ŞİZOFRENİ VE GLUTENSİZ DİYET
Year 2023,
Volume: 3 Issue: 8 - October 2023, 16 - 24, 13.10.2023
Melis Bozoğlu
Abstract
Gluten bazı hastalıkların etiyolojisindeki rolü nedeniyle sağlık profesyonelleri için önemli bir araştırma konusudur. Glutenin vücuttaki inflamatuar etkisi gluten ile birçok hastalığın arasındaki ilişkinin incelenmesine neden olmuştur. Gastrointestinal sistem ve merkezi sinir sistemi arasında mevcut olan ilişki sebebiyle, bağırsak geçirgenliğinin bozulduğu durumlarda nöropsikiyatrik hastalıkların ortaya çıkabilme olasılığı son yıllarda gündeme gelmiştir. Patofizyolojisinde glutenin rolü olduğu düşünülen birçok nöropsikiyatrik hastalık bulunmaktadır. Otizm spektrum bozukluğu, epilepsi, iki uçlu bozukluk ve şizofreni bunlardan bazılarıdır. Bunların arasında şizofreni ve gluten ilişkisi 1960’lı yıllardan beri araştırılmaktadır. 2.Dünya Savaşı sırasında buğday tüketiminin azalması ile orantılı şekilde, şizofreni tanısı alan insanların sayısındaki azalma bilim insanlarının dikkatini çekmiştir. Kesin tedavisi olmayan şizofreni hastalığı için alternatif tedavi arayışları bu konuda yapılan araştırmaları yoğunlaştırmıştır. Bu arayış sonunda şizofreni hastalarında glutensiz diyet denenmiştir. Şizofreni hastalarında glutensiz diyet uygulaması konusunda yapılan araştırmalarda çelişkili sonuçlar olmakla birlikte, ortak bir kanıya varılmıştır. Bir kişide şizofreni gelişmesinin risk faktörü eğer gluten maruziyetiyse, glutensiz diyet şizofreninin bazı alt gruplarının ilaçsız tedavisinde yeni bir umut olabilir.
Ethical Statement
Bu çalışmada herhangi bir potansiyel çıkar çatışması ve etik ikilem bulunmamaktadır.
Supporting Institution
İstanbul Atlas Üniversitesi
Thanks
Prof. Dr. H. Şeyda Özcan'a teşekkürler
References
- Lerner BA, Green PHR, Lebwohl B. Going Against the Grains: Gluten-Free Diets in Patients Without Celiac Disease-Worthwhile or Not? Dig Dis Sci. 2019;64(7):1740-1747.
- Venter C, Maslin K, Arshad SH, et al. Very low prevalence of IgE mediated wheat allergy and high levels of cross-sensitisation between grass and wheat in a UK birth cohort. Clin Transl Allergy. 2016; 6:22.
- Volta U, Bardella MT, Calabrò A, Troncone R, Corazza GR; Study Group for Non-Celiac Gluten Sensitivity. An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity. BMC Med. 2014; 12:85.
- Ergün C, Urhan M, Ayer A. A review on the relationship between gluten and schizophrenia: Is gluten the cause? Nutr Neurosci. 2018;21(7):455-466.
- Jackson J, Eaton W, Cascella N, et al. A gluten-free diet in people with schizophrenia and anti-tissue transglutaminase or anti-gliadin antibodies. Schizophr Res. 2012;140(1-3):262-263.
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5, (Çev. Prof. Dr. Ertuğrul Köroğlu). Ankara: HYB Yayıncılık.
- Dohan FC, Wheat "consumption" and hospital admissions for schizophrenia during World War II. A preliminary report. The American Journal of Clinical Nutrition, 1966; 18(1):7–10.
- Samaroo D, Dickerson F, Kasarda DD, et al. Novel immune response to gluten in individuals with schizophrenia. Schizophr Res. 2010;118(1-3):248-255.
- Lindfors K, Ciacci C, Kurppa K, et al. Coeliac disease. Nat Rev Dis Primers. 2019;5(1):3. Published 2019 Jan 10.
- Barone MV, Zanzi D, Maglio M, et al. Gliadin-mediated proliferation and innate immune activation in celiac disease are due to alterations in vesicular trafficking. PLoS One. 2011;6(2): e17039.
- Green PH, Cellier C. Celiac disease. N Engl J Med. 2007;357(17):1731-1743.
- Cascella NG, Kryszak D, Bhatti B, et al. Prevalence of celiac disease and gluten sensitivity in the United States clinical antipsychotic trials of intervention effectiveness study population. Schizophr Bull. 2011;37(1):94-100.
- Bromet EJ, Fennig S. Epidemiology and natural history of schizophrenia. Biol Psychiatry. 1999;46(7):871-881. doi:10.1016/s0006-3223(99)00153-5
- Dickerson F, Stallings C, Origoni A, et al. Markers of gluten sensitivity and celiac disease in bipolar disorder. Bipolar Disord. 2011;13(1):52-58.
- Ruuskanen A, Kaukinen K, Collin P, et al. Gliadin antibodies in older population and neurological and psychiatric disorders. Acta Neurol Scand. 2013;127(1):19-25.
- Kelly DL, Demyanovich HK, Rodriguez KM, et al. Randomized controlled trial of a gluten-free diet in patients with schizophrenia positive for antigliadin antibodies (AGA IgG): a pilot feasibility study. J Psychiatry Neurosci. 2019;44(4):269-276.
- Jackson J, Eaton W, Cascella N, et al. Gluten sensitivity and relationship to psychiatric symptoms in people with schizophrenia. Schizophr Res. 2014;159(2-3):539-542.
- Severance EG, Gressitt KL, Alaedini A, et al. IgG dynamics of dietary antigens point to cerebrospinal fluid barrier or flow dysfunction in first-episode schizophrenia. Brain Behav Immun. 2015; 44:148-158.
- Wei J, Hemmings GP. Gene, gut and schizophrenia: the meeting point for the gene-environment interaction in developing schizophrenia. Medical Hypotheses. 2005;64(3):547-52.
- Voisine J, Abadie V. Interplay Between Gluten, HLA, Innate and Adaptive Immunity Orchestrates the Development of Coeliac Disease. Front Immunol. 2021; 12:674313.
- Nimgaonkar VL, Rudert WA, Zhang XR, et al. Further evidence for an association between schizophrenia and the HLA DQB1 gene locus. Schizophr Res. 1995;18(1):43-49.
- International Schizophrenia Consortium, Purcell SM, Wray NR, et al. Common polygenic variation contributes to risk of schizophrenia and bipolar disorder. Nature. 2009;460(7256):748-752.
- Jungerius BJ, Bakker SC, Monsuur AJ, et al. Is MYO9B the missing link between schizophrenia and celiac disease?. Am J Med Genet B Neuropsychiatr Genet. 2008;147(3):351-355.
- Law MH, Bradford M, McNamara N, et al. No association observed between schizophrenia and non-HLA coeliac disease genes: integration with the initial MYO9B association with coeliac disease. Am J Med Genet B Neuropsychiatr Genet. 2011;156B (6):709-719.
- Chen LL, Abbaspour A, Mkoma GF, et al. Gut Microbiota in Psychiatric Disorders: A Systematic Review. Psychosom Med. 2021;83(7):679-692.
- Nikolova VL, Smith MRB, Hall LJ, et al. Perturbations in Gut Microbiota Composition in Psychiatric Disorders: A Review and Meta-analysis. JAMA Psychiatry. 2021;78(12):1343-1354.
- Fasano A. Regulation of intercellular tight junctions by zonula occludens toxin and its eukaryotic analogue zonulin. Ann N Y Acad Sci. 2000; 915:214-222.
- Severance EG, Yolken RH, Eaton WW. Autoimmune diseases, gastrointestinal disorders and the microbiome in schizophrenia: more than a gut feeling. Schizophr Res. 2016;176(1):23-35.
- Torrey EF, Yolken RH. Toxoplasma gondii and schizophrenia. Emerg Infect Dis. 2003;9(11):1375-1380.
- Szeligowski T, Yun AL, Lennox BR, et al. The Gut Microbiome and Schizophrenia: The Current State of the Field and Clinical Applications. Front Psychiatry. 2020; 11:156. Published 2020 Mar 12.
- Prandota J. Possible Link Between Toxoplasma Gondii and the Anosmia Associated With Neurodegenerative Diseases. American Journal of Alzheimer’s Disease & Other Dementias®. 2014;29(3):205-214.
- Severance EG, Kannan G, Gressitt KL, et al. Anti-gluten immune response following Toxoplasma gondii infection in mice. PLoS One. 2012;7(11):e50991.
- Dohan FC, Harper EH, Clark MH, Rodrigue RB, Zigas V. Is schizophrenia rare if grain is rare?. Biol Psychiatry. 1984;19(3):385-399.
- Kraft, B.D., Westman, E.C. Schizophrenia, gluten, and low-carbohydrate, ketogenic diets: a case report and review of the literature. Nutr Metab (Lond) 6, 10 (2009).
- Potkin SG, Weinberger D, Kleinman J, et al. Wheat gluten challenge in schizophrenic patients. Am J Psychiatry. 1981;138(9):1208-1211.
- Storms LH, Clopton JM, Wright C. Effects of gluten on schizophrenics. Arch Gen Psychiatry. 1982;39(3):323-327.
- Midhagen G, Aberg AK, Olcén P, et al. Antibody levels in adult patients with coeliac disease during gluten-free diet: a rapid initial decrease of clinical importance. J Intern Med. 2004;256(6):519-524.
- Levinta A, Mukovozov I, Tsoutsoulas C. Use of a Gluten-Free Diet in Schizophrenia: A Systematic Review. Adv Nutr. 2018;9(6):824-832.