Gluten sensitivity: from gut to brain

• Published in: Lancet neurology 2010-03, Vol.9 (3), p.318-330
• Main Authors: Hadjivassiliou, Marios, MD, Sanders, David S, MD, Grünewald, Richard A, DPhil, Woodroofe, Nicola, PhD, Boscolo, Sabrina, PhD, Aeschlimann, Daniel, PhD
• Format: Article
• Language: English
• Subjects: Animals; Antibodies; Ataxia; Biopsy; Brain Diseases - diet therapy; Brain Diseases - etiology; Case reports; Celiac disease; Celiac Disease - complications; Celiac Disease - diet therapy; Celiac Disease - epidemiology; Clinics; Dermatitis; Diet; Diet, Gluten-Free; Etiology; Gastroenterology; Gastrointestinal Diseases - diet therapy; Gastrointestinal Diseases - etiology; Gluten; Glutens - adverse effects; Humans; Nervous System Diseases - diet therapy; Nervous System Diseases - etiology; Neurology; Serology; Vitamin deficiency
• ISSN: 1474-4422; 1474-4465
• DOI: 10.1016/S1474-4422(09)70290-X

Summary Gluten sensitivity is a systemic autoimmune disease with diverse manifestations. This disorder is characterised by abnormal immunological responsiveness to ingested gluten in genetically susceptible individuals. Coeliac disease, or gluten-sensitive enteropathy, is only one aspect of a range of possible manifestations of gluten sensitivity. Although neurological manifestations in patients with established coeliac disease have been reported since 1966, it was not until 30 years later that, in some individuals, gluten sensitivity was shown to manifest solely with neurological dysfunction. Furthermore, the concept of extraintestinal presentations without enteropathy has only recently become accepted. In this Personal View, we review the range of neurological manifestations of gluten sensitivity and discuss recent advances in the diagnosis and understanding of the pathophysiological mechanisms underlying neurological dysfunction related to gluten sensitivity.