More MS news articles for July 2002

Elimination of dietary gluten does not reduce titers of type 1 diabetes-associated autoantibodies in high-risk subjects

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12087006&dopt=Abstract

Diabetes Care 2002 Jul;25(7):1111-6
Hummel M, Bonifacio E, Naserke HE, Ziegler AG.
Diabetes Research Institute and 3rd Medical Department, Academic Teaching Hospital Munchen-Schwabing, Munich, Germany. Instituto Scientifico San Raffaele, Milan, Italy.

OBJECTIVE

Removal of the dietary wheat protein gluten protects against autoimmune diabetes in animal models. Furthermore, elimination of dietary gluten reduces the frequency of type 1 diabetes in patients with celiac disease. Herein we test the hypothesis that gluten is the driving antigen for type 1 diabetes-associated islet autoimmunity.

RESEARCH DESIGN AND METHODS

Seven autoantibody-positive, first-degree relatives of patients with type 1 diabetes were placed on a gluten-free diet for 12 months followed by gluten reexposure for 12 months. Gliadin antibodies as well as the diabetes-related antibodies insulin autoantibody (IAA), GAD antibody (GADA), and tyrosin phosphatase IA2 antibody (IA-2A) were measured every 3 months; oral glucose tolerance tests were performed every 6 months. Changes in autoantibody titers were compared with those observed in a matched historical cohort.

RESULTS

A reduction in IgG gliadin antibody titers was observed during the gluten-free period, but titers of diabetes-associated autoantibodies changed independently of gluten exposure. Type 1 diabetes-associated islet autoantibody levels at the end of the gluten-free diet period were not significantly different from those before commencement of the diet (P = 0.2) or at the end of the gluten reexposure period (P = 0.4). Changes in individual subjects were identified, but no differences were noted between the gluten-free and the gluten re-exposure periods, and the changes were similar to those observed in the historical control cohort (P = 1.0). Major titer reductions (>50%) in the gluten-free period were observed in only one subject for all antibodies. Type 1 diabetes developed in this subject and in a second subject during the gluten reexposure period.

CONCLUSIONS

The findings do not support the hypothesis that gluten is a driving antigen in type 1 diabetes.