Could IBS be an autoimmune condition?

Most people have never heard about a protein called vinculin, but a recent study of 165 IBS, 30 IBD and 26 healthy controls found that people with IBS have higher levels of (auto) antibodies to this protein than do healthy controls or people with inflammatory bowel disease.

One possible outcome of this work is a specific diagnostic blood test for IBS that can distinguish this condition from IBD. But the findings from this multicenter study, led by Dr. Mark Pimentel of Cedars-Sinai Medical Center in collaboration with researchers from Beth Israel Deaconess Medical GAS in Boston could shed more light on how IBS develops and lead to alternative treatment approaches for this condition.

Vinculin is what’s called a “cytoskeletal protein”, and is found at junctions between cells as well as junctions between cells and extra cellular matrices. Vinculin appears to help anchor a filamentous protein called F-actin which helps muscles contract, but also helps the immune system fight off pathogenic bacteria.

One cause of IBS is having a previous bout of gastroenteritis (a gut infection) which often triggers small intestinal bacterial overgrowth (SIBO). The idea behind this study is that a bacterial toxin called cytolethal distending toxin B (CdtB) produced by gram negative Proteobacteria (such as Shigella sp. and E. coli), triggers gastroenteritis by molecular mimicry which stimulates auto-antibodies to vinculin. This process may be involved eventual development of IBS, though the details of how this happens are far from clear. Studying antibody titers to vinculin in IBS patients can establish the role of gastroenteritis in IBS and help determine the extent to which autoimmune processes are involved.

Clearly vinculin is relevant to gut infections as another study showed that Shigella flexneri (another Proteobacteria pathogen), which causes a form of dysentery, secretes an invasion protein called IpaA which binds to the vinculin to facilitate the bacteria’s entry into cells that line the intestine. How this all ties together will be an interesting story to follow.

About Norm Robillard

Norman Robillard, Ph.D., is a microbiologist and researcher who spent 20 years in the pharmaceutical industry before founding the Digestive Health Institute. His goal is to develop holistic treatments for digestive illnesses based on a clear understanding of the underlying causes of disease. Norm was the first to recognize a connection between bacteria in our intestines, nutritional malabsorption and the symptoms of acid reflux. Based on his extensive research, he created the clinically proven Fast Tract Diet, a safe and effective alternative to proton pump inhibitor (PPI) and H2 blocking drugs. Fast Tract Digestion books are now available for Heartburn and IBS on the books page. Bacterial overgrowth fueled by nutritional malabsorption is a factor in several other digestive health conditions. Research in this area is the main focus of the DHI. Additional versions of Fast Tract Digestion are in the works for a number of these conditions. Norm received his Ph.D. at the University of Massachusetts, Amherst and completed post-doctoral training at Tufts University.
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8 Responses to Could IBS be an autoimmune condition?

  1. Alexandra says:

    Excellent article Dr. Robillard! There is also some evidence that GERD could have autoimmune “root” (i think you saw this article already, but here is the link http://www.newswise.com/articles/reflux-esophagitis-due-to-immune-reaction-not-acute-acid-burn-ut-southwestern-researchers-report )

    Maybe this information can help to understand the process of healing for those who don’t respond quickly at low FP diet (as in my case). Maybe such people need some restricion in pro-inflammatory or pro-autoimmune foods? (like it is described in the recent book The Paleo Approach: Reverse Autoimmune Disease, Heal Your Body written by Sarah Ballantyne).

    • Thanks Alexandra. I had seen that article. While I’m interested in seeing where they go with this research, the triggering event, even in this case, is the insult on the esophagus from reflux involving a combination of damaging ingredients such as acid, bile, enzymes and possibly bacteria or bacterial toxins. So I am convinced that stopping reflux is the key. By the way, was that your review on Amazon this morning? If so, thank you! I enjoyed reading it.

      • Alexandra says:

        Me too, i think that the most important is to stop gas from bacteria.
        It’s just like two paralleling jobs: to work with bacterias (by following low FP) and to work with any linked condition (like maybe some autoimmune process promoting inflammation).

        PS Yes, it is my review at Amazon! My writing style is recognisable :) I’m glad that you liked it! I hope that more reviews will appear to promote people to read your great book!

        • I think the symptoms of SIBO and autoimmune reactions both caused by leaky gut triggered by SIBO and/or dysbiosis, so the diet that best controls this overgrowth should be the best for both problems. Of course any other factors, such as gluten removal in some cases are also important. That’s why I am working on the next Fast Tract book that will address autoimmune conditions.

          Thanks again for the review. : )

  2. Kelly says:

    Happy to hear that a book on autoimmune disorders is planned for your series. I’m currently reading The Paleo Approach mentioned above, and would love to see what you and Sarah Ballantyne would come up with if you conferred & learned from each other.

  3. bearsmom says:

    For me part of what gets lost in this debate is the fact that the Fast Track Diet alone may clear up the issues for people and is honestly so much less restrictive than Auto-Immune Paleo diet. I tried for 2 years to figure out what my trigger foods were that were causing all my digestive symptoms. My holistic doctor did not really want me on a total elimination diet and I was really stuck. Using the Fast Track approach yeilded quick results and is relatively easy to accomplish if one is used to cooking with whole foods. I am looking forward to further improvements. It would only be after about 3 months on the Fast Track Diet that I would start looking into other immune issues, seek testing, or take out other foods. Given the presentation of my symptoms they are in line with SIBO symptoms (even if there might be some crossover into auto-immune) and so reducing the microbial burden alone to see if this reduces inflammation and enhances nutrient absorbtion, this seems a prudent and also a reasonable way to go and honestly way less restrictive than AIPaleo.

    • I agree with you Bearsmom in this regard. Inflammation caused by either a GI infection or SIBO itself can lead to leaky gut and autoimmunity. The fist step is stopping the insult leading to leaky gut. The Fast Tract Diet is directed at this most basic problem.

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