The scientific community is finally noticing something that nutritionists have been dealing with for years — leaky gut syndrome. In fact, a paper called Leaky gut and autoimmune diseases was published in February 2012 in the journal, Clinical Reviews in Allergy and Immunology. The author, Alessio Fasano, M.D., (he is my hero) has been researching this very topic for years in relationship to celiac disease and gluten sensitivity. The review paper he wrote is focused on the role of impaired intestinal barrier function (leaky gut) on autoimmune pathogenesis. In short, he is trying to get to the real causes of autoimmunity.
In this paper, Dr. Fasano proposes a new theory that suggests that autoimmune disease is not only preventable, but also reversible. Amazing!
Since his expertise is with celiac disease, that is what he has studied. If you read his bio you will see that he is quite accomplished:
Can celiac disease be reversed?
Typically, any autoimmune disease diagnosis comes with a life sentence. Along with the life sentence are increasingly dangerous levels of drugs to manage the symptoms.
Fasano’s new theory explains how an autoimmune condition may develop. It involves a perfect storm of three conditions:
- Increased intestinal permeability (leaky gut)
- A genetic predisposition to autoimmunity
- An exposure to the environmental trigger (in this case gluten)
What this means is that people who have a leaky gut, as well as the genetics for celiac disease, can develop autoimmunity when they eat gluten. This will cause intestinal damage. The increased intestinal permeability that is part of the leaky gut, allows the environmental trigger (which in this case is gluten) to access the body and this triggers the genetic predisposition.
Conventional understanding of celiac included variable numbers 2 and 3, but instead of leaky gut, the third variable was the presence of circulating autoantibodies to the enzyme tissue transglutaminase.
Acknowledging that autoantibodies are present does not explain why they are there. Fasano’s theory does explain this. Furthermore, it suggests that if you can cure the leaky gut, you can cure the autoimmune disease.
Alternative treatments may help a little
Nutritionists may offer supplements — something natural that can address the underlying inflammation. However, these do not get to the real problem — the leaky gut.
My frustration with allergy testing (delayed IGg allergies) is that many times the tests show that the person is allergic to everything they eat. When speaking to the doctors at the lab they say “you must heal the gut”.
Their solution? A rotation diet with food that would be difficult to obtain, like venison because the patient was allergic to most proteins, or unusual types of fish because they were allergic to all the common kinds. Who is going to do that? What child would eat that?
The other part of that solution is to take oodles of supplements three times a day. Who has the time and the money for that? Most importantly, supplements do not heal a hyper-reactive immune system. They may help, but they can not heal and seal a leaky gut.
Tight Junction dysfunction is part of leaky gut
The cells lining the intestine (enterocytes) are stacked up close together, creating the hills and valleys of the brush border, in order to increase the surface area of the intestine. That close fitting area in between the cells is called the tight junction. But since these cells are part of the intestinal lining — a barrier — certain small particles and nutrients are allowed through.
We know that a protein called zonulin is a signaling mechanism for opening and closing the tight junctions in the intestine. Zonulin also serves as an escort through the membrane for certain molecules and bacteria.
We know that gliadin (the prolamine in gluten) causes zonulin levels to increase in people with the genetic pre-disposition to celiac disease. As zonulin levels go up, the tight junctions become lax, widening the space between the cells of the lining and increasing gut permiability. Now the gut membrane has spaces which allow large food particles into the body that shouldn’t be there. These are noticed by the immune system and targeted as foreign.
An immune response ensues and the worse it gets, the more damage to the enterocytes occurs. The more damaged the enterocytes, the leakier the gut gets and so on, in a vicious cycle. As more aspects of the immune system get involved (various cytokines involved in the cellular and innate immune systems) the worse things get, and in the process, the micro villi are damaged and eventually flattened. That is a condition that makes it very difficult to absorb nutrients.
There are many causes of leaky gut syndrome
Gliadin is just one of the ways a leaky gut may develop. Other ways, include damage to the intestinal lining from antibiotics, steroids, NSAIDS, imbalance in gut bacteria or dysbiosis, etc. But for people with the genetics for celiac, gliadin is a dangerous molecule.
For people with the genetics for celiac, gliadin is like kryptonite was to superman. It is very destructive and should be avoided like the plague.
Gliadin is a protein that is very difficult to digest. Even in a properly prepared grain, gliadin can be difficult to digest — it is especially difficult for people with the celiac gene. Even in healthy people with the gene for celiac, particles of gliadin will be bouncing around the intestine, undigested. This starts an immune response and a vicious cascade of inflammatory cytokines which eventually leads to flattened and destroyed microvilli.
What you can do to heal and seal a leaky gut
The gluten-free diet is conventional treatment for celiac. Some people do very well with this but there is research that shows that only 66% of celiacs fully heal on the gluten-free diet after 5 years.
Those 66% need to go beyond gluten-free
Research also shows that celiacs have a four fold increase in morbidity and mortality. That means that even with a gluten-free diet, celiacs will be sicker and die younger.
The solution is to go grain-free and eat a diet that includes foods that are very easy to digest and assimilate, which are full of the nutrients so desperately needed.
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