Gluten sensitivity in multiple sclerosis: experimental myth or clinical truth?
Patients with neurological disease of unknown etiology sometimes present with antigliadin and antitissue transglutaminase antibodies. The association between these antibodies and multiple sclerosis has been previously suggested. The purpose of this study was to determine the prevalence of these antibodies in multiple sclerosis patients. We determined the level of serum immunoglobulin A and immunoglobulin G antigliadin and antitissue transglutaminase antibodies in 98 patients with multiple sclerosis. We found a highly significant increase in titers of immunoglobulin G antibodies against gliadin and tissue transglutaminase in the multiple sclerosis patients. Seven patients had a positive IgG AGA, whereas only 2 controls presented positive titers (P = 0.03). Four patients had positive IgG anti-tTG while all the controls tested negative (P = 0.02). However, immunoglobulin A antibodies against gliadin and tissue transglutaminase were not statistically higher in the multiple sclerosis group in comparison to the control group. Our findings support the associations between antibodies against gliadin and tissue transglutaminase to multiple sclerosis. The specific role of these antibodies in the pathogenesis of multiple sclerosis remains uncertain and requires additional research. A gluten free diet should be considered in specific cases of patients who present with gluten antibodies.
Shor
Dana Ben-Ami
DB
Center for Autoimmune Diseases, Department of Medicine B, Sheba Medical Center, Ramat-Gan, Israel.
Barzilai
Ori
O
Ram
Maya
M
Izhaky
David
D
Porat-Katz
Bat Sheva
BS
Chapman
Joab
J
Blank
Miri
M
Anaya
Juan-Manuel
JM
Shoenfeld
Yehuda
Y
D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D005903:Gliadin / Q000276:immunology; D005983:Glutens / Q000276:immunology*; D006801:Humans; D007118:Immunoassay / Q000379:methods; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000097:blood* / Q000276:immunology; D011503:Transglutaminases / Q000276:immunology
D001323:Autoantibodies; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D005983:Glutens; D005903:Gliadin; D011503:Transglutaminases