Increased Prevalence of Antibodies Against Dietary Proteins In Children And Young Adults With Cerebral Palsy

OBJECTIVES: Undernourishment is common in children with cerebral palsy (CP) but the reasons are unknown. We previously reported elevated levels of immunoglobulin (Ig) A and IgG antibodies against gliadin (AGA) and tissue transglutaminase (tTG) in 99 children and young adults with CP without characteristic findings of gluten enteropathy in small bowel biopsies. Our aim was to perform a case-control study of IgG-antibodies against other dietary antigens, AGA, anti-tTG and IgE-antibodies against wheat and gluten. METHODS: Sera from 99 CP-cases and 99 healthy, age- and sex-matched controls were analysed with fluorescence enzyme-linked immunosorbent assay(FEIA) for detection of IgG-antibodies against beta-lactoglobulin, casein, egg white, IgG- and IgA-AGA, IgA-anti-tTG and IgE antibodies against gluten and wheat. RESULTS: Compared with controls, the odds ratio (OR) in CP cases for having elevated levels of IgG antibodies against beta-lactoglobulin was 17.0 (95% CI 2.3-128), against casein 11.0 (95% CI 2.6-46.8) and against egg white 7.0 (95% CI 1.6-30.8). The IgE-responses for wheat/gluten were generally low. The tetraplegic (TP) and dyskinetic (DK) CP-subtypes had significantly higher frequencies of elevated levels for all tested antibodies except IgG against egg white, and IgA-anti- tTG. A significantly lower weight was seen in CP-cases with positive versus negative serology. CONCLUSION: Elevated levels of IgG against dietary antigens were more frequent in the CP-group compared with controls, and particularly in the TP and DK CP-subtypes with the most severe neurologic handicap and undernourishment. Hypothetically, malnourishment may cause increased intestinal permeability and thus immunization against dietary antigens.