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Senior Member (jccglutenfree)
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Join Date: Aug 2006
Location: Wisconsin
Posts: 1,581
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Senior Member (jccglutenfree)
Join Date: Aug 2006
Location: Wisconsin
Posts: 1,581
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More:
Gluten sensitivity as a neurological
illness
M Hadjivassiliou, R A Grünewald, G A B Davies-Jones
Quote:
”But antigliadin antibodies lack
specificity”
IgG anti-gliadin antibodies have been
the best diagnostic marker in the neurological
population we have studied. IgG
anti-gliadin antibodies have a very high
sensitivity for CD but they are said to
lack specificity. In the context of a range
of mucosal abnormalities and the concept
of potential CD, they may be the
only available immunological marker for
the whole range of gluten sensitivity of
which CD is only a part. Further support
for our contention comes from our HLA
studies. Within the group of patients
with neurological disease and gluten
sensitivity (defined by the presence of
anti-gliadin antibodies) we have found a
similar HLA association to that seen in
patients with CD: 70% of patients have
the HLA DQ2 (30% in the general population),
9% have the HLA DQ8, and the
remainder have HLA DQ1. The finding of
an additional HLA marker (DQ1) seen in
the remaining 20% of our patients may
represent an important difference between
the genetic susceptibility of patients
with neurological presentation to
those with gastrointestinal presentation
within the range of gluten sensitivity.
”But antigliadin antibodies have
been superseded by
anti-endomysial and
transglutaminase antibodies”
The introduction of more CD specific
serological markers such as antiendomysium
and more recently transglutaminase
antibodies may have helped
in diagnosing CD but their sensitivity as
markers of other manifestations of gluten
sensitivity (where the bowel is not
affected) is low. This certainly reflects
our experience with patients with gluten
sensitivity who present with neurological
dysfunction. Endomysium and transglutaminase
antibodies are only positive
in the majority but not in all patients
who have an enteropathy. Patients with
an enteropathy represent only a third of
patients with neurological manifestations
and gluten sensitivity. Antigliadin
antibodies unlike endomysium and
transglutaminase antibodies are not autoantibodies.
They are antibodies against
the protein responsible for gluten sensitivity.
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