New research by a group of Italian scientists indicates that fermented wheat flour may be a viable option for those suffering from celiac disease.

The study, which appeared in Clinical Gastroenterology and Hepatology, the official journal of the American Gastroenterology Association, examined the effects of baked products made with a hydrolyzed form of wheat flour on a group of 16 celiac sufferers. The researchers created the fermented wheat flour using sourdough lactobacilli and fungal proteases, which decreased the concentration of gluten in the baked products.

The participants in the study ranged in age from 12 to 23, were healthy and had been on a gluten-free diet for at least five years. Each received 200 g of baked products every day for 60 days. Six were randomly selected to receive baked products made with natural flour, five were selected to receive products with extensively hydrolyzed flour, and five were selected to receive products with fully hydrolyzed flour. The natural flour contained 80,127 ppm of gluten, the extensively hydrolyzed flour contained 2,480 ppm of gluten, and the fully hydrolyzed flour contained 8 ppm of gluten.

“This is the first time that a wheat flour-derived product is shown to not be toxic after being given to celiac patients for 60 days,” said Luigi Greco, M.D., Ph.D., the lead author of the study.

Two of the six participants that ate the natural-flour products dropped out of the study due to symptoms that included abdominal pain and diarrhea. Those on the extensively hydrolyzed-flour diet reported no medical complaints, but researchers did observe that the participants lacked villi, the protrusions in the gut that absorb nutrients from digested food. The participants who ate the baked products containing fully hydrolyzed flour reported no medical complaints.

The researchers added that additional and lengthier trials are necessary to determine if fermented wheat flour is safe for all celiac sufferers.

“A period of 60 days, although repeatedly shown to be sufficient to evaluate gluten toxicity in the majority of patients, might not be long enough to evaluate toxicity in all celiac disease subjects who might show different sensitivity to gluten. Prolonged trials have to be planned to state the safety of the baked goods manufactured by applying this rediscovered and adapted biotechnology,” the study’s authors concluded.