Wheat sensitivity in people without celiac disease linked to leaky gut, systemic inflammation
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This editorial also appeared in the Fall 2016 issue of ARI's Autism Research Review International newsletter.

Many individuals experience symptoms including bloating, abdominal pain, diarrhea, anxiety, and cognitive problems when they eat foods containing gluten—a condition called non-celiac gluten or wheat sensitivity (NCWS). A new study indicates that NCWS, which affects many people with autism, stems from a “leaky gut” that causes body-wide inflammation.

Peter Green, a co-author of the study headed by Melanie Uhde, says, “Our study shows that the symptoms reported by individuals with this condition [NCWS] are not imagined, as some people have suggested. It demonstrates that there is a biological basis for these symptoms in a significant number of these patients.”

In their study, Uhde and her colleagues evaluated 80 people with NCWS, 40 individuals with celiac disease (an autoimmune disease in which gluten exposure causes severe intestinal damage), and 40 healthy controls. They found that people with celiac disease, while they had extensive intestinal damage, did not have elevated blood markers of systemic immune system activation. In contrast, the NCWS group exhibited a marker of intestinal cell damage that correlated with blood markers of acute systemic immune activation.

The researchers say their results indicate that system-wide immune activation in NCWS occurs because microbial and dietary components escape through a weakened intestinal barrier and enter the bloodstream. This, they say, “would be consistent with the generally rapid onset of the reported symptoms in people with NCWS.”

The researchers also found that individuals with NCWS who ate a diet free of wheat and related grains for six months normalized their levels of immune activation and intestinal cell damage markers. As a result, these individuals experienced fewer intestinal and non-intestinal symptoms, although the magnitude of change in biological markers did not correlate significantly with the magnitude of change in symptom severity.

Study coauthor Armin Alaedini says, “The data suggest that in the future, we may be able to use a combination of biomarkers to identify patients with NCWS and to monitor their response to treatment.”

“Intestinal cell damage and systemic immune activation in individuals reporting sensitivity to wheat in the absence of coeliac disease,” Melanie Uhde, Mary Ajamian, Giacomo Caio, Roberto De Giorgio, Alyssa Indart, Peter H. Green, Elizabeth C. Verna, Umberto Volta, and Armin Alaedini, Gut, July 25, 2016 (online). Address: Armin Alaedini, Department of Medicine, Columbia University Medical Center, 1130 Saint Nicholas Ave., Room 937, New York, NY 10032, [email protected] columbia.edu.

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“Columbia researchers find biological explanation for wheat sensitivity,” news release, Columbia University Medical Center, July 26, 2016.