Interview with Dr. Peter Green on the People's Pharmacy

[jcc]

http://www.peoplespharmacy.com/2009/06/ ... interv-31/

Has this been posted here yet? Dr. Green is among the experts who are morphing their opinion in regard to gluten sensitivity outside of celiac disease. People who have seen him lecture recently said he now admits to changing his mind about gluten sensitivity w/o celiac disease.

In this interview, he discusses the fact that we know people with DH have celiac disease, yet 20% do not show damage on biopsy and would fail the diagnostics... except we KNOW those with DH have CD. He mentions that those with DH may have positive anti-tTG3. He mentions those with gluten ataxia show anti-tTG6. People with intestinal damage show anti-tTG2. From someone who saw him speak at the recent GIG conference, we learned tests for transglutaminase 3 and 6 are not available except for research.

Then he mentions they see people with IBS who are gluten sensitive, and they have found damage to the intestinal microvilli that can be seen with electron microscopy, but this is very expensive and not readily available. Apparently this is true with gluten ataxia and DH patients, too, who may not show villous atrophy.

He starts discussing gluten sensitivity without celiac disease around the 7 minute mark, I think. I checked when he finished discussing it and it was 9 minutes in.


Dr. Fasano has also revealed that 70% of the patients he sees are gluten sensitive without celiac disease.

Cara

[JLH]

THANKS. Great information.....

[JLH]

A little ammo for your B-I-L, the pathologist? I haven't listened to it yet, but I will after dinner.........

[tex]

No, that hasn't been posted here, yet.

In this interview, he discusses the fact that we know people with DH have celiac disease, yet 20% do not show damage on biopsy and would fail the dianostics... except we KNOW those with DH have CD.

Hmmmmm. Great observation! Now why didn't we think of that. I suppose I'd better check out that interview, to see if he explains exactly how we KNOW that those with DH have CD, even though they fail to meet the diagnostic criteria for CD.

The anti-tTG2,3 6,etc., issue is very interesting. Obviously, this another example of doctors not being able to find what they don't look for, (which has been extremely common with MC, for decades, of course).

Thanks for posting that information.

Tex

P. S. Joan, it was no-more-muffins, who has a BIL, who is a unenlightened pathologist.

[jcc]

P. S. Joan, it was no-more-muffins, who has a BIL, who is a unenlightened pathologist

But it was THAT post that inspired THIS one ;).

Here is the study behind the anti-tTG6:

Autoantibodies in gluten ataxia recognize a novel neuronal transglutaminase.
Hadjivassiliou M, Aeschlimann P, Strigun A, Sanders DS, Woodroofe N, Aeschlimann D.
Department of Neurology, Royal Hallamshire Hospital, Sheffield, UK.

OBJECTIVE: Gluten sensitivity typically presents as celiac disease, a chronic, autoimmune-mediated, small-intestinal disorder. Neurological disorders occur with a frequency of up to 10% in these patients. However, neurological dysfunction can also be the sole presenting feature of gluten sensitivity. Development of autoimmunity directed toward different members of the transglutaminase gene family could offer an explanation for the diversity in manifestations of gluten sensitivity. We have identified a novel neuronal transglutaminase isozyme and investigated whether this enzyme is the target of the immune response in patients with neurological dysfunction. METHODS: Using recombinant human transglutaminases, we developed enzyme-linked immunosorbent assays and inhibition assays to analyze serum samples of patients with gluten-sensitive gastrointestinal and neurological disorders, and various control groups including unrelated inherited or immune conditions for the presence and specificity of autoantibodies. RESULTS: Whereas the development of anti-transglutaminase 2 IgA is linked with gastrointestinal disease, an anti-transglutaminase 6 IgG and IgA response is prevalent in gluten ataxia, independent of intestinal involvement. Such antibodies are absent in ataxia of defined genetic origin or in healthy individuals. Inhibition studies showed that in those patients with ataxia and enteropathy, separate antibody populations react with the two different transglutaminase isozymes. Furthermore, postmortem analysis of brain tissue showed cerebellar IgA deposits that contained transglutaminase 6. INTERPRETATION: Antibodies against transglutaminase 6 can serve as a marker in addition to human leukocyte antigen type and detection of anti-gliadin and anti-transglutaminase 2 antibodies to identify a subgroup of patients with gluten sensitivity who may be at risk for development of neurological disease.

PMID: 18825674 Sept 2008
http://www.ncbi.nlm.nih.gov/pubmed/18825674

And yes, how many other gluten related antibodies, or autoantibodies, might there be, just waiting to be discovered?

[no-more-muffins]

I think it is great that someone who is so respected in the celiac world is finally acknowleging that. I think that holds a lot of weight and may be just what we need to get things changed for the better. (slowly of course, since it is always slow.)

And, yeah it was my BIL who is convincec that if the biospy doesn't show it it can't exist. (DUH.)

[jcc]

Well, I hope I have not misqouted him... so, I hope everyone will listen to it, too! But, I agree. Some of the top docs are transitioning... learning new things... :).

Yes... most definitely some of the top docs are broadening their scope. How could they not?

Collectively, we've all been awfully NOISY!!!!

[JLH]

It was in the subject line.........

[tex]

Cara,

Thanks for that great research article by Dr. Hadjivassiliou, also.


Joan,

Sorry, my bad. I never seem to notice those subject lines in responses, since most people rarely use them, and they're so easy to overlook.

Tex