An excerpt from:

Cereal Grains: Humanity's Double Edged Sword
Loren Cordain; World Review of Nutrition & Dietetics, 1999;84:19-73

Rheumatoid arthritis is a complex autoimmune disease involving numerous environmental and genetic components, and similar to a number of other autoimmune diseases is found more often in celiac patients (251,281). Multiple studies of arthritic patients have demonstrated elevated antibody levels for gliadin (282,283), and gluten free diets have been shown to be effective in reducing arthritic symptoms in celiac patients (283,284,285). No large clinical trials have been undertaken to specifically examine the effectiveness of gluten free diets in the treatment of arthritis, however there are numerous case studies reporting alleviation of arthritis symptoms with grain free diets (286,287,288,289). Additionally, complete withdrawal of food during fasting reduces objective and subjective indices of the disease (290).

Because serum antibodies in arthritic patients recognize the antigen, bovine serum albumin (BSA) from cow's milk, and since BSA contains homologous amino acid sequences with human collagen type I, C1q, it has been suggested that molecular mimicry represents a potential mechanism by which milk consumption may trigger arthritis (291). In addition to milk, glycine rich cell wall protein (GRP 1.8), which is ubiquitous in cereal grains and legumes, shares significant amino acid homology with fibrillar collagen and procollagen and has been shown to stimulate T cells from the synovial fluid of juvenile and adult rheumatoid arthritis patients (292). A third dietary antigen which may also induce rheumatoid arthritis via molecular mimicry is the alpha gliadin component of wheat which shares significant amino acid sequences with calreticulin (245). Anti-calreticulin antibodies have been found in rheumatoid arthritis patients (293), and HLA-DR4 molecules from arthritic patients are known to present a peptide fragment derived from calreticulin (294). Dietary antigens from three food sources (milk, grains and legumes) contain multiple peptides which mimic those found in joint tissue from arthritis patients, whereas grains and legumes additionally contain lectins which can induce inappropriate presentation of HLA class II molecules (235,237), consequently, future dietary interventions aimed at reducing arthritis symptoms would need to consider these potential confounding effects.

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