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Patients with small fiber neuropathy and cerebellar ataxia were more likely to have anti-gliadin antibodies when a lower test threshold was used, raising the possibility of hidden gluten sensitivity in unexplained neurological conditions.
The study was published in June 2025 issue of Journal of Neurology discussed that the researchers conducted a retrospective study to determine the prevalence of anti–tissue transglutaminase-2 (anti-TG2), anti–tissue transglutaminase 6 (anti-TG6), and Antibodies directed against gliadin (anti-gliadin) antibodies in a large cross-sectional sample.
Immune reactivity to gluten had long been proposed as a contributor to peripheral neuropathies and cerebellar ataxia, though supporting evidence remained limited.
They collected sera from individuals with idiopathic cerebellar ataxia, idiopathic small fibre neuropathy (SFN), chronic idiopathic axonal polyneuropathy (CIAP), and age- and sex-matched controls. The samples were tested for anti-gliadin IgA/IgG antibodies using both the manufacturers and lower cut-off values. Anti-TG2 IgA and anti-TG6 IgA/IgG antibodies were also analyzed.
The results showed that 683 samples were analyzed, including 476 individuals (249 with SFN, 161 with CIAP, and 66 with idiopathic cerebellar ataxia) and 195 controls. No significant differences were noted between groups in the prevalence of elevated anti-TG6, anti-TG2, or anti-gliadin antibodies using the manufacturer’s cut-off. When applying a lower cut-off of 3 U/mL (previously used in gluten-related neurological disorders), anti-gliadin IgA was detected in 20.8% of individuals vs 12.8% controls (P= 0.017), and anti-gliadin IgG in 7.6% vs 2.6% (P= 0.013). Subgroup analysis revealed significant differences for anti-gliadin IgA in SFN and for anti-gliadin IgG in idiopathic cerebellar ataxia after adjusting for age and sex.
Gut inflammation is believed to play a key role in the progression of liver cancer, particularly hepatocellular carcinoma (HCC), by influencing immune responses and tumor microenvironment.
Source: link.springer.com/article/10.1007/s00415-025-13187-w
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