Gluten Psychosis: Confirmation of a New Clinical Entity

Lionetti, Elena; Leonardi, ﻿Salvatore; Franzonello, Chiara; Mancardi, Margherita; Ruggieri, Martino; Catassi, Carlo

doi:10.3390/nu7075235

Cited by 64 publications

(52 citation statements)

References 31 publications

(39 reference statements)

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“…The girl refused to continue the gluten challenge and went back to the GFD, with a complete and persistent regression of all symptoms within 1 week. Our case report confirms the existence of 'gluten psychosis' as a possible manifestation of NCGS [38] .…”

Section: Ncgs and Other Psychiatric Disorderssupporting

confidence: 84%

Gluten Sensitivity

Catassi¹

2015

Ann Nutr Metab

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Non-celiac gluten sensitivity (NCGS) is a syndrome characterized by intestinal and extraintestinal symptoms related to the ingestion of gluten-containing food in subjects who are not affected by either celiac disease (CD) or wheat allergy (WA). The prevalence of NCGS is not clearly defined yet. Indirect evidence suggests that NCGS is slightly more common than CD, the latter affecting around 1% of the general population. NCGS has been mostly described in adults, particularly in females in the age group of 30-50 years; however, pediatric case series have also been reported. Since NCGS may be transient, gluten tolerance needs to be reassessed over time in patients with NCGS. NCGS is characterized by symptoms that usually occur soon after gluten ingestion, disappear with gluten withdrawal, and relapse following gluten challenge within hours/days. The ‘classical' presentation of NCGS is a combination of irritable bowel syndrome-like symptoms, including abdominal pain, bloating, bowel habit abnormalities (either diarrhea or constipation), and systemic manifestations such as ‘foggy mind', headache, fatigue, joint and muscle pain, leg or arm numbness, dermatitis (eczema or skin rash), depression, and anemia. In recent years, several studies explored the relationship between the ingestion of gluten-containing food and the appearance of neurological and psychiatric disorders/symptoms like ataxia, peripheral neuropathy, schizophrenia, autism, depression, anxiety, and hallucinations (so-called gluten psychosis). The diagnosis of NCGS should be considered in patients with persistent intestinal and/or extraintestinal complaints showing a normal result of the CD and WA serological markers on a gluten-containing diet, usually reporting worsening of symptoms after eating gluten-rich food. NCGS should not be an exclusion diagnosis only. Unfortunately, no biomarker is sensitive and specific enough for diagnostic purposes; therefore, the diagnosis of NCGS is currently based on establishing a clear-cut cause-effect relationship between the ingestion of gluten and the appearance of symptoms by a standardized double-blind, placebo-controlled gluten challenge.

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Section: Ncgs and Other Psychiatric Disorderssupporting

confidence: 84%

Gluten Sensitivity

Catassi¹

2015

Ann Nutr Metab

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“…Moreover, it has been proposed that gluten causes depression, anxiety, autism and schizophrenia in patients with NCGS [109], and also reported that psychosis might be a manifestation of NCGS [110]. …”

Section: Gluten Intolerance Pathogenesismentioning

confidence: 99%

Properties of Gluten Intolerance: Gluten Structure, Evolution, Pathogenicity and Detoxification Capabilities

2016

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Theterm gluten intolerance may refer to three types of human disorders: autoimmune celiac disease (CD), allergy to wheat and non-celiac gluten sensitivity (NCGS). Gluten is a mixture of prolamin proteins present mostly in wheat, but also in barley, rye and oat. Gluten can be subdivided into three major groups: S-rich, S-poor and high molecular weight proteins. Prolamins within the groups possess similar structures and properties. All gluten proteins are evolutionarily connected and share the same ancestral origin. Gluten proteins are highly resistant to hydrolysis mediated by proteases of the human gastrointestinal tract. It results in emergence of pathogenic peptides, which cause CD and allergy in genetically predisposed people. There is a hierarchy of peptide toxicity and peptide recognition by T cells. Nowadays, there are several ways to detoxify gluten peptides: the most common is gluten-free diet (GFD), which has proved its effectiveness; prevention programs, enzymatic therapy, correction of gluten pathogenicity pathways and genetically modified grains with reduced immunotoxicity. A deep understanding of gluten intolerance underlying mechanisms and detailed knowledge of gluten properties may lead to the emergence of novel effective approaches for treatment of gluten-related disorders.

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“…Significant improvement was described in two patients with schizophrenia [109], and in two with dementia [110]. Complete remissions were described in three different patients with psychotic symptoms [111,112,113].…”

Section: The Role Of Diet In the Therapymentioning

confidence: 97%

“…Znacząca poprawa opisana została u dwóch pacjentów ze schizofrenią [109] oraz u dwóch z otępieniem [110]. Pełne remisje opisane zostały u trzech różnych pacjentów z objawami psychotycznymi [111,112,113].…”

Section: Rola Diety W Leczeniuunclassified

Review paper. Gluten-related disorders and schizophrenia - potential linking mechanisms, diagnostic and therapeutic challenge

Tomaka

Karakuła-Juchnowicz

Morylowska-Topolska

et al. 2017

Current Problems of Psychiatry

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More and more evidence confirms the theory that the intake of cereal products containing gluten may play an important role in the pathogenesis of many diseases. There are also premises indicating the relationship between the so-called gluten-related diseases and the development and course of mental disorders, including schizophrenia.The aim of this article is to review the literature on the potential relationship between the consumption of gluten and schizophrenia, considering the etiopathogenesis and the role of gluten-free diet in the treatment of schizophrenia.Methods: There were analysed available research papers in PubMed and Google Scholar with the key words: schizophrenia, gluten-related disorders, allergy to grain products, celiac disease, microbiota, immune system, exorphins and time span: 1960-2016 .Conclusions: Existing research results indicate a possible relationship between diet rich in grain products with high gluten content and the occurrence or exacerbation of schizophrenia symptoms. However, further studies are necessary to: 1) identify groups of patients for whom the consumption of cereal products (gluten) is associated with a particular risk of schizophrenia exacerbation, 2) determine the mechanisms relating the consumption of gluten with the mental state of schizophrenic patients, 3) get the possible benefits of implementing gluten-free diet in patients with schizophrenia.Keywords: schizophrenia, gluten, celiac disease, gluten-related disorders, allergy to gluten. StreszczeniePrzybywa dowodów na to, iż w patogenezie wielu chorób istotną rolę może odgrywać spożywanie produktów zbożowych zawierających gluten. Istnieją także przesłanki wskazujące na związek tzw. chorób glutenozależnych z powstawaniem i przebiegiem zaburzeń psychicznych, w tym schizofrenii.Celem niniejszego artykułu jest przegląd literatury na temat potencjalnego związku pomiędzy spożyciem glutenu a schizofrenią, z uwzględnieniem etiopatogenezy oraz roli diety bezglutenowej w terapii schizofrenii.Metoda: Analizie poddano dostępne artykuły z bazy PubMed oraz Google Scholar przy użyciu słów-kluczy: schizofrenia, nadwrażliwość na gluten, alergia na produkty zbożowe, celiakia, mikrobiota, układ immunologiczny, egzorfiny oraz deskryptorów czasowych: 1960-2016 rok.Wnioski: Dotychczasowe wyniki badań wskazują na możliwy związek diety bogatej w produkty zbożowe z dużą zawartością glutenu na występowanie lub zaostrzanie objawów schizofrenii. Konieczne są jednak dalsze badania celem: 1) identyfikacji grup pacjentów, dla których spożywanie produktów zbożowych (glutenu) wiąże się ze szczególnym ryzykiem pogorszenia przebiegu schizofrenii, 2) ustalenia mechanizmów łączących spożywanie glutenu ze stanem psychicznym pacjentów ze schizofrenią, 3) możliwych korzyści z wdrożenia diety bezglutenowej u pacjentów ze schizofrenią.

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Gluten Psychosis: Confirmation of a New Clinical Entity

Cited by 64 publications

References 31 publications

Gluten Sensitivity

Gluten Sensitivity

Properties of Gluten Intolerance: Gluten Structure, Evolution, Pathogenicity and Detoxification Capabilities

Review paper. Gluten-related disorders and schizophrenia - potential linking mechanisms, diagnostic and therapeutic challenge

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