Posted April 18, 2014
Armin Alaedini, Ph.D., Columbia University
Wheat and milk proteins are thought to contribute to immune system abnormalities and play a role in autism spectrum disorder (ASD). It has been suggested that there may be a higher incidence of celiac disease (the autoimmune disease caused by the wheat protein gluten) and gluten sensitivities among individuals with autism. As a result, gluten-free diets are becoming increasingly popular in the autism community, although studies examining the link between gluten sensitivities or celiac disease and autism show inconsistent results. Dr. Armin Alaedini of Columbia University received an Autism Research Program Concept Award in Fiscal Year 2009 in part to perform a controlled study to determine the connection between wheat proteins and autism. "Despite years of speculation and immense interest by families of affected children regarding the potential connection between autism and gluten sensitivity, no well-controlled study had been performed until now," says Dr. Alaedini.
The study, that included children diagnosed with autism, unaffected siblings, and typically developing age-matched controls, showed a subset of children with autism had increased immune reactivity to dietary wheat gluten. This reaction, as measured by an IgG antibody response to gluten proteins, was independent of celiac disease but was associated with reported gastrointestinal symptoms. Dr. Alaedini suspected this antibody response might be a "non-specific antibody response to a wide array of foreign and self antigens," so he tested the antibody response to a foreign antigen (Lyme disease) and an autoantigen (GM1 ganglioside) in the study population. He found no connection between these and the immune response to gluten, suggesting the gluten antibody response is specific. While previous studies suggested a connection between Lyme disease or a heightened immune response (measured through autoreactivity to gangliosides) and autism, this study suggests there is no connection. Therefore, the resultant recommended antibiotic or immunomodulatory treatments for ASD may not be useful treatment options.
Dr. Alaedini asserts that "the observed increase in antibody response to gluten does not necessarily indicate sensitivity to gluten or any disease-causing role for the antibodies in the context of autism." He hopes that antibody response determined in this study may serve as a biomarker to identify a subgroup of autism patients. In addition, the data could support the need for future studies looking at treatment options, such as a gluten-free diet, in a specific subset of individuals with autism.
Lau NM, Green PH, Taylor AK, et al. 2013. Markers of celiac disease and gluten sensitivity in children with autism. PLoS One 8(6):e66155.
Ajamian M, Kosofsky BE, Wormser GP, et al. 2013. Serologic markers of Lyme disease in children with autism. JAMA 309:1771-1773.
Systematic Characterization of the Immune Response to Gluten and Casein in Autism Spectrum Disorder