Gluten sensitivity and neurological manifestations

Berio, A; Mangiante, Giuseppe; Mariottini, Gian Luigi; Piazzi, A

doi:10.4081/jbr.2015.5405

Cited by 2 publications

(3 citation statements)

References 19 publications

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“…All the included studies support a link between epilepsy and CD [54][55][56][57][58][59][60][61][62][63][64][65]. Adverse outcomes were reported in two studies although this is not necessarily a result of the GFD [54,56].…”

Section: Resultsmentioning

confidence: 99%

“…TG6 linked to gluten ataxia [92] and TG6 antibodies have also been associated with CD, epilepsy and cerebral calcifications [93]. High serum anti-tTG antibodies were observed in participants with epilepsy, demonstrating a general stimulation of both innate and adaptive immune response via T cells due to gluten [59,65]. Furthermore, autoimmune disorders are often comorbid with epilepsy [94].…”

Section: Gluten Involved Immune-mediated Mechanismsmentioning

confidence: 99%

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A Gluten Free Diet in the Management of Epilepsy in People with Coeliac Disease or Gluten Sensitivity

Gilbey

Bold

2020

Gastrointestinal Disorders

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The aim of this review was to assess the effects of a gluten free diet (GFD) in the management of epilepsy in people with coeliac disease (CD) or gluten sensitivity (GS). A systematic approach was used to undertake a literature review. Five electronic databases (PubMed; Scopus; Google Scholar; Cochrane Epilepsy Group specialised register; Cochrane Register of Controlled Trails (CENTRAL) via the Cochrane Register of Online Trials) were searched using predetermined relevant search terms. In total, 668 articles were identified. Duplicates were removed and predefined inclusion and exclusion criteria were applied, and a PRISMA flow chart was produced. Data was extracted using Covidence software. Twelve studies on Epilepsy and CD involving a total of 70 participants were selected for analysis; narrative synthesis was used owing to the small sample sizes in the selected studies. None of the 12 studies meeting inclusion criteria investigated gluten sensitivity and epilepsy. All the included studies support a link between epilepsy and CD. GFD was effective in 44 out of 70 participants across the studies in terms of a reduction of seizures, reduction of antiepileptic drugs (AEDs) or normalisation of EEG pattern. A total of 44 participants showed a reduction in seizures (across eight studies) and complete cessation of seizures was reported in 22 participants. In general, the earlier the GFD is implemented after the onset of seizures, the better the likelihood of the GFD being successful in supporting control of seizures. Mechanisms linking gluten with epilepsy are not fully understood; possible hypotheses include gluten mediated toxicity, immune-induced cortical damage and malabsorption. Evidence suggests the effectiveness of a GFD in supporting the management of epilepsy in patients with CD, although the quality of evidence is low. There appears to be a growing number of neurologists who are prepared to advocate the use of a GFD. A multidisciplinary approaches and further research are recommended. It could be argued that when balancing potential treatments such as AEDs or surgery, a GFD has a low likelihood of harm.

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Section: Resultsmentioning

confidence: 99%

Section: Gluten Involved Immune-mediated Mechanismsmentioning

confidence: 99%

A Gluten Free Diet in the Management of Epilepsy in People with Coeliac Disease or Gluten Sensitivity

Gilbey

Bold

2020

Gastrointestinal Disorders

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“…Microglia are the main cerebellar innate immune cells involved in surveillance of the brain. Upon damage, microglia change their phenotype and can act as antigen presenting cells or phagocytes and release inflammatory cytokines, neurotrophic factors and growth hormones exerting both protective and detrimental effects [28,29]. In several SCA animal models microglia were found to actively contribute to the neuropathological process depending on the stage of disease.…”

Section: Discussionmentioning

confidence: 99%

Cerebellar presence of immune cells in patients with neuro-coeliac disease

Rouvroye

Bontkes

Bol

et al. 2023

acta neuropathol commun

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Although various neurodegenerative disorders have been associated with coeliac disease (CD), the underlying neuropathological link between these brain and gut diseases remains unclear. We postulated that the neuronal damage sporadically observed in CD patients is immune-mediated. Our aim was to determine if the loss of neurons, especially Purkinje cells, coincides with microglia activation and T- and B-cell infiltration in the cerebellum of patients with CD and a concomitant idiopathic neurological disease affecting the cerebellum (NeuroCD). Post-mortem cerebellar tissue was collected of validated NeuroCD cases. Gender- and age-matched genetic spinocerebellar ataxia (SCA) controls and non-neurological controls (NNC) were selected based on clinical reports and pathological findings. Cerebellar tissue of seventeen patients was included (6 NeuroCD, 5 SCA, 6 NNC). In SCA cases we found that the Purkinje cell layer was 58.6% reduced in comparison with NNC. In NeuroCD cases this reduction was even more prominent with a median reduction of 81.3% compared to NNC. Marked increased numbers of both CD3+ and CD8+ cells were observed in the NeuroCD but not in SCA patients. This coincided with significantly more microglial reactivity in NeuroCD patients. These findings demonstrate that the massive loss of Purkinje cells in the cerebellum of neuro CD patients is accompanied by local innate and T-cell mediated immune responses.

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Gluten sensitivity and neurological manifestations

Cited by 2 publications

References 19 publications

A Gluten Free Diet in the Management of Epilepsy in People with Coeliac Disease or Gluten Sensitivity

A Gluten Free Diet in the Management of Epilepsy in People with Coeliac Disease or Gluten Sensitivity

Cerebellar presence of immune cells in patients with neuro-coeliac disease

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