Autoimmunity, Gluten, & Osteoporosis

A new report in the New England Journal of Medicine identifies antibodies against osteoprotegerin (a protein that prevents bone breakdown) in several patients with celiac disease. This protein is responsible for helping maintain bone density. When it is attacked by the body’s immune system, bone loss becomes accelerated leading to osteoporosis.

Source:

N Engl J Med 2009;361:1459-65.

Gluten Free Society’s Stance:

It is a common thought that osteoporosis associated with celiac disease is a result of malabsorption of vitamins and minerals (mainly vitamin D and calcium). The above report links an autoimmune process of bone loss to gluten sensitivity separate and distinct from gluten induced malabsorption. This finding begs the question – Is Osteoporosis an autoimmune process?

Why is this an important link?

If osteoporosis has an autoimmune component, then we have to go back and look at gluten as a potential cause as it is the only known cause for any of the autoimmune diseases. That means that everyone with osteoporosis should potentially be screened for gluten sensitivity. Additionally, we have to consider the possibility that osteoporosis is another manifestation of the “gluten syndrome”. Very few are aware of the field of research called Osteoimmunology. This relatively new field of research explores the connection between a healthy immune system and bone tissue. It has been well established that many immune system derived chemicals help regulate inflammation, bone cell growth, bone resorption, and more. That being said, we know that gluten can cause a dysfunctional immune system leading to a host of different immune chemical reactions that have negative impacts on human health (especially bone health). The diagram below displays some common effects gluten can have on bone: