Anaphylaxis: the Darth Vader of allergies
Gluten Intolerance Vs. Coeliac Disease; It Gets Confusing, Here's How To Spot The Difference
Gluten has become a hot topic in recent years, with a growing number of people eliminating it from their diets. However, many remain unclear about the distinctions between gluten intolerance and coeliac disease, and even use the two terms interchangeably.
While both conditions involve a reaction to gluten, a protein found in grains like wheat, barley, and rye, they differ significantly in their causes, symptoms, and management. Understanding these differences is crucial for effective diagnosis and management. To do the same, we at OnlyMyHealth interacted with Dr. Piyush Ranjan, Vice-Chairperson, Institute Of Liver Gastroenterology & Pancreatico Biliary Sciences, Sir Ganga Ram Hospital, New Delhi.
RELATED: 3 Common Coeliac Disease Myths Debunked By A Gastroenterologist
What is Gluten?Dr Ranjan explains that gluten is a type of protein found in the outer layers of grains such as wheat, barley, and rye. It is responsible for giving dough its elasticity and helping baked goods maintain their shape. However, in some individuals, gluten can cause adverse reactions ranging from mild discomfort to severe autoimmune responses.
What is Coeliac Disease?"Coeliac disease is an autoimmune disorder that affects at least 1% of the global population. When individuals with this condition consume gluten, their immune system mistakenly attacks the lining of the small intestine", says our expert. Over time, this immune response damages the villi, the tiny, finger-like projections in the intestine responsible for nutrient absorption. This damage leads to malabsorption of essential nutrients.
What is Gluten Intolerance?"Gluten intolerance, also known as non-coeliac gluten sensitivity (NCGS), is less severe than coeliac disease. People with gluten intolerance may experience symptoms like bloating, gas, diarrhoea, and abdominal pain after consuming gluten", says Dr Ranjan. However, unlike coeliac disease, gluten intolerance does not involve an autoimmune reaction or intestinal damage.
The symptoms of gluten intolerance typically subside when gluten is removed from the diet and return when it is reintroduced. Importantly, while gluten intolerance can cause significant discomfort, it does not have the long-term health risks associated with coeliac disease.
Expert Tips To Differentiate Between The TwoOne can simply use this as a guide to map out the difference between the two by comparing the causes, genetic basis, and symptoms of each, according to our expert.
1. CAUSECoeliac disease is triggered by an autoimmune reaction to gluten. The immune system mistakenly attacks the small intestine.
Gluten intolerance is caused by a sensitivity to gluten but without an autoimmune or allergic response.
2. GENETIC PREDISPOSITIONCoeliac disease commonly has a genetic link and often runs in families. Specific genes like HLA-DQ2 or HLA-DQ8 are involved.
Gluten intolerance has no genetic connection.
3. DAMAGE TO INTESTINECoeliac disease causes significant damage to the villi in the small intestine, leading to malabsorption of nutrients.
Gluten intolerance does not cause any physical damage to the intestine.
4. SYMPTOMSCoeliac disease manifests as chronic and severe symptoms, such as,
While gluten intolerance manifests as temporary and milder symptoms, such as,
How is Coeliac Disease Diagnosed?Dr Ranjan says that diagnosing coeliac disease typically involves,
There is no definitive test for gluten intolerance. Diagnosis is often made by exclusion, ruling out coeliac disease and wheat allergy through blood tests and food elimination trials. Symptoms typically improve when gluten is removed from the diet.
Specific Management Of These Gluten-Induced IssuesFor those diagnosed with coeliac disease, the only treatment is a strict, lifelong gluten-free diet, as per Dr Ranjan. Even small amounts of gluten can cause damage to the intestines and lead to severe complications. Foods containing wheat, barley, and rye must be completely avoided, and cross-contamination with gluten-containing foods should be carefully managed.
In contrast, gluten intolerance does not require such strict adherence to a gluten-free diet. Many people with gluten intolerance can reintroduce gluten after a period of elimination, depending on their tolerance levels.
When Should You Seek Medical Advice?If you experience gastrointestinal discomfort, persistent fatigue, or unexplained weight loss after consuming gluten, seek medical advice. A specialist can help differentiate between coeliac disease, gluten intolerance, and other potential conditions, such as irritable bowel syndrome (IBS) or wheat allergy.
TakeawayMisdiagnosing gluten intolerance as coeliac disease can lead to unnecessary dietary restrictions, while overlooking coeliac disease can have serious health implications. If you suspect you have a gluten-related condition, consult a gastroenterologist who can recommend appropriate testing and dietary guidance.
Fighting Food Allergies The Natural Way – With Flavonoids
New research has found that a chemical abundant in fruits, vegetables and plant products can suppress the immune response seen in food allergies. It paves the way to developing a natural treatment for this globally increasing problem.
Flavonoids are natural compounds found in fruits, vegetables, plants and leaves that possess a number of medicinal benefits. In the past, New Atlas has reported on studies finding that flavonoids may safeguard against dementia, possess anti-aging properties, and help make diabetes-friendly bread.
Now, a new study out of the Tokyo University of Science (TUS) has found that a particular flavonoid, kaempferol, can dampen the body's allergic response – including food allergies – via its effect on the immune system.
Allergic conditions like food allergies, hay fever, eczema and asthma have become much more common. There are a few explanations about why this might be the case, but that's a discussion for another time. The bottom line is this: allergies are rife.
In the gut are a subset of specialized antigen-presenting cells called dendritic cells (DCs) that prime immune responses crucial to the development of food allergies. Antigen-presenting cells, or APCs, literally do what their name suggests: present antigens (foreign substances that trigger an immune response) to T cells, activating them. DCs produce an enzyme called retinaldehyde dehydrogenase 2 (RALDH2), which converts the chemical retinal, derived from vitamin A, to retinoic acid. Retinoic acid then triggers the development of regulatory T cells (T-regs), immune cells that suppress the body's allergic response.
In the present study, the researchers examined around 40 different flavonoids to see if they increased the expression and efficiency of RALDH2 in DCs. They found that kaempferol was the most effective at this, so they studied it more thoroughly.
Kaempferol is abundant in tea, beans, broccoli, apples, and strawberries. It's also found in medicinal herbs like aloe vera, Ginkgo biloba, and rosemary (Rosemarinus officinalis). Kaempferol is a flavonol, a type of flavonoid that is known to have an anti-inflammatory effect and that existing studies have associated with a reduced risk of cancer and heart disease, tumor growth prevention, and alleviating damage caused by free radicals, among other health benefits.
In the lab, the researchers observed that kaempferol-treated DCs produced more RALDH2. Digging deeper, the researchers examined the molecular mechanisms underlying kaempferol's effects on RALDH2. Focusing on the aryl hydrocarbon (AhR) receptor, which kaempferol targets, they found that the flavonol acted as an antagonist, blocking the AhR receptor and, in turn, accelerating T-reg development.
They then moved to testing kaempferol in animal models, inducing food allergy in mice using the ovalbumin (OVA) protein found in egg whites. Administering kaempferol increased the number of T-regs and "significantly suppressed" the physical symptoms caused by the food allergy, namely a decreased body temperature and diarrhea.
The researchers will investigate further to see whether these effects can be replicated in human cells. They maintain that kaempferol's anti-inflammatory and immune-suppressing effect could be a promising way to treat allergies.
"When taken as a daily food, they [flavonoids] are expected to reduce allergies, inflammation, and autoimmune diseases that are caused or aggravated by excessive immune response," said Professor Chiharu Nishiyama, from TUS's Department of Biological Science and Technology and the study's corresponding author.
The study was published in the journal Allergy.
Source: Tokyo University of Science
Severe Food Allergies Are Way Up For Black People
EpiPens can deliver life-saving medicine to someone having a dangerous allergic reaction. PHOTO: PIXELUMINA PHOTOGRAPHY/UNSPLASH
As the cofounder of Black Girl Disney in 2018, online influencer Dominique Brown was an obvious choice to attend a Dec. 5 holiday event in Los Angeles. As one of the 20 million people with food allergies, she purportedly knew to ask an obvious question: Does the food include peanuts?
Not long after food was served, however, the deejay suddenly stopped the music and urgently asked if anyone at the event had an EpiPen — a device that delivers life-saving medicine to someone having a dangerous allergic reaction. That day, it was Brown.
Within hours, the Disney superfan with dimples and a bright smile, known as Domo to her friends, was dead.
The tragedy brought to light an overlooked medical issue: the number of severe allergic reactions to food has been climbing over the last two decades, and Black people account for a disproportionate number of those affected. Studies also suggest the rise in severe reactions is most prevalent among those with lower incomes.
"The prevalence of self-reported food allergies has been increasing in recent decades, especially among [Black] children. Black children have been reported to have higher rates of food allergies compared with [White] children in the U.S.
"Less is known about racial differences in [food allergies] among adults, although the limited available evidence suggests that the differences reported in pediatric samples may also exist among adults," the research says.
According to reports, Brown asked whether food at the event contained the allergen and she was told no. But a friend who has launched a change.Org petition stemming from the tragedy said Brown was known to be allergic to peanuts.
The U.S. Department of Agriculture says the nine leading causes of food allergies identified are milk, eggs, fish, shellfish, tree nuts, peanuts, wheat, soybeans, and sesame. But severe allergic reactions can be triggered by latex, some medications, animal dander, or bee stings. About 33 million people in the U.S. Have severe allergies, and around 200 people die from allergic reactions each year.
If consumed or exposed to those allergy triggers, a person can experience anaphylaxis, a condition that includes a sudden drop in blood pressure, difficulty breathing, nausea and vomiting. If not treated immediately, severe anaphylactic shock can be fatal.
More than 10% of adults, and 8% of the nation's children, are allergic to several kinds of foods. A 2021 study found that incidences of peanut allergy reactions have increased in the last 20 years. Also, Black people account for 15.5% of those with peanut allergies although they are just 11.6% of the U.S. Population.
Research published just last year finds that Asian, Black, and Hispanic people were more likely to report having food allergies than whites. No one knows exactly why allergies are on the rise among people of color, but researchers found this trend is strongly tied to household income.
"The prevalence of self-reported or parent-reported food allergies was lowest within households earning more than $150,000 per year," according to the study.
Earlier this year the FDA approved the drug omalizumab, sold as Xolair, to treat moderate to severe allergic asthma in adults and adolescents. The drug differs from emergency medicines like EpiPens; Xolair is for use in people aged 1 year and older to reduce the risk of allergic reactions to peanuts and other foods over time.
Research found omalizumab can also significantly reduce the risk of food allergy to peanuts and other foods after about four months of treatment. But Xolair does not cure food allergies, so patients need to avoid foods with allergens in them.
In August, the FDA approved the neffy epinephrine nasal spray, which is the first allergy emergency treatment that, unlike EpiPen, doesn't have to be injected. The nasal spray from ARS Pharmaceuticals can treat anaphylaxis in people weighing at least 66 pounds.
Meanwhile, those around her are still processing Brown's death.
In a Dec. 13 statement posted on Instagram, BoxLunch, which sponsored the charity luncheon, said it was "devastated" by the young influencer's death. It promised to "do everything possible to support Dominique's family, her loved ones, the Collective and our team members during this painful time."
Brown's friends have launched an online petition urging more protections for people with food allergies. They want venues, restaurants, and other establishments that serve food to take more precautions, and keep EpiPens on hand.
"Domo's death was preventable," according to the petition. "Her story is not unique, and it's time for change."
This article originally appeared on Word in Black.
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