“…Although some studies have shown clinical improvement in patients consuming hydrolyzed gluten (20, 28), few have included biopsy data, the gold standard for the diagnosis of CD (16). The majority of studies have evaluated the theoretical safety of gluten hydrolysates by assessing the size of the remaining protein fragments (17,22,29,30) or by performing ELISA analysis of residual gluten levels (14,16,17,22,28,(30)(31)(32)(33)(34)(35), in vitro analysis (13-15, 18, 21-23, 25, 31, 33, 35-38), or LC-MS (reviewed in ref. 39).…”