Aaron Lerner1, Jozélio Freire de Carvalho2, Anna Kotrova3, Yehuda Shoenfeld1,3,4,5. 1. The Zabludowicz Research Center for Autoimmune Diseases, Chaim Sheba Medical Center, Tel Hashomer, Israel. 2. Department of Rheumatology, Institute for Health Sciences of the Federal University of Bahia, Salvador, Bahia, Brazil. 3. Department of Autoimmune research, Saint Petersburg State University, St. Petersburg, Russia. 4. Department of Administration, Ariel University, Israel. 5. Department of Autoimmune research, I.M Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia.
Abstract
CONTEXT: A gluten-free diet (GFD) is the recommended treatment for gluten-dependent disease. In addition, gluten withdrawal is popular and occasionally is suggested as a treatment for other autoimmune diseases (ADs). OBJECTIVE: The current systematic review summarizes those entities and discusses the logic behind using a GFD in classical non-gluten-dependentADs. DATA SOURCES: A search for medical articles in PubMed/MEDLINE, Web of Sciences, LILACS, and Scielo published between 1960 and 2020 was conducted, using the key words for various ADs and GFDs. DATA EXXTRACTION: Eight-three articles were included in the systematic review (using PRISMA guidelines). DATA ANALYSIS: Reduction in symptoms of ADs after observance of a GFD was observed in 911 out of 1408 patients (64.7%) and in 66 out of the 83 selected studies (79.5%). The age of the patients ranged from 9 months to 69 years. The duration of the GFD varied from 1 month to 9 years. A GFD can suppress several harmful intraluminal intestinal events. Potential mechanisms and pathways for the action of GFD in the gut - remote organs' axis have been suggested. CONCLUSION: A GFD might represent a novel nutritional therapeutic strategy for classical non-gluten-dependent autoimmune conditions.
CONTEXT: A gluten-free diet (GFD) is the recommended treatment for gluten-dependent disease. In addition, gluten withdrawal is popular and occasionally is suggested as a treatment for other autoimmune diseases (ADs). OBJECTIVE: The current systematic review summarizes those entities and discusses the logic behind using a GFD in classical non-gluten-dependentADs. DATA SOURCES: A search for medical articles in PubMed/MEDLINE, Web of Sciences, LILACS, and Scielo published between 1960 and 2020 was conducted, using the key words for various ADs and GFDs. DATA EXXTRACTION: Eight-three articles were included in the systematic review (using PRISMA guidelines). DATA ANALYSIS: Reduction in symptoms of ADs after observance of a GFD was observed in 911 out of 1408 patients (64.7%) and in 66 out of the 83 selected studies (79.5%). The age of the patients ranged from 9 months to 69 years. The duration of the GFD varied from 1 month to 9 years. A GFD can suppress several harmful intraluminal intestinal events. Potential mechanisms and pathways for the action of GFD in the gut - remote organs' axis have been suggested. CONCLUSION: A GFD might represent a novel nutritional therapeutic strategy for classical non-gluten-dependent autoimmune conditions.