title: Increased prevalence of antibodies against dietary proteins in children and young adults with cerebral palsy.
abstract: OBJECTIVE
  Undernourishment is common in children with cerebral palsy (CP), but the reasons are unknown. We previously reported elevated levels of immunoglobulin (Ig) A and IgG antibodies against gliadin (AGA) and tissue transglutaminase (tTG) in 99 children and young adults with CP without characteristic findings of gluten enteropathy in small bowel biopsies. Our aim was to perform a case-control study of IgG antibodies against other dietary antigens, AGA, anti-tTG, and IgE antibodies against wheat and gluten.
  
  
  METHODS
  Sera from 99 cases with CP and 99 healthy, age- and sex-matched controls were analysed with fluorescence enzyme-linked immunosorbent assay for detection of IgG antibodies against β-lactoglobulin, casein, egg white, IgG- and IgA-AGA, IgA-anti-tTG, and IgE antibodies against gluten and wheat.
  
  
  RESULTS
  Compared with controls, the odds ratio in cases with CP for having elevated levels of IgG antibodies against β-lactoglobulin was 17.0 (95% confidence interval [CI] 2.3-128), against casein 11.0 (95% CI 2.6-46.8), and against egg white 7.0 (95% CI 1.6-30.8). The IgE responses for wheat/gluten were generally low. The tetraplegic and dyskinetic CP subtypes had significantly higher frequencies of elevated levels for all of the tested antibodies except IgG against egg white, and IgA-anti-tTG. A significantly lower weight was seen in cases with CP with positive versus negative serology.
  
  
  CONCLUSIONS
  Elevated levels of IgG against dietary antigens were more frequent in the CP group compared with controls, and particularly in the tetraplegic and dyskinetic CP subtypes with the most severe neurologic handicap and undernourishment. Hypothetically, malnourishment may cause increased intestinal permeability and thus immunization against dietary antigens.
authors.affiliation: Centre for Rehabilitation Research, Örebro University Hospital, Örebro, Sweden. reidun.stenberg@orebroll.se
authors.forename: Reidun
authors.initials: R
authors.lastname: Stenberg
authors.forename: Charlotte
authors.initials: C
authors.lastname: Dahle
authors.forename: Anders
authors.initials: A
authors.lastname: Magnuson
authors.forename: Dan
authors.initials: D
authors.lastname: Hellberg
authors.forename: Curt
authors.initials: C
authors.lastname: Tysk
mesh_terms: D000293:Adolescent; D000328:Adult; D000906:Antibodies / Q000097:blood*; D001323:Autoantibodies / Q000097:blood; D001835:Body Weight; D016022:Case-Control Studies; D002364:Caseins / Q000276:immunology; D002446:Celiac Disease / Q000150:complications / Q000276:immunology; D002547:Cerebral Palsy / Q000150:complications / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D004044:Dietary Proteins / Q000276:immunology*; D004529:Egg White; D005260:Female; D005983:Glutens / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007073:Immunoglobulin E / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007223:Infant; D007782:Lactoglobulins / Q000276:immunology; D008297:Male; D044342:Malnutrition / Q000209:etiology* / Q000276:immunology; D011503:Transglutaminases / Q000276:immunology; D014908:Triticum / Q000276:immunology; D055815:Young Adult
chemical_list: D000906:Antibodies; D001323:Autoantibodies; D002364:Caseins; D004044:Dietary Proteins; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007782:Lactoglobulins; D007073:Immunoglobulin E; D005983:Glutens; D011503:Transglutaminases