Tuesday, 13 May 2014

Gluten sensitivity and psychiatry reviewed

It's Coeliac Awareness Week here in the UK (see here) from 12-18 May 2014. With the rate of coeliac (celiac) disease going up according to the BBC website I thought it pertinent to talk today about something relevant to these issues.

So...

The review article by Genuis and Lobo [1] (open-access here) is the source material for today's short and quite descriptive post and their focus on how the protein gluten may be doing so much more than that currently recognised with the autoimmune condition coeliac disease in mind. To quote: "Emerging scientific literature contains several reports linking gluten sensitivity states with neuropsychiatric manifestations including autism, schizophrenia, and ataxia".
Wheat a minute... @ Wikipedia 

Gluten and its various metabolites, its intestinal and extra-intestinal effects, remains a primary interest of mine. Regular readers of this blog may already have come across other musings on the topic of this stuff, covering both my professional interest in gluten and autism, some autism (see here) and also a wider appreciation of its potential links to all manner of conditions and states (see here).

One of the advances currently being made when it comes to some of the research examination of gluten is the notion that non-coeliac gluten sensitivity (NCGS) may be an important one and by inference, coeliac disease is not the only manifestation of a gluten-related issue. My recent ramblings on the Simone Peters paper is testament to this.

The Genuis/Lobo paper covers quite a bit of the evidence so far for NCGS and the growing links between gluten and various conditions, including mention of some of the trailblazers in this field such as Mario Hadjivassiliou and colleagues (see here) and Faith Dickerson / Robert Yolken et al (see here). I'd also like to give a hat-tip to Emily Severance who is also an emerging force in this area (see here). The study by Jessica Biesiekierski and colleagues (see here) also gets a mention, which may very well go down as a classic study in this area of investigation. Even one of the authors of the paper - Stephen Genuis - has some research form in this area of investigation (see here).

There's little more for me to say about the Genuis/Lobo paper beyond the age-old requirement for a lot more research in this area. Outside of correlation not being the same as causation, I know some people still have a tendency to frown on this area of investigation, food as medicine and the like, particularly in light of the seemingly large number of conditions/states where gluten has been reported to have a potential effect breaking a cardinal rule of 'real science' (7. Does the claim involve multiple unassociated disorders? ). Assuming however that you see some commonalities across conditions like autism, schizophrenia and ataxia - or at least sub-groups of these quite heterogeneous conditions - and understand that comorbidity or an increased risk of certain comorbidity might be important to some people diagnosed with these conditions, you might see your way to taking a longer look at some of the peer-reviewed evidence hinting at some connection.

And now for some music. Smokey and the Bandit theme tune OK for you?

----------

[1] Genuis SJ. Lobo RA. Gluten Sensitivity Presenting as a Neuropsychiatric Disorder. Gastroenterol Res Pract. 2014;2014:293206.

----------

ResearchBlogging.org Genuis SJ, & Lobo RA (2014). Gluten Sensitivity Presenting as a Neuropsychiatric Disorder. Gastroenterology research and practice, 2014 PMID: 24693281