Jump to content
  • Sign Up
  • Join Our Community!

    Get help in our celiac / gluten-free forum.

  • Jefferson Adams
    Jefferson Adams

    Study Shows Gluten Sensitivity and Celiac Disease Clinically Different

    Reviewed and edited by a celiac disease expert.

    Celiac.com 03/30/2011 - A team of medical researchers set out to compare gut permeability and mucosal immune gene expression in celiac disease and gluten sensitivity.

    The research team included Anna Sapone, Karen M Lammers, Vincenzo Casolaro, Marcella Cammarota, Maria T Giuliano, Mario De Rosa, Rosita Stefanile, Giuseppe Mazzarella, Carlo Tolone, Maria I Russo, Pasquale Esposito, Franca Ferraraccio, Maria Carteni, Gabriele Riegler, Laura de Magistris  and Alessio Fasano.

    People with celiac disease suffer an adverse autoimmune reaction when they consume gluten. People with gluten-sensitivity cannot tolerate gluten and may develop gastrointestinal symptoms similar to those in celiac disease.

    However, for people with gluten intolerance, the overall clinical picture is usually less severe, and is not accompanied by the concurrence of tissue transglutaminase autoantibodies or autoimmune comorbidities.

    By examining and comparing mucosal expression of genes associated with intestinal barrier function, along with innate and adaptive immunity the team sought to better understand the similarities and differences between celiac disease and gluten sensitivity.

    For their study, the team enrolled a group of subjects with celiac disease, a group with gluten sensitivity, and a control group of healthy, gluten-tolerant individuals.

    They assessed intestinal permeability using a lactulose and mannitol probe, and collected mucosal biopsy specimens to study the expression of genes involved in barrier function and immunity.

    They found that gluten sensitivity, unlike celiac disease, is not associated with increased intestinal permeability.

    In fact, subjects with gluten sensitivity showed significantly reduced intestinal permeability compared with controls (P = 0.0308). This was accompanied with significantly increased expression of claudin (CLDN) 4 (P = 0.0286).

    Relative to controls, subjects with celiac disease expressed higher levels of adaptive immunity markers interleukin (IL)-6 (P = 0.0124) and IL-21 (P = 0.0572), while those with gluten sensitivity showed no higher levels.

    Subjects with gluten intolerance showed increased expression of the innate immunity marker Toll-like receptor (TLR) 2, but subjects with celiac disease showed no such increase (P = 0.0295).

    Finally, subjects with gluten intolerance showed significantly reduced expression of the T-regulatory cell marker FOXP3 relative to controls (P = 0.0325) and celiac subjects (P = 0.0293).

    This study supports the existence of gluten sensitivity and celiac disease as two clinically different gluten-associated disorders.

    The study also supports the characterization of gluten sensitivity as a condition associated with prevalent gluten-induced activation of innate, rather than adaptive, immune responses in the absence of detectable changes in mucosal barrier function.

    Source:


    User Feedback

    Recommended Comments



    I do hope this stops those from gluten sensitivity from calling themselves celiacs. As a celiac, it's rather frustrating. These are seemingly 2 different conditions, and there is no benefit to either group by gluten intolerant people considering themselves celiac. You are not celiac. As a celiac, a crumb of gluten will destroy my intestines. This does not happen in gluten intolerance. Now hopefully we can find a way to prevent and cure these conditions (the gluten-free diet is not a cure, it is a treatment, just as insulin does not cure diabetes or nor does an epi pen cure allergies).

    My son tests negative for celiac disease but develops extreme psychosis from gluten (has very high anti-gliadin antibodies). In celiac disease gluten causes the immune system to attack the lining of the gut. GS can affect many organ systems, especially the nervous system and is linked to ataxia, epilepsy, schizophrenia, ADHD, autism and very likely MS. These can be just as severe and in some cases as deadly as celiac disease.

    Share this comment


    Link to comment
    Share on other sites

    Would be interesting to see how many people have heart problems with their gluten sensitivity? I have arrhythmia within half an hour of having small quantities of gluten. Large quantities, as well as rice, send me into tachycardia...along with all the other gut issues etc.

    Share this comment


    Link to comment
    Share on other sites
    While I agree somewhat overall with the team's finding, I also have some major issues with this report:

     

    I have gluten intolerance, and I also have tissue transglutaminase autoantibodies or autoimmune comorbidities. That is, I have low threshold markers of all of the same lab markers that are noted for Celiac disease, just that none of mine put me over the edge of having Celiac disease. The biopsy I had done also showed no Celiac disease, and I had the genetics test taken that showed no propensity for having the Celiac markers. But stating that those with gluten intolerance do not have any of the same lab markers that those with Celiacs do is simply false, as I and my blood work can attest to.

     

    “They found that gluten sensitivity, unlike celiac disease, is not associated with increased intestinal permeability.†This is ONLY true if the only issue you have wrong with your body is gluten intolerance. I also had soy intolerance and a casein allergy when my gluten intolerance was diagnosed, along with a multitude of other intolerances to different foods. I ALSO had severe malabsorption and Leaky Gut, meaning that I had (maybe still have?) very increased intestinal permeability.

     

    Our local gluten intolerance/Celiac group had a researcher from the Celiac research department at the Univ of Chicago come and speak to our group. When I talked to her and mentioned the fact that along with my gluten intolerance not only did I have soy intolerance and casein allergy, but I also had a wide variety of other food intolerances, this researcher then went on to tell me that she does not believe it is possible for a person to have multiple food intolerances and/or allergies to different areas that are not connected or are so very different from each other. And all I could think of was—huh? I and my family are living with multiple food intolerances (we all have gluten intolerance) and all this researcher can say is that she doesn't believe in it? She's not interested in researching to discover WHY our bodies react differently than that of a Celiacs?

     

    Both gluten intolerance and Celiac disease are, at the moment, able to be tolerated with a gluten free diet. As someone else mentioned, it isn't a cure but rather a treatment. Until the real cause of both Celiac and Gluten Intolerance is found, a gluten free diet is the only way to manage symptoms and to prevent more from occurring. I am glad that, finally, scientists/the medical community have discovered that Celiac disease and Gluten Intolerance are two totally different dis-eases with different pathologies. Maybe now we'll finally get someone who is interested in helping those of use with gluten intolerance as well. Although I tend to doubt it, because while ours makes us sick (with a lot of the same issues and problems as Celiac disease), ours doesn't compromise our autoimmune system/give us autoimmune disorders and therefore, we aren't candidates for “drugs.†Well, at least at the moment. Maybe they'll discover after all that they can find a drug to help “cure†us. I suspect, though, that the only cure will be to get rid of wheat/rye/barley from the diet, quit playing around with the germoplasma, and quit playing God with GMOs, chemicals, pesticides, and anything else manmade and not natural. It will be interesting to see what comes about from this study.

     

    Oh! Two things I wanted to mention. 1) While many Celiacs discover they have lactose intolerance, I have been finding out that many people I know who have Gluten Intolerance have either a casein or a whey allergy, along with numerous intolerances to other foods. 2) I also tested positive for severe heavy metal toxicity when I discovered I had gluten intolerance (mine is to the gliadin protein, not the gluten). My question was: why was it so extremely high? I read about the P450 cytochrome--specifically the CYP2C9 gene—and how if you have mutations in this specific cytochrome/gene, your body can't detoxify and metabolize correctly. I was tested, and I have no active alleles and three mutations—meaning my body is unable to detoxify and metabolize at all without help (which I give it with organic food and various supplements, both to support my health/body and to help it detoxify). Once I told my Naturopathic doctor about this specific genetic liver mutation, he told me he'd had 3 more patients after me who had the same liver mutation AND also had gluten/gliadin intolerance.

     

    Perhaps a researcher should look more closely into that.

    I would really like to hear more of what you have to say. I am just beginning all of this and you seem to have a lot of knowledge.

    Share this comment


    Link to comment
    Share on other sites

    I suspect that I am celiac. I am short, skinny, and recently have been suffering from strange bowl movements like steatorrhea, constipation and diarrhea, as well as nausea. I want to do a biopsy but I am somewhat lazy and pessimistic about the test. I eat a lot but I can't gain any weight. I guess that my villi can't absorb the nutrients. I ask God to help me find my disease so that I start my gluten free diet. I can't try a gluten few diet because my mom always cooks wheat food and she gets really angry when I don't eat.

    Share this comment


    Link to comment
    Share on other sites
    I do hope this stops those from gluten sensitivity from calling themselves celiacs. As a celiac, it's rather frustrating. These are seemingly 2 different conditions, and there is no benefit to either group by gluten intolerant people considering themselves celiac. You are not celiac. As a celiac, a crumb of gluten will destroy my intestines. This does not happen in gluten intolerance. Now hopefully we can find a way to prevent and cure these conditions (the gluten-free diet is not a cure, it is a treatment, just as insulin does not cure diabetes or nor does an epi pen cure allergies).

    WHOA Girl, you seem very angry Sarah, you sound pretty worked up over someone with gluten intolerance saying they have celiac disease. Too many other things in life a lot worse than that! Settle down!

    Share this comment


    Link to comment
    Share on other sites

    Because the diagnosis for celiac is a biopsy and some of us never get a biopsy- and we are gluten intolerant- how do we know if we are celiacs or not? I tested negative for the antigen test and therefore could not be given a biopsy- but I have the DNA markers for celiac and have elected to go gluten-free and get sick if I accidentally eat anything containing gluten. I would be labelled "Gluten Intolerant," but now that I am on a gluten-free diet and not willing to go back to gluten- how would I know I am not a celiac- a latent celiac or a silent celiac?? Is it possible that there is a range of symptoms for anyone who cannot tolerate gluten in their diet? Maybe at one end they get the "Celiac" label and at the other they get "Gluten Intolerant" label for the same problem? Certainly, I need better information and the doctors need to have better information. There needs to be more studies.

    Share this comment


    Link to comment
    Share on other sites



    Join the conversation

    You are posting as a guest. If you have an account, sign in now to post with your account.
    Note: Your post will require moderator approval before it will be visible.

    Guest
    Add a comment...

    ×   Pasted as rich text.   Paste as plain text instead

      Only 75 emoji are allowed.

    ×   Your link has been automatically embedded.   Display as a link instead

    ×   Your previous content has been restored.   Clear editor

    ×   You cannot paste images directly. Upload or insert images from URL.


  • 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 2,000 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.

×
×
  • Create New...