Anti-Ganglioside Antibodies Analyzed in Celiac Disease

Celiac disease, sometimes called celiac sprue or gluten-sensitive enteropathy, is an immune reaction to eating gluten, a protein found in wheat, barley and rye. Coeliac disease can cause a range of symptoms, including diarrhea, abdominal pain and bloating.

Anti-ganglioside antibodies and analysis of the various human pathologies in which anti-ganglioside antibodies have been reported, including celiac disease (CD) as a condition associated with the presence of antibodies to ganglioside-monosialic acid (GM). Some scientists support the hypothesis that the formation of complexes between gliadin and GM1 ganglioside leads to the generation of antibodies to GM1 as a “secondary product”.

A team of Medical Scientists at the University of Bologna (Bologna, Italy) studied anti-GM1, anti-GD1b, and anti-GQ1b serum IgG and IgM antibodies in 22 adult patients (median age 35, range: 19–56 years; three males, 19 females) with CD and neurological manifestations, including eight cases of idiopathic cerebellar ataxia, seven cases with epilepsy (without cerebral calcifications), two with multiple sclerosis, three with attention/memory impairment, and two with peripheral neuropathies. In the study the team used a commercially available ELISA kit (IMMCO Diagnostics, Buffalo, NY, USA).

The investigators reported that at least one of the three anti-ganglioside IgG antibodies tested for (anti-GM1, anti-GD1b, and anti-GQ1b) was found in 64% of CD patients with neurological dysfunction compared to 30% of CD patients without neurological symptoms, 50% of neurological patients without CD, 20% of autoimmune controls and none of the healthy controls. No significant difference between groups was found for anti-GQ1b IgG.

Ganglioside reactivity, expressed in terms of Enzymatic Units (AEU) associated with anti-GM1 and anti-GD1b IgG were significantly higher in CD patients with neurological disorders than in CD patients without neurological disorders. Of note, eight (47%) of the 17 patients with CD and neurological manifestations who were positive for at least one anti-ganglioside IgG antibody became negative for the antibody after a year of strict adherence to a gluten-free diet. Interestingly, anti-ganglioside IgM antibodies, although at a lower prevalence than anti-ganglioside IgG antibodies and without any significant difference among the various groups studied, were confined to three cases of epilepsy within the CD group with neurological dysfunction.

The authors concluded that their study supports the potential pathogenic role of anti-ganglioside antibodies in immuno-mediated neurological disorders and provide evidence that detection of anti-ganglioside antibodies could indicate associated neurological symptoms in CD patients. Anti-ganglioside antibodies may therefore represent immunological markers for neurological dysfunction in CD patients and should be included in the work-up of CD patients. The study was published on May 28, 2021 in the journal Allergy, Asthma & Clinical Immunology.

Related Links:
University of Bologna
IMMCO Diagnostics