Troubles de l'humeur et sensibilité au gluten non cœliaque

Aperçu: G.M.

L'association entre les troubles liés au gluten et les maladies psychiatriques a été fermement démontrée. La sensibilité au gluten non cœliaque (NCGS) est un syndrome diagnostiqué chez les patients sensibles à un régime sans gluten après avoir exclu la maladie cœliaque et l'allergie au blé. La pathogenèse des troubles neuropsychiatriques dans le NCGS n'est pas claire. Une association entre le gluten et la schizophrénie a été décrite pour la première fois en 1950 par Bender et al. Dans les années 1950, Dicke a noté que l'alimentation sans gluten améliorait l'humeur chez les patients cœliaques. En 1970, Goldberg et al., dans une étude portant sur 80 patients cœliaques, ont constaté que 34% d'entre eux présentaient des troubles affectifs mineurs. Les patients atteints de troubles bipolaires présentent une augmentation des anticorps sanguins anti-gliadine désamidés (IgG). L'effet de l'alimentation et de la nutrition sur les troubles du spectre de l'autisme a été étudié au cours des deux dernières décennies, en se concentrant particulièrement sur les symptômes de l'hyperactivité et de l'attention. Toxoplasma gondii et d'autres pathogènes neurotropes tels que l'influenzavirus et le coronavirus peuvent être associés à des troubles de l'humeur, probablement secondaires à une augmentation de la perméabilité intestinale. *
Des anomalies des interactions hôte-microbiote ou de la composition du microbiote intestinale ont été associées à des troubles du système nerveux central, tels que l'autisme, l'anxiété, la dépression et l'intégrité du microbiote intestinal peut être considéré comme un objectif thérapeutique potentiel pour traiter ces conditions.

Minerva Gastroenterol Dietol. 2017 Mar;63(1):32-37. doi: 10.23736/S1121-421X.16.02325-4. Epub 2016 Sep 20.

Mood disorders and non-celiac gluten sensitivity

Casella G¹, Pozzi R², Cigognetti M³, Bachetti F⁴, Torti G⁴, Cadei M³, Villanacci V³, Baldini V¹, Bassotti G⁵.

Author information

1

Medical Department, Desio Hospital, Desio, Italy.

2

Gastro-intestinal Endoscopy Service, "Zucchi" Private Clinics, San Donato Hospitals, Monza, Italy.

3

Institute of Pathology, Spedali Civili, Brescia, Italy.

4

Section of Gastroenterology and Hepatology, Department of Medicine, University of Perugia Medical School, Perugia, Italy.

5

Section of Gastroenterology and Hepatology, Department of Medicine, University of Perugia Medical School, Perugia, Italy - gabassot@tin.it.

Abstract

The association between gluten related disorders and psychiatric diseases has been firmly demonstrated. Non-celiac gluten sensitivity (NCGS) is a syndrome diagnosed in patients responsive to gluten-free diet after ruling out celiac disease and wheat allergy. The pathogenesis of neuro-psychiatric disorders in NCGS is unclear. An association between gluten and schizophrenia was described for the first time in 1950 by Bender et al. In the 1950's, Dicke noted that gluten-free diet improved mood in celiac patients. In 1970, Goldberg et al., in a study of 80 celiac patients, found that 34% of them showed minor affective disorders. Bipolar disorder patients show an increase of blood anti gliadin deamidated antibodies (IgG). The effect of diet and nutrition on autistic spectrum disorders has been investigated in the last two decades, particularly focusing on the symptoms of hyperactivity and attention. Toxoplasma gondii and other neurotropic pathogens as Influenzavirus and Coronavirus may be associated with mood disorders, probably secondary to an increased intestinal permeability. Abnormalities of host-microbiota interactions or of gut-microbiota composition have been associated with central nervous system disorders, such as autism, anxiety, depression and the integrity of intestinal microbiota may be considered a potential therapeutic goal to treat these conditions.

PMID:27647538

DOI:10.23736/S1121-421X.16.02325-4

Régime sans gluten et sans caséine et "troubles du spectre de l'autisme" chez les enfants: une revue systématique

Aperçu: G.M.

Des traitements efficaces pour les symptômes de base des "troubles du spectre de l'autisme"(TSA) font défaut. L'étude a systématiquement mis à jour des preuves sur l'efficacité d'un régime sans gluten et sans caséine (SGSC) en tant que traitement pour les TSA chez les enfants.

Six essais contrôlés randomisés (ECR) ont été obtenues à partir d'articles examinés (214 participants).À quelques exceptions près, il n'y avait pas de différences statistiquement significatives dans les symptômes de base du trouble du spectre de l'autisme entre les groupes, mesurés par des échelles normalisées.

Aucun événement indésirable associé à un régime de FBCF n'a été signalé. 

Eur J Nutr. 2017 Jun 13. doi: 10.1007/s00394-017-1483-2.

Gluten- and casein-free diet and autism spectrum disorders in children: a systematic review

Piwowarczyk A¹, Horvath A², Łukasik J³, Pisula E⁴, Szajewska H³.

Author information

1

Department of Paediatrics with Clinical Decisions Unit, The Medical University of Warsaw, Żwirki i Wigury 63a, 02-091, Warsaw, Poland.

2

Department of Paediatrics, The Medical University of Warsaw, Żwirki i Wigury 63a, 02-091, Warsaw, Poland. andrea.hania@gmail.com.

3

Department of Paediatrics, The Medical University of Warsaw, Żwirki i Wigury 63a, 02-091, Warsaw, Poland.

4

Department of Rehabilitation Psychology, University of Warsaw, Stawki 5/7, 00-183, Warsaw, Poland.

Abstract

PURPOSE:

Effective treatments for core symptoms of autism spectrum disorders (ASD) are lacking. We systematically updated evidence on the effectiveness of a gluten-free and casein-free (GFCF) diet as a treatment for ASD in children.

METHODS:

The Cochrane Library, MEDLINE, and EMBASE databases were searched up until August 2016, for randomized controlled trials (RCTs); additional references were obtained from reviewed articles.

RESULTS:

Six RCTs (214 participants) were included. With few exceptions, there were no statistically significant differences in autism spectrum disorder core symptoms between groups, as measured by standardized scales. One trial found that compared with the control group, in the GFCF diet group there were significant improvements in the scores for the 'communication' subdomain of the Autism Diagnostic Observation Schedule and for the 'social interaction' subdomain of the Gilliam Autism Rating Scale. Another trial found significant differences between groups in the post-intervention scores for the 'autistic traits', 'communication', and 'social contact' subdomains of a standardized Danish scheme. The remaining differences, if present, referred to parent-based assessment tools or other developmental/ASD-related features. No adverse events associated with a GFCF diet were reported.

CONCLUSIONS:

Overall, there is little evidence that a GFCF diet is beneficial for the symptoms of ASD in children.

PMID:28612113

DOI:10.1007/s00394-017-1483-2

Leaky gut autism theory doubted

BBC News

Children with autism do not appear to leak damaging proteins from their intestines, a study into the so-called "leaky gut" theory has suggested.

It has been claimed autistic children cannot fully digest proteins found in many foods - and that the resulting peptides escape and affect the brain.

But UK researchers found children with autism did not have more peptides in their urine than a control group.

They have published their findings in the Archives of Diseases in Childhood.

The "leaky gut" theory is based in part on the idea that vaccines such as MMR - given to immunise against measles, mumps and rubella - damage the wall of the intestines.

This causes the digestive problems which lead to the production of peptides, the theory goes.

To try to counter the effects of this, some parents of autistic children then reduce the amount of proteins such as gluten - found in wheat, oats, rye and barley - and casein - found in dairy products, such as milk, cheese and yogurt - in their child's diet.

Looking for a cure

But a team from Great Ormond Street Hospital, Guy's and St Thomas' Hospital and the University of Edinburgh have found no evidence of a higher level of peptides in the urine of autistic children.

They looked at 65 boys with autism and 158 without.

"It is very distressing to have a diagnosis of autism, a lifelong condition. Many families are driven to try out interventions which currently have no scientific basis," said Dr Hilary Cass of Great Ormond Street.

"Advocates of the leaky gut theory offer children a casein and gluten-free diet which as yet lacks an evidence base. Our research throws serious scientific doubt on the putative scientific basis of that diet."

But Paul Whiteley of the Autism Research Unit at Sunderland University said while the study appeared to have ruled out one reason why a gluten and casein-free diet may work, that did not mean it was not effective for some sufferers.

"It is very good news that more research is being carried out in this area. But evidence suggest that the diet does have beneficial effects for a proportion of those with autism, many of whom do suffer from bowel problems," he said.

"We need further investigation to find out if there are other reasons why it may work."

Benet Middleton of the National Autistic Society said there was an "urgent need" for more research into the efficacy of special diets for thos with autism.

"We are aware of anecdotal support for some dietary interventions, particularly those involving the exclusion of wheat and dairy products," he said.

"There is limited evidence about whether or not these diets are effective and concerns have been raised about their unregulated use."