Association between gluten sensitivity and epilepsy based on HLA-DQ genotyping together with celiac disease related antibody / Dr. Nur Malina Mat Reffien

Introduction : Gluten sensitivity (GS) is a common autoimmune disease that has been reported to affect 1 in every 100 people worldwide. (I, 2) GS is associated with several neurological conditions including epilepsy. (3) About 95% of people diagnosed with gluten intolerance were genetically predisposed through the human leukocyte antigen (HLA), HLA-DQ 2 and HLA-DQ 8. (4, 5) e purpose of this study is to investigate the association between epilepsy and gluten sensitivity based on HLA-DQ genotyping, alpha-gliadin antibody (AGA), and tissue transglutaminase antibody (anti-tTG).
Method: A case-control study was conducted with a target sample size of 100 patients. 50 epilepsy patients and 50 non-epileptic adults matched for age, gender, and race were recruited. All patients were subjected to an interview, clinical examination and venous blood sampling. AGA and anti-tTG antibodies were detected using a commercially available ELISA kit. The blood sample were also sent for genotRefyping of HLA-DQ alleles represented by 6 single nucleotide polymorphisms (SNPs) [(i) DQ2.2 (rs2395182; rs7775228 rs4713586); (ii) DQ2.5 rs2187668; (iii) DQ7 (rs4639334) and (iv) DQ 8 (rs7454108)].
Results: The overall seroprevalence of gluten sensitivity in the study group was 40%. Out of this 21 (42%) patients were from epilepsy group. HLA-DQ 2.2 genotype was found to be strongly associated with epilepsy where 9 epileptic patients were positive for HLA-DQ 2.2 [p-value 0.003]. However, the seroprevalence of HLA-DQ 8 was 18 (36%) in the epileptic group and 19 (38%) in the control group [p-value=0.836]. The AGA was positive in 4 (8%) epilepsy patients while anti-tTG antibody was negative in both study groups. Overall, there was no association seen between gluten sensitivity seropositivity and epilepsy in our study [OR 0.85 (CI 0.380-1.885), (p-value 0.838)]. Nevertheless, we found that 8 out of 21 epileptic patients with gluten sensitivity used more than 1 anti-seizure medication. (p-value 0.014).
Conclusion: Our study showed no association between GS and epilepsy. However, the seroprevalence of HLA-DQ 2.2 genotype was significantly higher in epileptic patients and those epileptic patients with GS required multiple anti-seizure medications.