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Lungs and
Respiratory Conditions
Respiratory problems are associated with gluten intolerance and Celiacs Disease. The problem range from frequent colds or lung infections perhaps prompted by weaken (or hyperactive) immune to heightened sensitivity to proteins in certain kinds of dust, to Cystic Fibrosis.
Prior to the diet, ever since 1977, I used to get about one sinus infection and 3 lung infections each year. Each lung infection would last about 6 weeks. Added all up, that was several years of my life spent suffering lung infections. As I write this note, I have been gluten free for 34 months and I have had NO lung infections in that time. Sure, I still get colds, but they now only last a couple days and are milder than what several other people in the office get. Do you think that this cure is worth the effort of the gluten free diet?
Contents:
Pseudomonas Bronchitis (Sweet Taste)
Cystic Fibrosis Mild or Atypical Cystic Fibrosis
Lung Cavities
Sinusitis
Frequent Colds
Frequent Lung Infections
Frequent or repeated lung infections are reported as a symptom or consequence of gluten intolerance and Celiac Disease. Why is this? Gluten sensitivity can easily cause vitamin and antioxidant deficiencies, which can contribute to a weakened immune system and to slow healing from infection. (Should autoimmunity to inflamed lung tissue in some cases should not be entirely ruled out?)
Weak mucus membranes contribute to gluten sensitivities. Since the mucus membranes are the first defense against infection in the respiratory and digestive systems, this same weakness could contribute to susceptibility to infection.
Lung congestion or infection that occurs when a person spends time certain air-conditioned buildings may well be infection by airborne Pseudomonas or similar bacteria. Such bacteria form biofilms in dirty and poorly drained air conditioner coils. When the air conditioner runs, bacteria spores and bacteria aerosols are sent through the building. Anyone with compromised mucus membranes (such as cases of gluten sensitivity and undiagnosed mild Cystic Fibrosis) will be more prone to infection from air condition.
Pseudomonas Bronchitis (Sweet Taste)
Bronchitis with a symptom of sweet tasting sputum (cough up) may be the result of an infection by sugar-loving bacteria, such as Pseudomonas. Apparently this sort of bacteria can feed by breaking a bond in non-sweet saccharide chains resulting in sweet sugars in the pus. Chronic Pseudomonas Bronchitis is usually associated with severe and mild Cystic Fibrosis, however at least some portion is not associated with CF. In some cases, who knows how many yet, the chronic lung infections are reduced on a gluten free diet.
See also pseudomonas bronchitis links.
Cystic Fibrosis (CF) See also Mild or Atypical Cystic Fibrosis
What Is CF? -- Long: Merck Manual Short: Cystic Fibrosis Foundation
Typical Cystic Fibrosis is the most common lethal recessive genetic disorder among Caucasians. People with CF have a variety of symptoms, particularly very salty-tasting skin, but also some that are similar to some cases of gluten intolerance; persistent coughing, at times with phlegm; wheezing or shortness of breath; weakness; weak pancreases; an excessive appetite but poor weight gain; and greasy, bulky stools.
When either symptoms or diagnosis of Cystic Fibrosis is present, gluten intolerance should be considered; and vice versa. Patients with cystic fibrosis are more likely to have classic celiac disease, and patients with celiac disease are more likely to have cystic fibrosis. Could a gluten free diet ease some symptoms of Cystic Fibrosis?
“Celiac Disease: A Pediatric Perspective”, Eleni Mihailidi, MD; Penelope Paspalaki, MD, PhD; Emilia Katakis, MD; Athanasios Evangeliou, MD, PhD, International Pediatrics, Vol. 18/No. 3/2003 p141.
Patients with cystic fibrosis have a 5-fold risk of celiac disease compared with the general population (5:1000). A sweat test to exclude cystic fibrosis is mandatory in all children with celiac disease at the time of diagnosis, while every child with cystic fibrosis who displays protracted symptoms of malabsorption, despite pancreatic enzyme supplementation, should undergo jejunal biopsy.1,2
1.Branski D, Troncone R. Celiac disease: a reappraisal. J Pediatr, 1998;133:181-7.
2. Littlewood JM. Coeliac disease in childhood. Cpt. 6 In: Howdle PD (ed) Bailliere’s Clinical Gastenterology. International practice and research. Coeliac disease. 1995;9:295-327.
“Cystic fibrosis and celiac disease. Report of two cases”, [Article in German], Santer R, Harms HK., Universitats-Kinderkliniken Kiel. Monatsschr Kinderheilkd. 1990 Sep;138(9):623-6.
“Two patients with cystic fibrosis who subsequently developed celiac disease are described. Difficulties in the diagnosis of coexistence of both diseases are discussed.”
“Study of intestinal malabsorption diseases as cause of monosymptomatic short stature”, [Article in Portuguese], Oliveira MC, Reis FJ, Chagas AJ, Brasileiro Filho G, Bahia M, Silva LD, Penna FJ., Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil., J Pediatr (Rio J). 1998 May-Jun;74(3):213-6.
“A total of 51 children [with short stature were] studied, most of them belonging to the group of normal variants. Four children had abnormally high sweat chloride, compatible with the diagnosis of cystic fibrosis. These children were asymptomatic regarding respiratory and gastrointestinal tract. CONCLUSIONS: We conclude that cystic fibrosis, besides celiac disease, must be included in the differential diagnosis of short stature in childhood.”
Mild or Atypical Cystic Fibrosis
There exists a milder form of Cystic Fibrosis, which may be largely misunderstood and underdiagnosed. Study and understanding of this atypical Cystic Fibrosis could provide relief to some people who presently suffer from chonic ill health related to untreated “mild” Cystic Fibrosis.
“A Novel Mutation in the Cystic Fibrosis Gene in Patients with Pulmonary Disease but Normal Sweat Chloride Concentrations*”, W. Edward Highsmith, et al, New England Journal of Medicine, Vol. 331:974-980, Oct. 13, 1994 # 15
(*Translation: A type CF that would be misdiagnosed and go untreated according to the gold standard sweat test.)
“We have identified a point mutation in intron 19 of CFTR and abnormal epithelial function in patients who have cystic fibrosis-like lung disease but normal sweat chloride values. The identification of this mutation indicates that this syndrome is a form of cystic fibrosis. Screening for the mutation should prove diagnostically useful in this population of patients.”
“A Cystic Fibrosis Mutation Associated with Mild Lung Disease”, King-Han Gan, et al, New England Journal of Medicine, Vol. 333:95-99 Jul. 13, 1995 # 2.
A total of 33 patients with the A455E mutation were matched according to age and sex with patients who were homozygous for the F508 mutation. As observed, the A455E mutation associated is less intense progression of Cystic Fibrosis. Those with the A455E mutation experienced a greatly slowed progress of the conditions and generally better health
|
|
A455E mutation (“mild” CF) |
F508 mutation (typical CF) |
|
Mean age at diagnosis |
15.0 years |
3.1 years |
|
Pancreatic insufficiency |
21.2% |
93.9% |
|
Diabetes mellitus |
0% |
27.3% |
|
Forced expiratory volume |
73.9% |
54.3% |
|
Forced vital capacity |
88.7% |
76.3% |
|
Pseudomonas aeruginosa colonization |
33.3% |
60.6% |
“Opsonophagocytic killing antibody to Pseudomonas aeruginosa mucoid exopolysaccharide in older noncolonized patients with cystic fibrosis.”, GB Pier, New England Journal of Medicine, Vol. 317:793-798 Sep 24, 1987 # 13
Patients with typical cystic fibrosis typically succumb to Pseudomonas aeruginosa infections. This study reveals that older, relatively healthy patients with cystic fibrosis have mucoid-exopoly-saccharide-specific antibodies that seem to effectively present Pseudomonas aeruginosa infections.
|
|
opsonophagocytic killing antibody |
mucoid-exopoly-saccharide-specific opsonophagocytic killing antibody |
|
16 older (greater than or equal to 12 years) patients not colonized |
Present (titers of 4 to 80) |
Present |
|
11 older (greater than or equal to 14 years) colonized patients |
Present (more than older noncolonized) |
Not detected |
|
10 younger (less than or equal to 11 years) noncolonized patients |
Not detected in 9 of 10 |
Not detected |
|
20 healthy adults |
Not detected in 20 of 20 |
Not detected |
“Mild cystic fibrosis linked to chromosome 7q22 markers with an uncommon haplotype.”, McConkie-Rosell A, Chen YT, Harris D, Speer MC, Pericak-Vance MA, Ding JH, Highsmith WE Jr, Knowles M, Kahler SG., Ann Intern Med. 1989 Nov 15;111(10):797-801.
“These DNA
linkage studies provide additional evidence for the existence of a cystic
fibrosis allele that is associated with mild disease.”
“Nonsense mutation R1162X of the cystic fibrosis transmembrane conductance regulator gene does not reduce messenger RNA expression in nasal epithelial tissue”, R Rolfini and G Cabrini, Journal of Clinical Investigation. 1993 December; 92(6): 2683–2687.
“In
conclusion.... The presence of the transcript in respiratory cells of patients
with mild to moderate lung disease could suggest that a partially functional
protein could be expressed in at least the airway duct.”
Genetic Testing for Cystic Fibrosis?
Carcinoid Tumors
Carcinoid Tumors of the lungs or intestines can produce hormones that interfere with the neuroendocrine organs (thyroid, adrenal glands, …), thereby producing symptoms similar to gluten intolerance, and vice versa.
From: “American Cancer Society -- What Are the Risk Factors For Lung Carcinoid Tumor?
“Family history: A genetic tendency to develop lung carcinoid tumors can be inherited. Rare families have been described in which several members have been diagnosed with this cancer. Also, in general children of parents with this disease have a higher chance of developing carcinoid. Still, because this cancer is so uncommon, that risk is still low. And, most people with carcinoid tumors do not have a parent with this form of cancer.”
From: “MedlinePlus -- Carcinoid Tumors Information”
“About 10% of the time, carcinoid tumors produce hormone-like substances that are released into the bloodstream. The carcinoid syndrome results from the effect of these substances. Symptoms include facial flushing (redness and warm feeling), severe diarrhea, wheezing, and fast heartbeat. Many patients find that stress, strenuous exercise, and drinking alcohol may make these symptoms worse. Over a long time, these hormone-like substances can damage heart valves, causing shortness of breath, weakness, and a heart murmur (abnormal heart sounds a doctor can hear through a stethoscope). Some carcinoid tumors may produce adrenocorticotrophic hormone (ACTH), a substance that stimulates the adrenal gland to produce excessive amounts of cortisol and related adrenal hormones. Symptoms of excessive amounts of adrenal hormones include weight gain, weakness, secondary diabetes, and increased body and facial hair.”
Sarcoidosis
Please see Article on Celiac.com
Asthma
I haven’t made time to look into this association.
Here’s one I stumbled on (I suspect there is much more)
“Could
Th1 and Th2 disease coexist? Evaluation of asthma incidence in children with
coeliac disease, type 1 diabetes, or rheumatoid arthritis;a register study.”
Kero
J, Gissler
M. Hemminki, Isolauri E., J Allergy Clin Immunol 2001;108:781783.
Emphysema
Emphysema is a “pathological condition of the lungs marked by an abnormal increase in the size of the air spaces, resulting in labored breathing and an increased susceptibility to infection. It can be caused by irreversible expansion of the alveoli or by the destruction of alveolar walls.” [1]
Baker's Lung
This is usually passed off as sensitivity to mold in moldy flour, but common sensitivity to the wheat flour itself should always be considered, especially if symptoms occur when handling fresh flour. (Wouldn’t flour in Western countries be generally protected from mold?)
Farmer's Lung
This is usually passed off as sensitivity to mold in moldy flour, but common sensitivity to the wheat dust itself should always be considered, especially if symptoms occur when handling fresh, non-moldy grain.
Bird Fancier's Lung
(There is controversy on this subject.)
Thorax. 1978 Aug;33(4):425-8. Related Articles, Links
Is bird fancier's lung associated with coeliac disease?
Hendrick DJ, Faux JA, Anand B, Piris J, Marshall R.
Clin Allergy. 1978 Mar;8(2):101-8. Related Articles, Links
Precipitins to different avaian serum antigens in bird fancier's lung and coeliac disease.
Faux JA, Hendrick DJ, Anand BS.
Precipitins to avian serum antigens have been found in the sera of bird fanciers and, until now, they have been considered strong supporting evidence for a clinical diagnosis of bird fancier's lung (BFL). We now report that 35% of patients with coeliac disease, none of whom had recently kept a bird, had precipitins against an avian serum antigen common to all the avian species tested, but which was distinct from the antigens usually associated with BFL. This antigen was a component of hen egg yolk but not of bird droppings. In patients with BFL the antibody response results from inhaled antigens in the bird droppings, whereas the antibody response in patients with coeliac disease probably results from eating uncooked or soft-boiled eggs.
Lancet. 1977 Jul 30;2(8031):249. Related Articles, Links
Bird-fancier's lung and gluten-sensitive enteropathy.
Novey HS, Wells ID, Heiner DC.
Lancet. 1975 Nov 22;2(7943):1006-8. Related Articles, Links
Bird-fancier's lung and jejunal villous atrophy.
Berrill WT, Fitzpatrick PF, Macleod WM, Eade OE, Hyde I, Wright R.
Sixteen patients with bird-fancier's lung were screened for evidence of coeliac disease by assessing their clinical features, red-bloodcell or serum folate levels, and serum for reticulin antibodies. Five of nine patients selected for jejunal biopsy showed villous atrophy, and in some this seemed to be a true gluten-sensitive enteropathy.
Anti-avian antibodies and rheumatoid factor in pigeon hypersensitivity pneumonitis
Clinical & Experimental Allergy
Volume 33 Issue 2 Page 226 - February 2003
doi:10.1046/j.1365-2222.2003.01526.x
1: Eur J Gastroenterol Hepatol. 2001 Sep;13(9):1119-21.
Coeliac disease: the cause of the various associated disorders?
James MW, Scott BB.
Department of Gastroenterology, Lincoln County Hospital, Lincoln LN2 5QY, UK.
The advent of the endomysial antibody test has allowed the true association between coeliac disease and at least 12 other disorders to be established. There is evidence suggesting that coeliac disease is a cause of these disorders; a mechanism for this is proposed.
Check out (not lung related):
How many hospital visits does it take before celiac sprue is diagnosed?
NFL's Gannon has game plan for celiac disease
“Brain
White-Matter Lesions in Celiac Disease: A Prospective Study of 75 Diet-Treated
Patients”, Matthias Kieslich, MD, Germán Errázuriz, MD, Hans Georg Posselt,
MD, Walter Moeller-Hartmann, MD, Friedhelm Zanella, MD, and Hansjosef Boehles,
MD, Pediatrics Vol. 108 No. 2 August 2001, p. e21.