What Happened

by Spyros Bakis D.C., D.A.C.N.B., C.C.S.P

Diplomate American Chiropractic Neurology Board

Mayo Clinic’s Online Research magazine states that Celiac Disease is four times as common now as it was 60 years ago.

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“Celiac disease, an immune reaction to eating the protein gluten, is far more than an occasional tummy upset. Mayo Clinic research suggests the disease is becoming a major public health issue. Although the cause is unknown, celiac disease is four times more common now than 60 years ago, and affects about one in 100 people. According to Mayo studies, undiagnosed celiac disease can quadruple the risk of death. Mayo researchers are working to discover the causes and improve diagnosis.”

In addition to celiac disease being on the rise, a new medical condition associated with eating gluten has been identified in the literature.  This condition has been termed Non-Celiac Gluten Sensitivity. In Celiac Disease the autoimmune reaction that occurs as a result of ingesting gluten is an immune reaction against the lining of the large intestine. Non-celiac gluten sensitivity also causes an immune reaction and in some cases this immune reaction cross reacts with the individuals own body proteins and can cause a reaction to other body tissue other than a large intestine as in celiac.

It is true that modern science to date has not been able to answer the question as to why there has been such a dramatic rise in Celiac Disease or why millions of people that are eating gluten free are benefiting from a number of symptoms above and beyond their gastrointestinal symptoms.

At this point, after reviewing much of the literature as well as many of the theories that have been developed by clinicians treating these patients on a daily basis, it is my professional opinion that the hybridization of wheat that started occurring in the early 60’s with progression into a modern wheat plant is at the least a plausible theory.  Some have written that because the modern plant does not have more gluten that this theory is somehow invalid.  If the theory that more gluten is the problem is used in an attempt to explain the increase in celiac incidence in our society, I would agree that the modern plant should not be considered. Pure volume of gluten per plant does not make sense.  In that case just eating more gluten should have the same reaction.  It can definitely be argued that we are indeed eating more gluten.  We are eating more processed food that comes in a box.  We are eating more food that contains wheat than ever before, but this alone does not explain the problem.

In my opinion what we need to look at is what gluten is actually doing in the body.  If we start with what we know for a fact in Celiac disease we can move forward from there and look at non-Celiac Gluten Sensitivity as well.  We have to remember that Celiac Disease is an autoimmune disease that is triggered by an outside protein (gluten) that is introduced into the system. People that have Celiac disease have been identified to have a certain genetic profile. Genetic testing for Celiac disease includes identifying HLA DQ2 and HLA  DQ8.  The HLA DQ is a receptor type protein that is found on antigen presenting cells.  Antigens are any substances that provoke an immune response. Antigen presenting cells are part of the immune reaction and are cells that will bind and present substances thought to be foreign to the system to the point that the immune system needs to have a reaction.  What this means is that for some people with a certain genetic make-up, they are more likely to react to the gluten protein.

The immune system is indeed a protein recognition system.  Our white blood cells are the protective soldiers of our body constantly on patrol looking out for foreign proteins that may be invaders. Foreign invaders that need to be identified and attacked come in many forms most commonly they are bacteria, viruses and fungi. The immune system recognizes there foreign invaders by chemically looking at their protein coat.  These organisms are made of protein.  Our bodies are made of protein. The beauty of our immune system is that when things are working properly, it can differentiate between our own cell proteins that are friendly and foreign cell proteins as a potential threat.  This is what I mean by a protein recognition system. As an example when a bacteria that is not friendly comes into the body like one that may cause a sinus infection, our white blood cells identify the bacteria (the antigen) as a foreign body and a threat to the health of the system…in this case we call this an inflection.  Our soldiers, the white blood cells, identify the threat and then initiate an immune response.  This response is a reaction that uses the inflammatory response.  This response includes many steps that cause specialty cells, certain chemicals, and a series of reaction that are designed to contain and kill the invading bacteria.  This attack or response causes a variety of symptoms.  In the sinuses for instances the reaction can cause mucus build up, swelling of the sinuses resulting in congestion, inflammation and pain.

In the case of gluten protein, if the immune system identifies the gluten protein as a foreign invader that may pose a threat…again an immune response is initiated.  What this means is that your white blood cells identify then gluten molecule as an invader…as a threat.  If this happens an immune response is initiated.  This means that there will be some level of inflammation which includes all of those chemicals, immune cells, and reactions that are designed to kill the foreign invader. For many people that are sensitive to gluten this means a chronic low grade inflammatory response. Gluten has been identified as a cross-reactive protein in the body because the structure of gluten is similar to the structure of certain body tissues and can sometimes cause confusion within the immune system.

Autoimmune Disease

The inflammation, therefore, can involve different tissue.  For the celiac patient it’s the intestine that gets the reaction.  For some celiac patients there is also an associated brain reaction known as cerebellar ataxia, where the patient becomes weak and in some cases has extreme difficulty in walking and balancing. For an eczema patient it is the skin that gets the immune reaction.  For an autoimmune neuropathy patient it’s the nerves that get the immune reaction. For a multiple sclerosis patient the immune reaction ends up in the central nervous system….the brain and spinal cord.  For a diabetes patient the reaction ends up affecting the pancreas.

The gluten molecule is obviously not the only protein found in food that humans are sensitive to. Other proteins such as casein which is found in dairy can cause similar reactions. We all know a family that has had to switch a baby off of formula containing casein because the baby developed a rash secondary to an immune reaction from dairy. Removing the dairy completely from a baby’s diet many times clears up the rash rather quickly.

Here is some information on autoimmune disease from the American Autoimmune Related Disease Association (AARDA).

One very interesting fact is that the National Institutes of Health estimates that up to 23.5 million Americans suffer from autoimmune disease.

The AARDA estimates that there are 15 million Americans that suffer from autoimmune disease.

https://www.aarda.org/autoimmune-information/autoimmune-statistics/

Autoimmune Statistics

Autoimmune Statistics

AUTOIMMUNE DISEASE FACT SHEET

Autoimmune Disease…is a major health problem.
• The National Institutes of Health (NIH estimates up to 23.5* million Americans suffer from autoimmune disease and that the prevalence is rising. We at AARDA say that 50 million* Americans suffer from autoimmune disease. Why the difference? The NIH numbers only include 24 diseases for which good epidemiology studies were available.
• Researchers have identified 80-100 different autoimmune diseases and suspect at least 40 additional diseases of having an autoimmune basis. These diseases are chronic and can be life-threatening.
• Autoimmune disease is one of the top 10 leading causes of death in female children and women in all age groups up to 64 years of age.
• A close genetic relationship exists among autoimmune disease, explaining clustering in individuals and families as well as a common pathway of disease.
• Commonly used immunosuppressant treatments lead to devastating long-term side effects.
• The Institute of Medicine reports that the US is behind other countries in research into immune system self recognition, the process involved in autoimmune disease.
• Understanding how to modulate immune system activity will benefit transplant recipients, cancer patients, AIDS patients and infectious disease patients.

…faces critical obstacles in diagnosis and treatment.
• Symptoms cross many specialties and can affect all body organs.
• Medical education provides minimal learning about autoimmune disease.
• Specialists are generally unaware of interrelationships among the different autoimmune diseases or advances in treatment outside their own specialty area.
• Initial symptoms are often intermittent and unspecific until the disease becomes acute.
• Research is generally disease-specific and limited in scope. More information-sharing and crossover among research projects on different autoimmune diseases is needed.

…offers surprising statistical comparisons with other disease groups.
• NIH estimates up to 23.5 million Americans* have an AD. In comparison, cancer affects up to 9 million and heart disease up to 22 million.
• NIH estimates annual direct health care costs for AD to be in the range of $100 billion (source: NIH presentation by Dr. Fauci, NIAID). In comparison, cancers costs are $57 billion (source: NIH,ACS), and heart and stroke costs are $200 billion (source: NIH, AHA).
• NIH research funding for AD in 2003 came to $591 million. In comparison, cancer funding came to $6.1 billion; and heart and stroke, to $2.4 billion (source: NIH).
• The NIH Autoimmune Diseases Research Plan states; “Research discoveries of the last decade have made autoimmune research one of the most promising areas of new discovery.”
• According to the Department of Health and Human Services’ Office of Women’s Health, autoimmune disease and disorders ranked #1 in a top ten list of most popular health topics requested by callers to the National Women’s Health Information Center.

* We at AARDA say that 50 million Americans suffer from autoimmune disease. Why the difference? The NIH numbers only include 24 diseases for which good epidemiology studies were available.

https://www.aarda.org/autoimmune-information/autoimmune-statistics/