Immunological Impact of a Gluten-Free Dairy-Free Diet in Children With Kidney Disease: A Feasibility Study

Pérez‐Sáez, María José; Uffing, Audrey; Léon, Juliette; Murakami, Naoka; Watanabe, Andréia; Borges, Thiago J.; Sabbisetti, Venkata; Cureton, Pamela; Kenyon, Victoria; Keating, Leigh; Yee, Karen; Satiro, Carla Aline Fernandes; Serena, Gloria; Hildebrandt, Friedhelm; Riella, Cristian; Libermann, Towia A.; Wang, Minxian; Pascual, Julio; Bonventre, Joseph V.; Cravedil, Paolo; Fasano, Alessio; Riella, Leonardo V.

doi:10.3389/fimmu.2021.624821

Cited by 13 publications

(9 citation statements)

References 60 publications

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“…In humans, it has been shown that gluten-free diet induced GM changes are essential for the increased T reg levels [ 51 ], although also a direct anti-inflammatory effect of a gluten-free diet has previously been shown in mice [ 52 ]. From studies in two-generation studies in non-obese diabetic mice, it is known that the effects of a gluten-free diet on the immune system can be transferred over generations both dependently and independently of the GM [ 15 , 53 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of gluten-free diet and antibiotics on murine gut microbiota and immune response to tetanus vaccination

et al. 2022

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The purpose of this study was to compare the effect of a gluten-free diet and/or antibiotics on tetanus vaccine induced immunoglobulin G titers and immune cell levels in BALB/c mice. The gluten-free diet was associated with a reduced anti-tetanus IgG response, and it increased the relative abundance of the anti-inflammatory Bifidobacterium significantly in some of the mice. Antibiotics also led to gut microbiota changes and lower initial vaccine titer. After a second vaccination, neither gluten-free diet nor antibiotics reduced the titers. In the spleen, the gluten-free diet significantly increased regulatory T cell (Treg) fractions, CD4+ T cell activation, and tolerogenic dendritic cell fractions and activation, which extend the downregulating effect of the Treg. Therefore, the systemic effect of the gluten-free diet seems mainly tolerogenic. Antibiotics reduced the fractions of CD4+ T and B cells in the mesenteric lymph nodes. These results suggest that vaccine response in mice is under influence of their diet, the gut microbiota and the interplay between them. However, a gluten-free diet seems to work through mechanisms different from those induced by antibiotics. Therefore, diet should be considered when testing vaccines in mice and developing vaccines for humans.

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Section: Discussionmentioning

confidence: 99%

Effect of gluten-free diet and antibiotics on murine gut microbiota and immune response to tetanus vaccination

et al. 2022

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“…The reason for the difference between this response and the complete remission of NS in previous dietary intervention studies [5][6][7] is unclear. Ongoing efforts by other investigators to assess the effect of a GFD as a treatment for glomerular diseases will help determine the place of this dietary intervention for the treatment of childhood NS [19,20].…”

Section: Discussionmentioning

confidence: 99%

Gluten-Free Diet in Childhood Difficult-to-Treat Nephrotic Syndrome: A Pilot Feasibility Study

et al. 2022

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Introduction: Minimal change disease in childhood can follow a frequently relapsing or steroid dependent course in up to 40% of cases. Second-line immunosuppressive medications that are used to manage these patients are associated with significant adverse effects. There is a need for safer alternative treatments for difficult-to-treat nephrotic syndrome. Therefore, we conducted an open-label feasibility study to assess the safety and efficacy of a gluten-free diet as treatment for pediatric patients with difficult-to-treat nephrotic syndrome. As a second aim, we sought to determine if the plasma zonulin concentration can identify those who are more likely to respond to this intervention. Methods: 17 patients who were placed on a gluten-free diet for 6 months. A positive response was defined as a 50% reduction in the relapse rate compared to the preceding 6 months or the ability to discontinue 1 immunosuppressive drug. Results: Five (29%) participants had a positive response to the dietary intervention. The gluten-free diet was well tolerated with no clinical or laboratory adverse events. Plasma zonulin concentration was elevated in patients who failed to benefit from the gluten-free diet. Discussion/Conclusion: A gluten-free diet may be a useful adjunctive intervention for patients with difficult-to-treat nephrotic syndrome that can be implemented prior to resorting to second-line immunosuppressive therapy. Development of plasma zonulin level as a biomarker to predict efficacy would facilitate rational use of a gluten-free diet in the management of nephrotic syndrome.

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“…Innate and adaptive immunity coexist in these conditions: the first one shows an increase in mucosal toll-like receptor 2 (TLR2), granulocyte colony-stimulating factor (GCSF), IL-10, transforming growth factor alpha (TNF-α) and CXCL-10 chemokine from peripheral blood mononuclear cells (PBMCs), while the second one increases interferon (IFN)-gamma mRNA [ 39 ]. Finally, in a study using a GFD and dairy-free diet in children with steroid-resistant nephrotic syndrome (SRNS), findings showed a decrease in the inflammatory status of this population [ 40 ].…”

Section: Gluten-free Diet and Inflammationmentioning

confidence: 99%

Gluten-Free Diet and Metabolic Syndrome: Could Be a Not Benevolent Encounter?

et al. 2023

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Celiac disease is a rising disorder and is becoming frequently diagnosed in recent years. To date, the only available treatment is the gluten-free diet (GFD). The role of gluten on components of metabolic syndrome and on related inflammatory response is still unclear due to controversial results. In recent years, scientific focus on this topic has been growing up, in particular regarding the role of the GFD on glycometabolic parameters and diabetes. In addition, studies on the remaining components showed discordant results, which was likely due to heterogeneous and large celiac disease populations and to the lack of prospective studies. Furthermore, knowledge about the role of the GFD on inflammatory cytokines and the relationship among vitamin D and celiac disease, metabolic syndrome (MS) and GFD is needed. In this narrative review, we provided evidence regarding the role of the GFD on glycometabolic parameters, cholesterol, triglycerides, waist circumference, blood pressure and inflammatory cascade, also evaluating the role of vitamin D, trying to summarize whether this nutritional pattern may be a value-added for subjects with dysmetabolic conditions. Finally, due to the limited findings and very low-certainty evidence, predominantly based on observational studies, the real effects of a GFD on different components of MS, however, are unclear; nevertheless, an improvement in HDL levels has been reported, although data on glycemic levels are discordant.

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Immunological Impact of a Gluten-Free Dairy-Free Diet in Children With Kidney Disease: A Feasibility Study

Cited by 13 publications

References 60 publications

Effect of gluten-free diet and antibiotics on murine gut microbiota and immune response to tetanus vaccination

Effect of gluten-free diet and antibiotics on murine gut microbiota and immune response to tetanus vaccination

Gluten-Free Diet in Childhood Difficult-to-Treat Nephrotic Syndrome: A Pilot Feasibility Study

Gluten-Free Diet and Metabolic Syndrome: Could Be a Not Benevolent Encounter?

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