Posts Tagged ‘gluten’

« Older Entries

Why are autoimmune and allergic diseases on the rise?

Friday, September 3rd, 2010

An interesting paper just published in PLoS (Public Library of Science) clarifies one of the mechanisms that account for the recent increase in autoimmune disorders. The authors set out to investigate the possibility of an induced dysregulation of the immune system:

“Repeated immunization with antigen causes systemic autoimmunity… Overstimulation of CD4+ T cells led to the development of autoantibody-inducing CD4+ T (aiCD4+ T) cell[s]…[which became] antigen-specific cytotoxic T lymphocytes (CTL). These CTLs could be further matured by antigen cross-presentation, after which they caused autoimmune tissue injury akin to systemic lupus erythematosus (SLE).”

This essentially means that overexposure to a potential antigen (increased amounts of gluten in hybridized wheat, higher environmental levels of mercury, etc.) can result in sensitization of the immune system with cross-reaction to our own tissues (autoimmune disease). The authors clearly state their conclusion drawn from the evidence:

“Systemic autoimmunity appears to be the inevitable consequence of over-stimulating the host’s immune ‘system’ by repeated immunization with antigen, to the levels that surpass system’s self-organized criticality.”

Bookmark and Share

Tags: , , ,
Posted in Autoimmune | No Comments »

Neurological disease with GAD antibodies and gluten sensitivity

Thursday, September 2nd, 2010

GAD (glutamic acid decarboxylase) antibodies are expressed in type 1 (autoimmune) diabetes, adrenal failure (Addison disease), autoimmune thyroid diseases, premature ovarian failure, myasthenia gravis, pernicious anemia, Stiff-man syndrome and a number of other disorders. An informative study recently published in Acta Neurologica Scandinavica documents the link between these conditions and gluten sensitivity. The authors state:

“The high prevalence of gluten sensitivity in patients with stiff-person syndrome (SPS) lead us to investigate the relationship between gluten sensitivity and GAD-antibody-associated diseases.”

They used ELISA assays for GAD antibodies and serological markers of gluten sensitivity that generated compelling data:

“”Six of seven (86%) patients with SPS were positive for anti-GAD…This compared with 9/90 (11%) patients with idiopathic sporadic ataxia…16/40 (40%) patients with gluten ataxia…and 6/10 patients with type 1 diabetes only…”

Note that the serological tests for gluten sensitivity are a blunt instrument—only 40% of confirmed cases of gluten ataxia were recognized. The abundance of false negatives is why the gluten gene sensitivity test is so valuable.

Additionally, the authors found that…

“The titre of anti-GAD reduced following the introduction of a gluten-free diet in patients with SPS who had serological evidence of gluten sensitivity.”

Their conclusion is simply stated:

“These findings suggest a link between gluten sensitivity and GAD antibody-associated diseases.“

This study is especially interesting in connection with earlier research published in the journal Psychiatry. The authors set out to investigate the role of GAD antibodies in schizophrenia and related disorders:

“We hypothesized that GAD antibodies are increased in patients with chronic psychotic disorders. The aim of this pilot study was to compare the level of GAD antibodies in patients with chronic psychotic disorders with normal controls.”

By way of background they note that:

“The role of GABAergic neurotransmission in epilepsy, anxiety disorders, schizophrenia, and premenstrual dysphoric disorder has been a subject of some recent investigations. Absence of structural abnormalities in the brains of most patients with chronic psychotic disorders has always raised suspicion for an alternative pathogenesis and a possible functional disturbance at the neuronal/cellular level. Glutamic acid decarboxylase (GAD)…is involved in the formation of gamma aminobutyric acid (GABA) a central inhibitory neurotransmitter of the nervous system. Antibodies to GAD may impair GABA formation or inhibitory function.“

What did the data show?

“Serum levels of GAD antibodies in 12 patients with chronic psychotic disorders (schizophrenia and schizoaffective disorders) and 10 age-matched healthy control subjects were evaluated… Antibodies to GAD in patients with chronic psychotic disorders have a higher mean than nonpatient control individuals.”

The authors’ conclusion alerts the practitioner to be on the lookout:

“Antibodies to GAD65 are peripherally present in patients with chronic psychotic disorders (schizophrenia/schizoaffective disorders)... The presence of such antibodies also suggests a possible role for autoimmune mechanism in the pathogenesis of these disorders. In summary, from a practicing psychiatrist’s point of view, measurements of antibodies to GAD65 could potentially be used to screen for chronic psychotic disorders and for diabetes mellitus very early on in the disease process.”

GAD (glutamic acid decarboxylase) produces GABA, the most abundant inhibitory (calming) neurotransmitter in the body. Suboptimal levels can manifest as anxiety, insomnia, hyperarousal, panic, feeling overwhelmed, disorganized attention, restlessness, worry, tension, inner excitability, inability to relax, etc.

Bookmark and Share

Tags: , , , , , , , , , , , , , , ,
Posted in Autoimmune, Brain Health, Gluten & Casein | No Comments »

Feeling uncoordinated? Gluten sensitivity and ataxia

Wednesday, August 25th, 2010

A paper published a while back in the prestigious medical journal The Lancet is a useful reminder of a common neurological disorder resulting from gluten sensitivity that manifests as problems with coordination and balance. The authors state:

“Ataxia is the commonest neurological manifestation of coeliac disease. Some individuals with genetic susceptibility to the disease have serological evidence of gluten sensitivity without overt gastrointestinal symptoms or evidence of small-bowel inflammation. The sole manifestation of disease in such patients may be ataxia.”

The authors carried out clinical, neurophysiological, neuroradiological, and neuropathological examinations patients with antibodies to gliadin (the immunoreactive component of gluten):

“28 patients with gluten ataxia were identified. All had gait ataxia and most had limb ataxia….16 patients had no gastrointestinal symptoms…Six patients had evidence of cerebellar atrophy on magnetic-resonance imaging. Necropsy was done on two patients who died; there was lymphocytic infiltration of the cerebellum, damage to the posterior columns of the spinal cord, and sparse infiltration of the peripheral nerves.”

A key point is that most of the patients whose gluten sensitivity caused severe neurological damage had no gastrointestinal symptoms.

The authors conclude:

“Gluten sensitivity is an important cause of apparently idiopathic ataxia and may be progressive. The ataxia is a result of immunological damage to the cerebellum, to the posterior columns of the spinal cord, and to peripheral nerves.“

Bookmark and Share

Tags: , , , ,
Posted in Autoimmune, Brain Health, Gluten & Casein, Uncategorized | No Comments »

There is a broad range of neurologic disorders in children with gluten sensitivity

Monday, July 26th, 2010

This paper recently published in the journal Pediatrics draws attention to our concern for the non-celiac manifestations of gluten sensitivity, especially the neurological dimension. The authors note importantly that:

“During the past 2 decades, celiac disease (CD) has been recognized as a multisystem autoimmune disorder. A growing body of distinct neurologic conditions such as cerebellar ataxia, epilepsy, myoclonic ataxia, chronic neuropathies, and dementia have been reported, mainly in middle-aged adults…The aim of the present study is to look for a broader spectrum of neurologic disorders in CD patients, most of them children or young adults.”

They found a much greater prevalence of neurological disorders in children with CD compared to normal controls: 51.4% to 19.9%, including hypotonia, developmental delay, learning disorders and ADHD, headache, and cerebellar ataxia.

The authors conclude:

“This study suggests that the variability of neurologic disorders that occur in CD is broader than previously reported and includes “softer” and more common neurologic disorders, such as chronic headache, developmental delay, hypotonia, and learning disorders or ADHD.”

Bear in mind that we are equally concerned with the neurologic manifestations of gluten sensitivity in the absence of celiac disease.

Bookmark and Share

Tags: , , , , , , , , , ,
Posted in Autoimmune, Brain Health, Children's Health, Gluten & Casein | No Comments »

Gluten sensitivity without celiac disease in the elderly: is there a concern?

Monday, July 19th, 2010

Scandinavian Journal of GastroenterologyOften tests shows anti-gliadin antibodies (AGA; gliadin is the immunoreactive component of gluten) in the absence of celiac disease but with various autoimmune conditions representing the non-celiac manifestations of gluten sensitivity. The authors of a study just published in the Scandinavian Journal of Gastroenterology explore this issue for the elderly.

“…data suggest that AGA positivity [without celiac disease] might be related to distinct disease entities such as allergy and gluten ataxia (loss of muscular coordination with unsteady movements and gait). Our aim here is to explore the clinical relevance of positive AGA in the elderly population.”

The authors correlated positive lab tests for gluten sensitivity with the incidence of depression and rheumatoid arthritis in 2815 individuals aged 52–74 years. What did their data show?

“Rheumatoid arthritis and depression were found significantly more often in AGA-positives than controls. The significance remained even when tTGA-positive and known celiac disease cases were excluded.”

Don’t forget that anti-gliadin antibody tests are not an absolute screen for gluten (or any other food) sensitivity because there are a number of factors that can suppress the expression of antibodies at the time of specimen collection. However, this study shows that if an elderly person is suffering from depression or rheumatoid arthritis the possibility of gluten sensitivity should be investigated.

Bookmark and Share

Tags: , , , , , , , ,
Posted in Autoimmune, Brain Health, Healthy Aging | No Comments »

Gluten-free diet can improve depression and behavioral problems in adolescents

Friday, May 28th, 2010

BMC PsychiatryAs the authors of this study published in the journal BMC Psychiatry observe:

“Coeliac disease in adolescents has been associated with an increased prevalence of depressive and disruptive behavioural disorders, particularly in the phase before diet treatment.”

We are equally concerned with the ‘non-celiac’ aspects of gluten sensitivity. Gluten related inflammation in the brain can manifest as a host of cognitive, emotional and neurodegenerative disorders in the absence of intestinal manifestations. This is often referred to as “silent celiac disease”:

“Coeliac disease is an under-diagnosed autoimmune type of gastrointestinal disorder resulting from gluten ingestion in genetically susceptible individuals. Non-specific symptoms such as fatigue and dyspepsia are common, but the disease may also be clinically silent.”

They further note that:

“”Depressive symptoms and disorders are common among adult patients with coeliac disease, and depressive and disruptive behavioural disorders are highly common also among adolescents, particularly in the phase before diet treatment. Recently 73% of patients with untreated coeliac disease – but only 7% of patients adhering to a gluten-free diet – were reported to have cerebral blood flow abnormalities similar to those among patients with depressive disorders.”

Their data revealed abnormalities in tryptophan assimilation (tryptophan is the amino acid precursor to serotonin) and prolactin levels in adolescents with celiac disease and depression prior to treatment. Consequently…

“A significant decrease in psychiatric symptoms was found at 3 months on a gluten-free diet compared to patients’ baseline condition, coinciding with significantly decreased coeliac disease activity…”

They also make a fascinating observation that links gluten sensitivity, inflammation, and the serotonergic aspect of depression unrelated to malabsorption:

“…increased production of interferon-γ (IFN-γ), known to be the predominant cytokine produced by gluten-specific T-cells in active coeliac disease, can suppress serotonin function both directly and indirectly by enhancing tryptophan and serotonin turnover…even without malabsorption.”

To diagnose gluten sensitivity in the absence of celiac disease the gluten gene sensitivity test is the most reliable method for a number of reasons.

Bookmark and Share

Tags: , , , , , , , ,
Posted in Autoimmune, Brain Health, Children's Health, Depression, Gluten & Casein | No Comments »

Gluten sensitivity and brain disease: neuronal transglutaminase

Monday, March 8th, 2010

Annals of NeurologyThe authors of this paper published in Annals of Neurology make an important statement:

“Gluten sensitivity typically presents as celiac disease, a chronic, autoimmune-mediated, small-intestinal disorder. Neurological disorders occur with a frequency of up to 10% in these patients. However, neurological dysfunction can also be the sole presenting feature of gluten sensitivity.”

Antibodies directed toward transglutaminase in the gut are a well-known diagnostic feature of celiac disease. These investigators have identified another member of the transglutaminase family:

“…a novel neuronal transglutaminase isozyme and investigated whether this enzyme is the target of the immune response in patients with neurological dysfunction.” They found that “Whereas the development of anti-transglutaminase 2 IgA is linked with gastrointestinal disease, an anti-transglutaminase 6 IgG and IgA response is prevalent in gluten ataxia, independent of intestinal involvement.”

(Ataxia is loss of the ability to coordinate muscle movement, especially as it appears with difficulty walking.) Their conclusion:

“Antibodies against transglutaminase 6 can serve as a marker…to identify a subgroup of patients with gluten sensitivity who may be at risk for development of neurological disease.“

If you are gluten sensitive, you can have neurological disease without celiac involvement.

Bookmark and Share

Tags: , , , ,
Posted in Autoimmune, Brain Health, Gluten & Casein | No Comments »

Gluten can cause brain lesions like ALS

Saturday, February 13th, 2010

American Journal of NeuroradiologyHere is another alarming paper published in the American Journal of Neuroradiology reporting a case of apparent Amyotrophic Lateral Sclerosis (ALS, also known as Lou-Gehrig’s Disease) that was caused by a reaction to gluten. ALS is a particularly vicious autoimmune disease that attacks the central nervous system, typically following a terminal course. The authors note regarding celiac disease that “Initial symptom presentation is variable and can include neurologic manifestations that may comprise ataxia, neuropathy, dizziness, epilepsy, and cortical calcifications rather than gastrointestinal-hindering diagnosis and management.” I’m sure they were relieved to find that “MR imaging findings suggestive of ALS improved after gluten-free diet institution.” (MR = magnetic resonance)

Bookmark and Share

Tags: , , ,
Posted in Autoimmune, Brain Health | No Comments »

Increase in death risk from gluten-related gut inflammation

Tuesday, February 2nd, 2010

JAMA 091609This paper published in JAMA (The Journal of the American Medical Association) recently examined the risk of death associated with celiac disease. The investigators found a modest but significant increase in risk of death not only with celiac, but also with latent celiac disease and small intestine inflammation. They note that “This risk increase was also seen in children.” The take home message here is that even in the absence of gastrointestinal symptoms (“latent celiac disease”), there is an overall negative impact. The authors’ conclusion: “Risk of death among patients with celiac disease, inflammation, or latent celiac disease is modestly increased.”

Bookmark and Share

Tags: ,
Posted in Children's Health, General Science & Health, Gluten & Casein | No Comments »

Atrial fibrillation and subclinical hyperthyroidism (and gluten sensitivity)

Tuesday, December 8th, 2009

It’s necessary to bear in mind when dealing with atrial fibrillation that subclinical hyperthyroidism is a common cause. Subclinical means that there are symptoms from excess thyroid hormone activity even though the lab values appear normal. There are a plethora of recent studies that investigate this phenomenon; here are a few. The authors of the first paper state: “Overt and subclinical hyperthyroidism are both well-known independent risk factors for atrial fibrillation.”

  1. High-Normal Thyroid Function and Risk of Atrial Fibrillation
  2. Activation of Electrical Triggers of Atrial Fibrillation in Hyperthyroidism
  3. Atrial fibrillation and heart attack associated with subclinical hyperthyroidism
  4. Atrial fibrillation associated with exogenous subclinical hyperthyroidism
  5. The mechanisms of atrial fibrillation in hyperthyroidism
  6. Effects of Thyroid Hormone on the Cardiovascular System
  7. Association Between Serum Free Thyroxine Concentration and Atrial Fibrillation

Now the plot thickens. Here is a paper recently published in Nature Reviews Endocrinology discussing the link between celiac disease (gluten sensitivity) and autoimmune thyroiditis. Here is another, fresh off the presses, from the journal Gut. One more for now: this paper published in the journal Thyroid demonstrates that the antibodies involved in celiac disease also bind to thyroid follicles.

Bookmark and Share

Tags: , , ,
Posted in Autoimmune, General Science & Health, Gluten & Casein | 1 Comment »

« Older Entries