Inflammation in people with rheumatoid arthritis may be promoted by a group of proteins, called amylase-trypsin inhibitors (ATIs), that are commonly found in wheat, researchers reported. ATIs might also play a role in the development of gluten sensitivity unrelated to celiac disease, a condition diagnosed in non-celiacs who also benefit from gluten-free diets.

The team presented the work at the recent United European Gastroenterology (UEG) Week in Vienna.

Researchers analyzed multiple tissues for the development of inflammation following intake of ATIs, and looked for inflammatory markers in tissues not typically associated with digestion. They found that ATIs augmented inflammatory processes taking place not only in the gut, but also in the lymph nodes, spleen, kidneys and brain; a finding that lead them to suggest that ATIs can be a trigger in people with chronic autoimmune conditions characterized by inflammation, such as rheumatoid arthritis (RA) and multiple sclerosis (MS).

According to an increasing body of  ATI-centered literature — albeit mostly associated with the proteins’ impact on the gut — there is reason to believe that these inhibitory proteins may not necessarily initiate, but seem to exacerbate, some of the most common complaints of people with inflammatory disease such as RA and MS.

“As well as contributing to the development of bowel-related inflammatory conditions, we believe that ATIs can promote inflammation of other immune-related chronic conditions outside of the bowel. The type of gut inflammation seen in non-celiac gluten sensitivity differs from that caused by celiac disease, and we do not believe that this is triggered by gluten proteins. Instead, we demonstrated that ATIs from wheat, that are also contaminating commercial gluten, activate specific types of immune cells in the gut and other tissues, thereby potentially worsening the symptoms of pre-existing inflammatory illnesses,” Detlef Schuppan, the study’s principal investigator and a professor at Johannes Gutenberg University in Germany, said in a press release.

“We are hoping that this research can lead us towards being able to recommend an ATI-free diet to help treat a variety of potentially serious immunological disorders,” Schuppan added.

Highlighting the importance of identifying the disease-causing agents for non-celiac individuals who do well on a gluten-free diet, Schuppan concluded, “Rather than non-celiac gluten sensitivity, which implies that gluten solitarily causes the inflammation, a more precise name for the disease should be considered.”

In 2015, Schuppan published the study, “Wheat amylase trypsin inhibitors as nutritional activators of innate immunity,” in which researchers showed that ATIs “appear to play a role in promoting other immune-mediated diseases within and outside the GI [gastrointestinal] tract.”

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