Transglutaminase 6 antibodies in gluten neuropathy

Zis, Panagiotis; Rao, Dasappaiah Ganesh; Sarrigiannis, Ptolemaios G.; Aeschlimann, Pascale; Aeschlimann, Daniel; Sanders, David S.; Grünewald, Richard A.; Hadjivassiliou, Marios

doi:10.1016/j.dld.2017.08.019

Cited by 39 publications

(33 citation statements)

References 24 publications

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“…Extraintestinal manifestations of celiac disease include various forms of neuropathy, with length‐dependent sensorimotor polyneuropathy and sensory ganglionopathy being the most common . Neuropathy is the second most common neurological manifestation of celiac disease after gluten ataxia . It has also been argued that gluten sensitivity (i.e., wheat or gluten sensitivity) in the absence of enteropathy or endomysial or tissue transglutaminase antibodies may be a distinct syndrome, although this is somewhat controversial.…”

Section: Lifestyle Interventions For Neuropathymentioning

confidence: 99%

“…75 Neuropathy is the second most common neurological manifestation of celiac disease after gluten ataxia. 76 It has also been argued that gluten sensitivity (i.e., wheat or gluten sensitivity) in the absence of enteropathy or endomysial or tissue transglutaminase antibodies may be a distinct syndrome, although this is somewhat controversial. Nonetheless, gluten sensitivity in the absence of diagnosed celiac disease is becoming increasingly recognized and has been confirmed, with a placebo-controlled trial demonstrating the existence of gluten sensitivity by food challenge.…”

Section: Celiac Neuropathy and Nonceliac Gluten-sensitivitymentioning

confidence: 99%

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Integrative neuromuscular medicine: Neuropathy and neuropathic pain: Consider the alternatives

Rowin

2019

Muscle and Nerve

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Complementary and alternative treatment modalities are commonly utilized by patients for neuropathy and neuropathic pain due to perceived lack of benefit from conventional medical treatment. As the association between metabolic syndrome and neuropathy is increasingly recognized, diet and lifestyle interventions are becoming important components in the management of neuropathy. Progress in the understanding of the gut–immune interaction highlights the role the gut microbiome and inflammation plays in the modulation of neuropathy and neuropathic pain. Evidence for nutritional interventions, exercise, supplements, acupuncture, and mindfulness‐based practices in the treatment of neuropathic pain is encouraging. This article reviews the available evidence to support the safe use of complementary and alternative treatments for commonly encountered conditions associated with neuropathy and neuropathic pain. Muscle Nerve 60: 124–136, 2019

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Section: Lifestyle Interventions For Neuropathymentioning

confidence: 99%

Section: Celiac Neuropathy and Nonceliac Gluten-sensitivitymentioning

confidence: 99%

Integrative neuromuscular medicine: Neuropathy and neuropathic pain: Consider the alternatives

Rowin

2019

Muscle and Nerve

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“…48 The differential diagnosis for sensory neuronopathy is relatively narrow, and as many are treatable, it may be reasonable to test for all the acquired causes. These include Sjogren's syndrome, 49 nonceliac gluten sensitivity and celiac disease, 50 anti-Hu and anti-CV2/contactin response mediator protein 5 paraneoplastic syndromes, 51 vitamin B6 excess, 52 and HIV. 53 An inherited cause is Friedrich's ataxia, typically associated with profound sensory complaints but with more accompanying features alongside neuropathy.…”

Section: Chronic Pure Sensory Neuropathy/neuronopathymentioning

confidence: 99%

“…It was recently suggested that transglutaminase-6 antibodies may be helpful in identifying gluten sensitivity without definitive celiac disease. 50 Screening for paraneoplastic disease is generally ordered as part of a serum panel. Screening for HIV involves immunoassays that detect p24 antigen along with IgM and IgG antibodies to HIV-1 and -2.…”

Section: Chronic Pure Sensory Neuropathy/neuronopathymentioning

confidence: 99%

Laboratory Evaluation of Peripheral Neuropathy

Lau

2019

Semin Neurol

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Peripheral neuropathy is a common neurological disorder, with high prevalence especially in the aged population. The general evaluative approach is to first identify the type of peripheral neuropathy prior to investigating for a possible underlying etiology, which is an increasingly important endeavor, as many causes of peripheral neuropathy are now recognized as treatable. To this end, laboratory testing plays an important adjunctive role to a detailed history and examination. This review will discuss possible diagnostic laboratory testing pathways for different types of peripheral neuropathy, with the goal of minimizing costs and false-positive results while maximizing the likelihood of identifying a potentially reversible etiology.

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“…Gastritis is commonly found in CD and some authors even hypothesized that increased anti-tissue transglutaminase (anti-tTG) antibodies observed in the gastritis group might indicate either a longer disease duration or perhaps a role of the gastric mucosa in the gluten-mediated immune reaction [4,5].…”

Section: Culture Of Gastric Biopsies In Celiac Disease and Its Relatimentioning

confidence: 99%

Transglutaminase 6 antibodies are not yet mainstream in neuro-coeliac disease

Mulder

Rouvroye

Dam

2018

Digestive and Liver Disease

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Transglutaminase 6 antibodies are not yet mainstream in neuro-coeliac disease Worldwide 1% of the population suffers from a gluten related disorder (GRD) that severely impacts ones life, and no therapeutic treatment, except a gluten-free diet, is available. GRD's are a group of immune mediated diseases triggered by the ingestion of gluten. Well known is coeliac disease (CD) that presents with enteropathy. Some patients present exclusively with extra-intestinal manifestations such as skin involvement in dermatitis herpetiformis (DH). Over the last fifty years, patients with gluten sensitivity presenting with neurological symptoms have been described more and more. These symptoms include e.g. cerebellar ataxia and peripheral neuropathies and were thus far considered to be a rare manifestation of GRD. Thus, the diagnosis of neuro-coeliac disease is not yet based on objective and verifiable clinical and/or pathological criteria set by international working groups, such as those of the international Society for the Study of Celiac Disease, the European Society of Pediatric Gastroenterology and Nutrition or Neurological Societies. It would be recommended that groups working on neuro-coeliac disease bundle their forces to obtain a large international cohort of patients to standardize the clinical and pathological picture of this disease. The Sheffield group, led by professor Hadjivassiliou, is one of the leading groups working on neuro-coeliac disease. In the past they have shown that cerebellar ataxia in gluten sensitive patients coincides with white matter abnormalities and neuropathology. Moreover, they found that Transglutaminase (TG) 6 antibodies are overrepresented in the serum of these patients [1]. Serum markers in CD include the presence of TG2 antibodies, and in DH elevated levels of TG3 antibodies can be found [2,3]. In a previous issue of this journal, Panagiotis Zis et al. present a cross-sectional study on 28 patients with peripheral neuropathies, i.e. sensory ganglionopathy, symmetrical axonal neuropathy or mononeuritis multiplex. The notion that TG6 antibodies were enhanced in cerebellar ataxia patients, and that TG6 is considered to be a Transglutaminase more specific to the central nervous system, they now questioned whether TG6 antibodies were elevated in gluten sensitive patients with peripheral neuropathy. The prevalence of TG6 antibodies was 50% compared to 4% in the healthy population, suggesting that TG6 involvement is not confined to the central nervous system alone, but also can affect the peripheral nervous system. In addition, in CD more than 95% of patients share the HLA DQ2 or DQ8 haplotype, whereas of the patients in this study only 62% shared those HLA haplotypes. Moreover, TG2 antibodies were also elevated in this population [4]. As mentioned the so-called neuro-coeliac disease manifestations are not well studied by neurologists and neuroscientists and

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Transglutaminase 6 antibodies in gluten neuropathy

Cited by 39 publications

References 24 publications

Integrative neuromuscular medicine: Neuropathy and neuropathic pain: Consider the alternatives

Integrative neuromuscular medicine: Neuropathy and neuropathic pain: Consider the alternatives

Laboratory Evaluation of Peripheral Neuropathy

Transglutaminase 6 antibodies are not yet mainstream in neuro-coeliac disease

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