Gluten and Liver Cancer

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Gluten & Cancer

 

http://www.nutramed.com/celiac/celiacrefcancer.htm

 

A striking association is that celiac disease predisposes patients to

the eventual development of lymphoma and other cancers. If this

relationship is re-stated as "cereal grains cause cancer," the

implication is more easily understood. There is evidence that strict

adherence to a gluten-free diet long term will reduce the incidence of

lymphoma.

High-grade T-cell lymphomas of the small intestine

are the most common neoplasms. The intestinal mucosa distant from the

tumor contains T cells often of the same clone as the high-grade T-cell

lymphoma. It appears that the T-cell lymphoma evolves from reactive

intraepithelial lymphocytes through a low-grade lymphocytic neoplasm to

a high-grade tumor. Ulcers may appear in the jejunum and are probably

part of the same disease process, occurring when the neoplastic T-cells

are low grade and recognition of tumor cells in biopsies of the ulcers

may be impossible. Patients with enteropathy-associated T-cell lymphoma

have genetic markers - the HLA DQA1*0501, DQB1*0201 phenotype, although

additional HLA-DR/DQ alleles may represent risk factors for lymphoma

development. (see abstract)

Malignancy and survival in dermatitis

herpetiformis: a comparison with coeliac disease.

 

 

Author Collin P; Pukkala E; Reunala T

Address Medical School, University of Tampere, Finland.

Source Gut, 1996 Apr, 38:4, 528-30

 

BACKGROUND--Dermatitis herpetiformis is a lifelong, gluten sensitive

skin disease. Patients with dermatitis herpetiformis, similar to

patients with coeliac disease not adhering to a gluten free diet, seem

to have increased risk for lymphoma. AIMS--This study looked at the

occurrence of malignancy and survival of patients with dermatitis

herpetiformis and compared the results with those seen in patients with

coeliac disease or in the general population. PATIENTS--A total of 305

adult patients with dermatitis herpetiformis diagnosed at the

University Hospital of Tampere in 1970-1992 were studied. Most patients

started a gluten free diet and at the end of the study 93% of the

patients were adhering to the diet. A control group comprised 383 adult

patients with coeliac disease, 81% of them adhered to a gluten free

diet, 6% had a normal diet, and in 13% the diet history remained

unknown. METHODS--The occurrence of malignant diseases and survival of

the patients were assessed up to the end of 1993. Standardised

incidence ratios (SIR) with 95% confidence intervals were used for the

malignant diseases. The survival of the patients was compared with that

of the general population. RESULTS--Thirteen (4.3%) patients with

dermatitis herpetiformis developed 14 malignant disorders during the

follow up (SIR 1.25; 95% confidence intervals 0.68 to 2.09). A

non-Hodgkin's lymphoma occurred in four patients with dermatitis

herpetiformis, significantly more than expected (SIR 10.3; 2.8-26.3).

Thirteen (4.3%) patients with dermatitis herpetiformis died during the

follow up but there was no increased general mortality. In coeliac

disease, 13 (3.4%) patients developed malignancy (SIR 1.16; 0.62 to

1.97), 31 (8.1%) patients died but the survival rate did not differ

from that in the general population. CONCLUSIONS--The incidence of

non-Hodgkin's lymphoma was significantly increased in patients with

dermatitis herpetiformis. The results also confirm that the patients

with dermatitis herpetiformis treated mainly with a gluten free diet

have no increased general mortality.

 

Protective effect of gluten-free diet against development of

lymphoma in dermatitis herpetiformis.

 

 

Author Lewis HM; Renaula TL; Garioch JJ; Leonard JN; Fry JS;

Collin P; Evans D; Fry L

Address Department of Dermatology, St. Mary's Hospital, London,

UK.

Source Br J Dermatol, 1996 Sep, 135:3, 363-7

 

Abstract A retrospective study of 487 patients with dermatitis

herpetiformis showed that lymphoma developed in eight patients, the

expected incidence being 0.21 (standardized registration ratio 3810).

All lymphomas occurred in patients whose dermatitis herpetiformis had

been controlled without a gluten-free diet (GFD) or in those who had

been treated with a GFD for less than 5 years. The results are

suggestive of a protective role for a GFD against lymphoma in

dermatitis herpetiformis and give further support for advising patients

to adhere to a strict GFD for life.

Primary T cell CD30-positive anaplastic large-cell lymphoma

associated with adult-onset celiac disease and presenting with skin

lesions.

 

Author Mantovani G; Esu S; Astara G; Lampis B; MacciÄo A; Usai P;

Santa Cruz G; Mura E; Ferreli A

Address Department of Medical Oncology, University of Cagliari,

Italy.

Source Acta Haematol, 1995, 94:1, 48-51

 

We report the case of a 52-year-old woman with primary CD30+

anaplastic large-cell lymphoma of T cell phenotype with skin

involvement, stage IVB, fulfilling almost all the clinical,

histopathologic and immunophenotypic criteria for this disease,

associated with adult-onset celiac disease. The diagnoses of malignancy

and celiac disease were made during the same clinical episode. The

clinical course of the patient has been extremely favorable and she is

in complete remission, 15 months after finishing consolidation therapy.

 

Study of the immunohistochemistry and T cell clonality of

enteropathy-associated T cell lymphoma.

 

 

Author Murray A; Cuevas EC; Jones DB; Wright DH

Address University Department of Pathology, Southampton

University Hospitals, United Kingdom.

Source Am J Pathol, 1995 Feb, 146:2, 509-19

 

Specimens from 23 patients with enteropathy-associated T cell

lymphoma were studied by immunohistochemistry after antigen retrieval.

Specimens from 14 of these patients were investigated for the presence

of clonal T cell gene rearrangements in both the tumor and the adjacent

enteropathic intestine by the polymerase chain reaction. Primers for T

cell receptor beta and gamma genes were used in a combination that

permits the identification of approximately 90% of T cell receptor

rearrangements. Clonal rearrangements of the T cell receptor were found

in 13 of the 14 tumors studied. Specimens of enteropathic bowel

resected with the tumor, but showing no morphological or

immunohistochemical evidence of tumor involvement, showed clonal T cell

receptor gene rearrangements in 11 cases. In 10 of these, the amplified

DNA was of the same molecular weight in the enteropathic bowel as in

the corresponding tumor. In 2 cases, sequencing the polymerase chain

reaction product showed identical T cell receptor gene rearrangements

in the tumor and in the adjacent intestine. Uniform staining for p53

was seen in 22 of the 23 tumors. In 9 of 19 cases studied, collections

of small lymphocytes in the enteropathic bowel expressed p53. In all

but one of these specimens, a clonal rearrangement of the T cell

receptor genes was identified. We interpret these findings as support

for the concept that enteropathy-associated T cell lymphoma arises on a

background of gluten-sensitive enteropathy with evolution of neoplastic

T cell clones from the reactive T cell population present in the

enteropathic bowel.

Enteropathy-associated T-cell lymphoma in the West of Ireland:

low-frequency of Epstein-Barr virus in these tumors.

 

Author Walsh SV; Egan LJ; Connolly CE; Stevens FM; Egan EL;

McCarthy CF

Address Department of Histopathology, University College

Hospital, Galway, Ireland.

Source Mod Pathol, 1995 Sep, 8:7, 753-7

 

Abstract The Epstein-Barr virus has been implicated in the etiology

of endemic Burkitt's lymphoma, post-transplant lymphoma, large-cell

anaplastic CD30 (Ki-1)-positive lymphoma, and in many T-cell lymphomas.

A recent report has found Epstein-Barr virus genome in association with

4 of 11 cases (36%) of enteropathy-associated T-cell lymphoma. In a

retrospective study, we have characterized 22 consecutive cases of

enteropathy-associated T-cell lymphoma from the West of Ireland where

celiac disease is endemic. All cases were immunophenotyped with T- and

B-cell markers

Premalignant conditions of the small intestine.

Author Ryan JC Source Semin Gastrointest Dis, 1996 Apr, 7:2, 88-93

Abstract Cancer of the small intestine is rare compared with other

sites in the gastrointestinal tract. Of the four major primary

small-bowel tumors (adenocarcinomas, lymphomas, carcinoid, and

leiomyosarcomas), adenocarcinomas and lymphomas are associated with

diseases that seem to increase the risk of developing these

malignancies. In the case of immunoproliferative small intestinal

disease and celiac disease, both of which are thought to predispose

patients to the development of primary lymphoma, treatment of the

predisposing conditions seems to decrease the risk of developing

subsequent malignancy. Recognition of the increased risk associated

with other conditions, such as immunodeficiency syndromes, nodular

lymphoid hyperplasia, Crohn's disease, the gastrointestinal polyposis

syndromes, hereditary nonpolyposis colon cancer, neurofibromatosis,

long-standing ileostomy, and urinary diversion procedures, may lead to

early diagnosis and improved survival.

The gut as a lymphoepithelial organ: the role of intestinal

epithelial cells in mucosal immunity.

Author TlaskalovÆa-HogenovÆa H; FarrÆe-Castany MA; StÅepÆankovÆa R;

KozÆakovÆa H; TuÅckovÆa L; Funda DP; Barot R; Cukrowska B; Sinkora J;

Mandel; L; et al Source Folia Microbiol (Praha), 1995, 40:4, 385-91

Abstract Mucosal surfaces covered by a layer of epithelial cells

represent the largest and most critical interface between the organism

and its environment. The barrier function of mucosal surfaces is

performed by the epithelial layer and immune cells present in the

mucosal compartment. As recently found, epithelial cells, apart from

their participation in absorptive, digestive and secretory processes

perform more than a passive barrier function and are directly involved

in immune processes. Besides the well known role of epithelial cells in

the transfer of polymeric immunoglobulins produced by lamina propria B

lymphocytes to the luminal content of mucosals (secretory Igs), these

cells were found to perform various other immunological functions, to

interact with other cells of the immune system and to induce an

efficient inflammatory response to microbial invasion: enzymic

processing of dietary antigens, expression of class I and II MHC

antigens, presentation of antigens to lymphocytes, expression of

adhesive molecules mediating interaction with intraepithelial

lymphocytes and components of extracellular matrix, production of

cytokines and probable participation in extrathymic T cell development

of intraepithelial lymphocytes. All these functions were suggested to

influence substantially the mucosal immune system and its response.

Under immunopathological conditions, e.g. during infections and

inflammatory bowel and celiac diseases, both epithelial cells and

intraepithelial lymphocytes participate substantially in inflammatory

reactions. Moreover, enterocytes could become a target of mucosal

immune factors. Mucosal immunosurveillance function is of crucial

importance in various pathological conditions but especially in the

case of the most frequent malignity occurring in the intestinal

compartment, i.e. colorectal carcinoma. Proper understanding of the

differentiation processes and functions of epithelial cells in

interaction with other components of the mucosal immune system is

therefore highly desirable.

 

 

 

 

 

 

Gluten Free: The exclusion of wheat, rye, barley are

the initial steps when gluten allergy is suspected. Gluten elimination

should be part of a more comprehensive dietary study, preferably in the

form outlined in the Alpha Nutrition Program. The Program is

gluten-free and is recommended as the best diet revision strategy for

anyone with diagnosed celiac disease, or any person with symptoms

suggestive of gluten allergy. Learn more about the Alpha Nutrition Program

Gluten free recipes are found in the book,

Alpha

Nutrition

Cooking

and Recipes.

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