Post Date: July 13, 2011
Italian and U.S. Researchers Differentiate Celiac Disease and Gluten Sensitivity
‘‘It has become apparent that classic celiac disease represents the tip of the iceberg of an overall disease burden’’
The March 2011 issue of BMC Medicine published a collaborative effort between Italian and U.S. researchers to differentiate between celiac disease and gluten sensitivity. This paper provided a beginning understanding of key differences between the two conditions.
The study included 42 patients with celiac disease, 26 patients with gluten sensitivity, and 39 control patients. The researchers tested each participant’s intestinal permeability and gene expression.
The research team found that gluten sensitivity is not associated with increased intestinal permeability, which is a distinct difference from celiac disease. In addition, markers for adaptive immunity (IL-6 and IL-21) were expressed at higher levels in celiac disease than in the control patients; however, no increase was seen in the gluten-sensitive patients, Conversely, a marker for innate immunity (Toll-like receptor 2) was increased in the gluten-sensitive patients, but not in the celiac patients.
According to the researchers, “these findings support the idea that the prevalent involvement of innate versus adaptive immune pathways may help explain the clinical and serological differences in gluten-sensitive versus celiac disease patients.” They add that the study results suggest “that celiac disease and gluten sensitivity are distinct clinical entities caused by different intestinal mucosal responses to gluten.”
Given there appears to be a 6-fold increase in Gluten Sensitivity vs. Celiac Disease, these findings will help Physicians to determine the appropriate tests and treatment recommendations to deliver to their patients.
Sapone A, Lammers KM, Casolaro V, Cammarota M, Giuliano MT, De Rosa M, et al. Divergence of gut permeability and mucosal immune gene expression in two gluten-associated conditions: celiac disease and gluten sensitivity. BMC Med. 2011 Mar 9;9:23.