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Abdel-Maksoud M, Aly El-Gabry D, Al Kayoumi T, Alketbi J, Mohamednour D, Elhassan Elamin M, Subhash Reddy M, Al Yafei ZA, Stip E, Abdel Aziz K, Arnone D. Measures of gluten-related reactivity in children with autism spectrum disorders in the absence of overt gastrointestinal symptoms: a pilot study from the United Arab Emirates. J Int Med Res 2021; 48:300060520952655. [PMID: 32959707 PMCID: PMC7513412 DOI: 10.1177/0300060520952655] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objectives The aetiology of autism spectrum disorder (ASD) is multifactorial, sometimes
genetic, and may be associated with abnormal immunological responses to
peptides from proteins such as gluten. These peptides may cross the
blood-brain barrier and affect neurotransmission, resulting in behavioural
symptoms consistent with ASD. The aim of this study was to screen for
markers of gluten-related immune reactivity in the absence of overt
gastrointestinal symptoms in patients with ASD in the United Arab Emirates,
a country associated with a high prevalence of ASD but lacking this type of
research. Methods Patients diagnosed with ASD (using Diagnostic and Statistical Manual of
Mental Disorders-IV-based criteria and Autism Diagnostic Observational
Schedules) were compared with controls, regarding anti-tissue
transglutaminase (tTG) immunoglobulin (Ig) A and anti-deamidated gliadin
peptide (DGP) IgA levels. Results Sixty-six patients with ASD and 101 controls were included. Patients with ASD
showed statistically significant lower anti-DGP IgA levels, but no
significant difference in anti-tTG IgA levels, versus healthy controls.
Correlations between immunological data and clinical symptoms were
synergistic, but not statistically significant. Conclusion ASD may be associated with reduced levels of anti-DGP IgA.
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Affiliation(s)
- Mohamed Abdel-Maksoud
- Department of Psychiatry, Maudsley Health, Al-Amal Psychiatric Hospital, Dubai, United Arab Emirates.,Department of Psychiatry, Ministry of Health and Prevention (MOHAP), Al-Amal Psychiatric Hospital, Dubai, United Arab Emirates
| | - Dina Aly El-Gabry
- Okasha Institute of Psychiatry, Neuropsychiatry Department, Ain Shams University, Cairo, Egypt
| | - Tahani Al Kayoumi
- Department of Psychiatry, Ministry of Health and Prevention (MOHAP), Al-Amal Psychiatric Hospital, Dubai, United Arab Emirates
| | - Jamila Alketbi
- Department of Psychiatry, Behavioural Science Institute, Al-Ain Hospital, Al-Ain, United Arab Emirates
| | - Duaa Mohamednour
- Erada Centre for Treatment and Rehabilitation, Dubai, United Arab Emirates
| | | | - Marri Subhash Reddy
- Department of Psychiatry, Behavioural Science Institute, Al-Ain Hospital, Al-Ain, United Arab Emirates
| | - Zain Ali Al Yafei
- Medical Laboratories Department, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Emmanuel Stip
- Department of Psychiatry and Behavioural Science, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Hospitalier Universitaire de Montreal (CHUM), Institut Universitaire en Santé Mentale de Montréal, Université de Montreal, Canada
| | - Karim Abdel Aziz
- Department of Psychiatry and Behavioural Science, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Danilo Arnone
- Department of Psychiatry and Behavioural Science, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Asri N, Rostami-Nejad M, Anderson RP, Rostami K. The Gluten Gene: Unlocking the Understanding of Gluten Sensitivity and Intolerance. APPLICATION OF CLINICAL GENETICS 2021; 14:37-50. [PMID: 33603437 PMCID: PMC7886246 DOI: 10.2147/tacg.s276596] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 01/18/2021] [Indexed: 12/14/2022]
Abstract
Wheat flour is one of the most important food ingredients containing several essential nutrients including proteins. Gluten is one of the major protein components of wheat consisted of glutenin (encoded on chromosome 1) and gliadin (encoded on chromosome 1 and 6) and there are around hundred genes encoding it in wheat. Gluten proteins have the ability of eliciting the pathogenic immune responses and hypersensitivity reactions in susceptible individuals called “gluten-related disorders (GRDs)”, which include celiac disease (CD), wheat allergy (WA), and non-celiac gluten sensitivity (NCGS). Currently removing gluten from the diet is the only effective treatment for mentioned GRDs and studies for the appropriate and alternative therapeutic approaches are ongoing. Accordingly, several genetic studies have focused on breeding wheat with low immunological properties through gene editing methods. The present review considers genetic characteristics of gluten protein components, focusing on their role in the incidence of gluten-related diseases, and genetic modifications conducted to produce wheat with less immunological properties.
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Affiliation(s)
- Nastaran Asri
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Rostami-Nejad
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Robert P Anderson
- Wesley Medical Research - The Wesley Hospital, Brisbane, Queensland, Australia
| | - Kamran Rostami
- Department of Gastroenterology, MidCentral DHB, Palmerston North, New Zealand
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Masaebi F, Azizmohammad Looha M, Rostami-Nejad M, Pourhoseingholi MA, Mohseni N, Samasca G, Lupan I, Rezaei-Tavirani M, Zali MR. The Predictive Value of Serum Cytokines for Distinguishing Celiac Disease from Non-Celiac Gluten Sensitivity and Healthy Subjects. IRANIAN BIOMEDICAL JOURNAL 2020; 24:340-6. [PMID: 32660201 PMCID: PMC7601547 DOI: 10.29252/ibj.24.6.335] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Accepted: 11/23/2019] [Indexed: 02/07/2023]
Abstract
Background It has been established that the level of some inflammatory cytokines increases in celiac disease (CD) and non-celiac gluten sensitivity (NCGS) in comparison with healthy subjects. Therefore, the primary interest in our research was proposing an accurate tool to diagnose patients with CD and NCGS from healthy individuals in an Iranian population. Methods The serum samples were examined in 171 participants, including 110 CD patients, 46 healthy individuals, and 15 NCGS. The commercial ELISA kits were used to detect the level of the following cytokines: IL-1, IL-6, IL-8, IL-15, and IFN-γ. The receiver operating characteristic (ROC) curve analysis was applied to determine the optimal thresholds for high sensitivity, specificity, positive and negative predictive values of cytokines, as the indicators of CD, NCGS, and healthy control groups. Results In NCGS group, the values of area under the ROC curve for IL-1, IL-8, and IFN-γ were 71%, 78%, and 70%, respectively. To differentiate the CD and NCGS groups from the control group, IL-15 had the highest sensitivity (82.70%), specificity (56.50%), positive predictive value (81.98%), and negative predictive value (57.78%), followed by IL-8 with the highest sensitivity of 74.50%, specificity of 73.30%, and positive and negative predictive values of 95.35% and 30.21%, respectively. Conclusion The obtained results demonstrate that IL-15 and IL-8 could be proposed as potential markers in their optimal cut-off points for distinguishing CD from the NCGS and the healthy control. Based on our findings, the evaluation of cytokine levels can be recommended as a useful tool for the diagnosis of CD and NCGS in a clinical practice.
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Affiliation(s)
- Fatemeh Masaebi
- Depatment of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Azizmohammad Looha
- Depatment of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Rostami-Nejad
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohamad Amin Pourhoseingholi
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Navid Mohseni
- Depatment of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Gabriel Samasca
- Department of Immunology, Iuliu Hatieganu University of Medicine and Pharmacy ClujNapoca, Romania;
| | - Iulia Lupan
- Department of Molecular Biology and Biotechnology, BabesBolyai University, Cluj-Napoca, Romania
| | - Mostafa Rezaei-Tavirani
- Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Zali
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Roszkowska A, Pawlicka M, Mroczek A, Bałabuszek K, Nieradko-Iwanicka B. Non-Celiac Gluten Sensitivity: A Review. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E222. [PMID: 31142014 PMCID: PMC6630947 DOI: 10.3390/medicina55060222] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 05/21/2019] [Accepted: 05/22/2019] [Indexed: 12/12/2022]
Abstract
Background and objectives: Grain food consumption is a trigger of gluten related disorders: celiac disease, non-celiac gluten sensitivity (NCGS) and wheat allergy. They demonstrate with non-specific symptoms: bloating, abdominal discomfort, diarrhea and flatulence. Aim: The aim of the review is to summarize data about pathogenesis, symptoms and criteria of NCGS, which can be helpful for physicians. Materials and Methods: The PubMed and Google Scholar databases were searched in January 2019 with phrases: 'non-celiac gluten sensitivity', non-celiac gluten sensitivity', non-celiac wheat gluten sensitivity', non-celiac wheat gluten sensitivity', and gluten sensitivity'. More than 1000 results were found. A total of 67 clinical trials published between 1989 and 2019 was scanned. After skimming abstracts, 66 articles were chosen for this review; including 26 clinical trials. Results: In 2015, Salerno Experts' Criteria of NCGS were published. The Salerno first step is assessing the clinical response to gluten free diet (GFD) and second is measuring the effect of reintroducing gluten after a period of treatment with GFD. Several clinical trials were based on the criteria. Conclusions: Symptoms of NCGS are similar to other gluten-related diseases, irritable bowel syndrome and Crohn's disease. With Salerno Experts' Criteria of NCGS, it is possible to diagnose patients properly and give them advice about nutritional treatment.
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Affiliation(s)
- Anna Roszkowska
- Medical University of Lublin, Radziwillowska 11 Street, 20-080 Lublin, Poland.
| | - Marta Pawlicka
- Medical University of Lublin, Radziwillowska 11 Street, 20-080 Lublin, Poland.
| | - Anna Mroczek
- Medical University of Lublin, Radziwillowska 11 Street, 20-080 Lublin, Poland.
| | - Kamil Bałabuszek
- Medical University of Lublin, Radziwillowska 11 Street, 20-080 Lublin, Poland.
| | - Barbara Nieradko-Iwanicka
- Chair and Department of Hygiene, Medical University of Lublin, Radziwillowska 11 Street, 20-080 Lublin, Poland.
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Assessing of Celiac Disease and Nonceliac Gluten Sensitivity. Gastroenterol Res Pract 2015; 2015:723954. [PMID: 26064097 PMCID: PMC4429206 DOI: 10.1155/2015/723954] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 04/15/2015] [Indexed: 12/17/2022] Open
Abstract
The publication of papers on the topic of gluten related disorders has substantially increased over the last few years. This has motivated healthcare professionals to pay attention not only to celiac disease and wheat allergy but also to a condition termed nonceliac gluten sensitivity (NCGS). Until now this condition has been diagnosed clinically on the basis of exclusion criteria and clinical response to gluten withdrawal. In addition, recent research in this field has shown that other food components distinct from gluten are implicated in NCGS cases, thereby changing our general understanding of NCGS diagnosis in either individuals on gluten containing diets or those already following a gluten-free diet with no proper diagnostic work-up of celiac disease. With this in mind, the assessment of NCGS will require extensive knowledge of celiac disease manifestations and the laboratory tests commonly performed during diagnosis of celiac disease.
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Vojdani A, Kharrazian D, Mukherjee PS. The prevalence of antibodies against wheat and milk proteins in blood donors and their contribution to neuroimmune reactivities. Nutrients 2013; 6:15-36. [PMID: 24451306 PMCID: PMC3916846 DOI: 10.3390/nu6010015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 12/06/2013] [Accepted: 12/10/2013] [Indexed: 01/21/2023] Open
Abstract
The aim of this study was to look for the presence of IgG, IgM, and IgA antibodies against two widely consumed foods, wheat and milk, in a relatively large number of specimens. As wheat, milk, and their antigens have been found to be involved in neuroimmune disorders, we measured the co-occurrence of their antibodies against various neural antigens. We assessed the reactivity of sera from 400 donors to wheat and milk proteins, GAD-65, cerebellar, MBP, and MOG. Statistical analysis showed significant clustering when certain wheat and milk protein antibodies were cross-referenced with neural antibodies. Approximately half of the sera with antibody elevation against gliadin reacted significantly with GAD-65 and cerebellar peptides; about half of the sera with elevated antibodies against α + β-casein and milk butyrophilin also showed antibody elevation against MBP and MOG. Inhibition studies showed that only two out of four of the samples with elevated cerebellar or MOG antibodies could be inhibited by gliadin or α + β-casein, confirming individual variation in epitope recognition. We conclude that a subgroup of blood donors, due to a breakdown in immunological tolerance, may react and produce significant levels of antibodies (p-values less than 0.05) against wheat and milk antigens that cross-react with different neural antigens, which may have broader implications in the induction of neuroimmune reactivities.
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Affiliation(s)
- Aristo Vojdani
- Immunosciences Lab., Inc., 822 S. Robertson Blvd., Ste. 312, Los Angeles, CA 90035, USA.
| | - Datis Kharrazian
- Department of Clinical Sciences, Bastyr University California, 4106 Sorrento Valley Blvd, San Diego, CA 92121, USA.
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