Almost No Cases Found of Celiac Disease and MS in New Analysis

Celiac disease, in which the ingestion of gluten causes the immune system to attack the lining of the small intestine, is not common in people with multiple sclerosis (MS), a meta-analysis found.

While the diet-caused autoimmune disease  is estimated to affect between 0.2% and 0.7% of people in the general population, the new analysis — which reviewed 16 published studies, involving more than 30,000 individuals — demonstrated that its prevalence in the MS population was close to zero.

The researchers noted that multiple sclerosis patients “suffer from a wide range of gastrointestinal manifestations,” but found that “the odds of [celiac disease] in … MS are not high.”

The study, “Is Celiac Disease (CD) Prevalent in Patients with Multiple Sclerosis (MS): A Systematic Review and Meta-Analysis,” was published in the journal Multiple Sclerosis International.

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Investigating links between celiac disease and MS

MS is a neurological condition in which the immune system attacks and causes damage to areas of the central nervous system, comprised of the brain and spinal cord. Its exact causes are not fully understood, but people with certain autoimmune conditions are known to have a greater risk of developing MS.

Conditions that have been associated with MS include type 1 diabetes, inflammatory bowel disease, and psoriasis. However, the link between celiac disease and multiple sclerosis is less well-known.

Celiac disease is autoimmune disorder of the small intestine triggered by the ingestion of gluten, a protein found in wheat and other grains. Most people with the disorder carry genetic factors strongly linked to MS, and the disease has been associated with a greater risk of nerve damage.

Now, a team of researchers in Iran sought, for the first time, to assess the prevalence of celiac disease among people with multiple sclerosis. To do so, the researchers conducted a systematic review and meta-analysis of published studies.

Their search covered five database — PubMed, Scopus, EMBASE, Web of Science, and Google Scholar — as well as studies published outside of traditional publishing and distribution channels.

A total of 16 studies, published through October 2022, covered 31,418 patients and were used for the meta-analysis. The majority of studies were from Italy, with additional studies from the U.K., Denmark, Spain, the U.S., Argentina, Iran, Australia, and Brazil.

In total, 124 cases of possible or confirmed celiac disease were registered. The patients had a mean age of 35–55. Among the studies, five also had information about participants without MS, who served as controls. Of a total of 22,394 controls included, 22 had the disease.

Results showed that the pooled prevalence of celiac disease among MS patients was zero. Also, the likelihood of MS patients developing the gluten-related autoimmune disease was 54% lower than controls, although the results failed to reach statistical significance.

Some limitations to the study were noted by researchers, including the exclusion of works that diagnosed celiac disease via a blood sample, though this is an acceptable diagnostic test for the condition. There also were distinct control groups used across the studies.

Overall, the results from this “systematic review showed that CD [celiac disease] is not prevalent in MS cases,” the researchers concluded.