Reunala T, Collin P, Holm K, Pikkarainen P, Miettinen A, Vuolteenaho N, Mäki M
Departments of Dermatology, University and University Hospitals of Tampere and Helsinki, Finland.
Gut. 1998 Oct;43(4):490-3. doi: 10.1136/gut.43.4.490.
Recent studies on coeliac disease have shown that oats can be included in a gluten-free diet without adverse effects on the small bowel. The presence of a rash is also a sensitive indicator of gluten ingestion in dermatitis herpetiformis, and this was used to study whether patients with this disease could also tolerate oats.
PATIENTS/METHODS: Eleven patients with dermatitis herpetiformis in remission on a gluten-free diet were challenged daily with 50 g oats for six months. Clinical symptoms were recorded, serum samples taken, and skin and small bowel biopsies performed before and after the oat challenge. A control group comprised of 11 patients with dermatitis herpetiformis on a conventional gluten-free diet was also studied.
Eight patients challenged with oats remained asymptomatic, two developed a transient rash, and one withdrew because of the appearance of a more persistent but mild rash. Three of the 11 controls also developed a transient rash. IgA endomysial antibodies remained negative in all patients. The small bowel villous architecture, the densities of intraepithelial CD3 and alpha/beta and gamma/delta T cell receptor positive lymphocytes and crypt epithelial cell DR expression remained unaltered during the oat challenge.
The results confirm the absence of oat toxicity on the gluten sensitive small bowel mucosa and suggest that the rash in patients with dermatitis herpetiformis is not activated by eating oats.
近期关于乳糜泻的研究表明，燕麦可纳入无麸质饮食中，且对小肠无不良影响。皮疹的出现也是疱疹样皮炎患者摄入麸质的敏感指标，本研究以此来探究该疾病患者是否也能耐受燕麦。
患者/方法：11名在无麸质饮食下病情缓解的疱疹样皮炎患者，连续6个月每天食用50克燕麦进行挑战试验。记录临床症状，采集血清样本，并在燕麦挑战试验前后进行皮肤和小肠活检。还研究了一个由11名采用传统无麸质饮食的疱疹样皮炎患者组成的对照组。
8名接受燕麦挑战的患者无症状，2名出现短暂皮疹，1名因出现更持久但轻微的皮疹而退出。11名对照组患者中有3名也出现了短暂皮疹。所有患者的IgA肌内膜抗体均保持阴性。在燕麦挑战试验期间，小肠绒毛结构、上皮内CD3以及α/β和γ/δ T细胞受体阳性淋巴细胞的密度和隐窝上皮细胞DR表达均未改变。
结果证实燕麦对麸质敏感的小肠黏膜无毒性，并表明疱疹样皮炎患者的皮疹并非由食用燕麦引发。
