January 24, 2013 — A hoped-for biological marker for non-celiac gluten sensitivity could help determine which children with autism suffer from gluten sensitivity, says top celiac disease and gluten sensitivity researcher Dr. Alessio Fasano. That ultimately could help physicians target dietary interventions in autism to those children who really could benefit from the gluten-free diet.
Dietary interventions (most often the gluten-free casein-free (GFCF) diet) are controversial in autism treatment -- most physicians say they don't work, yet a significant number of parents have tried the GFCF diet or another type of diet. In some cases, parents say they are certain that the GFCF diet has cured their children of autism or at least helped them improve, and many physicians who treat autism routinely prescribe a GFCF diet for their patients.
Studies, meanwhile, have been mixed -- some show a benefit while most others don't. All this has led to massive confusion and disagreement in the autism community, Dr. Fasano says, adding that identification of a gluten sensitivity biomarker and development of a test for gluten sensitivity could change all that.
"In looking at the only markers we have now, there is a group of kids with autism who have positive antibodies [typically the AGA-IgG antibody, which is not used to diagnosed celiac disease], and a leaky gut," which may be indicative of gluten sensitivity, Dr. Fasano, who heads the Center for Celiac Research (formerly at the University of Maryland and now at Massachusetts General Hospital) told me in an interview. It's possible that some or all of these children would benefit from a gluten-free diet, he says.
Dr. Fasano says he views autism as a "final destination" that children reach by a variety of pathways, or causes. Those different causes all result in a similar biological process that ultimately results in the constellation of symptoms we call autism, and one of those causes could be gluten sensitivity, he says.
"If out of every 100 patients with autism, 20 reach that 'final destination' via gluten sensitivity, then you have the chance to stratify the population and personalize treatment." The gluten-free diet could offer those 20 children the possibility of improvement in their conditions or even a cure, he says.
First, though, the medical community needs an accepted test for gluten sensitivity (while there are gluten sensitivity testing options available, they don't have the backing of the conventional medical community). And before a test can be developed, scientists need to identify a biological marker, or biomarker, for the condition.
Dr. Fasano and his colleagues are working on that now (see: Gluten Sensitivity Biomarker Likely Coming Soon). Ultimately, identification of a biomarker for gluten sensitivity could help show why the GFCF diet appears to work for some, but not all, autism patients ... and allow doctors and parents to really target the diet toward those children it can help.