Friday, July 08, 2005

Gluten Allergy and Celiac Disease

Gluten Allergy, A Prototype of Disease Causation

My discovery that I had celiac disease 20 years ago changed my diet, lifestyle and my approach to medical practice. These changes led me to consider areas of ignorance in medicine that persist today.

Immune responses to gluten, the proteins found in cereal grains are a common cause of disease. In celiac disease the gastrointestinal tract is the primary target organ; however systemic disease is an important consequence of cereal grain ingestion. I think that the people diagnosed with celiac disease are a sub-population of a much larger, undiagnosed group with gluten allergy.

I invented the Alpha Nutrition Program as the best diet revision strategy for anyone with diagnosed celiac disease, or any person with symptoms suggestive of gluten allergy

Immune responses to gluten in the digestive tract are just the beginning for remarkably prolific disease-causing mechanisms that can affect every tissue in the body. A list of diseases that occur with increased frequency in celiac patients include diabetes, thyroid disease, anemia, rheumatoid arthritis, sacroileitis, sarcoidosis, vasculitis, inflammatory lung disease, eye inflammation, cerebellar ataxia and schizophrenia. These and other immune-mediated diseases can be linked to gluten ingestion. These associations suggest that people with a tendency to immune hypersensitivity diseases are vulnerable to food antigens that can cause systemic autoimmune disease.

In their review of these associated disorders, Mulder and Tygart repeated the basic ideas that can explain the prolific ability of of gluten to cause disease downstream from a disordered gastrointestinal tract. They stated:

"Patients with (celiac disease and) selective IgA deficiency often have circulating antibodies to food proteins; they also have circulating immune complexes, suggesting that absence of an intestinal IgA barrier might allow the absorption of antigenic material from the gut. Antibodies to some of the antigens might cross react with the host's self components and might indirectly produce autoimmune disease."

For example, Lubrano et al evaluated the overall prevalence of joint involvement in 200 adult celiac patients An arthritis was present in 26% of patients. Prevalence ranged from 41% in patients on a regular diet to 21.6% in patients on a gluten-free diet. Arthritis was peripheral in 19 patients, axial in 15 and an overlap of both in 18 subjects. Their data suggest that arthritis is more common than previous reported. Arthritis occurring in 21.6% of patients on a gluten-free diet suggests that other food allergens may be responsible - cow's milk, eggs, meat and soya protein would have to be considered high risk foods and further diet revision undertaken.

See Gluten Problems and Solutions by Stephen Gislason MD