Tulane University School of Medicine
Department of Neurology

Author Of 1 Presentation

Comorbidities Late Breaking Abstracts

LB1212 - Evaluating Multiple Sclerosis patients for gluten sensitivity – worthwhile or not? (ID 2071)

Speakers
Presentation Number
LB1212
Presentation Topic
Comorbidities

Abstract

Background

MS is a T- cell mediated CNS autoimmune disease of likely multifactorial etiology. Although gluten has been suggested to play a role in MS, it is not standard medical practice to evaluate for gluten sensitivity in MS patients.

Objectives

The aim of this review is to consider current evidence of gluten’s role in MS, and to explore if the evaluation of MS patients for gluten sensitivity should be incorporated into patient care plans.

Methods

A literature search was conducted in PubMed, Embase, Google Scholar and Ovid Medline. Studies on gluten’s role in MS, other CNS autoimmune diseases and T-cell mediated autoimmune diseases were included. Studies on effects of other diets on MS as well as studies exploring methods of evaluating non-celiac gluten sensitivity were also included.

Results

The positive effects of gluten-free diets (GFD) on MS was noted, even though the serological evidence for gluten-sensitivity markers in MS patients was inconsistent. However, existing studies used only celiac gluten sensitivity markers in the serologic evaluation, and did not include non-celiac gluten sensitivity markers. Positive effects of GFD on other CNS autoimmune diseases and other T-cell mediated autoimmune diseases were noted in select case studies. Other diets were also shown to have some positive impact on Quality of Life (QOL) measures in MS patients, although evidence is not strongly convergent.

Conclusions

Although GFD intervention studies show positive trends in health outcomes for MS patients, gluten’s role in MS needs to be further explored. Non-celiac gluten sensitivity evaluation using PBL miRNA expression, in addition to using current markers of celiac gluten-sensitivity, may be beneficial. Excluding celiac MS patients from GFD intervention studies, as well as using miRNA expression of PBL, have been suggested as directions for future research. Since distinct diets have been shown to improve MS in the peer reviewed literature, the shared aspect of mindful eating may be an operative component. In conclusion, using PBL miRNA expression laboratory evaluation for non-celiac gluten sensitivity, as well as recommending a food diary to promote mindful eating, can be considered by physicians who treat MS patients.

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