Gluten - a protein found in wheat and other cereals - may not be the only trigger for celiac disease, according to a new study that found patients with the disease also showed reactions to non-gluten wheat proteins.

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Researchers found that for patients with celiac disease, some non-gluten wheat proteins triggered the condition.

Writing in the Journal of Proteome Research, Armin Alaedini, assistant professor in the department of medicine at Columbia University in New York, NY, and colleagues suggest their findings could improve understanding of celiac disease and lead to better treatments.

Celiac disease is an autoimmune disease where a trigger causes the immune system to attack the body's own tissue - specifically, part of the gut. A known trigger is gluten - a protein found in cereals like wheat, rye and barley.

Prof. Alaedini and colleagues note that the gluten group accounts for around 75% of all the proteins found in wheat.

At present, the only recommended treatment for people with celiac disease is to avoid foods containing gluten. But the authors say few studies have looked at the effect of non-gluten proteins, and where they have, the results have been mixed. As such, they decided to investigate further.

Using serum samples from patients with celiac disease and dermatitis herpetiformis (a rash associated with the disease), alongside samples from healthy controls, the team tested their immune reaction to a number of non-gluten proteins and found:

"Compared with healthy controls, patients exhibited significantly higher levels of antibody reactivity to non-gluten proteins. The main immunoreactive non-gluten antibody target proteins were identified as serpins, purinins, α-amylase/protease inhibitors, globulins and farinins."

The authors recommend that when researchers explore potential clinical treatments for celiac disease, they do not overlook non-gluten proteins.

Celiac disease damages the gut's ability to absorb nutrients

In celiac disease, the immune attack damages the villi - small finger-like fleshy projections that line the small intestine and aid food digestion. Damaged villi means the body cannot absorb all the nutrients it needs. When people with celiac disease consume gluten, they develop diarrhea, abdominal pain, anemia and nutritional deficiencies.

Undiagnosed, celiac disease can lead to other autoimmune diseases and long-term health problems. These include multiple sclerosis, type 1 diabetes, dermatitis herpetiformis, anemia, osteoporosis, infertility, miscarriage, neurological conditions and intestinal cancers.

Celiac disease affects around 1 in 100 people worldwide. The condition is hereditary, so anyone with a first-degree relative with celiac disease (parent, child or sibling) has a 1 in 10 risk of developing it.

According to The Celiac Disease Foundation, an estimated 2.5 million Americans have celiac disease and do not know it.

In April 2014, Medical News Today reported a study published in JAMA Pediatrics that suggests celiac disease is more common in children with irritable bowel syndrome.