Let's talk about those 'meaningless' antigliadin IgG antibodies. I know we have done this before, but sadly, its no longer accessible.

What I'd like to do is find references of various conditions where AGA positivity is found, particularly AGA IgG.

Gluten related neurological disease:
Gluten sensitivity as a neurological illness, M Hadjivassiliou, et al.
Neuropathy associated with gluten sensitivity. PMID: 16835287 July 2006

I believe I have read about antigliadin IgG antibodies seen in these conditions, but I would like to track down some references. If anyone knows or finds anything, please post!



Crohn's Disease
High prevalence of celiac disease among patients affected by Crohn's disease. PMID: 15973121 July 2005

Diabetes
We found a significantly higher occurrence of gliadin antibodies in LADA patients: the rate of AGGAb was 19.1% in comparison with 3.5% in the T2DM group (P = 0.0026), the rate of AGAAb was 13.2% in comparison with 3.5% (P = 0.035). The prevalence of EMAb was very low in both groups (1.5% and 0).
Gliadin, endomysial and thyroid antibodies in patients with latent autoimmune diabetes of adults (LADA). PMID: 12823288 July 2003
[Risk markers for insulin-dependent diabetes mellitus and duration of exposure to gluten in celiac patients] PMID: 15478300 Aug 2004


Down Syndrome
Down syndrome and coeliac disease: usefulness of antigliadin and antiendomysium antibodies.
PMID: 9001668 Dec 1996
Prevalence of IgA-antigliadin antibodies and IgA-antiendomysium antibodies related to celiac disease in children with Down syndrome. PMID: 9445503 Feb 1998

IgA Deficiency
Role of human-tissue transglutaminase IgG and anti-gliadin IgG antibodies in the diagnosis of coeliac disease in patients with selective immunoglobulin A deficiency. PMID: 15571003 Nov 2004

Irritable Bowel Syndrome

Determination of the level of specific markers of celiac disease (in our research--antigliadin Ig) is considered to be the optimal method of diagnostic celiac disease in this group of patients.
[Prevalence of undiagnosed celiac disease in patients with irritated bowel syndrome] Oct 2003

Liver Disease
Antigliadin antibody classes in chronic liver disease. PMID: 1421449 Oct 1992

MS
Results - Highly significant increases compared with controls were found for IgA and IgG antibodies against gliadin and gluten. IgA antibodies against casein were significantly increased. Anti-endomycium and anti-transglutaminase antibodies were negative.
IgA antibodies against gliadin and gluten in multiple sclerosis. PMID: 15355487 Oct 2004

Psoriasis
Coeliac disease-associated antibodies correlate with psoriasis activity. PMID: 15491433 Oct 2004
[The significance of diet and associated factors in psoriasis.] PMID: 16758223 June 2006

Rheumatoid Arthritis
[Antigliadin antibodies in rheumatoid arthritis] PMID: 8293004 Mar 1993
Gliadin immune reactivity in patients with rheumatoid arthritis. PMID: 8575138 Sept 1995

Schizophrenia
Autoantibodies associated with psychiatric disorders. PMID: 16719797 May 2005
[could not find anything specific to antigliadin antibodies...but several newer studies looking at schizophrenia as an immune mediated disease]

The gluten connection: the association between schizophrenia and celiac disease. PMID: 16423158 Feb 2006

SLE
Gluten sensitivity masquerading as systemic lupus erythematosus Feb 2004


More schizophrenics than controls showed IgA antibody levels above the upper normal limit to gliadin, beta-lactoglobulin, and casein. [do you suppose they looked for antigliadin IgG antibodies? jcc]
Specific IgA antibody increases in schizophrenia. PMID: 7772650 Mar 1995

Sjogren's
Even among nonceliac patients with primary Sjogren's syndrome, an ongoing inflammation is often present in the small bowel mucosa.
Celiac disease and markers of celiac disease latency in patients with primary Sjogren's syndrome. PMID: 10201480 April 1999

Thyroid disease
The presence of the antigliadin antibodies in autoimmune thyroid diseases. PMID: 15244201 Dec 2003

Ulcerative Colitis
High frequency of antigliadin antibodies and absence of antireticulin and antiendomysium antibodies in patients with ulcerative colitis. PMID: 10204612 Feb 1999

William Walsh of the Pfeiffer Treatment Center thinks it boils down to oxidative stress in the gut.

http://www.gatago.com/sci/med/nutrition/9952267.html

http://asa.confex.com/asa/2005/techprogram/S1181.HTM

Instead of thinking that gluten issues are behind other conditions like auto immune problems, it may be that one thing is behind those two things, both gluten sensitivity and auto-immune problems.

I think there may be one thing that is common to all sufferers, one thing among those with gluten AND auto immune problems. That one thing may boil down to oxidative stress in the gut.

The GI tract is important; if there is any damage the effect it has on the whole body can be pretty far reaching, causing problems with anti-oxidant levels for one thing. But I think it may be possible that if these anti-oxidant levels stay low long enough if may cause other problems too.

Oxidative stress and autoimmune problems.
http://www.lef.org/protocols/prtcl-017.shtml

Autoimmune means the body is attacking itself. Usually the first place this can start is with foods not digested properly. The body attacks these foods that are not digested completely, beginning the cycle of autoimmune problems. Why do the foods not get digested properly? Different problems but damage to the GI tract may occur because of the lack of anti-oxidants over time, I guess.

Had to break this up...I couldn't edit anymore because the length was too long.


Antigliadin antibodies (AGA) mark celiac disease, but AGA are also encountered in IgA-nephritis, psoriasis, sickle-cell anemia, hepatic disorders, juvenile rheumatoid arthritis, autoimmune thyroidism and in persons who occupationally contact great amounts of wheat. AGA IgA and/or IgG were registered in 19 of 60 subjects (51 adults and 9 children) with various immunomediated diseases without symptoms of celiac disease: in 4 cases of chronic active hepatitis, in 2 of 4 cases of chronic persistent hepatitis, in 4 of 16 cases of rheumatoid arthritis, in 3 of 19 cases of IgA-deficiency, in 1 of 8 cases of SLE, in 2 cases of postvaccine reaction, in all the single cases of juvenile rheumatoid arthritis, focal scleroderma, macroglobulinemia. IgA only occurred in in 6 patients, IgG- in 6 patients, both IgA and IgG in 7 patients. The most pronounced positive reaction to AGA was recorded in 8-year-old girl with juvenile rheumatoid arthritis. The emergence of AGA in immunomediated diseases may be attributed to the response to food protein in pathological conditions and is often unrelated closely with celiac disease.
[Antigliadin antibodies in the absence of celiac disease] PMID: 9553358 1998

Our results showed that while AGA-IgA were absent in all children studied, with the exception of 3 cases of acute diarrhoea, a moderate percentage of AGA-IgG was observed in subjects with cow's milk protein intolerance, acute diarrhoea, irritable bowel syndrome, lactase deficiency, chronic intractable diarrhoea and in a low percentage of children with parasitosis, intestinal lymphangiectasia and nodular lymphoid hyperplasia.
The predictive value of antigliadin antibodies (AGA) in the diagnosis of non-celiac gastrointestinal disease in children] PMID: 8341233 Mar 1993

CONCLUSIONS: IgA-class antireticulin or antigliadin antibody-positive patients with normal small-bowel mucosal morphology frequently have immunohistochemical markers of coeliac disease latency. Together with our follow-up data this implies that they may be gluten-sensitive.
Small-bowel mucosal inflammation in reticulin or gliadin antibody-positive patients without villous atrophy. PMID: 9759950 Sept 1998

We describe a unique case of atypical natural killer (NK)-cell proliferation likely related to gluten sensitivity, mimicking NK-cell lymphoma. >>> Two years after initial presentation, the patient was found to have high titers of antigliadin antibodies with no other evidence of celiac disease. After instituting a gluten-free diet, many of the lesions regressed, suggesting that this atypical NK-cell proliferation may be driven by an anomalous immune response. Awareness of this case may prevent pathologists from misdiagnosing similar lesions as NK/T-cell lymphomas. It is as yet unknown whether this process occurs more commonly in patients with gluten sensitivity, or in other settings, and the pathogenesis is as yet undetermined.
Atypical NK-cell proliferation of the gastrointestinal tract in a patient with antigliadin antibodies but not celiac disease. PMID: 16625103 April 2006


CONCLUSION: We show that Caucasian Argentine women with RPL showed significantly higher incidence of anticardiolipin antibodies than normal controls and finally we recommended the screening of IgA and IgG antigliadina and IgA antitransglutaminase antibodies in pregnancy, because of the high prevalence of subclinical CD in RPL and the chance of reversibility through consumption of a gluten free diet.
Autoantibodies in Argentine women with recurrent pregnancy loss. PMID: 16451354

Longitudinal follow-up examination of antigliadin antibody positive children and adults. PMID: 16607144 May 2006
[this one supports the antibodies are meaningless because they disappear over time (4 years later in this study) in 50%, but... but don't antibodies fluctuate in other autoimmune disease as well... ? What about those who remained positive? Gee... didn't they used to think celiac disease was outgrown, too? I'm still not convinced those antibodies are meaningless...something is going on there. jcc].



Discussion/Commentary

Do antigliadin antibodies suggest gluten sensitivity may be involved in diseases other than Celiac Disease? If gluten sensitivity can cause celiac disease, why is it such a far stretch to consider it might be relevant in other autoimmune disease? If gluten sensitivity can cause autoimmune disease, what about a similar response to other foods? Casein? Soy?

Association does not prove cause, granted. BUT, it is interesting to me that so many of these other conditions have not only increased associations with celiac disease, but anecdotal reports (and a few medical journal reports) of some of these patients with other autoimmune conditions improving on a gluten free diet. When other conditions remit on a gluten free diet, what does that say???

There is so much left unanswered, but~

It's time the researchers look more closely at gluten sensitivity (beyond the confines of celiac disease) rather than dismissing it. How do we know whether a gluten free diet might help these other conditions if we don't suspect it, don't test for it, and don't try treating it? And of course, it is difficult to have controlled studies on diet, because compliance (even among good effort) and monitoring are difficult to control. I think the anecdotal reports I read about are promising, and should give people pause to consider a gluten free diet when gluten sensitivity of any degree is present. JMO.

I think you make a good point. I have considered this to be the case, since my family lacks the celiac genes, and my daughter also tested positive to pyroluria. The point of the above exercise (looking at gluten sensitivity/antigliadin antibody's in other disease) suggests that the researchers should be looking beyond "celiac disease" for an explanation of gluten sensitivity and its consequences, rather than ignoring that which occurs outside of the confines of 'celiac disease'. Also not to be dimissed is that many of these condition do improve on a gluten free diet.

I've quoted this excerpt from Dr. Walsh a few times on oxidative stress... of course, lost on the old forum:

I think this may be particularly noteworthy for those who have gluten sensitivity outside of celiac disease. I do believe that any number of conditions may damage the gut and lead to secondary gluten sensitivity and all that goes with it. In that case, removing gluten is sort of a band-aid fix if you don't correct the underlying condition affecting the gut, and might be why some of us continue to have so much trouble with foods in addition to gluten? Gluten is just among the most damaging.

I don't believe I've seen the LEF link...so I will take a look at it, plus the others you leave. Thank you!

At one point the LEF article states:
Autoimmune states can be induced by food sensitivities that cause intestinal gut permeability and complicate leaky gut syndrome (Kitts et al. 1997).

I think sometimes the food sensitivity is primary and starts the cascade of events, and other times the food sensitivity is secondary... but in either case, the same complications may arise. Do you agree, Ortho, or do you have a different thought?

We consulted with Dr. McGinnis regarding my daughter with Pyroluria. Still, I have read/heard conflicting opinions about whether the gluten sensitivity associated with pyroluria is primary or secondary. Since she is the one refusing the diet based on the GI's advice, I really hope that dealing with the oxidative stress will reduce or eliminate her gluten sensitivity.

I saw another DAN! doctor who believed Pyroluria was not a primary condition, but that underlying immune system dysfunction was. So many ways to turn, but it all seems to go together..in a circular sort of way.

Both of these doctors, btw, recommend the removal of gluten/casein and other foods in those who show sensitivity. So...maybe we need to do it all? Do you eat gluten? Would you consider adding it back at some point, assuming you've corrected the oxidative stress?


Cara

Which came first the chicken or the egg? I think this could be debated on and on. I think that some people, because of the nutritional deficiencies, may have these reactions to certain foods. So, yes sometimes it is a result of nutritional deficiencies or damage to the GI gut that causes these reactions to foods containing gluten. But, I think it may be possible that it doesn't always work this way in every case. Who really knows which came first?

But I guess the conclusion I would want to draw is that the best treatment approach would include all the issues that play a role. So if you make sure your immune system is healthy, that your nutritional status is at its best, and that you are striving to eat the right (diversified rotation diet, perhaps) diet to not contribute to any sensitivities or allergies, then you are dealing with all facets of this problem.

And it does seem to be the case that some people can introduce those offending foods when they have made those changes like improve nutritional status or healing the damaged GI tract. It can seem to go around in a circle if you really try to think about this stuff.


"I think sometimes the food sensitivity is primary and starts the cascade of events, and other times the food sensitivity is secondary... but in either case, the same complications may arise. Do you agree, Ortho, or do you have a different thought? "

EXACTLY! It may be they don't really understand completely the etiology of this problem. I think it is possible that the experts haven't researched this enough.

I agree .

Great thread - will have to take time to read more of the links later.

Another paper from Dr. Hadjavassiliou is Gluten sensitivity masquerading as systemic lupus erythematosus
You can read the complete paper http://ard.bmjjournals.com/cgi/content/full/63/11/1501
Another question. How does Zonulin fit in? Apparently every person who eats wheat makes Zonulin. Zonulin is the stuff that loosens up the tight junctions between the cells that line the small intestinr. Only those with CD make a large amount of Zonulin. How much does a person have to make to become celiac? How much to become gluten sensitive?
Anne

Thanks, Anne. I edited the SLE article up into the first post. I should probably copy and save this somewhere off site!

Where did you read this about Zonulin being made by every person who eats wheat? I'd like to read the chemistry/biology behind this mechanism. I have some guesses, but I'm curious about the findings.

I was surprised initially when I read that gluten ingestion actually increased the production of zonulin in some people...that there was a direct link there. I can't remember off hand, but have found it in print in the past. YOu can start by looking at the zonulin thread in TGF, there are some full text articles if you click on the links, others are abstracts. We'll be able to find it...just a matter of finding it.

http://jccglutenfree.googlepages.com/zonulin


Cara