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Immune Reactivity to Gluten in Patients with Rheumatoid Arthritis

In this study, we will focus on antibody-mediated immune responses. Antibodies are extremely important for any immune response. They are produced by activated B cells after which, they are released into circulation. Antibodies are vital for elimination of microbial infections or other perceived foreign antigens and for establishment of immune system memory to previously seen antigens. Antibodies, by themselves, cause very little harm. However, their strength lies in their ability to tag a molecule as harmful, block its function or mark it for elimination. Because different areas of the body are diverse in their form, function and composition, there are different types of antibodies suited for each area. Different antibody types are called isotypes. In our study, we will focus on three isotypes: IgA, IgE and IgG. IgA is used by the immune system in mucosal tissues, including gastrointestinal tract tissue, IgG is used by the immune system in blood and IgE mediates allergic responses. The presence in blood of IgA, IgG or IgE antibodies that bind specific antigens indicates a person is not tolerant to that antigen and they have mounted an immune response to it.

This is a pilot study that will evaluate the frequency of gluten sensitivity in a sample of patients with the diagnosis of Seropositive Rheumatoid Arthritis (RA). RA is an autoimmune disease that is caused by a complex mixture of genetic, environmental and immunologic factors. When these factors are combined, a patient’s immune system develops antibodies to their own cells or proteins, leading to immune system attack (the body is fighting itself). Continuous immune system activation to a patient’s tissue leads to chronic inflammation, resulting in architectural deformation of bone and joints. The systemic inflammation of RA may also involve the heart (and vasculature), lungs, eyes, skin, nerves and most internal organs. 

We will test serum samples from the blood of RA patients for the presence of total and wheat-specific IgE antibodies. The presence of these specific IgE antibodies will indicate participant allergic status. The results from this analysis will elucidate the number of RA patients in our study with a true IgE-mediated wheat allergy, as opposed to sensitivity to wheat or gluten. Total IgE and wheat IgE will indicate the levels of allergic IgE antibodies a patient produces to wheat. The presence of wheat IgE antibodies will suggest the participant has a true allergy to wheat as opposed to Celiac Disease or Non Celiac Gluten Sensitivity. 

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