Al­lergy alert

The Star Malaysia - Star2 - - FAMILY -

Ge­netic re­sponse to gluten

PROF Dr Man­mo­han Ya­dav ( pic), an al­ler­gist spe­cial­is­ing in gluten al­lergy, has been re­search­ing the topic for nearly 40 years.

The doc­tor who is at­tached with Pan­tai Med­i­cal Cen­tre in Kuala Lumpur ex­plains that there are three cat­e­gories of gluten al­lergy that peo­ple need to be aware of. n For more in­for­ma­tion on gluten al­lergy, go to www.al­ler­gy­cen­tre.com.my.

Called Celiac dis­ease, it is a per­son’s ge­netic con­sti­tu­tion that makes them un­able to process gluten. There­fore, gluten be­comes toxic to their bod­ies and causes dam­age to the mu­cosa sur­face of the in­tes­tine.

“Ab­sorp­tion of nu­tri­ents is ham­pered and the per­son be­comes mal­nour­ished be­cause food is not di­gested and ab­sorbed,” says Dr Ya­dav.

The symp­toms are blood in stool, up­set stom­ach, di­ar­rhoea. Be­cause dam­age is done to the in­tes­tine, their growth doesn’t fol­low the nor­mal pat­terns.

Di­ag­no­sis is via en­doscopy, copy , which can de­tect dam­age to the mu­cosa lin­ing.

Al­lergy to gluten

This al­lergy to the gluten pro­tein can hap­pen to chil­dren and adults. It goes away if gluten is avoided.

Food that con­tains gluten trig­gers a re­ac­tion that pro­duces an an­ti­body called Im­munoglob­u­lin E (IgE).

The IgE an­ti­bod­ies stick to the mast cells in skin and mu­cosal tis­sue, and ba­sophils (found in blood cir­cu­la­tion), and the per­son is now sen­si­tised.

The next con­tact with the al­ler­gen (in this case, gluten) will cause the mast cells to re­lease his­tamine, which leads to symp­toms.

The good news is that once you stop tak­ing gluten, the IgE an­ti­body drops.

“Af­ter a while, when the an­ti­body level is very low (this will take a pe­riod of up to two years), you can start tak­ing gluten again,” says Dr Ya­dav.

Hy­per­sen­si­tiv­ity

This hy­per­sen­si­tiv­ity to gluten is a meta­bolic re­ac­tion to gluten, and has noth­ing to do with the im­mune sys­tem. This is preva­lent in chil­dren with autism.

What hap­pens is that cer­tain en­zymes are miss­ing in the bod­ies of autis­tic chil­dren. These en­zymes are needed to break down pro­tein into polypep­tides, then pep­tides, then amino acids.

When the en­zymes are lack­ing, pep­tide is taken into the body, which be­comes a toxic com­pound. This hap­pens with gluten.

The struc­ture that is ab­sorbed into the body is sim­i­lar to mor­phine – glu­teo­mor­phin. This struc­ture starts ac­cu­mu­lat­ing in the body, and goes into the brain.

They in­ter­fere with the en­dor­mor­phines in the brain, and cause be­havioural changes such as hy­per­ac­tiv­ity and tantrums.

There is no cure for hy­per­sen­si­tiv­ity to gluten. About 70% of autis­tic chil­dren have this hy­per­sen­si­tiv­ity to gluten. They need to be di­ag­nosed cor­rectly.

“Some par­ents are mis­led into think­ing their (autis­tic) child is al­ler­gic to gluten, and there­fore take them for al­lergy tests, which are not nec­es­sary. It is a ge­net­i­cally pre­dis­posed con­di­tion, and the only way is to avoid gluten,” says Dr Ya­dav.

He usu­ally tells par­ents of autis­tic chil­dren to have their child avoid gluten for six to eight months, and ob­serve them. If it is ben­e­fi­cial, then he will tell them to have the child avoid gluten for life.

Foods to avoid

If you’re al­ler­gic to gluten, avoid wheat, rye and bar­ley.

Re­cent find­ings say oats con­tain gluten. But upon fur­ther in­ves­ti­ga­tion not much gluten is found in oats.

So per­haps it’s con­tam­i­na­tion dur­ing plant­ing, pro­cess­ing or pack­ag­ing. But peo­ple who are gluten-in­tol­er­ant are avoid­ing oats as well.

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