Current Evidence on the Efficacy of Gluten-Free Diets in Multiple Sclerosis, Psoriasis, Type 1 Diabetes and Autoimmune Thyroid Diseases

Passali, Moschoula; Josefsen, Knud; Frederiksen, Jette Lautrup; Antvorskov, Julie Christine

doi:10.3390/nu12082316

Cited by 62 publications

(42 citation statements)

References 186 publications

(239 reference statements)

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“…However, some authors reported a higher prevalence of anti-gliadin immunoglobulins (AGA) or immunoglobulin against tissue transglutaminase (IgA-tTG, IgG-tTG) in pwMS, whereas similar antibody levels between pwMS and healthy controls were revealed by others [90]. Furthermore, several studies investigated the prevalence and the risk to develop MS in patients with CD failing to show a significant association [91]. The benefit of GFD with respect to a free diet among pwMS has been investigated only by a single, non-randomized trial, suggesting a significant lower activity on magnetic resonance imaging (MRI) and lower EDSS scores [92].…”

Section: Gluten-free Diet (Gfd)mentioning

confidence: 98%

The Role of Nutritional Lifestyle and Physical Activity in Multiple Sclerosis Pathogenesis and Management: A Narrative Review

et al. 2021

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Studies on the role of nutritional factors and physical activity (PA) in the pathogenesis of multiple sclerosis (MS) go back a long time. Despite the intrinsic difficulty of studying their positive or negative role in MS, the interest of researchers on these topics increased during the last few decades, since the role of diet has been investigated with the perspective of the association with disease-modifying drugs (DMD). The association of DMD, diets, and PA might have an additive effect in modifying disease severity. Among the various diets investigated (low-carbohydrate, gluten-free, Mediterranean, low-fat, fasting-mimicking, and Western diets) only low-carbohydrate, Mediterranean, and fast-mimicking diets have shown both in animal models and in humans a positive effect on MS course and in patient-reported outcomes (PROs). However, the Mediterranean diet is easier to be maintained compared to fast-mimicking and low-carbohydrate diets, which may lead to detrimental side effects requiring careful clinical monitoring. Conversely, the Western diet, which is characterized by a high intake of highly saturated fats and carbohydrates, may lead to the activation of pro-inflammatory immune pathways and is therefore not recommended. PA showed a positive effect both in animal models as well as on disease course and PROs in humans. Training with combined exercises is considered the more effective approach.

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Section: Gluten-free Diet (Gfd)mentioning

confidence: 98%

The Role of Nutritional Lifestyle and Physical Activity in Multiple Sclerosis Pathogenesis and Management: A Narrative Review

et al. 2021

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“…Indeed, gliadin may induce immune responses, which are related to autoimmunity. 9,38,39 Our results showed the elevated levels of IFN-γ and IL-17 and upregulation of inflammatory chemokines CXCL-2, CCL-2, and CXCL-10 in further analysis for evaluating the possible mechanism of neurological complications after gliadin immunization, which played essential roles in leukocyte trafficking. These data could be considered as possible immune-mediated responses against gliadin.…”

Section: Discussionmentioning

confidence: 63%

Effects of Gliadin on Autoimmune Responses of Central Nervous System of C57BL/6 Mice

Esmaeili¹,

Rostami²,

Akbarijavar³

et al. 2021

IJAAI

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Gluten sensitivity contributes to various degrees of neurological manifestations and neurodegenerative immunological changes. We investigated the experimental features of antigliadin immune responses in the central nervous system (CNS) of mice. Female C57BL6 mice were divided into three groups. Mice immunized with complete Freund's adjuvant (CFA) or gliadin emulsified in CFA, and the control group received phosphate-buffered saline (PBS). Immunohistochemistry, hematoxylin-eosin, and Luxol fast blue staining were performed on the sections. The serum levels of interleukin (IL)-17 and interferongamma (IFN-γ) were measured using enzyme-linked immunosorbent assay (ELISA). Reverse transcriptase-polymerase chain reaction (RT-PCR) was used to assess the mRNA levels of chemokine (C-X-C motif) ligand-2 (CXCL-2), C-C motif chemokine ligand-2 (CCL-2), and CXCL-10. In gliadin+CFA immunized mice, the microscopic lesions included perivascular edema, focalmicrogliosis, and acute neuronal necrosis in the cortex, subcortical, Purkinje cell layer, and ventral horn of the spinal cord. While extravasation of anti-IgG antibodies and selective targeting of Purkinje cells were observed in gliadin+CFA immunized mice. A significant increase in serum IL17 and IFN-γ levels (p<0.05), as well as expression of CXCL-2, CCL-2, and CXCL-10 in mice immunized with gliadin+CFA, were monitored versus controls. Our findings indicated that the immune responses directed against gliadin peptides might contribute to blood-brain barrier breakdown, extravasation of serum anti-IgG, gliosis, and acute neuronal necrosis in the cortex and cerebellar Purkinje cells. Anti-IgG antibodies may cause extravasation of blood-born anti-gliadin antibodies and selective targeting of Purkinje cells observed in mice immunized with peptide tryptic (pt) -gliadin in CFA.

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“…Large population studies on patients with CD do not confirm the beneficial effect of GFDs on the autoimmune process in HT, and so caution is advised when prescribing a GFD to patients with cAITD [ 37 ]. It seems that it is not so much the GFD itself as general diet modification (including nutrition education and healthy dietary habits promotion, such as increased fiber consumption) that may play an important role in the GFDG, especially in terms of improving the absorption of levothyroxine from the gastrointestinal tract.…”

Section: Discussionmentioning

confidence: 99%

Whether a Gluten-Free Diet Should Be Recommended in Chronic Autoimmune Thyroiditis or Not?—A 12-Month Follow-Up

Pobłocki

Pańka

Telesiński

et al. 2021

JCM

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Elimination diets have recently become extremely popular among people with autoimmune diseases. A gluten-free diet is indicated in celiac disease (CD), but some studies show its effectiveness in cases of autoimmunity. The aim of this study was to assess whether the use of a gluten-free diet is also effective in patients with chronic autoimmune thyroid disease (cAITD), which is the most common thyroid autoimmune pathology associated with chronic inflammation, over-reactivity of the immune system, auto-destruction of thyrocytes and hypothyroidism. The final analysis of the study included 62 Caucasian women randomized into a control group (CG: n = 31) and an experimental group on a gluten-free diet (GFDG: n = 31), were subject to a 12-month follow-up, during which the concentrations of thyrotropin (TSH), free triiodothyronine (fT3), free thyroxine (fT4), anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) antibodies were assessed at baseline and after 3, 6 and 12 months. During the 12-month follow-up between the CG and the GFDG, no differences were found in anti-TPO and anti-TG antibodies, fT3 or fT4 levels, except a significant reduction in TSH levels in the GFDG. Additionally, performed analysis between individual appointments presented no significant differences in changes in the median concentrations of anti-TPO, anti-TG or fT3, but confirmed a significant decrease in TSH and showed accessory an increase in fT4 after 12 months in GFDG. Statistical analyses performed separately for both groups indicated a constant reduction of anti-TG concentrations in the GFDG. In conclusion, a GFD may be administered in cAITD after ruling out celiac disease, but it is necessary to perform more studies to assess if cAITD patients achieve the benefits of following a GFD. Patients with cAITD should be offered proper nutrition education combined with a healthy lifestyle promotion.

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Current Evidence on the Efficacy of Gluten-Free Diets in Multiple Sclerosis, Psoriasis, Type 1 Diabetes and Autoimmune Thyroid Diseases

Cited by 62 publications

References 186 publications

The Role of Nutritional Lifestyle and Physical Activity in Multiple Sclerosis Pathogenesis and Management: A Narrative Review

The Role of Nutritional Lifestyle and Physical Activity in Multiple Sclerosis Pathogenesis and Management: A Narrative Review

Effects of Gliadin on Autoimmune Responses of Central Nervous System of C57BL/6 Mice

Whether a Gluten-Free Diet Should Be Recommended in Chronic Autoimmune Thyroiditis or Not?—A 12-Month Follow-Up

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