Autoimmune Diseases and Food Sensitivities

A leaky gut can lead to the initiation and progression of autoimmune disease, especially in people who are genetically predisposed. Autoimmune diseases associated with increased intestinal permeability include

• Inflammatory bowel disease
• Celiac disease
• Autoimmune hepatitis
• Type 1 diabetes mellitus
• Multiple sclerosis
• Systemic lupus erythematosus (SLE)

In type 1 diabetes, impaired intestinal barrier function has been shown to occur before the onset of the disease, indicating it may play a role in the pathogenesis. Moreover, lipopolysaccharides (LPS), a cell wall component of gram-negative bacteria, can penetrate the intestinal epithelium and translocate into tissues, triggering the development and progression of SLE. The resolution of intestinal permeability through the use of probiotic organisms is a promising approach to supporting the health of people with autoimmune diseases.

Clinically I find that identify specifically which foods are truly agreeable with each of our unique patients is essential.  Testing IgG, IgA and IgE are all important ways to eliminate guessing whether a specific food is “an antigenic and immune burden.”  As clinicians we all know food is either our best friend or worse enemy.

References:

1. Lin R, Zhou L, Zhang J, et al. Abnormal intestinal permeability and microbiota in patients with autoimmune hepatitis. Int J Clin Exp Pathol. 2015 May 1;8(5):5153-60.

2. Khaleghi S, Ju JM, Lamba A, et al. The potential utility of tight junction regulation in celiac disease: focus on larazotide acetate. Therap Adv Gastroenterol. 2016 Jan;9(1):37-49.

3. Fasano A, Shea-Donohue T. Mechanisms of disease: the role of intestinal barrier function in the pathogenesis of gastrointestinal autoimmune diseases. Nat Clin Pract Gastroenterol Hepatol. 2005 Sep;2(9):416-22.

4. Tlaskalová-Hogenová H, Stěpánková R, Kozáková H, et al. The role of gut microbiota (commensal bacteria) and the mucosal barrier in the pathogenesis of inflammatory and autoimmune diseases and cancer: contribution of germ-free and gnotobiotic animal models of human diseases. Cell Mol Immunol. 2011 Mar;8(2):110-20.

5. Fasano A. Zonulin, regulation of tight junctions, and autoimmune diseases. Ann N Y Acad Sci. 2012 Jul;1258:25-33.