Gastroenterology · 2026
A Prospective Study of Gluten Transfer Through Kissing in Celiac-Discordant Couples.
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Lee Anne R, Chen Zhijun, Jossen Jackie, Lebovits Jessica, Lebwohl Benjamin, Lewis Suzanne K, Krishnareddy Suneeta, Wolf Randi L, Emerson Luke, Green Peter H R
Аннотация
BACKGROUND & AIMS: Current management of celiac disease (CeD) depends on a restrictive gluten-free diet (GFD). Studies have reported CeD patients' anxiety about gluten transfer via kissing, but data to support this concern are lacking.
METHODS: To assess the transfer of gluten through kissing, the non-CeD partner consumed a gluten load (10 crackers with 59,107 ppm or 590 mg gluten). In 2 protocols, after consuming the gluten load, the non-CeD partner kissed the partner with CeD. In the first kissing protocol, the non-CeD partner waited 5 minutes before kissing, and in the second, the non-CeD partner drank 4 oz of water and then immediately kissed the partner with CeD. Saliva was collected from the partner with CeD immediately after the kiss. Gluten in saliva was assessed by R-5 enzyme-linked immunosorbent assay test method and in the urine by GlutenDetect (Glutenostics, Inc).
RESULTS: Gluten was detectable in the saliva of the non-CeD partner in all protocols (80 ppm to >25,000 ppm). The amount detected in the saliva of those with CeD varied from <5 ppm to 153.9 ppm. Only 2 of the 20 gluten exposures tested >20 ppm gluten, the level defined as gluten free. None of the saliva samples tested >20 ppm when the non-CeD partner drank 4 oz of water after eating the gluten load.
CONCLUSIONS: There was not an increased risk of significant gluten transfer when kissing. Drinking 4 oz of water before kissing further reduces the risk. These results should guide our clinical practice and should be shared with our patients to help reduce the burden of the diet.
METHODS: To assess the transfer of gluten through kissing, the non-CeD partner consumed a gluten load (10 crackers with 59,107 ppm or 590 mg gluten). In 2 protocols, after consuming the gluten load, the non-CeD partner kissed the partner with CeD. In the first kissing protocol, the non-CeD partner waited 5 minutes before kissing, and in the second, the non-CeD partner drank 4 oz of water and then immediately kissed the partner with CeD. Saliva was collected from the partner with CeD immediately after the kiss. Gluten in saliva was assessed by R-5 enzyme-linked immunosorbent assay test method and in the urine by GlutenDetect (Glutenostics, Inc).
RESULTS: Gluten was detectable in the saliva of the non-CeD partner in all protocols (80 ppm to >25,000 ppm). The amount detected in the saliva of those with CeD varied from <5 ppm to 153.9 ppm. Only 2 of the 20 gluten exposures tested >20 ppm gluten, the level defined as gluten free. None of the saliva samples tested >20 ppm when the non-CeD partner drank 4 oz of water after eating the gluten load.
CONCLUSIONS: There was not an increased risk of significant gluten transfer when kissing. Drinking 4 oz of water before kissing further reduces the risk. These results should guide our clinical practice and should be shared with our patients to help reduce the burden of the diet.