title: Gluten sensitivity in multiple sclerosis: experimental myth or clinical truth?
abstract: 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.
authors.affiliation: Center for Autoimmune Diseases, Department of Medicine B, Sheba Medical Center, Ramat-Gan, Israel.
authors.forename: Dana Ben-Ami
authors.initials: DB
authors.lastname: Shor
authors.forename: Ori
authors.initials: O
authors.lastname: Barzilai
authors.forename: Maya
authors.initials: M
authors.lastname: Ram
authors.forename: David
authors.initials: D
authors.lastname: Izhaky
authors.forename: Bat Sheva
authors.initials: BS
authors.lastname: Porat-Katz
authors.forename: Joab
authors.initials: J
authors.lastname: Chapman
authors.forename: Miri
authors.initials: M
authors.lastname: Blank
authors.forename: Juan-Manuel
authors.initials: JM
authors.lastname: Anaya
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Shoenfeld
mesh_terms: 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
chemical_list: D001323:Autoantibodies; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D005983:Glutens; D005903:Gliadin; D011503:Transglutaminases