scholarly journals Gluten Ataxia Associated with Dietary Protein Cross-Reactivity with GAD-65

Reports ◽  
2020 ◽  
Vol 3 (3) ◽  
pp. 24
Author(s):  
Datis Kharrazian
Keyword(s):  
Dietary Protein ◽  
Structural Similarity ◽  
Cross Reactivity ◽  
Gluten Free Diet ◽  
Acid Decarboxylase ◽  
Gluten Free ◽  
Gluten Ataxia ◽  
Clinical Responses ◽  
Gad 65 ◽  
Sporadic Ataxia

Cross-reactivity occurs when antibodies formed against an antigen have amino acid sequence homology with another target protein. This allows antibodies formed against the antigen to also bind to similar proteins that share structural similarity. Autoimmune reactions to gluten can lead to sporadic ataxia in susceptible genotypes due to cross-reactivity. With gluten ataxia, dietary consumption of gluten proteins induce immunological cross-reactivity with glutamic-acid decarboxylase-65 (GAD-65) target proteins found in the cerebellum. Implementation of a strict gluten-free diet has been shown to improve the expression of this form of ataxia with most patients in this subgroup. However, there are some subjects that have limited clinical responses to only a strict gluten-free diet. Dietary protein cross-reactivity to other food proteins, besides gluten, that also share structural similarity to GAD-65 may also play a role in this reaction. In this case report, we report of a patient suffering from gluten-ataxia in which a gluten-free diet alone did not generate significant clinical outcomes until other foods that cross-react with GAD-65 were also removed from their diet.

Effect of gluten-free diet on cerebellar MR spectroscopy in gluten ataxia

Neurology ◽  
2017 ◽  
Vol 89 (7) ◽  
pp. 705-709 ◽  
Author(s):  
Marios Hadjivassiliou ◽  
Richard A. Grünewald ◽  
David S. Sanders ◽  
Priya Shanmugarajah ◽  
Nigel Hoggard
Keyword(s):  
Clinical Care ◽  
Area Ratio ◽  
Gluten Free Diet ◽  
Resonance Spectroscopy ◽  
Gluten Free ◽  
Positive Serology ◽  
Gluten Ataxia ◽  
Antigliadin Antibodies ◽  
Sporadic Ataxia ◽  
Repeat Scanning

Objective:To evaluate the effect of gluten free diet (GFD) on magnetic resonance spectroscopy (MRS) of the cerebellum in patients with gluten ataxia (GA).Methods:Patients with GA, defined as sporadic ataxia with positive antigliadin antibodies in the absence of an alternative cause, routinely undergo MRS at baseline and after the introduction of GFD as part of their clinical care. We present our experience of the effect of GFD on MRS of the cerebellum.Results:A total of 117 consecutive patients with GA were included in this report. Sixty-three were on strict GFD with elimination of antigliadin antibodies, 35 were on GFD but were still positive for antigliadin antibodies, and 19 patients opted not to go on GFD. The N-acetylaspartate (NAA)/creatine (Cr) area ratio from the cerebellar vermis increased in 62 out of 63 (98%) patients on strict GFD, in 9 of 35 (26%) patients on GFD but positive antibodies, and in only 1 of 19 (5%) patients not on GFD. The NAA/Cr ratio decreased in all 14 ataxia control patients (cerebellar variant of multisystem atrophy). There were no differences in the MRS results between those patients who had and those who did not have enteropathy (celiac disease) within each group.Conclusions:The demonstration of increased NAA/Cr ratio on repeat scanning following strict GFD strengthens previous findings of clinical improvement of the ataxia in patients with GA. The presence of enteropathy is not a prerequisite for such improvement; therefore patients with positive serology and negative duodenal biopsy should still be treated with strict GFD.

scholarly journals Neurological disorders associated with gluten sensitivity

2017 ◽  
Vol 89 (2) ◽  
pp. 99-102
Author(s):  
D A Degterev ◽  
I V Damulin ◽  
A I Parfenov
Keyword(s):  
Clinical Features ◽  
Neurological Disorders ◽  
Gluten Free Diet ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Gluten Ataxia

The review considers the pathogenetic, clinical, and therapeutic aspects of neurological disorders associated with gluten sensitivity. Gluten ataxia and polyneuropathy are most common. The clinical features of neurological disorders in patients with gluten sensitivity and the effects of a gluten-free diet are described.

Gluten-Related Disorders: Gluten Ataxia

2015 ◽  
Vol 33 (2) ◽  
pp. 264-268 ◽  
Author(s):  
Marios Hadjivassiliou ◽  
David D. Sanders ◽  
Daniel P. Aeschlimann
Keyword(s):  
Age At Onset ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Cerebellar Atrophy ◽  
Gluten Free Diet ◽  
Neurological Dysfunction ◽  
Gluten Free ◽  
Strict Adherence ◽  
Gluten Ataxia ◽  
Antigliadin Antibodies

The term gluten-related disorders (GRD) refers to a spectrum of diverse clinical manifestations triggered by the ingestion of gluten in genetically susceptible individuals. They include both intestinal and extraintestinal manifestations. Gluten ataxia (GA) is one of the commonest neurological manifestations of GRD. It was originally defined as otherwise idiopathic sporadic ataxia in the presence of circulating antigliadin antibodies of IgA and/or IgG type. Newer more specific serological markers have been identified but are not as yet readily available. GA has a prevalence of 15% amongst all ataxias and 40% of all idiopathic sporadic ataxias. It usually presents with gait and lower limb ataxia. It is of insidious onset with a mean age at onset of 53 years. Up to 40% of patients have evidence of enteropathy on duodenal biopsy. Gastrointestinal symptoms are seldom prominent and are not a reliable indicator for the presence of enteropathy. Furthermore, the presence of enteropathy does not influence the response to a gluten-free diet. Most patients will stabilise or improve with strict adherence to gluten-free diet depending on the duration of the ataxia prior to the treatment. Up to 60% of patients with GA have evidence of cerebellar atrophy on MR imaging, but all patients have spectroscopic abnormalities primarily affecting the vermis. Recent evidence suggests that patients with newly diagnosed coeliac disease presenting to the gastroenterologists have abnormal MR spectroscopy at presentation associated with clinical evidence of subtle cerebellar dysfunction. The advantage of early diagnosis and treatment (mean age 42 years in patients presenting with gastrointestinal symptoms vs. 53 years in patients presenting with ataxia) may protect the first group from the development and/or progression of neurological dysfunction.

scholarly journals Glycine receptor antibodies and coeliac disease-related neurological dysfunction

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Lewis Kass-Iliyya ◽  
Ptolemaios G. Sarrigiannis ◽  
David S. Sanders ◽  
Marios Hadjivassiliou
Keyword(s):  
Coeliac Disease ◽  
Glycine Receptor ◽  
Gluten Free Diet ◽  
Neurological Dysfunction ◽  
Acid Decarboxylase ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Gad Antibodies ◽  
Cortical Myoclonus ◽  
Receptor Antibodies

AbstractGluten sensitivity can manifest with a spectrum of neurological dysfunction including ataxia, encephalopathy and neuropathy with or without associated coeliac disease (CD). Gluten sensitivity can also present with central nervous system (CNS) hyperexcitability and cortical myoclonus which is often accompanied with refractory CD. CNS hyperexcitability can also be associated with Glutamic Acid Decarboxylase (GAD) antibodies or much less commonly with Glycine Receptor Antibodies (GlyR-Abs) but the direct pathogenic roles of these antibodies remain debatable. We have previously reported a link between gluten sensitivity and anti-GAD associated ataxia which improves with the adoption of gluten-free diet. It is unclear if a similar link exists between gluten driven CNS hyperexcitability and the presence of GlyR-Abs. We report two cases of CD presenting with CNS hyperexcitability and associated GlyR-Abs. Apart from ataxia and cortical myoclonus, one patient had refractory CD and died from enteropathy-associated T-cell lymphoma. The other patient not only improved with strict gluten-free diet but also showed serological elimination of circulating GlyR-Abs. We conclude that there is an interaction between gluten sensitivity and GlyR-Abs-associated CNS hyperexcitability and in such patients gluten-free diet is an important therapeutic intervention. The elimination of GlyR-Abs by the adoption of gluten free diet suggests that these antibodies may represent an epiphenomenon rather than being directly implicated in the pathogenesis.

scholarly journals GLUTEN ATAXIA - A COMMON, COMMONLY MISDIAGNOSED DISEASE

2021 ◽  
Vol 7 (1-2) ◽  
pp. 3-6
Author(s):  
Y.O. Trufanov ◽  
N.K. Svyrydova ◽  
M.M. Martynovsky
Keyword(s):  
Celiac Disease ◽  
Early Diagnosis ◽  
Clinical Symptoms ◽  
Family Physicians ◽  
Review Article ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Gluten Ataxia ◽  
Diagnostic Approaches ◽  
Timely Treatment

The objective of our research was to raise awareness of neurologists and family physicians about gluten ataxia and improve the diagnostic approaches. Methods. PubMed and Google Scholar resources were used to write the review article. Discussion. It is incredibly important not to overlook treatable courses of ataxia. One of these diseases is gluten ataxia. Early diagnosis and timely treatment (gluten-free diet) of gluten ataxia leads to a significant improvement of clinical symptoms and prevents their progression. Gluten ataxia is one of the most common and commonly misdiagnosed ataxia. Its prevalence among all ataxias is 15% and reaches 40% among all idiopathic sporadic ataxias (Hadjivassiliou M., Sanders D.D., Aeschlimann D.P., 2015). Keywords: gluten ataxia, celiac disease, gluten-related disorders.

scholarly journals Gluten Sensitivity Biomarkers in Menière's Disease: Is It a Gluten Related Disorder?

2017 ◽  
Author(s):  
Federica Di Berardino ◽  
Diego Zanetti ◽  
Marina Socci ◽  
Luca Elli
Keyword(s):  
Immune Reaction ◽  
Acid Decarboxylase ◽  
Healthy Controls ◽  
Gluten Free ◽  
Positive Skin ◽  
Related Disorder ◽  
Humoral Immune ◽  
Humoral Immune Responses ◽  
Gad 65 ◽  
Extract Fraction

Background: Meniere's disease (MD) has been recently linked to gluten assumption. Approximately 75% of MD patients show positive skin test to food and about 50% of the positive responses are specific to the gliadin acid extract fraction. Aim of this study was to investigate the humoral immune responses to wheat antigens and related autoantigens in MD patients. Methods. We assessed the reactivity of sera from 28 patients with definite MD and 100 healthy controls against a repertoire of 51 antigens usually associated with immune reaction to gluten. Results. MD patients showed an increase of anti-wheat IgA, anti-cerebellar peptide IgA and anti-glutamic acid decarboxylase (GAD) 65 IgM compared to healthy controls. In particular, the increase of anti-wheat IgA and GAD 65 IgM has been confirmed in a subgroup of MD patients symptomatically responding to a gluten free diet (GFD). Conclusion. In MD patients, an increase of the antibody production against gluten biomarkers was observed; in particular, anti-wheat IgA seems to be associated to clinical response to GFD.

Studies of Celiac Sprue. IV. The Response of the Whole Length of the Small Bowel to a Gluten-Free Diet

1964 ◽  
Vol 47 (6) ◽  
pp. 573-589 ◽  
Author(s):  
W.C. MacDonald ◽  
L.L. Brandborg ◽  
A.L. Flick ◽  
J.S. Trier ◽  
C.E. Rubin
Keyword(s):  
Small Bowel ◽  
Gluten Free Diet ◽  
Celiac Sprue ◽  
Gluten Free

A Clinical and Histochemical Study of Celiac Disease Before and During a Gluten-Free Diet

1965 ◽  
Vol 48 (2) ◽  
pp. 155-172 ◽  
Author(s):  
I. Michael Samloff ◽  
John S. Davis ◽  
Eric A. Schenk
Keyword(s):  
Celiac Disease ◽  
Histochemical Study ◽  
Gluten Free Diet ◽  
Gluten Free

Gluten-Free Diet Response Flagged

2007 ◽  
Vol 37 (15) ◽  
pp. 34
Author(s):  
DIANA MAHONEY
Keyword(s):  
Gluten Free Diet ◽  
Gluten Free
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