Celiac Disease, Gluten Sensitivity and Autoimmune Diseases

Dr. Alessio Fasano, professor and director of the Mucosal Biology Research Center and the Center for Celiac Research at the University of Maryland School of Medicine has written extensively on the subject of gluten sensitivity symptoms and Celiac Disease. In his August 2009 article published in Scientific American, Surprises from Celiac Disease, Dr. Fasano proposes that Celiac Disease has a common theme that is shared among all autoimmune conditions.

In order for symptoms of gluten sensitivity to manifest into a diagnosis of Celiac Disease, 3 important factors come into play.

Scientific American Aug. 2009 – Surprises from Celiac Disease – Box 1

1. There must be a trigger.  In the case of Celiac Disease, the trigger is the gluten protein found in certain grains (wheat, barley, rye) and the derivatives of the gluten protein (gliadin, glutenin, etc.
2. Genetic susceptibility, or predisposition is also present among patients with Celiac Disease.  The most common gene abnormalities are located with the HLA-DQ2 and HLA-DQ8 molecules.  This genetic imbalance increases the immune system’s potential to attack the patient’s intestinal lining.
3. Intestinal permeability problems, or a leaky gut, allow for the indigestible gluten fragments to squeeze between the cells of the intestines, and enter into the blood stream.  Once there, the immune system response through inflammatory mechanisms, and more symptoms present.

Patients that have all three factors frequently have the diagnosis of Celiac Disease, and begin an elimination diet of gluten containing foods in order to manage their symptoms.  Other individuals experience one or two of the factors and frequently report an increase in health, and decrease in symptoms when managing their diet.

Dr. Fasano believes that the three factors above apply to other autoimmune disease, but so far we have been unable to identify the specific triggers, or genetic tests that would confirm his hypothesis.

In clinical practice, we frequently encourage patients to remove common inflammation producing substances from their life in order to see positive symptomatic changes.  In many cases, patients respond well when gluten is removed from their diet, even if they are not diagnosed with Celiac Disease.  Other times we see foods like dairy, tomatoes, soy, and corn that are triggering the symptomatic processes of the patient.

If you are a patient that suspects that gluten (or another trigger) may be causing the symptoms that you are experiencing, contact our office and see if a simple blood test can identify the inflammatory trigger.  Other tests such as stool samples, saliva tests, and blood analysis can screen for intestinal permeability problems, and genetic susceptibility to various known imbalances.