This is my second post in a series assessing the effects of gluten and the value of gluten-free diets. In my last post I mentioned the promising research about gluten-free diets to fight type-1 diabetes. Type-1 diabetes is an autoimmune disease, and in this post I will elaborate on the relationship between gluten and autoimmune diseases. Many of those with an autoimmune disease are helped by a gluten-free diet, and it is important to understand why, so that the treatments for these diseases can be improved.
(For reference, the American Autoimmune Related Diseases Association (AARDA) has an extensive list of autoimmune diseases. A handful of well-known examples are rheumatoid arthritis, multiple sclerosis, Crohn’s disease, ulcerative colitis, Hashimoto’s, psoriasis, and lupus.)
Rates of autoimmune diseases have been increasing at a brisk pace, although it is not fully understood why. Autoimmune diseases are complex, and have been tied to genetics, viruses, environmental toxins, and more. They are all caused by the immune system attacking parts of the body instead of protecting it. They are often closely associated, i.e. someone with one autoimmune disease has a much greater chance of developing additional ones. Also, family members often have an assortment of different autoimmune diseases between them. Yet, the diseases vary so greatly in symptoms that they are difficult to diagnose, and any common underlying causes can be difficult to see.
According to the American Autoimmune Related Diseases Association, it takes on average about five years and five different doctors to receive a diagnosis of an autoimmune (AI) disease. In addition, 45% of people who are diagnosed with a serious AI disease were originally labelled as hypochondriacs or complainers. Even after diagnosis, current treatments are inadequate to say the least, and the drugs used often have severe side effects
The widely ranging symptoms of autoimmune diseases make them difficult to diagnose, yet it is also notable that 3 out of 4 sufferers of autoimmune disease are women. (This is due to differences in the immune system and in hormones.) In some diseases, such as lupus, 9 out of 10 sufferers are women, and predominantly minority women as well. Especially judging by our medical track record, this is undoubtedly part of the reason why these individuals are not always taken seriously, and it is a great reason to think twice before dismissing those who are gluten-free as hysterical fad-followers.
So what exactly ties autoimmune disorders to gluten?
We do not yet have a complete understanding, but one thing we do know is that a leaky gut is a common factor in all of the various autoimmune diseases, and may be the most universal of all factors. In fact, it has been shown to precede autoimmune disease, so it seems to be involved in the progression of the disease, and is not just a side effect that comes later. As described in my last post, gluten is particularly good at triggering a leaky gut, which leads to a heightened immune response (inflammation) as the gut wall is damaged and foreign particles enter the body. Autoimmune diseases are diseases of inflammation: inflammation directed at the body.
Gluten fragments also directly trigger the immune system, contributing to chronic inflammation. The impact of gluten on our gut health and microbiome (mentioned in Part 1) is also significant because our symbiotic gut microbes play a huge role in regulating our immune systems. The connection between our microbiomes and autoimmunity is a huge area of current research.
Another factor tying gluten to autoimmunity is that there are many protein segments in gluten that are very similar to proteins in the body. Thus, if the immune system begins to attack gluten protein fragments, it can then be “confused” and go on to attack similar proteins in the body as well. Other fragments of bacteria, viruses, food, etc., can also be similar to our own cells, and gluten can help these particle escape the gut and thus become a target of the immune system. This process, whereby our immune system learns to attack a protein and then also attacks other similar proteins, is called “molecular mimicry” or “cross-reactivity” and is one of the leading theories about how autoimmune diseases develop.
Thus even though gluten is certainly not the only cause of an autoimmune disease, nor even the only cause of a leaky gut, it can be a powerful contributor. For people with autoimmune disease, who are already struggling with a medical system that generally does not know how to help them, it is important not to dismiss the potential of a gluten-free diet. It is troubling to think that misguided public opinion could keep people from ever trying what for many is an effective and safe treatment.
In my next post, I will talk about some of the problematic aspects of the gluten-free diet, and talk a bit about why it could be that gluten is becoming a bigger and bigger problem for people’s health.
- Leaky gut and autoimmune diseases. Fasano A. Clin Rev Allergy Immunol. 2012 Febhttp://www.ncbi.nlm.nih.gov/pubmed/22109896
- Alterations in intestinal permeability. M C Arrieta, L Bistritz, and J B Meddings. Gut. Oct 2006. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1856434/
- Intestinal Barrier Dysfunction Develops at the Onset of Experimental Autoimmune Encephalomyelitis. Nouri et al. PLoS ONE Sept 2014. http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0106335 (Also source of header image.)
- Role of the Microbiota in Immunity and Inflammation. Belkaidemail Y., Hand T.W. Cell March 2014. http://www.cell.com/abstract/S0092-8674(14)00345-6
- The Prevalence of Antibodies against Wheat and Milk Proteins in Blood Donors and Their Contribution to Neuroimmune Reactivities. Aristo Vojdani et al. Nutrients 2014. http://www.mdpi.com/2072-6643/6/1/15
- Autoimmune Disease Rates Increasing. http://www.medicalnewstoday.com/articles/246960.php
- The Paleo Approach: Reverse Autoimmune Disease and Heal You Body by Sarah Ballantyne, PhD
- American Autoimmune Related Diseases Association. http://www.aarda.org/
- Policy: NIH to balance sex in cell and animal studies. http://www.nature.com/news/policy-nih-to-balance-sex-in-cell-and-animal-studies-1.15195