del 1 %. Esta patología se produce debido a la generación de anticuerpos dirigidos frente a péptidos deaminados de la gliadina (un componente del gluten transformado químicamente por enzimas intestinales) y a enzimas transglutaminasas endógenas. Esta respuesta inmune participa en la generación de un ambiente proinflamatorio que termina por destruir el tejido intestinal. Existe un tercer grupo de patologías, denominadas sensibilidad al gluten no celíaca, cuyo mecanismo molecular exacto es aún desconocido, pero se piensa que los componentes de la inmunidad innata participan de manera fundamental. Se han intentado desarrollar diversas alternativas para tratar estas patologías, pero ninguna ha demostrado un mejor coste-efectividad que la estricta adherencia a una dieta sin gluten. Esta dieta no sólo inhibe los síntomas, sino que estimula la regeneración del tejido intestinal, especialmente en niños. Para poder asegurar que estas personas puedan llevar a cabo una dieta libre de gluten, se ha desarrollado una legislación específica en diversos países.
En este artículo de revisión se abordan las patologías relacionadas con el gluten, su tratamiento, el marco legislativo internacional sobre el contenido en gluten en alimentos y las medidas que se aplican en la industria alimentaria para proteger a los pacientes sensibles a este compuesto.
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