Autism: Its Gut Stupid

Not all gluten, wheat or grains are the same

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Gluten is not a singular entity. It is comprised of numerous proteins coming from grains, and these have variable properties.

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Looking at different grains in context of gluten

Wheat, barley and rye are intimately closely linked grains. Oats are distant cousins.

• Wheat gluten as well as the other gluten-like proteins hordeins in barley and secalins from rye bear many similarities structurally and in potential for gluten toxicity.
• Avenins derived from distant cousins oats are much less similar and create low toxicity.
• The gluten-like proteins in rice, corn, sorghum and tef are absolutely different from wheat gluten and are devoid of toxicity for humans.

All wheat is not the same

Wheat is not a monolithic entity.

• Thousands of varieties of wheat have been grown over the course of history. They have come up as a result of evolution, selective breeding and modern hybridization techniques.
• The most commonly used wheat for food are tetraploid durum wheats used mostly for pasta) and the hexaploid wheats used for breads.
• In fact, the term "durum" has now become part of common lexicon among people buying wheat flour for their cooking.  These are also the two types that contain the most gluten proteins.

Is It Leaky Gut or Leaky Gut Syndrome?

Why high gluten wheats are preferred by food industry?

• High nutritional value
• Higher the gluten content, the better the dough quality for baking.

What is gluten really?

Gluten is a multifaceted mixture of proteins seen in the seeds from wheat, barley and rye. These proteins are a source of food for the germinating seeds.

• Basically gluten comprises of two types of proteins: the gliadins and the glutenins. While many gliadin genes are seen in wheat, the genes for glutenins.are relatively uncommon.
• It is the glutenins that have most advantageous baking properties like elasticity and are critical for high quality dough widely used in food chain.
• The gliadins on the other hand are the proteins with the most toxic potential.

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Protein complex in rye versus barley

Rye contains both gliadin-like as well as glutenin-like proteins; The gliadin like proteins in rye are called secalins. Barley on the other hand has no glutenins but has gliadin-like proteins known as hordeins.

The oat exception

Because of distant cousin status, oat proteins are mostly gluten-like avenins which are dissimilar to gluten. Oat also has very few avenin genes, and as such oats contain kuch less avenins than the wheat.

• Thus oats consumption only creates a limited gluten exposure to the body and can be safely consumed by most unless contaminated by other grains.

Gluten and digestive juices in gut

• Gluten is highly resistant to breakdown by digestive juices in human gut.
• Gluten is rich in glutamine and proline aminoacids. It is the high proline content that makes it resistant to digestion in the gut.

Glutenins versus gliadins

While most of the gluten toxicity has been blamed on gliadins, it now appears that glutenins also have toxic potential in provoking immune system, albiet to smaller extent.

 Is It Leaky Gut or Leaky Gut Syndrome?

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Is It Leaky Gut or Leaky Gut Syndrome?

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Butyrate is the healthy acid for gut, body and brain

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Gut bacteria can have both a beneficial as well as harmful effect on our brain through gut brain connections.

Fermentation of undigested carbohydrates by gut bacteria can produce certain biochemicals that enter body, affecting not just the body but also cross blood-brain barrier and exercise their functions in different parts of the brain.

These neuro-chemicals play a critical role in messaging circuits in the brain and beyond. Other bacterial chemicals are involved in affecting our immune system, and help generate more energy from the cells in the body.

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Potential benefits of pre- and probiotics

All of above indicates that manipulation of diet and gut bacteria by prebiotics/probiotics could bring about a healthier beneficial gut bacteria which in turn would lead to healthy brain.

What is butyrate?

Butyrate, a short chain fatty acid (SCFA), is one such byproduct of food-bacteria interactions in the colon. In fact most of the butyrate in gut is produced by bacterial fermentation of undigested carbohydrates although small amounts may be derived from the food consumed.

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 Effects of butyrate

• Energy source for intestinal cells
• Energy source for bacteria themselves
• Effect on various forms of brain including neuro-degenerative diseases and neuro-behavioral dysfunction

According to Drs. Leonel and Alvarez-Leite, one the most prominent roles of butyrate is blocking the enzymes that play a critical role in intestinal health:

• Affecting gene function by turning them on or off
• Affect immune system, both suppressing and/or activating as needed
• Blocking cancer process
• Helping gut wall barrier to prevent leaky gut
• Control of intestinal movements and control diarrhea

Is It Leaky Gut or Leaky Gut Syndrome?

Different diets/bacteria result in different amounts of butyrate production

The fermentation capacity of all the bacteria is not the same, some producing more butyrate than others.

For example, the fermentation by  Clostridium, Eubacterium, and Butyrivibrio type of bacteria are the richest source of butyrate in colon.

Foods to consume to get more butyrate

Helpful high fiber foods that are a rich source of butyrate  including:

• Whole grains
• Lentils
• Oat bran
• Bananas
• Onions
• Asparagus
• Cellulose
• Gum arabic

On the other hand starch-free wheat bran is a relatively poor source of butyrate.

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Our own body produces butyrate also

Butyrate is also produced by our own body, but that is a very small contribution to the total butyrate we use.

Butyrate directly from food

Cow’s milk is a rich source of butyrate in the form of tributrin. Tributtrin is broken into 3 times the butyrate by the digestive enzymes. Cow milk consumption should be taken in context that caseins in cow's milk may possibly adversely affect brain, although controversial in some quarters.

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How does butyrate affect brain?

It is amazing that a single chemical such as butyrate has affects numerous genes affecting numerous functions. Data indicates that it enhances function of genes that:

• Improve nerve cell adaptability
• Regeneration of nerve tissue
• Protecting nervous tissue against injury
• Enhancing the mitochondrial function in brain which can help to repair the damaged mitochondria in the brain.

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Increasing energy in brain: Alzheimer's analogy

Potential for increasing energy in brain is very exciting. For example, brain cells in Alzheimer’s show decrease in glucose consumption and reduced energy long before memory loss evident.

Henderson and colleagues examined the effect of ketogenic compound AC-1202, a medium chain triglyceride,  in patients with Alzheimer’s in a randomized placebo-controlled trial.

Results

• Patients consuming AP-1202 resulted in increased levels of butyrate
• Significant improvement in cognitive function by day 45 as compared to the placebo group
• Cognitive function returns to baseline within two weeks after stopping this dietary supplement
• The results are the best when the treatment starts early in the disease process.

The results of the study suggest that if enough of butyrate as a result of bacterial fermentation in the gut could reach the brain, it would serve as a great energy source for brain just as it does as a food for the colon. This would certainly counter the decreased glucose as a energy source  in brain in a variety of neuro-degenerative diseases.

Butyrate and neuro-degenerative diseases

Huntington disease

Ferrante and colleagues from the Bedford Veterans Affairs Medical Center, Bedford, MA have shown that use of butyrate in mice with Huntington’s disease:

• Protects against nerve toxicity
• Perks up body weight
• Improves muscle functioning
• Prolongs life

Is It Leaky Gut or Leaky Gut Syndrome?

Parkinson's disease

Dr. St Laurent from the Colby College, Waterville, ME that butyrate supplemented food salvaged chemical induced muscle functioning and prevented early death in Parkinson’s disease in animals.

Butyrate also suppresses inflammation in animals with Parkinson’s thus protecting the brain cells from damage.

Hearing

Butyrate protects against hearing loss caused by cancer chemotherapy.

Stroke

Multiple studies have documented that butyrate use limits the size of dead part of brain in stroke along with an improved behavioral function in animals.

Miscellaneous diseases based on animal models

• Alzheimer’s
• Traumatic brain injury
• Brain infections

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Clinical effects of butyrate

• Improve learning
• Improve memory

Diet, bacteria and brain: Butyrate is the connecting link

Typical American diet is much lower in fiber than is recommended. High fiber diet is believed to exert its beneficial effects in variety of diseases via its modification of microbiome, bacterial fermentation and production of short chain fatty acids especially butyrate.

Bacterial fermentation results in production of short chain fatty acids (SCFAs) including butyrate.  Most but not all of short chain fatty acids are consumed by gut wall as food, while some is absorbed to get into liver.

A small component of  gets into blood stream raising the blood butyrate levels with potential to enter our brain.

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Intestines and brain barrier in animals without gut bacteria

• Intestines of animals without any bacteria tend to be leaky gut as well as leaky blood brain barrier as compared to animals with healthy intestinal bacteria.
• This leakiness is accompanied with leaky tight junctions of the blood brain barrier and lower levels of tight junction proteins in different areas of the brain.

However, if these germ-free mice receive butyrate producing bacteria by mouth, the blood brain barrier is strengthened to healthy normal levels along with increased levels of tight junction proteins.

This illustrates the connection between gut bacteria, butyrate and the brain structure/function.

Is It Leaky Gut or Leaky Gut Syndrome?

Soluble fiber, butyarte, brain inflammation and sickness behavior

Sherry and colleagues from the University of Illinois, Champaign, IL studied the effect of prebiotic soluble fiber on toxin induced inflammation in brain.

Mice were administered toxin. One group received soluble fiber whereas the other was administered insoluble fiber in diet.

Results

• Mice fed soluble fiber suffered lower levels of sickness behavior as compared to the control group receiving insoluble fiber
• There was lower levels of inflammation in the brain

These investigators suggested that butyrate production via bacterial fermentation of the soluble fiber was responsible for the effects on the brain and the behavioral reaction of the animals.

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Is It Leaky Gut or Leaky Gut Syndrome?

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Abnormal Gut Structure and Function in Autism

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Gastrointestinal illness is common in patients with autism and related disorders although some literature has disputed this.

 

Study

 

 Dr. Kim and colleagues from the School of Medicine and Center for Neuroscience Research, SMART Institute of Advanced Biomedical Sciences, Korea wished to study if there are structure abnormalities in the gut associated with autism. They reported their findings in the journal Toxicology Research.

Is It Leaky Gut or Leaky Gut Syndrome?

 Methods of autism-gut study

• The study was conducted in a rat animal model of autism. Use of valproic acid during pregnancy is a risk factor for in human autism. In fact, autism like behavior can be induced in rats exposed to valproate during fetal life.
• On embryonic day 12, pregnant rats were injected with valproic acid or control solution without valproic acid.
• The gut of the resulting rat babies was analyzed at age 4 weeks.

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Results autism-gut study

Multiple structure and functional abnormalities were found in valproic acid treated animals as compared to controls.

• The gut was slow. This is consistent with frequent finding of constipation in human autism.
• There was thinning of the stomach and terminal small intestinal wall consistent with the leaky gut hypothesis in autism.
• There were fewer absorptive cells in small intestine which is consistent with reports of digestive problems encountered in autism.

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Conclusions of autism-gut study

Rat model of autism is associated with structural and functional gastrointestinal changes consistent with clinical manifestations in humans.

 

Dr. Minocha’s comments

The results of this study lend further add to the scientific evidence of GI involvement in autism and the gut-brain axis. The fact that such changes can be seen in early life suggests that these are part of and not the result of autism disorder. Gut-focused therapy is of paramount importance in autism.

 

Is It Leaky Gut or Leaky Gut Syndrome?

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Carnosine & Carnitine for Brain Health in Autism

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While not an absolute substitute for human studies, animal models are a scientifically accepted method of studying disease processes and treatments.

Background

Altered intestinal bacteria especially Clostridium difficile have been those implicated. One of the mechanisms postulated is that an overgrowth of certain bacteria including C. difficile produces greater amounts of propionic acid as well as bacterial lipopolysaccharides (LPS) toxin. 

Indeed propionic acid is known to produce autism like manifestations  in rats.  Antibiotic use increases the risk of an overgrowth of C. difficile and has been implicated in pathogenesis of autism.

Is It Leaky Gut or Leaky Gut Syndrome?

Autism study objective

Dr. Ansary and colleagues wished to examine the neurotoxic effects of antibiotic induced dysbiosis as well as oral administration of propionic acid in hamsters and the protection against damage by carnosine and carnitine.

Autism study methods

54 hamsters were studied in different groups of experimental and controls. Neurotoxicity was induced by oral use of clindamycin or propionic acid. Further treatment groups included animals receiving carnosine 10mg/kg/d or carnitine 50 mg/kg/day for one week. At the end of experimental period, animals were sacrificed and the brain tissue examined.

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Autism study results

• Clindamycin caused altered intestinal bacteria with overgrowth of pathogenic bacteria including Clostridia type.
• Both propionic acid and clindamycin treated animals shows DNA damage in the brain. DNA damage was greater in the propionic acid treated animals than clindamycin suggesting that propionic acid may effciently cross blood brain barrier.
• It also suggests that  dysbiosis causes damage via production of propionic acid. The difference in damage due to clindamycin and propionic acid  likely relates to higher propionate delivered when given directly in contrast to that produced by abnormal pathogenic bacterial overgrowth.
• Both carnosine and carnitine provided protection against DNA damage in brains in both animal models suggesting their potential therapeutic role in brain dysfunction like autism.
• Caveat: Animal studies only suggest possibilities which may or may not translate into applicability to humans.

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Dr. Minocha's comments on study implications

• Dysbiosis and antibiotics use play role in causing and/or sustaining brain dysfunction.
• Propionic acid may be one factor that links diet and gut bacteria in causing brain disorders.
• The fact that oral administration can affect brain damage suggests the importance of diet.  Diet high in antioxidants may help.
• Antioxidants supplements may help in some especially those with unhealthy and picky eating habits.

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Gut dysfunction link to behavioral problems: The autism model

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Autism spectrum disorders (ASD) are a group of heterogenous disorders characterized by behavioral problems etc along with non-neurological co-morbidities.

Evidence suggests that there is increased prevalence of gastrointestinal symptoms (whether or organic or neurobehavioral) in autism. Based on gut-brain hypothesis, such symptoms could be the child's method of communicating his/her symptoms to the care-giver.

Is It Leaky Gut or Leaky Gut Syndrome?

Autism-GI study overview

• Dr. Maenner and colleagues from the Waisman Center and Department of Population Health Sciences at the University of Wisconsin-Madison conducted the study.
• The investigators wished to examine if the behavioral problems tend to occur more in patients with gastrointestinal (GI) problems.
• The results of the study were reported in the Journal of Autism Developmental  Disorders.

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Autism-GI study design

• An ADDM network methodology was used. Behavioral features were compared between autism patients with and without GI problems.
• Patients were classified as autism if they met the DSM IV-TR  (American Psychological Association 2000) criteria  for the disorders at any time prior to the age of 8 years.
• The demographic and clinical information including results of psychometric tests and concurrent medical problems were recorded
• Eight different behavioral manifestations that may reflect a gastrointestinal disturbance were analyzed and included sleep abnormalities, mood disturbances and temper tantrums.
• Six non-GI related behavioral features like fear, delayed motor milestones were also analyzed for comparison.

Results of Autism-Gut study

• 7.2% of ASD patients studied had documented GI problems. Constipation and encopresis were common
• Autism patients with GI problems were more likely to have cerebral palsy and seizure like activity as compared to those who did not.
• Occurrence of gastrointestinal (G)I problems positively correlated with behavioral problems such as sleep problems, mood, abnormal eating habits, oppositional and defiant/destructive behavior, tantrums and delayed motor milestones.
• There was no association of GI problems with stereotypic/repetitive and self-injurious behaviors.
• There was lack of association with most control behaviors studied except delayed milestones.

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Conclusions of Autism-Gut Study

• The association of GI problems with cerebral palsy, seizure like activity and delayed milestones suggests that a subset of patients suffers from multisystem disorder involving nervous, gastrointestinal and immune system.
• Behavioral problems thought to be an expression of GI problems are common in autism although not specific to those with GI problems.
• Example: sleep problems were seen in 11% of those with GI problems as compared to 4% in those without
• Prevalence of autism behaviors does not accurately identify autism patients requiring gastrointestinal evaluation.

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Role of Teeth and Gums in Brain Health: The Autism Model

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Hippocrates aptly stated, All disease begins in gut."

In addition to the well known neurodevelopmental behavioral manifestations, autism spectrum disorders is characterized by atypical eating patterns including picky eating along with unhealthy oral practices such as bruxism, tongue thursting, lip biting and gingival picking.

Is It Leaky Gut or Leaky Gut Syndrome?

Implications of good oral-dental health in autism:

Bad teeth and gum equal to inflammation. The pro-inflammation cytokines, chemical signals are thus circulating throughout and effecting the whole body including the heart and the brain.

Inflammation is an important component of chronic disease states including disorders affecting brain. Neuro-inflammation creates disruption in brain cells as well as signalling pathways and as such may have important role in neuro-behavioral manifestations of autism spectrum disorders. Maintaining good oral-dental health is part of the 12-point autism treatment program.

Studies comparing the orodental issues among autism and non-autism subjects have yielded mixed results. In fact, some studies have reported lower prevalence of dental caries among kids with autism. Perhaps the prevalence of caries is higher only among institutionalized subjects in contrast to otherwise fully functional kids with autism.

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Autism oral-dental Study: Dr. Jaber from the Dental School, Ajman University of Science & Technology,  investigated the orodental health status and needs of kids with autism.The study titled, "Dental caries experience, oral health status and treatment needs of dental patients with autism" was published in the Journal of  Applied Oral Sciences in May-June 2011.

Objectives of autism oral-dental study:

• Prevalence of caries in children with autism
• Prevalence of periodontal disease in autism
• Oro-dental treatment needs in autism

Study design and methods:

• Study group n=61 kids with autism (6-16 years; males vs females 45:16)
• Controls: 61 kids without autism and selected from relatives or friends
• Full oral and periodontal examination
• Parameters examined: Caries prevalence, and caries severity, dental plaque, gingivitis, restorations and treatment needs.

Results of autism oral-dental study:

1. Only 3.3% of kids with autism have good oral hygiene as compared to 59% among controls

2.  Kids with autism have higher prevalence of:

• Tooth decay
• Missing or filled teeth
• Need for more restorative dental treatment

3. Dental caries occurs in 77% of kids with autism as compared to 46% among controls.

4. 97.0% of the autistic children have gingivitis including 78% with generalized gingivitis.

5. The ratio of Met Need Index to Restorative Index is lower in kids with autism. Only 9.5% of kids with autism received restorative care as compared to 29.6% among controls.

Conclusions of autism oral-dental study

• Children with autism have higher oral-dental problems and a greater unmet needs for oral-dental treatment as compared to controls.
• The differences in results from different studies may be due to cultural differences as well as the subjects recruited.

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Dr. Minocha's comments

Potential causes for high prevalence of oral-dental problems in autism

• Preference for soft, sweetened foods.
• Poor tongue coordination increasing the amount of time food staying in mouth prior to swallowing.
• Suboptimal manual dexterity causing problems related to brushing and flossing.
• Adverse effects due to psychoactive drugs use.
• Lower Met Need Index may be due to limited access to health services and/or problems controlling these kids.

Potential solutions to improve oral-dental health

• Improved dental awareness and education.
• Detailed personalized oral dental hygiene (brushing, cleaning, flossing) instructions from dentist and dental hygienist.
• Use of structured method and technique based on visual pedagogy  for brushing teeth using pictures and placing them in bathroom. Pilebro and Blackman produced a series of pictures that demonstrated a structured method of tooth brushing. The pictures were placed in the bathroom or wherever tooth brushing was performed. At 18 months, plaque was reduced in all kids and most parents found it easy to maintain good oral hygiene.  All but one of the 14  children adopted the program long-term.
• Use of sedation and even general anesthesia for difficult  to manage select patients.
• Use of combined dental and pedopsychiatric teams.

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Mother's probiotic use decreases risk of eczema

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Intestinal bacteria play a critical role in maturation of immune system especially in early phases of life and the effects may be seen during the life long-term. Alterations in maternal-fetal immune system may contribute to may disorders in later life.  Laboratory and clinical studies show that probiotic use can module the immune system.

Is It Leaky Gut or Leaky Gut Syndrome?

Accumulating evidence from many studies have documented beneficial effect of mothers’ use of probiotics during pregnancy and breast-feeding peiod in reducing the risk of skin eczema or atopic dermatitis. In fairness, there have been negative studies as well. The discrepancy may be related in part to the design of studies especially the timing, type and dose of probiotic formulations.

Now comes a study from Dr. Rautava and colleagues from Turku University Central Hospital in Finland further providing support for use of probiotics in those at high risk. The study was published in the Journal of Allergy and Clinical Immunology 2012.

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Design of probiotics-eczema study

• Double-blind placebo controlled trial
• Mothers with allergic disease and atopic sensitization
• 241 mother-infant pairs were included
• Probiotics as powder in water started 2 months before delivery and continued for 2 months of breast feeding

Study groups of probiotics-eczema study

Two probiotic formulations were compared to placebo

1. Lactobacillus rhamnosus LPR and Bifidobacterium longum BL999
2. L paracasei ST11 and B longum BL999
3. Placebo

Follow-up period and variable of probiotics-eczema study

• First 2 years of child's life
• Development of eczema rash
• Skin prick tests at 6, 12 and 24 months

Results of probiotics-eczema study

• Both probiotic formulations significantly reduced the risk of developing eczema. Only 29% of babies in probiotic group developed eczema rash at least once as compared to 71% in placebo group
• Both formulations reduced the risk of chronic persistent eczema. 26 percent of kids in placebo group developed chronic eczema as compared to only 10% and 6% in the two probiotic groups.
• Probiotic use had no effect on skin sensitization to a variety of allergens like milk, wheat, soy etc. as seen on skin prick tests.
• There was no adverse impact of probiotics

Dr. Minocha's comments on probiotics-eczema study

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• Probiotic use during pregnancy and early breast-feeding period is safe and effective in reducing the risk of skin eczema rash or atopic dermatitis in early childhood.
• Authors speculated that maternal use of probiotics modulates immune structure/function  via the fetus-placental unit during pregnancy. Maternal use of probiotics does impact on gene expression in the placenta as well as the gastrointestinal system of growing fetus.
• Breast feeding modulates infant's gut bacteria especially adding the helpful bifidobacteria as well as the modulation of  immune system.
• Although this study examined benefits for a period of 2 years, some other positive studies have documented an extended benefit against skin eczema for as long as 7 years.
• Of note, some data suggests that only prenatal use of probiotics may not provide benefits and needs to be continued during early breast-feeding period to provide cover during the still immature immune system during infancy.

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Is It Leaky Gut or Leaky Gut Syndrome?

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Probiotics improve memory, cognitive function

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There are many studies suggesting affect of neurological function in animals. Dr. Benton and colleagues  from the University of Wales Swansea, UK studied the effect of a probiotic drink on mood and memory and demonstrated a beneficial  impact.

Is It Leaky Gut or Leaky Gut Syndrome?

Study design:

• Double blind placebo controlled trial for 3 weeks
• Intervention: Probiotic drink supplied by Yakult ® containing Lactobacilus casei Shirota in milk, water and sugar. Each ml of the drink contained 6.5x109 bacteria.
• Measurements were done prior to trial and then 10 and 20 days after

Data analyzed:

1. Mood was assessed by POMS test questionnaire comprising of 72 adjectives spread over 6 domains (energetic/tired, clearheaded/muddled, composed/anxious, confident/unsure, elated/depressed and agreeable/angry.

2. Episodic memory

3. Long term memory

4. Verbal fluency

5. Eating related social behavior

6. NART to measure of intelligence

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Analysis:

Since majority of the subjects scored above average on mood at baseline, the analysis focused on those in the bottom 1/3rd of the subjects

Results:

1. Subjects who were constipated less frequently were more clearheaded, confident, and elated. The measures of higher energetic scores showed trend towards statistical significance..

2. Probiotic improved mood in those with low POMS depressed/elated scores.

3. Probiotic improved memory at 20 days. Those with failing memory appeared to benefit more.

4. There was no effect on verbals fluency

5. Probiotic did not improve eating related problems. However, the negative esult may be due to low baseline incidence of eating problems in this otherwise healthy population.

Dr. Minocha's comment:

Is It Leaky Gut or Leaky Gut Syndrome?

Constipation is associated with psychological dysfunction. This study confirms that probiotics can improve brain function including memory, mood in as few as 3 weeks. However, it should be pointed out that effects of probiotics are strain specific and the results from one probiotic strain may not necessarily be translated into effects for another.

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Abnormal Gluten-Gliadin Antibodies in Autism

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Gluten free diet is becoming increasingly popular across the Western society and even more so among those suffering from autism.

While many patients with autism benefit from gluten free diet that concept continues to be challenged by many scientists especially in the context of “biological plausibility” since there has been not much immunological evidence to suggest that subjects react differently to gluten.

Of note, gluten is actually a complex of proteins and gliadin is of the predominant components.

Is It Leaky Gut or Leaky Gut Syndrome?

Study by Dr. Lau and colleagues  from the Celiac Disease Center in Columbia University, New York, lends further support to the use of gluten free diet by autistic subjects.

Autism-gluten study

• Subjects diagnosed with autism based on both Autism Diagnostic Observation Schedule  and the Autism Diagnostic Interview, Revised (ADI-R) were recruited.
• Two sets of controls were used: Unaffected siblings and unrelated healthy subjects.

Tests performed

Serum antibodies to gliadin, deamidated gliadin, and transglutaminase 2

Celiac disease associated markers HLA-DQ2 and -DQ8.

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Results of Autism-gluten study

• Autism subjects had significantly elevated levels of higher levels of IgG antibody as compared with unrelated healthy controls.
• Although the levels of IgG gluten antibodies was greater than unaffected siblings as well, it did not reach statistical significance.
• Remarkably, the elevated IgG antibody response was more pronounced among those with gastrointestinal disturbances as compared to those without.
• There were no differences seen in IgA antibody response or the HLA genotypes studies.  Similarly there were no differences in antibody response to deamidated gliadin or transglutaminase.

Conclusions of Autism-gluten study

Is It Leaky Gut or Leaky Gut Syndrome?

There is an abnormal immunological reaction to gluten among at least a subset of subjects with autism. This is underlying mechanisms appear to be distinct since the anti-transglutaminase antibody response HLA genotypes were not different.

Dr. Minocha's comments

Above results give further credence to the claim that many patients with autism derive benefit from gluten-free diet. As in case of many patients with  irritable bowel syndrome related non-celiac gluten-sensitivity,  it appears that science may perhaps be lagging behind public driving the gluten-related.

Is It Leaky Gut or Leaky Gut Syndrome?

Wall Street Journal Best Seller Dr. M's Seven-X Plan for Digestive Health

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Is It Leaky Gut or Leaky Gut Syndrome?

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Wall Street Journal Best Seller Dr. M's Seven-X Plan for Digestive Health