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Associations Between Subclass Profile of IgG Response to Gluten and the Gastrointestinal and Motor Symptoms in Children with Cerebral Palsy
Örebro University, School of Medical Sciences. Örebro University Hospital. Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Medical Center, New York, USA; Celiac Disease Center, Columbia University Medical Center, New York, USA; University Health Care Research Center, School of Health and Medical Sciences, Örebro University, Örebro, Sweden.ORCID iD: 0000-0002-7468-1633
Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Medical Center, New York, USA; Celiac Disease Center, Columbia University Medical Center, New York, USA.
Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Medical Center, New York, USA; Institute of Human Nutrition, Columbia University Medical Center, New York, USA.
Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Medical Center, New York, USA; Celiac Disease Center, Columbia University Medical Center, New York, USA.
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2021 (English)In: Journal of Pediatric Gastroenterology and Nutrition - JPGN, ISSN 0277-2116, E-ISSN 1536-4801, Vol. 73, no 3, p. 367-375Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Gastrointestinal problems are often seen in children with cerebral palsy, although the etiology and underlying mechanisms are not fully understood. Recent data point to significantly elevated levels of IgG antibody to dietary gluten in cerebral palsy independent of celiac disease, a gluten-mediated autoimmune enteropathy. We aimed to further characterize this antibody response by examining its subclass distribution and target reactivity in the context of relevant patient symptom profile.

METHODS: Study participants included children with cerebral palsy (n = 70) and celiac disease (n = 85), as well as unaffected controls (n = 30). Serum IgG antibody to gluten was investigated for subclass distribution, pattern of reactivity towards target proteins, and relationship with gastrointestinal symptoms and motor function.

RESULTS: The anti-gluten IgG antibody response in the cerebral palsy cohort was comprised of all four subclasses. However, in comparison with celiac disease, IgG1, IgG2, and IgG3 subclasses were significantly lower, whereas the IgG4 response was significantly higher in cerebral palsy. Within the cohort of cerebral palsy patients, levels of anti-gluten IgG1, IgG3, and IgG4 were greater in those with gastrointestinal symptoms, and the IgG3 subclass antibody correlated inversely with gross motor function. The anti-gluten IgG antibodies targeted a broad range of gliadin and glutenin proteins.

CONCLUSION: These findings reveal an anti-gluten IgG subclass distribution in cerebral palsy that is significantly different from that in celiac disease. Furthermore, the observed association between IgG subclass and symptom profile is suggestive of a relationship between the immune response and disease pathophysiology that may indicate a role for defects in gut immune and barrier function in cerebral palsy.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2021. Vol. 73, no 3, p. 367-375
Keywords [en]
antibody subclass, B cell, celiac disease, cerebral palsy, gastrointestinal symptoms, gluten sensitivity, immune activation, immunoglobulin, motor function
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:oru:diva-93480DOI: 10.1097/MPG.0000000000003181ISI: 000683060000023PubMedID: 34231978OAI: oai:DiVA.org:oru-93480DiVA, id: diva2:1585134
Note

Funding agencies:

United States Department of Health & Human Services

National Institutes of Health (NIH) - USA

NIH National Center for Advancing Translational Sciences (NCATS)

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Available from: 2021-08-16 Created: 2021-08-16 Last updated: 2025-02-11Bibliographically approved

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Stenberg, Reidun

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