Many parents of autistic children testify of the effectiveness of gluten-free casein-free diets; and in some cases, have seen a complete reversal of their child’s symptoms.
Some medical experts believe a leaky gut allows undigested protein molecules to pass into the blood, setting off allergic reactions. For these children, healing brings amazing results in behavioral problems and sensory issues. However, hard science hasn’t backed up autism recovery. Recent research into the differences between gluten sensitivity and celiac disease might change that.
Celiac Disease Results from Autoimmune Damage and Intestinal Permeability
According to Alessio Fasana, medical director of the Center for Celiac Research at the University of Maryland, their latest study has produced the first scientific evidence that gluten sensitivity exists as a separate entity from celiac disease. Differing at the molecular level, the evidence shows sensitivity provokes a different immune response as well as damage.
To diagnose celiac disease, an endoscopy biopsy must show inflammation and damage to the intestinal villi – hair-like projections inside the small intestines that absorb macro and micronutrients. When damaged, various degrees of malnutrition results. This was confirmed by the study. However, results also showed that unlike gluten sensitivity, the autoimmune reaction that defines celiac disease comes from increased intestinal permeability.
Gluten Sensitivity Provokes a Different Immune System Response
Several years ago, the University of Maryland designed diagnostic tests to help detect gluten antibodies. When people insist they’re sensitive to gluten, but get negative results from these blood tests, often they’re told it’s just a placebo effect. However, this study shows otherwise.
Using 42 celiac-confirmed individuals, 26 suspected of gluten sensitivity, and 39 with dyspepsia symptoms but no inflammation, Anna Sapone and colleagues found no, or slight, intestinal inflammation, no permeability, and no villi damage in gluten-sensitive individuals. But they did discover a gluten-induced innate immune response that raised havoc with the body.
In celiac disease and wheat allergy the body reacts by initiating a T-cell reaction in the intestines to fight the gluten. This is an adaptive response, rather than an innate one. In the case of celiac disease, it sets off an autoimmune reaction that damages the intestines. In wheat allergy, an IgE antibody response triggers the release of chemical mediators such as histamine resulting in typical allergic symptoms such as hives, nausea, congestion, and/or anaphylaxis shock.
In suspected gluten-sensitive individuals, the study saw gluten reactions where neither autoimmune mechanisms nor allergy reactions were involved. In an article published in the Wall Street Journal, author Melinda Beck described this immune reaction as the body setting up barriers to repel the invaders rather than fighting against the gluten molecules themselves. She also reported that Fasano, as well as others, “speculate that once immune cells are mistakenly primed to attack gluten, they can migrate and spread inflammation, even to the brain.”
Gluten Sensitivity, Celiac Disease, and Autism
Contrary to what some medical authorities have taught, this study discovered that gluten sensitivity did not involve intestinal permeability. For those children who do have leaky gut syndrome, the study points towards a possible diagnosis of celiac disease rather than gluten sensitivity. This may be why some children on autism diets can completely recover from their symptoms, while others do not.
In an article published in the Il Messaggero.it, Dr. Fasano estimates that 2% of all children with autism actually have celiac disease, but the problem of gluten sensitivity is much higher – somewhere around 17 to 18%. Currently, the only way to discover these children is through an elimination diet and gluten challenge, similar to the methods used in this study.
Sensitivity to Gluten May or May Not Be Detected Through Blood Tests
Gluten sensitive individuals have similar symptoms as celiac disease; but blood tests are not reliable. The same goes for genetics. While the current belief is that all gluten intolerant individuals must have genetic markers, the study found only 56% of those sensitive to gluten actually had these markers. In addition, some had anti-gliadin antibodies, and some did not.
Another major difference between gluten sensitivity and celiac disease is the quickness of recovery. Those sensitive to gluten recover within only a few days of eliminating gluten from the diet, while those with celiac disease don’t improve until the villi heal enough to begin absorbing nutrients properly.
When it comes to autistic children, or even adults, a lot hangs on a proper diagnosis, but few physicians in the United States check for gluten sensitivity, or even celiac disease. With hypersensitivity suspected to affect almost one-fifth of all autistic individuals, the study clearly supports autism diets for those who suspect sensitivity, not just for those with celiac disease.
Sources:
- Beck, Melinda, The Wall Street Journal, “Clues to Gluten Sensitivity,” March 15, 2011 (accessed May 1, 2011).
- Il Messaggero.it, “The False Discovery Celiac Disease: Affected Three Million in Italy” (accessed May 1, 2011).
- Sapone, Anna, et al, BMC Medicine, “Divergence of Gut Permeability and Mycosal Immune Gene Expression in Two Gluten-associated Conditions: Celiac Disease and Gluten Sensitivity,” 9:23, March 2011; doi:10.1186/1741-7015-9-23.
- University of Maryland School of Medicine, “Univeristy of Maryland School of Medicine Researchers Identify Key Pathogenic Differences Between Celiac Disease & Gluten Sensitivity,” March 10, 2011 (accessed May 1, 2011).
Disclaimer: The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact a doctor for advice.
Vickie Ewell - Vickie has worked with autistic individuals for 9 years. She has celiac disease and specializes in gfcf living.
