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  • Jefferson Adams

    Case Study Indicates That CD8+, Perforin+ and Granzyme B+ Infiltrate the Cerrebullum in Gluten Ataxia

    Jefferson Adams
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    Reviewed and edited by a celiac disease expert.

      A recent case report notes an absence of B‐ or plasma cells, together with multiple CD8+, granzyme B, and perforin expressing cells in ataxia‐associated brain areas, and indicates that there are also pronounced cytotoxic effects in gluten sensitivity.


    Image: CC--Anna Shcherbina
    Caption: Image: CC--Anna Shcherbina

    Celiac.com 08/29/2018 - Up to one in twelve patients with gluten sensitivity develops neurological symptoms such as ataxia, dementia, seizures or peripheral neuropathy, though the reasons for this are still poorly understood.

    As a means of better understanding the immunological mechanisms behind this reality, a team of researchers recently reported the case of a 68‐year‐old male patient suffering from progressive ataxia and dementia associated with chronic diarrhea, and both elevated IgG and IgA antigliadin‐antibodies. 



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    The research team included Michel Mittelbronn, Jens Schittenhelm, Gellert Bakos, Rob A. De Vos, Manfred Wehrmann, Richard Meyermann, and Katrin Bürk. They are variously affiliated with the Institute of Brain Research at the University of Tübingen, and the Institute for Cell Biology, Department of Immunology at the University of Tübingen, Tübingen, Germany, the Neurological Institute/Edinger Institute, Goethe University Medical School, Frankfurt, the Department of Pathology, St. Georg Hospital, Leipzig, Germany, and with the Laboratory for Pathology, Enschede, the Netherlands.

    Autopsy indicated that frequent argyrophilic glial and neuronal inclusions within the basal nucleus of Meynert were the structural markers of the cognitive decline.  The patient showed substantial neuronal loss in the cerebellar cortex and the inferior olives, along with infiltrating CD8+/perforin+/granzyme B+ cells, and reactive astrogliosis and microglial activation. 

    In patients with gluten sensitivity and neurological disease, it is likely that CD8+ cytotoxic T and NK cells function as effector cells that trigger neuronal cell death, and thus might play some role in triggering cerebellar symptoms in gluten ataxia cases. The team concludes by noting that an absence of B‐ or plasma cells, along with multiple CD8+, granzyme B and perforin expressing cells in ataxia‐associated brain areas, indicates pronounced cytotoxic effects in neuro-pathogenesis of gluten sensitivity.

    This is one of the first reports to indicate that CD8+, perforin+, and granzyme B+ effector cells infiltrate the cerebellum and inferior olives in cases of gluten ataxia.

    Read more in: Neuropathology

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    Interesting, yet the same symptomology applies to gluten associated (secondary) diseases.

    I suffered from severe malnutrition from bowel "dumping" post gluten intake.  Months passed with fatigue so severe it took all my might to raise my head from the pillow after 8 hours of sleep.  The bowel dumping (12 to 16 per day of explosive diarrhea) resulted in calcium loss.  This in turn caused hyperparathyroidism.  Noted symptoms: encephalopathy, peripheral neuralgia, ataxic gate, nystagmus, blurred vision, double vision to name a few.

    So the question arises: Were the symptoms the result of the hyperparathyroidism or neuro-pathogenesis of gluten sensitivity?  Or both? The parathyroid adenoma was removed & measured 287 while the Ca+ blood analysis remained at a high clinical normal reading of 10.3.

    I was asked by my sig. other how the last doctor's appointment went.  I stated that I was told' "We'll monitor you for another six months".  I told my sig. other that I would not be here in another six months.  He made an appt. with a surgeon who stated; "We don't take people with a calcium of 10.3, but you have so many neuro-cognitive symptoms, we will schedule you for surgery right away.  This physician save my life.  Symptoms reversed & I tell others that "gluten" is truly the "silent-killer". 

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  • About Me

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,500 articles on celiac disease. His coursework includes studies in science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.


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