Gluten Revealed!

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<p>Gluten</p> <p>Gluten Revealed</p> <p> Todays Objectives</p> <p>Gluten OverviewHealth ImpactBiochemical/Physiological MechanismsAssociated Neurological ConditionsWhat is Gluten?Gluten means Glue</p> <p> Toxic Gluten ProteinsGliadin (soluble) and Glutenin (insoluble)</p> <p>Gives bread the elasticity to rise</p> <p>Sapone A et al. Spectrum of gluten-related disorders: consensus on new nomenclature and classification. BMC Medicine. 20012; 10:13.Physiological Response to Gluten </p> <p>Sapone et al. Spectrum of gluten mrelated disorders:consesnus of new nomenclature and classification. BMC Medicine. 2012; 10:13. Celiac Disease T-cell mediated reaction. Autoimmune disorder. Antibodies are produced. Intestinal lining damage.Wheat Allergy T-cell mediated reaction. (IgE) Triggers chemical mediators (Such as histamine.) Instestinal Lining damage.Gluten Sensitivity Not autoimmune or allergy related. No intestinal damage, yet patient develop adverse reactions.Sapone et al. Spectrum of gluten related disorders:consesus of new nomenclature and classification. BMC Medicine. 2012; 10:13. Clinical Presentation VariesGastrointestinal distress, chronic diarrhea, weight lossAshma related issues (Induced by exercise)Rhinitis inflammation of nose membranesDermatitis Herpetiformis blistering rashAnd, many other symptoms</p> <p>Sapone et al. Spectrum of gluten mrelated disorders:consesnus of new nomenclature and classification. BMC Medicine. 2012; 10:13. The Central Idea Increased Gut Permeability</p> <p>Increased Passage of Antigens(Food, Bacteria, or Viruses)</p> <p>Faulty Immune Response(Inflammation)</p> <p>Autoimmune DysfunctionInflammationSapone et al. Spectrum of gluten related disorders:consensus of new nomenclature and classification. BMC Medicine. 2012; 10:13. A Few Associated Heath Conditions Celiac Disease Multiple SchlerosisType 1 DiabetesPsoriasisImmunoglobulin (Ig)A nephropathyRhematoid ArthritisNeurological Conditions (Depression and Schizophrenia)Carrera-Bastos P et al. The western diet and lifestyle and diseases of civilization. Res Rep Clin Cardiol. 2011;2:15-35Diagnostic Criteria for Celiac DiseaseTypical Gastrointestinal Symptoms of Celiac DiseasePositive for IgA class autoantibodiesHLA-DQ2 and/or HLA DQ8 genotypesCeliac enteropathy found on small bowel biopsyResponse to a Gluten Free Diet Sapone et al. Spectrum of gluten related disorders:consesus of new nomenclature and classification. BMC Medicine. 2012; 10:13. </p> <p>Conclusion: The data provide evidence that dietary modification may be of clinical benefit for certain RA patients, and that this benefit may be related to a reduction in immunoreactivity to food antigens eliminated by change in diet.Hafstrom I et al. A vegan diet free of gluten improved signs and symptoms of arthritis correlate with a reduction in antibodies to food antigens. Rheumatology. 2001; 40:1175-1179Gluten Biochemistrycvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvv</p> <p>The most toxic fragment of gliadin the 33-mer peptide is from a2-gliadin. </p> <p>Shun-Zi J et al. A study of circulating gliadin antibodies in schizophrenia among a Chinese population. Schizophr Bull. 2012; 38(3): 514-518.Gliadin Protein Increases Gut Permeability By Zonulin ProductionGluten increases production of ZonulinsZonulins directly affect tight junction (paracellular) intestinal permeabilityIncrease in zolulins increases overall permeabilityVanuytsel T et al. The role of Haptoglobin and its related protein, Zonulin, in inflammatory bowel disease. Tissue Barriers. 2013; 1(5)</p> <p>Lipopolysacchardies (LPS)</p> <p>Lipid + Polysaccharide</p> <p>Found in Gram-Negative Bacteria</p> <p>Creates A Strong Immune Response </p> <p>Maes M et al. The gut-brain barrier in major depression:intestinal mucosal dysfunction with an increased translocation of LPS from gram negative enterobacteria (leaky gut) plays a role in the inflammatory pathophysiology of depression. Neuroendocrinol Lett 2008; 29(1):11712</p> <p>LPS Mechanism of Inflammation</p> <p>GenesMaes M et al. The gut-brain barrier in major depression:intestinal mucosal dysfunction with an increased translocation of LPS from gram negative enterobacteria (leaky gut) plays a role in the inflammatory pathophysiology of depression. Neuroendocrinol Lett 2008; 29(1):11712</p> <p>Intestinal Barrier DysfunctionLPS EndotoxinInflammatory EnzymesProinflammatory CytokinesCell Adhesion MoleculesAntiapoptotic proteinsNitric Oxide SynthaseMatrix-degrading enzymesMaes M et al. The gut-brain barrier in major depression:intestinal mucosal dysfunction with an increased translocation of LPS from gram negative enterobacteria (leaky gut) plays a role in the inflammatory pathophysiology of depression. Neuroendocrinol Lett 2008; 29(1):11712</p> <p>Gluten and The Brain</p> <p>The results of the present study provide clear evidence of high prevalence of cortical perfusion abnormality in adult coeliac patients, up to 71% displaying brain perfusion defects. Usai P et al. Frontal cortical perfusion abnormalities related to gluten intake and associated autoimmune disease in adult coeliac disease:99m Tc-ECD brain SPECT study. Digestive and Liver Disease. 2004; 36:513-518Associated Neurological ConditionsAnxiety DisordersDepressive and Mood DisordersAttention Deficit Hyperactivity DisorderAutism Spectrum Disorder Schizophrenia</p> <p>Jackson J et al. Neurological and psychiatric manifestations of celiac disease and gluten sensitivity. Psychiatr Q. 2012; 83: 91-102</p> <p>We found that the values for serum IgM and IgA agaisnt LPS of enterobacteria to be significantly greater in patients with major depressive disorder than in normal volunteers.Maes M et al. The gut-brain barrier in major depression:intestinal mucosal dysfunction with an increased translocation of LPS from gram negatieve enterobacteria (leaky but) plays a role in the inflammatory pathophysiology of depression. Neuroendocrinol Lett 2008; 29(1):11712</p> <p>19Main Idea Behind This ArticleMajor depression is accompanied by activation of the inflammatory response system (IRS) and that pro-inflammatory cytokines and lipopolysaccharides (LPS) may induce depressive symptoms. This theory is called the cytokine hypothesis of depression.This study is testing the correlation between antibody production and depressive symptoms. Maes M et al. The gut-brain barrier in major depression:intestinal mucosal dysfunction with an increased translocation of LPS from gram negatieve enterobacteria (leaky but) plays a role in the inflammatory pathophysiology of depression. Neuroendocrinol Lett 2008; 29(1):11712</p> <p>Maes M et al. The gut-brain barrier in major depression:intestinal mucosal dysfunction with an increased translocation of LPS from gram negatieve enterobacteria (leaky but) plays a role in the inflammatory pathophysiology of depression. Neuroendocrinol Lett 2008; 29(1):11712</p> <p>27.1% of patients were positive for IgA antibodies compared with 17.7% of control subjects.Shun-Zi J et al. A study of circulating gliadin antibodies in schizophrenia among Chinese population. Schizophr Bull. 2012; 38(3): 51451822473 Patients with Schizophrenia. 478 Control SubjectsPositive for IgA Antibody</p> <p>Patients with Schizophrenia 27.1 %Control Subjects 17.8 %Difference of 9.3 %</p> <p>Women Patients with Schizophrenia27.6 %Women Control Subjects 13.9 %Difference of 13.7 %</p> <p>Men Patients with Schizophrenia26.4%Men Control Subjects 19.8 %Difference of 6.6 %</p> <p>Shun-Zi J et al. A study of circulating gliadin antibodies in schizophrenia among a Chinese population. Schizophr Bull. 2012; 38(3): 514518Presentation Questions1. Which gliadin causes the most destructive autoimmune reaction in the human body?a) Alpha-gliadinb) Beta-Gliadinc) Gamma-Gliadin2. Lipopolysacchardies (LPS) has been directly linked to what neurological disorder?a) Attention deficit disorderb) Depressionc) Alzheimers 3. Zonulin proteins effect __________ which have a direct impact on intestinal permeability?a) Cell membranesb) Endoplasmic reticulumc) Tight junctions4. Gluten has been shown to ________ bloodflow to the brain. a) Increaseb) Decreasec) Not affect5. Many health conditions that relate to gluten, often have increased levels of ___________ in the blood. a) Immunoglobulinsb) Cholesterolc) Bacteria</p> <p>ReferencesCarrera-Bastos P et al. The western diet and lifestyle and diseases of civilization. Res Rep Clin Cardiol. 2011;2:15-35Jackson J et al. Neurological and psychiatric manifestations of celiac disease and gluten sensitivity. Psychiatr Q. 2012; 83: 91-102Hafstrom I et al. A vegan diet free of gluten improved signs and symptoms of arthritis correlate with a reduction in antibodies to food antigens. Rheumatology. 2001; 40:1175-1179Maes M et al. The gut-brain barrier in major depression:intestinal mucosal dysfunction with an increased translocation of LPS from gram negative enterobacteria (leaky gut) plays a role in the inflammatory pathophysiology of depression. Neuroendocrinol Lett 2008; 29(1):11712Sapone A et al. Spectrum of gluten-related disorders: consensus on new nomenclature and classification. BMC Medicine. 20012; 10:13.Shun-Zi J et al. A study of circulating gliadin antibodies in schizophrenia among Chinese population. Schizophr Bull. 2012; 38(3): 514518</p> <p>References Cont.7. Vanuytsel T et al. The role of Haptoglobin and its related protein, Zonulin, in inflammatory bowel disease. Tissue Barriers. 2013; 1(5)</p> <p>8. Usai P et al. Frontal cortical perfusion abnormalities related to gluten intake and associated autoimmune disease in adult coeliac disease:99m Tc-ECD brain SPECT study. Digestive and Liver Disease. 2004; 36:513-518</p>