Kind of a silly paper to start my journal club off with, but I think that it's a simple yet powerful result that could improve the quality of life of many with celiac disease. In their trial, Lee et al. from the Columbia University Celiac Center tested if a gluten exposure could occur amongst celiac-discordant couples. The non-celiac partner underwent various protocols for gluten-loading with 10 saltines (roughly a 590 mg gluten load). Seems that waiting after gluten exposure and even drinking water after the exposure did not meaningfully decrease saliva gluten concentrations.
Couples then underwent two protocols for gluten-exposure via kissing. First was with waiting 5 minutes after gluten-load and second was with the non-celiac partner drinking 4 ounces (only 1/2 cup!) of water prior to kissing. In the ten couples, there was no meaningful gluten transfer in the second protocol (4 oz water rinse). Testing of the celiac-positive partner was done both on saliva immediately after kissing and on urine later that evening.
Why is this important? Any disease where the treatment is food avoidance causes significant social stress. Being vigilant with accidental exposure seems to be exhausting from listening to the families I care for and friends I have with celiac. The paper mentions the large amount of intimacy advice online that is solely rooted in anecdote. Some of these solutions (carrying toothbrush, toothpaste and mouthwash to give to partners) sound like a real burden. With this trial, it seems that a healthy chug of water can really limit exposure during a post-dinner smooch, which could be a little liberating.