Lately there seems to be a body of fascinating research that is emerging which is persuasively demonstrating that a subset of patients diagnosed with Irritable Bowel Syndrome (or often with MC) are actually seeing severe and progressive motility problems because their immune systems are attacking the enteric nerves in their intestines.
In this up to date article from this year, researchers are actually making reference to this being akin to 'Parkinson's of the gut':
http://www.ncbi.nlm.nih.gov/pmc/article ... ool=pubmed
Apparently, the immune system begins to produce antibodies to the nerves in the myenteric plexus of the muscle layers of the gut. Very often a large number of lymphocytes are seen destroying the neurons in the gut wall. Unfortunately the only way to diagnose this process is to perform full thickness biopsies of the small and large bowel which is an invasive procedure. I'm particularly interested in some great research from Tornblom and colleagues from Sweden that shows a process of nerve damage which they call lymphocytic epithelioganglionitis.
I've read quite a number of posts on here from people who are reporting neuropathy or nervous system disorders which they link to Gluten and the research means that a blood test can be performed to see if the anti-enteric antibodies are present and medication given to try to stop the immune and lymphocyte attack of the ganglia and nerve cells. If anyone has severe dysmotility and lymphocytes on biopsy then they could request the test to see if they are suffering this autoimmune process which is different from autoimmune coeliac.
Al
IBS, Lymphocytes and Neuropathy
Moderators: Rosie, Stanz, Jean, CAMary, moremuscle, JFR, Dee, xet, Peggy, Matthew, Gabes-Apg, grannyh, Gloria, Mars, starfire, Polly, Joefnh
That is fascinating. Thanks for posting. I've long wondered if my LC was caused by my circulating autoantibodies, which I had at least 5 years before the onset of MC. The only connection I could make was to Anti-Actin (Smooth Muscle) Antibody, which is elevated in celiac disease and may be a marker for epithelial damage of the intestines.
http://www.ncbi.nlm.nih.gov/pubmed/16127984
http://www.ncbi.nlm.nih.gov/pubmed/16127984
CONCLUSIONS: Based on our findings we suggest that the presence of increased IgA AAA serum levels is a highly sensitive marker of the disturbed architecture of intestinal epithelial cells of CD patients with a potential relevance to diagnosis and follow-up. The presence of SMA seems to define a distinct subset of CD patients with a more severe clinical outcome.
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Gabes-Apg
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great article, thanks for posting 
i wonder if this is the 'medical' diagnosis of leaky gut?
(leaky gut has been around since medieval times)
I shared this article with a friend who is coeliac and runs the local GF shop, she replied with the following statement;
Just talking to Coeliac Qld yesterday and there is some consideration to changing the "March Score" from 3 to a 1. Stage 1 is the cells on the surface of the intestinal lining are being infiltrated by lymphocytes!
i wonder if this is the 'medical' diagnosis of leaky gut?
(leaky gut has been around since medieval times)
I shared this article with a friend who is coeliac and runs the local GF shop, she replied with the following statement;
Just talking to Coeliac Qld yesterday and there is some consideration to changing the "March Score" from 3 to a 1. Stage 1 is the cells on the surface of the intestinal lining are being infiltrated by lymphocytes!
Gabes Ryan
"Anything that contradicts experience and logic should be abandoned"
Dalai Lama
"Anything that contradicts experience and logic should be abandoned"
Dalai Lama
Gabes,
If they change the minimum Marsh score rating that qualifies for a diagnosis of celiac disease to 1, most of us would probably qualify for a diagnosis of celiac disease.
Tex
If they change the minimum Marsh score rating that qualifies for a diagnosis of celiac disease to 1, most of us would probably qualify for a diagnosis of celiac disease.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Gabes-Apg
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- Joined: Mon Dec 21, 2009 3:12 pm
- Location: Hunter Valley NSW Australia
Yep!
attitudes are a changing..... for the better...
what prompted her contact to the society and discuss the topic was that she had a customer that had a letter from the GI specialist/surgeon stating he was 'non celiac gluten intolerant'.
the letter was from the same GI specialist who diagnosed my MC.....
attitudes are a changing..... for the better...
what prompted her contact to the society and discuss the topic was that she had a customer that had a letter from the GI specialist/surgeon stating he was 'non celiac gluten intolerant'.
the letter was from the same GI specialist who diagnosed my MC.....
Gabes Ryan
"Anything that contradicts experience and logic should be abandoned"
Dalai Lama
"Anything that contradicts experience and logic should be abandoned"
Dalai Lama
You know, it's always interesting how, if a patient complains of non-celiac gluten-sensitivity, it's all in the patient's head. If a doctor has the problem, though, it actually exists. 
I realize that your GI doc may be an exception, and there are others, also, but I can't think of a better example of an egocentric attitude, than the attitude of gastroenterologists in general. IOW, if they don't have scientific proof, then the problem doesn't actually exist, unless they, or some of their peers have it - then it's real.
Tex
I realize that your GI doc may be an exception, and there are others, also, but I can't think of a better example of an egocentric attitude, than the attitude of gastroenterologists in general. IOW, if they don't have scientific proof, then the problem doesn't actually exist, unless they, or some of their peers have it - then it's real.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
This is very fascinating. What concerns me is that we are learning about it here, but our GI's probably won't buy into it or the testing for another 10 years. In the meantime, we can't get them to listen to us. It will be helpful for our descendents, though.
Gloria
Gloria
You never know what you can do until you have to do it.
I think it shows that some researchers are prepared to go to more scrupulous and methodical lengths to find out what is really causing people such misery with so-called 'benign' IBS. This could become something of a landmark study if other centres can repeat their results as the Ohio state researchers conclude:
To speculate: maybe once the major viral particles are cleared there may be some left in gut tissue or even the virus entered the nerve cells and the body cleared them but kept on producing antibodies to the infected nerve cells in a vicious phony war which destroys the enteric nerves and muscles. Certain viruses might have antigens on their surfaces that are similar to sections found on enteric nerves perpetuating an immune attack. I'm sure that findings like this in this paper will lead on to more intriguing research and get people's guts back to health.
Al
And you will see that I have added the emphasis on the word autoimmune (yes- just like coeliac) because like many on this board I laboured for years with a diagnosis of IBS before biopsies found lymphocytes and any autoimmune disease warrants thorough investigation and appropriate medication. What this study points to is that the immune system may become sensitised to certain antigens, maybe those found in an enterovirus that many complain of suffering before IBS sets in.Results of the present study suggest that symptoms in a subset of IBS patients might be a reflection of enteric neuronal damage or loss, caused by circulating anti-enteric autoimmune antibodies.
To speculate: maybe once the major viral particles are cleared there may be some left in gut tissue or even the virus entered the nerve cells and the body cleared them but kept on producing antibodies to the infected nerve cells in a vicious phony war which destroys the enteric nerves and muscles. Certain viruses might have antigens on their surfaces that are similar to sections found on enteric nerves perpetuating an immune attack. I'm sure that findings like this in this paper will lead on to more intriguing research and get people's guts back to health.
Al
Actually, it sort of appears that study is an attempt to reinvent the wheel, because they overlooked a large body of previous work done by Dr. Hadjivassiliou, the leading neurological researcher in the UK, who has published many research articles concerning the neurological effects of gluten, over the past 10 or 15 years. I can't help but notice that this article doesn't even cite a single article by Dr. Hadjivassiliou, (which is why I say that it is an attempt to reinvent the wheel). I don't recall any work by Dr. Hadjivassiliou that specifically addresses, anti-enteric neuronal antibodies, so this project is obviously an extension of his work, (even though they don't mention his many years of research).
The point is, the neuronal antibodies, (if they are indeed a valid issue), are almost certainly due to gluten-sensitivity, not to a virus. The reason why I'm not sure that they are an important issue, is because the results of this project clearly show that the association is somewhat minor:
What these researchers may have discovered, IMO, is a better way to detect gluten-sensitivity, in the earlier stages of damage. According to Dr. Hadjivassiliou's research, the damage from gluten-sensitivity often presents first as neurological damage, and in many cases, it never even proceeds to gastrointestinal damage. Check out this article, for example, that he published on the topic, 10 years ago:
http://jnnp.bmj.com/content/72/5/560.full
Tex
The point is, the neuronal antibodies, (if they are indeed a valid issue), are almost certainly due to gluten-sensitivity, not to a virus. The reason why I'm not sure that they are an important issue, is because the results of this project clearly show that the association is somewhat minor:
If 59% of controls showed anti-enteric neuronal antibodies, while the IBS cohort showed only 87% association, that's not exactly an earth-shattering difference. 59% is a relatively large statistical number for any control group. However, 59% would definitely fit the range of probability of people in the general population who are affected by gluten-sensitivity, (but who don't realize it, because they test negative to all the classic tests that are available.Eighty-seven percent of IBS sera and 59% of control sera contained anti-enteric neuronal antibodies.
What these researchers may have discovered, IMO, is a better way to detect gluten-sensitivity, in the earlier stages of damage. According to Dr. Hadjivassiliou's research, the damage from gluten-sensitivity often presents first as neurological damage, and in many cases, it never even proceeds to gastrointestinal damage. Check out this article, for example, that he published on the topic, 10 years ago:
http://jnnp.bmj.com/content/72/5/560.full
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Thanks Tex, that was a great link to Dr Hadjvassiliou's paper on gluten and neurological disease. Quite unnerving when you read it and think of the implications. It puts me in mind of Cycads and Guam Dementia which have arisen in Guam because people eat mashed up seeds from Cycad trees and over a long period of time develop serious neurological consequences. That paper ponders whether gluten is maybe cumulatively toxic too.
I agree somewhat with what you say about J Wood's paper unwittingly rehashing some research that was done several years ago. The original paper I linked to on IBS and inflammatory neuropathy is repeating elements of some research from a paper published 10 years before by a team in Sweden, entitled Full-Thickness Biopsy of the Jejunum Reveals Inflammation and Enteric Neuropathy in Irritable Bowel Syndrome: http://sadieo.ucsf.edu/course/old/pre-2 ... nblom1.pdf
I actually think this earlier paper is more thorough because they biopsy patients right through the bowel wall and show lymphocytes massed around nerves and ganglia in the bowel wall. They have shown that a subset of patients diagnosed with 'IBS' are experiencing nerve damage and loss of motility because of inflammation which may mean it's a different disease. I don't think they look at gluten as a culprit though.
I agree somewhat with what you say about J Wood's paper unwittingly rehashing some research that was done several years ago. The original paper I linked to on IBS and inflammatory neuropathy is repeating elements of some research from a paper published 10 years before by a team in Sweden, entitled Full-Thickness Biopsy of the Jejunum Reveals Inflammation and Enteric Neuropathy in Irritable Bowel Syndrome: http://sadieo.ucsf.edu/course/old/pre-2 ... nblom1.pdf
I actually think this earlier paper is more thorough because they biopsy patients right through the bowel wall and show lymphocytes massed around nerves and ganglia in the bowel wall. They have shown that a subset of patients diagnosed with 'IBS' are experiencing nerve damage and loss of motility because of inflammation which may mean it's a different disease. I don't think they look at gluten as a culprit though.
They only looked at IBS. I'm pretty sure that if they had taken the same biopsy samples from patients with Crohn's, UC, MC, and celiac disease, they would have found the same thing, (but I'm only guessing, of course). IMO, IBS doesn't exist - it's simply the undiagnosed early stages of some other disease, which will be determined by genetics, and environmental factors. IBS is a default diagnosis, handed down when the GI doc can't figure out what's actually wrong. Sooner or later, most "IBS" patients are correctly diagnosed.
Tex
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.