One More Reason To Stop Eating Gluten

Greetings Gang, Dr T here

A gluten-free diet may reduce symptoms in a particular subset of patients with schizophrenia, early research suggests.

In a small pilot study, investigators found individuals with schizophrenia who have elevated serum antibodies to gluten, specifically antigliadin antibodies (AGA IgG) and who were put on a gluten-free-diet for 5 weeks showed greater improvement in negative symptoms compared with their counterparts who ate a diet containing gluten.

“With a gluten-free diet, we do have the potential to improve psychiatric symptoms, particularly negative symptoms, which is a symptom domain with a high unmet clinical need,” said lead investigator Deanna L. Kelly, PharmD, professor of psychiatry, University of Maryland School of Medicine, Baltimore.

“We don’t have anything for negative symptoms, so this could be a treatment for people if they have these antigliadin antibodies,” Kelly said.

The findings were presented here at the first annual Congress of the Schizophrenia International Research Society (SIRS) 2019.3

Elevated AGA IgG may be present in about 30% of all patients with schizophrenia. The antigliadin antibody is not related to the antibodies seen in celiac disease, which affects roughly 1% of the overall population.

This subgroup of schizophrenia patients with elevated AGA IgG has significantly lower positive schizophrenia symptoms than patients with no AGA IgG. They also have higher levels of kynurenine, which has been linked to schizophrenia pathology, Kelly noted.

Strategies for treatment of schizophrenia have basically been a one-size-fits-all approach.

Kelly and her team set out to determine whether a gluten-free diet would improve psychiatric symptoms in this subgroup of patients with elevated AGA IgG.

“We had done a 2-week gluten-free trial in two people who had elevated AGA IgG and schizophrenia, and we noted robust symptom improvements, particularly in the domain of negative symptoms, so we wanted to do a feasibility study and enroll more patients,” she told Medscape Medical News in an interview after her plenary session talk.

The researchers randomized seven patients to receive a gluten-free diet and nine patients to receive a diet containing gluten for 5 weeks.

All were inpatients, had elevated AGA (IgG > 20 U), had been on the same antipsychotic for at least 4 weeks prior to study entry, and had a Brief Psychiatric Rating Scale total score > 29. The cohort ranged in age from 18 to 64 years.

At the end of the 5 weeks, AGA IgG levels had decreased by 34% in the gluten-free group vs 16% in those who consumed a diet containing gluten.