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Published on: December 15, 2011
Gluten sensitivity in patients with IgA nephropathy
Hilde Kloster Smerud1, Bengt Fellström, Roger Hällgren
1Section of Nephrology, Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden. hilde.kloster.smerud@smerud.com
Summary
Approximately one-third of IgA nephropathy (IgAN) patients show rectal mucosal sensitivity to gluten without coeliac disease. This sub-clinical gluten inflammation may contribute to IgAN pathogenesis in some individuals.
Area of Science:
- Nephrology
- Gastroenterology
- Immunology
Background:
- IgA nephropathy (IgAN) is more prevalent in patients with coeliac disease.
- Food antigens, particularly gluten, are hypothesized to play a role in IgAN onset.
- Investigating gluten's role in IgAN pathogenesis is crucial for understanding disease mechanisms.
Purpose of the Study:
- To assess rectal mucosal inflammatory responses to gluten in IgA nephropathy (IgAN) patients.
- To compare gluten reactivity in IgAN patients versus healthy controls.
- To explore the potential link between gluten sensitivity and IgAN.
Main Methods:
- Utilized a mucosal patch technique to evaluate rectal inflammation.
- Measured nitric oxide (NO), myeloperoxidase (MPO), and eosinophil cationic protein (ECP) in rectal mucosa.
- Analyzed serum for IgA/IgG antigliadin antibodies (AGA), anti-tissue transglutaminase, and anti-endomysium antibodies.
Main Results:
- Gluten reactivity (increased MPO and/or NO) observed in 8/27 (approx. 30%) IgAN patients.
- Elevated serum IgA AGA found in 9/27 IgAN patients, but did not correlate with mucosal gluten sensitivity.
- No significant increase in HLA-DQ2/DQ8 prevalence; no coeliac disease markers detected.
Conclusions:
- A subset of IgAN patients exhibits rectal mucosal sensitivity to gluten.
- This sub-clinical gluten inflammation may be a factor in IgAN pathogenesis for some patients.
- Further research is warranted to elucidate the role of gluten in IgAN.
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