The Neuropathology of Gluten-Related Neurological Disorders: A Systematic Review

Nutrients

AnnemiekeJ.M. Rozemuller¹  Marios Hadjivassiliou²  MaxineD Rouvroye²  Gerd Bouma³  Panagiotis Zis⁴  Anne-Marie Van Dam⁵ 

[1] Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience, 1081HZ Amsterdam, The Netherlands;;Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Gastroenterology and Hepatology, AG&Amsterdam UMC, Vrije Universiteit, Department of Pathology, Amsterdam Neuroscience, 1081HZ Amsterdam, The Netherlands;M research institute, 1081HZ Amsterdam, The Netherlands;Medical School, University of Cyprus, 2408 Nicosia, Cyprus;

关键词: gluten;    coeliac disease;    neurological disorders;    gliadin;    ataxia;    neuropathy;    myopathy;    encephalopathy;   

DOI  :  10.3390/nu12030822

来源: DOAJ

【 摘 要 】

Gluten-related neurological disorders (GRND) represent a spectrum of neurological manifestations that are triggered by gluten. In coeliac disease, a T-cell mediated enteropathy is triggered by gluten in genetically predisposed individuals. The underlying pathological mechanism of the neurological dysfunction is not yet clear. The aim of this review is to collate existing neuropathological findings in GRND as a means of aiding the understanding of the pathophysiology. A systematic search of the Pubmed Database yielded 188 articles, of which 32 were included, containing 98 eligible cases with a description of pathological findings in GRND. In gluten ataxia, loss of Purkinje cells, atrophy, gliosis and astrocytosis were apparent, as well as diffuse lymphocytic infiltration and perivascular cuffing with lymphocytes. In patients with large-fiber neuropathy, nerve biopsies revealed axonopathy, loss of myelinated fibers and focal and perivascular infiltration by inflammatory cells. Inflammatory infiltrate was also observed in muscle in myopathy and in cerebrum of patients with encephalopathy and patients with epilepsy. Such changes were not seen in skin biopsies from patients with small fiber neuropathies. The findings from this systematic review suggest an immune mediated pathogenesis for GRND. Future research should focus on the characterization of the inflammatory cell infiltrates and identifying target epitopes.

【 授权许可】

Unknown