Риск шизофрении и чувствительность к глютену у матери

Maternal infections and other inflammatory disorders during pregnancy have long been linked to greater risk for schizophrenia in the offspring but, the Swedish and U.S. investigators say, this is the first study that points to maternal food sensitivity as a possible culprit in the development of such disorders. The findings establish a strong link but do not mean that gluten sensitivity will invariably cause schizophrenia, the investigators caution. The research, however, does suggest an intriguing new mechanism that may drive up risk and illuminate possible prevention strategies.
"Our research not only underscores the importance of maternal nutrition during pregnancy and its lifelong effects on the offspring, but also suggests one potential cheap and easy way to reduce risk if we were to find further proof that gluten sensitivity exacerbates or drives up schizophrenia risk," said study lead investigator Håkan Karlsson, M.D., Ph.D., a neuroscientist at Karolinska Institutet and former neuro-virology fellow at Johns Hopkins.
The team's findings are based on an examination of 764 birth records and neonatal blood samples of Swedes born between 1975 and 1985. Some 211 of them subsequently developed non-affective psychoses, such as schizophrenia and delusional disorders.
Using stored neonatal blood samples, the investigators measured levels of IgG antibodies to milk and wheat. IgG antibodies are markers of immune system reaction triggered by the presence of certain proteins. Because a mother's antibodies cross the placenta during pregnancy to confer immunity to the baby, a newborn's elevated IgG levels are proof of protein sensitivity in the mother.
Children born to mothers with abnormally high levels of antibodies to the wheat protein gluten had nearly twice the risk of developing schizophrenia later in life, compared with children who had normal levels of gluten antibodies. The link persisted even after researchers accounted for other factors known to increase schizophrenia risk, including maternal age, gestational age, mode of delivery and the mother's immigration status. The risk for psychiatric disorders was not increased among those with elevated levels of antibodies to milk protein.

Maternal Antibodies to Gluten Linked to Schizophrenia Risk in Children

Антитела к глиадину у больных шизофренией

The present work measured circulating antibodies against native gliadins, deamidated gliadin–derived epitopes, and transglutaminase 2 (TGM2) in 473 patients with schizophrenia and 478 control subjects among a Chinese population. The results showed that 27.1% of patients with schizophrenia were positive for the IgA antibody against native gliadins compared with 17.8% of control subjects (χ2 = 11.52, P = .0007, OR = 1.72, 95% CI 1.25–2.35), although this significant difference appeared to be due mainly to low IgA gliadin antibody levels in female controls. A total of 27.6% of female patients were positive for IgA gliadin antibodies compared with 13.9% of female controls (χ2 = 10.46, P = .0012, OR = 2.36, 95% CI 1.39–4.01), and 26.4% of male patients were positive for IgA antibodies compared with 19.8% of male controls (χ2 = 3.26, P = .071, OR = 1.46, 95% CI 0.97–2.19). Of 128 patients who were positive for the IgA antibody against native gliadins, 8 were positive for the IgA antibody against deamidated gliadin epitopes and 1 was positive for IgA anti-TGM2 antibody. However, quantitative analysis demonstrated that the mean levels of IgA antibodies against deamidated gliadin epitopes and TGM2 were significantly lower in patients with schizophrenia than the control subjects (P < .001 and P = .008, respectively). The prevalence of IgG antibodies against native gliadins was not significantly different between the patient group and the control group (χ2 = 2.25, P = .134, OR = 1.32, 95% CI 0.92–1.88). This study suggests that specific gliadin-derived epitopes may be involved in schizophrenia.

 A Study of Circulating Gliadin Antibodies in Schizophrenia Among a Chinese Population

Исследование влияния диет без глютена или казеина на симптоматику расстройств аутистического спектра

For those children with GI and allergy symptoms, a gluten-free, casein-free diet was more effective in improving ASD behaviors, physiological symptoms and social behaviors compared to children without these symptoms.
Specifically, when a gluten-free, casein-free diet was strictly followed, parents witnessed an improvement in GI symptoms in their children as well as improvements in social behaviors, such as language production, eye contact, engagement, attention span, requesting behavior and social responsiveness.
Autism may be more than a neurological disease, says Laura Cousino Klein, associate professor of bio-behavioral health and human development and family studies—it may involve the GI tract and the immune system.
“There are strong connections between the immune system and the brain, which are mediated through multiple physiological symptoms,” Klein said. “A majority of the pain receptors in the body are located in the gut, so by adhering to a gluten-free, casein-free diet, you’re reducing inflammation and discomfort that may alter brain processing, making the body more receptive to ASD therapies.”
Furthermore, when all gluten and casein was removed from the diet, parents reported that a greater number of ASD behaviors, physiological symptoms and social behaviors improved in their children compared to those whose parents did not eliminate all gluten and casein. Also, parents who implemented the diet for six months or less reported that the diet was less effective in reducing ASD behaviors.
Some of the parents had eliminated only gluten or only casein from the diet, but survey results suggested that parents who completely eliminated both gluten and casein reported the most benefit.

Gluten-Free, Casein-Free Diet Shows Promise for Autism Symptoms

Восприимчивость к глютену в норме, при шизофрении и при целиакии

Individuals with recent-onset psychosis and with multi-episode schizophrenia who have increased antibodies to gliadin may share some immunologic features of celiac disease, but their immune response to gliadin differs from that of celiac disease.

Markers of Gluten Sensitivity and Celiac Disease in Recent-Onset Psychosis and Multi-Episode Schizophrenia.

In contrast to previous reports, we found no evidence for celiac disease in patients with chronic schizophrenia as manifested by the presence of serum IgA anti-endomysial antibodies. It is unlikely that there is an association between gluten sensitivity and schizophrenia.

"Bread madness" revisited: screening for specific celiac antibodies among schizophrenia patients.

These findings indicate that the anti-gliadin immune response in schizophrenia has a different antigenic specificity from that in celiac disease and is independent of the action of transglutaminase enzyme and HLA-DQ2/DQ8.

Novel immune response to gluten in individuals with schizophrenia

We report the unexpected resolution of longstanding schizophrenic symptoms after starting a low-carbohydrate ketogenic diet. After a review of the literature, possible reasons for this include the metabolic consequences from the elimination of gluten from the diet, and the modulation of the disease of schizophrenia at the cellular level.

Schizophrenia, gluten, and low-carbohydrate, ketogenic diets: a case report and
review of the literature

There are several case reports of coexistence of coeliac sprue and depression, schizophrenia and anxiety. Coeliac disease should be taken into consideration in patients with psychiatric disorders, particularly if they are not responsive to psychopharmacological therapy, because withdrawal of gluten from the diet usually results in disappearance of symptoms.

Psychiatric symptoms and coeliac disease.

A double-blind control trial of gluten-free versus a gluten-containing diet was carried out in a ward of maximum security hospital: 24 patients were studied for 14 weeks. Most suffered from psychotic disorders, particularly schizophrenia. Various dimensions of behaviour were rated on the Psychotic In-Patient profile (PIP) at different stages. There were beneficial changes in the whole group of patients between pre-trial and gluten-free period in five dimensions of the PIP, maintained during the gluten challenge period; these changes could be attributed to the attention the patients received. Two patients improved during the gluten-free period and relapsed when the gluten diet was reintroduced.

A double-blind gluten-free/gluten-load controlled trial in a secure ward population.

Непереносимость глютена и шизофрения

Celiac disease (CD) and schizophrenia have approximately the same prevalence, but epidemiologic data show higher prevalence of CD among schizophrenia patients. The reason for this higher co-occurrence is not known, but the clinical knowledge about the presence of immunologic markers for CD or gluten intolerance in schizophrenia patients may have implications for treatment. Our goal was to evaluate antibody prevalence to gliadin (AGA), transglutaminase (tTG), and endomysium (EMA) in a group of individuals with schizophrenia and a comparison group. AGA, tTG, and EMA antibodies were assayed in 1401 schizophrenia patients who were part of the Clinical Antipsychotic Trials of Intervention Effectiveness study and 900 controls. Psychopathology in schizophrenia patients was assessed using the Positive and Negative Symptoms Scale (PANSS). Logistic regression was used to assess the difference in the frequency of AGA, immunoglobulin A (IgA), and tTG antibodies, adjusting for age, sex, and race. Linear regression was used to predict PANSS scores from AGA and tTG antibodies adjusting for age, gender, and race. Among schizophrenia patients, 23.1% had moderate to high levels of IgA-AGA compared with 3.1% of the comparison group (chi(2) = 1885, df = 2, P < .001.) Moderate to high levels of tTG antibodies were present in 5.4% of schizophrenia patients vs 0.80% of the comparison group (chi(2) = 392.0, df = 2, P < .001). Adjustments for sex, age, and race had trivial effects on the differences. Regression analyses failed to predict PANSS scores from AGA and tTG antibodies. Persons with schizophrenia have higher than expected titers of antibodies related to CD and gluten sensitivity.

Prevalence of Celiac Disease and Gluten Sensitivity in the United States Clinical Antipsychotic Trials of Intervention Effectiveness Study Population.