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Autoimmune diseases common among patients with nonceliac wheat sensitivity
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Patients with nonceliac wheat sensitivity or celiac disease are more likely to develop autoimmune diseases and be positive for antinuclear antibodies and DQ2/DQ8 haplotypes compared with patients with irritable bowel syndrome, according to recent study data.
Aiming to compare the risk for autoimmunity between patients with nonceliac wheat sensitivity and celiac disease, researchers from Italy performed a two-part study. In the first component they retrospectively reviewed medical records of 131 patients diagnosed with nonceliac wheat sensitivity (121 female; mean age, 29.1 years) at two hospitals from January 2001 through June 2011, and 151 controls with celiac disease or IBS, to identify autoimmune diseases.
The second component was a prospective study of 42 patients (38 female; mean age, 34 years) who were diagnosed with nonceliac wheat sensitivity at three hospitals from July 2011 through March 2014, and 90 age- and sex- matched controls with celiac disease or IBS.
Antinuclear antibody levels in patient serum samples were measured using immunofluorescence analysis and patient medical records were reviewed to identify autoimmune diseases in both parts of the study. HLA-DQ typing was also performed in all patients. Structured questionnaires were also completed to identify autoimmune diseases in the prospective component.
In the retrospective study, 29% of patients with nonceliac wheat sensitivity and 29% of patients with celiac disease developed autoimmune diseases (primarily Hashimoto’s thyroiditis) compared with 4% of patients with IBS (P < .001). Serum samples from 46% of patients with nonceliac wheat sensitivity tested positive for antinuclear antibodies compared with 24% of patients with celiac disease (median titer for both, 1:80) and 2% of patients with IBS (both comparisons P < .001).
In the prospective study, 24% of patients with nonceliac wheat sensitivity and 20% of patients with celiac disease developed autoimmune diseases compared with 2% of patients with IBS (P < .001). Serum samples from 28% of patients with nonceliac wheat sensitivity tested positive for antinuclear antibodies compared with 7.5% of patients with celiac disease (P = .02) and 6% of patients with IBS (P = .005). Multivariate analysis showed only HLA DQ2/DQ8 positivity was associated with testing positive for antinuclear antibodies (OR = 3.5; 95% CI, 1.6-5.8 in the retrospective study; P = .04 in the prospective study).
“In conclusion, our data showed a strong tendency toward autoimmunity in the [nonceliac wheat sensitivity] patients, characterized by both associated [autoimmune diseases] and the presence of serum [antinuclear antibody] positivity, which, in turn, was correlated with the HLA DQ2/DQ8 haplotypes,” the researchers wrote.” – by Adam Leitenberger
Disclosures: The researchers report no relevant financial disclosures.
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