What is the common feature of all chronic disease?
Intuitively we know that this level of disease, dis-ease, and malaise is not normal, but we do not seem to know how to change our situation. I would like to offer some basic insights, supported by cutting edge science, that you can try in your life today to see if they can help you.Inflammation is the common feature of all chronic disease.
What causes this inflammation?
The immune system.
What is driving the immune system to create inflammation?
Food... and other things. But I am going to focus on food, specifically wheat gluten, to illustrate the interaction between food, the immune system, genetics, and inflammation.
Gluten can effect different people in different ways depending on their underlying genetic predisposition, timing of exposure to gluten as a child, and the microbiological environment of the GI tract.
There are at least three distinct entities linked to gluten:
- Celiac Disease, which is an autoimmune reaction caused by exposure to gluten
- Gluten Sensitivity, encompassing people who have clinical symptoms when they ingest gluten but they do NOT have autoimmune tissue destruction
- Potential Celiac Disease, whereby people are making antibodies to their own tissue as a result of gluten exposure, but they DO NOT yet have small bowel disease
70% of the immune system cells are located around the GI tract
There are two primary arms of the immune system: the innate arm which involves an immune cell "attacking" the foreign product with chemicals; and the acquired or "learned" arm, which produces anti-bodies that adhere to the foreign particle, attracting other inflammatory cells.
Celiac disease seems to primarily involve the acquired arm of the immune system. Nearly 100% of people with Celiac Disease have a genetic trait called HLA DQ2 or HLA DQ8; but, only about 4% of people with this genetic trait will develop Celiac Disease. Celiac Disease involves the development of antibodies to tissues, causing the immune system to damage the intestinal tissue.
Gluten sensitivity can cause similar gastrointestinal reactions to gluten, but does not cause the autoimmune reaction of the acquired immune system. Instead, gluten activates the innate immune system, leading to an inflammatory cascade that can create far reaching symptoms. Interestingly, gluten sensitivity symptoms can manifest as psychiatric symptoms. In fact, non-celiac reactions to gluten have been linked to acute psychosis, schizophrenia, and other mental illness such as autism. Some authors disagree with this connection.
Gluten studies do help us understand one thing: the immune system can respond to food and create a wide range of disease and symptoms states which are often difficult for patients and clinicians to link to the ingested food(s).
Although it is clear from clinical studies that food allergy testing (IgG) is primarily an indication of exposure to food, not a reaction to food, it may be effective to look at how the body's innate immune system reacts to food. By understanding what foods activate the immune system, causing inflammation, we can reduce this stress burden on our system and observe for symptoms improvement.
Improving the course of neuro-immune diseases, autism, and autoimmune conditions requires patience and persistence- there is almost NEVER a silver bullet. Focused testing of the immune and hormone systems combined with nutritional and lifestyle changes can improve quality of life.
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