Study: Gluten Causes Leaky Gut in Everyone

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Does everyone get leaky gut from gluten?. Maximillan Stock Ltd./Getty Images

March 6, 2015 — Everyone — not just people with celiac disease — experiences "leaky gut" when they're exposed to the gluten protein found in wheat, barley and rye, a new study finds. But it's still not clear what effect this increase in intestinal permeability might have on your health, the study's authors cautioned.

The study, published online in the journal Nutrients, also suggests that ongoing gluten exposure leads to an even leakier gut in those with newly diagnosed celiac disease and those with non-celiac gluten sensitivity when compared to celiacs already following the gluten-free diet.

This could indicate that the immune system has a chance to reset itself when those sensitive to the protein stop eating it.

"This study demonstrates that gliadin exposure induces an increase in intestinal permeability in all individuals, regardless of whether or not they have celiac disease," the authors wrote. "The results of this study suggest that gluten exposure leads to altered barrier function in both active celiac disease [celiacs who have been eating a gluten-filled diet for two months or more] and gluten sensitivity, resulting in an exaggerated increase in intestinal permeability" when compared to those with celiac disease in remission.

Biopsies Used To Determine Gluten's Effects

Many of us in the gluten-free community know that celiac disease and non-celiac gluten sensitivity are very difficult to tell apart — the symptoms are incredibly similar.

But because people with non-celiac gluten sensitivity do not have the intestinal damage known as villous atrophy that's found in celiac disease, it's not clear why the symptoms of the two conditions would be so similar.

The authors of this current study speculate that the similarities between the two conditions "may be more related to a common defect in intestinal barrier function" — in other words, the symptoms could be caused by a leaky gut that's a shared feature in both celiac and gluten sensitivity.

The study itself looked at digestive and immune system responses from four groups: people with so-called "active" celiac disease; people with celiac disease in remission (who had been following the gluten-free diet for a year or more); people with non-celiac gluten sensitivity who had been consuming a gluten-filled diet for at least two months; and control subjects eating a gluten-filled diet.

Researchers conducted endoscopies and collected biopsy samples of the 23 subjects' small intestinal linings. They then incubated the samples with either a solution containing gluten or a plain solution, and monitored the intestinal samples' permeability over the course of two hours.

They also measured increases in a particular anti-inflammatory protein known as interleukin-10 in each of the samples. Previous studies have shown that the interleukin-10 protein may be responsible for calming immune system responses in the intestinal tract.

Everyone Gets Leaky Gut from Gluten?

The study found increased leaky gut in all the biopsy samples, including those from people without any gluten-related diagnosis.

However, biopsy samples from those with active celiac disease and those with gluten sensitivity (who had, like those with active celiac, been eating a gluten-filled diet for some time) exhibited even more of a "leaky" response.

Meanwhile, samples from celiacs who had been following the gluten-free diet long-term exhibited the smallest change in permeability. This could mean that intestinal tissue that's regularly exposed to gluten reacts more strongly than intestinal tissue that hasn't been exposed to gluten in a while, the authors speculated.

In addition, levels of the protective protein IL-10 were higher in control subjects than in either those with gluten sensitivity or those with celiac disease who already were following the gluten-free diet. This could indicate "a more competent innate immune response" in people who don't have a gluten-related condition, although more research is needed to determine exactly what's happening, the authors wrote. Other biomarkers did not differ between groups.

The study was led by Dr. Justin Hollon, a pediatric gastroenterologist at the Naval Medical Center in Portsmouth, Va., and included clinicians from the University of Maryland School of Medicine, Johns Hopkins University School of Medicine, and the Center for Celiac Research at Massachusetts General Hospital.

Source:

Hollon J et al. Effect of gliadin on permeability of intestinal biopsy explants from celiac disease patients and patients with non-celiac gluten sensitivity. Nutrients. 2015 Feb 27;7(3):1565-76.

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