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Gluten and the Small Intestine in Rheumatoid Arthritis

Gluten and the Small Intestine in Rheumatoid Arthritis An entirely new concept of the pathogenesis of rheumatoid arthritis and other connective-tissue diseases, a theory in which a genetically determined abnormality of the small imtestine is the basic defect, has been proposed. Shatin's hypothesis1 is that patients with rheumatoid arthritis are heterozygous for nontropical sprue (adult celiac disease). Although they have no intestinal complaints, the intestinal mucosa is abnormal and important metabolites essential to connective tissue are not absorbed. The clinical expression of this heterozygotic condition is rheumatoid arthritis. He further states that the worldwide distribution of rheumatoid arthritis corresponds to the distribution of wheat ingestion, lending indirect support for his hypothesis. The validity of this theory is strengthened by Shatin's report that 18 out of 18 patients with rheumatoid arthritis improved on a gluten-free diet, often within two weeks after the beginning of the dietary restriction of cereal grains.2 Although many arguments could be marshaled against http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Gluten and the Small Intestine in Rheumatoid Arthritis

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References (10)

Publisher
American Medical Association
Copyright
Copyright © 1966 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.1966.03100100109033
Publisher site
See Article on Publisher Site

Abstract

An entirely new concept of the pathogenesis of rheumatoid arthritis and other connective-tissue diseases, a theory in which a genetically determined abnormality of the small imtestine is the basic defect, has been proposed. Shatin's hypothesis1 is that patients with rheumatoid arthritis are heterozygous for nontropical sprue (adult celiac disease). Although they have no intestinal complaints, the intestinal mucosa is abnormal and important metabolites essential to connective tissue are not absorbed. The clinical expression of this heterozygotic condition is rheumatoid arthritis. He further states that the worldwide distribution of rheumatoid arthritis corresponds to the distribution of wheat ingestion, lending indirect support for his hypothesis. The validity of this theory is strengthened by Shatin's report that 18 out of 18 patients with rheumatoid arthritis improved on a gluten-free diet, often within two weeks after the beginning of the dietary restriction of cereal grains.2 Although many arguments could be marshaled against

Journal

JAMA – American Medical Association

Published: Mar 7, 1966

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