Cereal Grain Proteins
Immune Responses to Gluten = Gluten Allergy
Immune responses to gluten, the proteins found in cereal grains are a common cause of disease. The gastrointestinal tract is the primary target organ; however systemic disease is an important consequence of cereal grain ingestion in many patients. We think that the people diagnosed with celiac disease are a sub-population of a much larger group with gluten allergy.
Immediate Patterns of Allergy
There are different types of food allergy. The practice of "Allergy" as a specialty has tended to restrict the definition of allergy to one pattern of immune reactivity described as "Atopy" by Coca and Cooke in 1925. The term "atopy" simply meant "strange disease". Allergists noticed connections among the "'strange diseases" including hay fever, asthma and eczema, the three members of the atopic group. Study of atopic hypersensitivity revealed a common immune mechanism that further confirmed the allegiance of many allergists to atopy, with the exclusion of other allergic diseases from their field of interest. It was found that a single antibody species, IgE or "reaginic antibody", was responsible for some of the typical manifestations of atopy. An inherited tendency to make excessive amounts of IgE antibody is one characteristic of atopic individuals. IgE reactions tend to be immediate, causing obvious allergic reactions. IgE-mediated reactions tend to correlate with positive skin and/or RAST tests for IgE antibodies in the blood. The immediate or type 1 food allergy pattern is easily recognized because it involves quick and dramatic symptoms. Hay fever is the most common type 1 allergy and can be diagnosed by allergy skin tests. Some food allergy is also type 1 and shows up on skin tests. The child who develops hives 30 minutes after eating strawberries has a type 1 reaction. A child who wheezes 20 minutes after eating peanut butter has a type 1 reaction and a potentially dangerous one. An infant who cries, squirms and vomits 15 minutes after ingesting a milk-based formula is suffering from a type 1 reaction, triggered in the stomach. The type 1 pattern of allergy is attractive to researchers, because of its simplicity and the ease of testing for sensitization; however, it selects only a special population with Type 1, IgE-mediated allergy. While this is an important reaction pattern, some physicians have claimed it is the only valid form of allergic reactions to food. Their opinion is not acceptable.
Wheat (Triticum aestivum ) ingestion can cause type 1 allergic reactions most dramatically as wheat-dependent exercise-induced anaphylaxis. The major allergen involved is ω-5 gliadin, a gluten protein coded by genes located on the wheat B genome. Skin prick test (SPT) with a commercial wheat extract are part of allergists' screening for food allergens. Mittag et al stated: “Baker's asthma, food allergy to wheat, and wheat-dependent, exercise-induced anaphylaxis (WDEIA) are different clinical forms of wheat allergy. “ They assessed IgE antibodies to three groups of wheat antigens: albumins and globulins; gliadins; and glutenins. Subjects with baker's asthma as well as the food-allergic subjects had the most intense IgE-reactivity to the albumin/globulin fraction. Subjects with WDEIA had IgE reactivity patterns to gliadins and especially to a 65 kDa protein. "(Mittag D et al. Immunoglobulin E-reactivity of wheat-allergic subjects (baker's asthma, food allergy, wheat-dependent, exercise-induced anaphylaxis) to wheat protein fractions with different solubility and digestibility. Mol Nutr Food Res. 2004; 48(5):380-9)
Delayed Patterns of Allergy
We refer to the delayed patterns of food allergy as the "great imitators" since immune responses to food materials can produce the symptoms of many diseases. Food allergy is a complex series of events. The effects can be multiple and symptoms can stretch out over time, involving a series of repeating health problems. The most common problems are sore throats, lymph node swelling, digestive disorders, skin eruptions, especially eczema and hives, respiratory problems, asthma, headaches, muscle, joint and abdominal pains. Physical symptoms are connected with emotional, behavioral and learning disturbances in children.
The surface lining of the digestive tract is the largest and most critical interface between you and your environment. In the small intestine, the lining epithelial cells are involved in immune processes. They transfer immunoglobulins produced by lamina propria B-lymphocytes to the surface and interact with other cells of the immune system to induce an inflammatory response to stop microbial invasion. The surface epithelium processes food antigens, and presents antigens to lymphocytes. Both epithelial cells and intraepithelial lymphocytes participate in inflammatory reactions. Epithelial cells proliferate in celiac disease. Crypt hyperplasia is a common tissue response to mucosal damage in food allergy and infection. A cell-mediated type of allergy leads to many complicated consequences, especially increased permeability of the gastrointestinal tract (GIT) with more problems downstream.Wheat Gliadin-specific T lymphocytes are found in the small intestinal mucosa and in the peripheral blood. The density of T cells is increased in the jejunal epithelium, an abnormality considered to be specific for celiac disease. Gluten specific T cell clones activated by gluten are key players in the pathogenesis of celiac disease. Antigen- induced production of cytokines was studied in lymphocytes that secreted interferon gamma, often at high concentrations (2000 U/ml); increased concentrations of other interleukins IL 4, IL 5, IL 6, IL 10, tumor necrosis factor (TNF), and transforming growth factor (TGF) beta are also found
A list of diseases that occur with increased frequency in celiac patients resembles the list of disorders reviewed under our descriptions of delayed pattern food allergy These diseases include diabetes, thyroid disease, anemia, rheumatoid arthritis, sacroileitis, sarcoidosis, vasculitis, inflammatory lung disease, eye inflammation, cerebellar ataxia and schizophrenia. These and other immune-mediated disease can be linked to gluten ingestion. These associations suggest that people with a tendency to immune hypersensitivity diseases are vulnerable to food antigens that can cause systemic autoimmune disease. In their review of these associated disorders, Mulder and Tygart repeated the basic ideas that can explain the prolific ability of of gluten to cause disease downstream from a disordered gastrointestinal tract. They stated:
"Patients with (celiac disease and) selective IgA deficiency often have circulating antibodies to food proteins; they also have circulating immune complexes, suggesting that absence of an intestinal IgA barrier might allow the absorption of antigenic material from the gut. Antibodies to some of the antigens might cross react with the hosts self components and might indirectly produce autoimmune disease."
Anti-gliadin antibodies are most commonly found in the immune complexes, associated with major systemic disease. A T cell-mediated or type IV reaction to gluten is likely the major cause of the gut lesions and increased permeability to gluten and other food antigens leads to whole-body consequences.
Gluten and other food antigens make their way through human bodies in a remarkable fashion. Consider the long and improbable path of milk proteins through a mothers gut, into her blood, through her liver, out into her breast milk, through her infants gut mucosa and into the infants nasal mucosa to cause rhinitis, the infants lung to cause asthma, or the infants skin to cause eczema. There are many potential paths from mouth to target organ for food antigens to follow. Every tissue of the body can manifest a food allergy response. Some activity is noticed in minutes; the onset of other activity is delayed hours to days. Manifestations include both systemic symptoms such as flushing, fever, aching, fatigue, and also localized target organ activity, usually some form of inflammation, manifest as pain, swelling, erythema, and local heat.
Antigens may enter and complex with antibody in the digestive tract wall causing local inflammation and increased permeability. Immune complexes may form in the gut submucosa and pass through lymphatics or capillaries in the general circulation. Food proteins may enter the circulation and be identified by circulating antibodies, forming circulating immune complexes (CICs). CICs in the portal circulation pass to the liver where they may be cleared by macrophages. However, if the immune complexes are passed beyond the liver, they will then circulate through the lungs that act as secondary filters and may suffer CIC-triggered inflammatory events. Complexes can activate the complement cascade anywhere in the circulation, triggering explosive events such as anaphylaxis with both local and general symptoms.
Recommendations: The Alpha Nutrition Program is gluten-free and is recommended as the diet revision strategy for anyone with diagnosed celiac disease, or any person with symptoms suggestive of gluten allergy.
Self -Help: The diet revision program is explained in enough detail in the Alpha Nutrition Program Manual that an intelligent, well-motivated person can follow the steps outlined.
Learn More about the Gluten Rescue Starter Pack - you will receive the Alpha Nutrition Program manual, the Book of Gluten and a 500 Gram bottle of Alpha ENF. Study the program, try the formula and then decide if and when you are ready for a food holiday.
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