Effect of gluten-free diet on the metabolic control of type 1 diabetes in patients with diabetes and celiac disease.

Iafusco, Dario; Rea, Francesco; Chiarelli, F; Mohn, Angelika; Prisco, F

doi:10.2337/diacare.23.5.712a

Cited by 16 publications

(9 citation statements)

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“…Idiopathic hypoparathyroidism is considered to be an autoimmune disorder characterized by the presence of autoantibodies against parathyroid antigens and its association with other autoimmune disorders (6,8,10,39,72,98,105). Idiopathic hypoparathyroidism of onset in childhood is commonly associated with hypofunction of other endocrine organs.…”

Section: Autoimmune Endocrine Disorders and CDmentioning

confidence: 99%

Celiac Disease-Associated Autoimmune Endocrinopathies

Kumar

Rajadhyaksha

Wortsman

2001

Clin Diagn Lab Immunol

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3Celiac disease (CD) is an autoimmune disorder induced by gluten intake in genetically susceptible individuals. It is characterized by the presence of serum antibodies to endomysium, reticulin, gliadin, and tissue transglutaminase. The incidence of CD in various autoimmune disorders is increased 10-to 30-fold in comparison to the general population, although in many cases CD is clinically asymptomatic or silent. The identification of such cases with CD is important since it may help in the control of type I diabetes or endocrine functions in general, as well as in the prevention of long-term complications of CD, such as lymphoma. It is believed that CD may predispose an individual to other autoimmune disorders such as type I diabetes, autoimmune thyroid, and other endocrine diseases and that gluten may be a possible trigger. The onset of type I diabetes at an early age in patients with CD, compared to non-CD, and the prevention or delay in onset of diabetes by gluten-free diet in genetically predisposed individuals substantiates this antigen trigger hypothesis. Early identification of CD patients in highly susceptible population may result in the treatment of subclinical CD and improved control of associated disorders.Autoimmunity as a concept evolved from the beginning of this century, when Ehrlich and Morgenroth (26) introduced the phenomenon of "horror autotoxicus," i.e., fear of selfpoisoning. Subsequently, many diseases were recognized with etiology arising from the abnormal reaction of the immune system to self antigens. These observations laid the foundation for establishing postulates that are characteristic of an autoimmune disease (4, 7). Since then, several hypotheses have been put forward regarding the mechanisms of autoimmunity (22,76,84,110,118).In general, autoimmune disorders can be classified as either organ specific or non-organ specific. In organ-specific autoimmune diseases, the autoantibodies are specifically directed against antigens localized in a particular organ and are often detected in circulation. Examples of organ-specific autoimmunity include Hashimoto's thyroiditis, type I diabetes, and myasthenia gravis.In contrast, the non-organ-specific autoimmune disorders are characterized by the presence of autoantibodies directed against ubiquitous antigens (not specific to a particular organ). This results in the involvement of several organs and is often characterized by the presence of specific circulating immune complexes. Non-organ-specific autoimmunity includes diseases such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and scleroderma.Epidemiologic studies have shown that genetic factors are involved in host susceptibility to autoimmune disease. For example, the concordance rate of a particular autoimmune diseases is much higher in monozygotic twins in comparison to fraternal twins (17). Moreover, this incidence is much higher in organ-specific autoimmune disorders in comparison to nonorgan-specific disorders. Thus, in Grave's thyrotoxicosis, Hashimoto's disease, a...

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Section: Autoimmune Endocrine Disorders and CDmentioning

confidence: 99%

Celiac Disease-Associated Autoimmune Endocrinopathies

Kumar

Rajadhyaksha

Wortsman

2001

Clin Diagn Lab Immunol

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“…Most CD patients with bone loss and hypocalcemia have secondary hypoparathyroidism. A gluten-free diet in patients with CD with secondary hypoparathyroidism has been reported to result in normal bone mineral density (39)(40). Therefore, the presence of hypocalcemia or nonnocalcemic hypoparathyroidism should prompt an examination for CD.…”

Section: Gluten Sensitivity and Autoimmune Endocrine Disordersmentioning

confidence: 99%

“…Therefore, the presence of hypocalcemia or nonnocalcemic hypoparathyroidism should prompt an examination for CD. Treatment with a gluten-free diet should result in clinical improvement and restoration of normal calcium levels (39)(40).…”

Section: Gluten Sensitivity and Autoimmune Endocrine Disordersmentioning

confidence: 99%

The Immunology of Gluten Sensitivity beyond the Intestinal Tract

Vojdani

O'Bryan²,

Kellermann

2008

Eur J Inflamm

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Celiac disease and gluten-sensitive enteropathy are terms that have been used to refer to a disease process affecting the small bowel. However, evidence has been accumulated in literature demonstrating that gluten sensitivity or celiac disease can exist even in the absence of enteropathy, but affecting many organs. Based on overwhelming evidence, immunological pathogenesis has been demonstrated in the joint, the heart, thyroid, bone, and, in particular, the brain cerebellum and neuronal synapsin I. When blood samples of patients with celiac disease are tested against gliadin and different tissue antigens, in addition to gliadin antibody, a significant percentage of them exhibit elevation in antibodies against transglutaminase, heat shock protein, collagen, thyroid, myosin, endothelial cell, bone antigen (transglutaminase), myelin basic protein, cerebellar and synapsin. This elevation of autoantibodies in patients with celiac disease may result in neuroimmune disorders. In fact, in comparison to the general population, the incidence of various autoimmune disorders, including gluten ataxia, is increased up to 30-fold in patients with celiac disease. Therefore, immune evaluation of patients with gluten sensitivity or celiac disease, in addition to gliadin and transglutaminase, should include antibody measurement against thyroglobulin, thyroid peroxidase, heat shock protein, bone transglutaminase, myelin basic protein, cerebellar peptide and synapsin. This novel laboratory approach to gluten sensitivity and autoimmunity may enable clinicians to detect markers of autoimmune diseases. Early identification of gluten sensitive and celiac disease patients and implementation of a gluten-free diet may result in significant improvement and control of associated diseases.

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“…30 Apart from gastrointestinal symptoms, some studies have reported a poor control of glycemia level, which improves after initiation of the gluten-free diet (GFD). 31 However, based on the examined epidemiological studies on the prevalence of CD in T1DM, patients with T1DM should be routinely screened for CD.…”

Section: Epidemiologymentioning

confidence: 99%

Dietary gluten and the development of celiac disease and type 1 diabetes

Ciacci¹,

Zingone²

2016

NDS

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Abstract:The objective of this study was to perform a review of the present knowledge on the epidemiology and pathogenesis of the association between celiac disease (CD) and type 1 diabetes mellitus (T1DM). Results from this review show that the estimated prevalence rate of CD in T1DM ranges from 4% to 11.5%, which seems higher in children than in adults, while there is no sex predominance in the prevalence of CD in T1DM. On the basis of the previous literature, screening for CD should be considered at diabetes diagnosis in all subjects and again within 2 and 5 years after diagnosis, even in the absence of symptoms. The anti-islet antibodies detection test, instead, is not recommended in CD, just as in the general population, except for CD patients having a relative with T1DM. Both genes and environmental factors seem to play a role in this association. HLADQ2 has been found to be the most frequent allele in the patients with both CD and T1DM, while gluten may be considered the trigger that induces the production of autoantibodies and the development, in genetically predisposed individuals, of both diseases.

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Effect of gluten-free diet on the metabolic control of type 1 diabetes in patients with diabetes and celiac disease.

Cited by 16 publications

References 0 publications

Celiac Disease-Associated Autoimmune Endocrinopathies

Celiac Disease-Associated Autoimmune Endocrinopathies

The Immunology of Gluten Sensitivity beyond the Intestinal Tract

Dietary gluten and the development of celiac disease and type 1 diabetes

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