Gluten Immunity and Islet Autoimmunity in Type-1 Diabetes

Participants meeting eligibility criteria will have blood collected before and after a
three-day oral gluten challenge. This blood will be tested for biomarkers associated with
islet autoimmunity and gluten-specific cellular immunity.

Inclusion Criteria:

- Diagnosis of Celiac Disease by histology and serology

- For those with Type-1 Diabetes, at least one anti-islet antibody

- HLA-DQ2.5 genotype

Exclusion Criteria:

- Not following a gluten free diet for at least 12 months

- Known gluten exposure within the prior 2 months

- Treatment with systemic immune modifying biological agents (adalimumab, etanercept,
infliximab, certolizumab pegol) in prior 6 months

- Treatment with systemic immunomodulatory agents in prior 30 days

- Human immunodeficiency virus infection, untreated hepatitis B virus, or hepatitis C
virus infection

- Nut allergy

- Hemoglobin level below normal range

- History of angina

- Pregnant or lactating

- Severe symptoms to gluten challenge in the past

- Elevation in transglutaminase-IgA or deamidated gliadin peptide IgA or IgG greater
than or equal to 50% above upper limit of normal

- Uncontrolled complications of type-1 diabetes or celiac disease which pose a risk to
participation