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Geni, ambiente e... intestino! Come prevenire, gestire e talvolta guarire da molte malattie
Artrite reumatoide, autismo, diabete giovanile, fibromialgia, lupus eritematoso, morbo di Crohn, sindrome da stanchezza cronica, tiroidite di Hashimoto, sclerosi multipla e varie malattie autoimmuni come pure molte forme tumorali, e disturbi neuro-pischiatrici, sono legati spesso ad un’alterata funzione della barriera intestinale; tutto questo raccomanda si segua una dieta sana, che preveda largo uso di frutta, verdura, semi oleosi e limiti l’uso di grassi animali, grassi idrogenati, additivi chimici, pesticidi.
Seguire una dieta adeguata significa sempre più controllare anche eventuali intolleranze alimentari. Il probabile meccanismo alla base della relazione tra dieta e prevenzione, o gestione delle malattie, ruota infatti attorno all’intestino.
Il tratto gastrointestinale non esplica meramente funzioni digestive e di assorbimento di nutrienti ed elettroliti. Tra le scoperte di questi ultimi anni vi è la sua proprietà di regolare il passaggio degli antigeni attraverso il meccanismo di azione della zonulina e la sua attivazione, tramite interazioni intestinali, della mucosa-microbiota e del glutine. Nell’intestino viene così modulato il segnale di “tolleranza” ed immunità e quando la barriera intestinale è infiammata innesca la patogenesi di ulteriori processi infiammatori che possono degenerare in processi autoimmuni e neoplastici.
La GI, ovvero infiammazione intestinale, con conseguente perdita della funzione della barriera intestinale è dunque da considerarsi oggi, insieme alle cause genetiche ed ambientali, un elemento responsabile di varie malattie, da quelle autoimmuni ai tumori, passando per varie malattie di tipo neuropsichiatrico.
Questo dato va visto con positività, una volta chiarito il ruolo chiave della dieta diventa più facile la prevenzione, non solo, anche la gestione della propria malattia sarà possibile seguendo accorgimenti semplici, che potranno tranquillamente integrare le cure stabilite offrendo importanti e spesso immediati benefici. Bloccare l’azione sinergica di uno dei tre fattori che portano alla malattia (genetica, ambiente, dieta) permette talvolta la remissione della stessa.
Navigando nel sito potete approfondire aspetti legati ad una specifica patologia ed anche trovare ricette e prodotti adatti la vostra persona.
A seguire una breve selezione di articoli che evidenziano una relazione tra dieta e malattia riportando l’importanza di una dieta specifica per la prevenzione o la buona gestione del caso. Per semplificare il vostro riscontro si è deciso di citare testualmente alcune frasi relativamente all’articolo evidenziato a seguire.

“The classical paradigm of inflammatory pathogenesis involving specific genetic makeup and exposure to environmental triggers has been challenged recently by the addition of a third element, the loss of intestinal barrier function. Genetic predisposition, miscommunication between innate and adaptive immunity, exposure to environmental triggers, and loss of intestinal barrier function secondary to the activation of the zonulin pathway by food-derived environmental triggers or changes in gut microbiota all seem to be key ingredients involved in the pathogenesis of inflammation, autoimmunity, and cancer. This new theory implies that once the pathological process is activated, it is not auto-perpetuating. Rather, it can be modulated or even reversed by preventing the continuous interplay between genes and the environment. Since zonulin-dependent TJ dysfunction allows such interactions, new therapeutic strategies aimed at reestablishing the intestinal barrier function by downregulating the zonulin pathway offer innovative and not-yet-explored approaches for the management of these debilitating chronic diseases”
-Zonulin and Its Regulation of Intestinal Barrier Function: The Biological Door to Inflammation, Autoimmunity, and Cancer
Alessio Fasano
Physiological ReviewsPublished 1 January 2011Vol. 91no. 151-175DOI: 10.1152/physrev.00003.2008

-Diet therapy for rheumatoid arthritis. A controlled double-blind study of two different dietary regimens.
Sarzi-Puttini P, Comi D, Boccassini L, Muzzupappa S, Turiel M, Panni B, Salvaggio A.
Scand J Rheumatol. 2000; 29 (5):302-7.PMID: 11093596

“Our results suggest that individualized dietary revisions may regulate TNF-α and IL-1β levels in selected patients with RA”
-The effect of individualized diet challenges consisting of allergenic foods on TNF-α and IL-1β levels in patients with rheumatoid arthritis
Karatay S, Erdem T, Yildirim K, Melikoglu MA, Ugur M, Cakir E, Akcay F, Senel K.
Rheumatology (2004) 43 (11): 1429-1433.
doi: 10.1093/rheumatology/keh366
First published online: August 10, 2004

-General or personal diet: the individualized model for diet challenges in patients with rheumatoid arthritis. Rheumatol Int.. Epub 2005 Jul 16

-Antibody response against gastrointestinal antigens in demyelinating diseases of the central nervous system (pages 1492–1495)
M. Banati, P. Csecsei, E. Koszegi, H. H. Nielsen, G. Suto, L. Bors, A. Trauninger, T. Csepany, C. Rozsa, G. Jakab, T. Molnar, A. Berthele, S. R. Kalluri, T. Berki and Z. Illes
Article first published online: 7 JAN 2013 | DOI: 10.1111/ene.12072

“The present and earlier studies lend some support tothe notion oh a benefical effect of vegetarian diets in at least somepatients with RA”
-A vegan diet free of gluten improves the signs and symptoms of rheumatoid arthritis: the effects on arthritis correlate with a reduction in antibodies to food antigens
I. Hafström, B. Ringertz, A. Spångberg, L. von Zweigbergk, S. Brannemark, I. Nylander, J. Rönnelid, L. Laasonen and L. Klareskog
Rheumatology (2001) 40 (10): 1175-1179.
doi: 10.1093/rheumatology/40.10.1175


“A vegan diet in RA induced decreased LDL and oxLDL levels and raised levels of natural antibodies of IgA and IgM subclasses to PC”
-Gluten-free vegan diet induces decreased LDL and oxidized LDL levels and raised atheroprotective natural antibodies against phosphorylcholine in patients with rheumatoid arthritis: a randomized study
Ann-Charlotte Elkan, Beatrice Sjöberg, Björn Kolsrud, Bo Ringertz, Ingiäld Hafström and Johan Frostegård*
Arthritis Research & Therapy 2008, 10:R34 doi:10.1186/ar2388


“The results show that some patients with RA can benefit from a fasting period followed by a vegetarian diet”
-Rheumatoid arthritis treated with vegetarian diets
Jens Kjeldsen-Kragh
Am J Clin Nutr September 1999 vol. 70 no. 3 594s-600s

"A high level of red meat consumption may represent a novel risk factor for inflammatory arthritis or may act as a marker for a group of persons with an increased risk from other lifestyle causes."
-Dietary risk factors for the development of inflammatory polyarthritis: Evidence for a role of high level of red meat consumption
Dorothy J. Pattison, Deborah P. M. Symmons, Mark Lunt, Ailsa Welch, Robert Luben, Sheila A. Bingham, Kay-Tee Khaw, Nicholas E. Day and Alan J. Silman
Article first published online: 8 DEC 2004
DOI: 10.1002/art.20731

“These data would help clarify the notion that meat-rich diets (e.g., the Western diet) may be proinflammatory and thus increase the risk of RA, cardiovascular disease, and type 2 diabetes, whereas diets rich in omega-3 fatty acids are antiinflammatory and thus beneficial for these disorders. Nonetheless, currently available data from rheumatology and other disciplines of medicine indicate that healthy dietary patterns advocated for cardiovascular disease prevention in the general public (13) may be doubly beneficial among patients with RA and need to be implemented accordingly”
-Diet and rheumatoid arthritis: Red meat and beyond
Hyon K. Choi MD, DrPH*
Article first published online: 8 DEC 2004
Volume 50, Issue 12, pages 3745–3747, December 2004
DOI: 10.1002/art.20732

-GLIADIN IMMUNE REACTIVITY IN PATIENTS WITH RHEUMATOID-ARTHRITIS
By:PAIMELA, L ); KURKI, P ; LEIRISALOREPO, M; PIIRAINEN, H.
CLINICAL AND EXPERIMENTAL RHEUMATOLOGY
Volume: 13 Issue: 5 Pages: 603-607
Published: SEP-OCT 1995 Accession Number: WOS:A1995TB09400006
ISSN: 0392-856X

“The present work indicates, however, that individual susceptibility (allergy?, unusual immune response?) may be an important area for future investigations of the pathogenesis of RA”.
-Effect of dietary restrictions on disease activity in rheumatoid arthritis
DEEPA BERI, A N MALAVIYA, RENU SHANDILYA, AND R R SINGH
From the Clinical Immunology Section, Department of Medicine, All India Institute of Medical Sciences, New Delhi 110029, India
Annals of the Rheumatic Diseases, 1988; 47, 69-72

“The existence of a subgroup of patients in whom food intolerance influences the activity of rheumatoid factor seropositive rheumatoid arthritis deserves serious consideration”
-Food intolerance in rheumatoid arthritis. I. A double blind, controlled trial of the clinical effects of elimination of milk allergens and azo dyes.
M A van de Laar, J K van der Korst
Ann Rheum Dis 1992; 51 : 298-302 doi: 10.1136/ard.51.3.298

-Overlap between functional GI disorders and other functional syndromes: what are the underlying mechanisms?
S. E. Kim and L. Chang
Article first published online: 2 AUG 2012
DOI: 10.1111/j.1365-2982.2012.01993.x

“Introduction:
Irritable bowel syndrome (IBS) and fibromyalgia syndrome (FMS) are two common central sensitization disorders frequently associated in the same patient, and some of these patients with IBS plus FMS (IBS/FMS) could actually be undiagnosed of coeliac disease (CD)(…)
Conclusions:
The findings of this screening indicate that a non-negligible percentage of IBS/FMS patients are CD patients, whose symptoms can improve and in whom long-term CD-related complications might possibly be prevented with a strict lifelong GFD(…)”
-Remarkable prevalence of coeliac disease in patients with irritable bowel syndrome plus fibromyalgia in comparison with those with isolated irritable bowel syndrome: a case-finding study
Luis Rodrigo, Ignacio Blanco, Julio Bobes and Frederick J de Serres
Arthritis Research & Therapy 2013, 15:R201 doi:10.1186/ar4391

-Dietary fish oil and olive oil supplementation in patients with Rheumatoid Arthritis clinical and immunologic effects
Joel M. Kremer, David A. Lawrence, William Jubiz, Ralph Digiacomo, Richard Rynes, Lee E. Bartholomew and Malcolm Sherman
Article first published online: 9 DEC 2005
DOI: 10.1002/art.1780330607

-n−3 Fatty acid supplements in rheumatoid arthritis1,2
Joel M Kremer
Am J Clin Nutr January 2000 vol. 71 no. 1 349s-351s

-High Incidence of Celiac Disease in Patients with Systemic Sclerosis
EDOARDO ROSATO, DANIELA De NITTO, CARMELINA ROSSI, VALERIO LIBANORI, GIUSEPPE DONATO, MARCO Di TOLA, SIMONETTA PISARRI, FELICE SALSANO and ANTONIO PICARELLI
Published online before print March 30, 2009, doi: 10.3899/jrheum.081000
The Journal of Rheumatology vol. 36 no. 5 965-969

-Antibodies to tissue transglutaminase and Saccharomyces cerevisiae in ankylosing spondylitis and psoriatic arthritis.
Lucrezia Riente, Daniele Chimenti, Federico Pratesi, Andrea Delle Sedie, Simona Tommasi, Cristina Tommasi, Stefano Bombardieri, and Paola Migliorini
J Rheumatol May 2004 31(5):920-924
The Journal of Rheumatology vol. 31 no. 5 920-924

-Autoantibodies to tissue transglutaminase in Sjögren's syndrome and related rheumatic diseases.
Leeanne M Luft, Susan G Barr, Liam O Martin, Edward K L Chan, and Marvin J Fritzler
J Rheumatol December 2003 30(12):2613-2619
The Journal of Rheumatology vol. 30 no. 12 2613-2619

-Commensal Gut Bacteria and the Etiopathogenesis of Rheumatoid Arthritis
CHRISTOPHER J. EDWARDS
J Rheumatol 2008;35;1477-1479 vol. 35 no. 8 1477-1479

-Dietary factors in relation to rheumatoid arthritis: a role for olive oil and cooked vegetables?
Athena Linos, Virginia G Kaklamani, Evangelia Kaklamani, Yvonni Koumantaki, Ernestini Giziaki, Sotiris Papazoglou, and Christos S Mantzoros
Am J Clin Nutr 1999;70:1077–82.

-Seroreactive marker for inflammatory bowel disease and associations with antibodies to dietary proteins in bipolar disorder.
Severance, GressitL, Yang, Stallings, Origoni, Vaughan, Khushalani, Alaedini, Dickerson, Yolken.
Bipolar Disord. 2013 Dec 6. doi: 10.1111/bdi.12159.

-Alterations of the intestinal barrier in patients with autism spectrum disorders and in their first-degree relatives.
de Magistris L, Familiari V, Pascotto A, Sapone A, Frolli A, Iardino P, Carteni M, De Rosa M, Francavilla R, Riegler G, Militerni R, Bravaccio C.
J Pediatr Gastroenterol Nutr. 2010 Oct;51(4):418-24. doi: 10.1097/MPG.0b013e3181dcc4a5

-Anti-Saccharomyces cerevisiae antibodies are elevated in Graves' disease but not in Hashimoto's thyroiditis.
Mankaï A1, Thabet Y, Manoubi W, Achour A, Sakly W, Ghedira I.
Endocr Res. 2013;38(2):98-104. doi: 10.3109/07435800.2012.723293. Epub 2012 Sep 19

-Effectiveness of the gluten-free, casein-free diet for children diagnosed with autism spectrum disorder: Based on parental report.
Pennesi Christine M.; Klein Laura Cousino.
Nutritional Neuroscience, 2012 DOI:10.1179/1476830512Y.0000000003

-Gluten- and casein-free dietary intervention for autism spectrum conditions.
Whiteley P, Shattock P, Knivsberg AM, Seim A, Reichelt KL, Todd L, Carr K, Hooper M.
Front Hum Neurosci. 2012; 6: 344.
Published online 2013 January 4. Prepublished online 2012 November 27. doi: 10.3389/fnhum.2012.00344

-Effects of high-dose fish oil on rheumatoid arthritis after stopping nonsteroidal antiinflammatory drugs clinical and immune correlates
Joel M. Kremer, David A. Lawrence, Gayle F. Petrillo, Laura L. Litts, Patrick M. Mullaly, Richard I. Rynes, Ralph P. Stocker, Nourollah Parhami, Neal S. Greenstein, Betsy R. Fuchs, Anupum Mathur, Dwight R. Robinson, Richard I. Sperling and Jean Bigaouette
Article first published online: 9 DEC 2005 DOI: 10.1002/art.1780380813

-Folate supplementation and methotrexate treatment in rheumatoid arthritis: a review
S. L. Whittle and R. A. Hughes
Rheumatology 2004;43:267–271 doi:10.1093/rheumatology/keh088

-Toll-like receptor signalling in the intestinal epithelium: how bacterial recognition shapes intestinal function
Maria T. Abreu
Nature Reviews Immunology 10, 131-144 (February 2010) | doi:10.1038/nri2707

-Epigenetics and the microbiome: developing areas in the understanding of the aetiology of lupus
CJ Edwards, KH Costenbader
Lupus May 2014 vol. 23 no. 6 505-506 doi: 10.1177/0961203314531636

-Diet Influences Expression of Autoimmune-Associated Genes and Disease Severity by Epigenetic Mechanisms in a Transgenic Mouse Model of Lupus
Faith M. Strickland, Anura Hewagama, Ailing Wu, Amr H. Sawalha, Colin Delaney, Mark F. Hoeltzel, Raymond Yung, Kent Johnson, Barbara Mickelson and Bruce C. Richardson
Article first published online: 2 JUL 2013
DOI: 10.1002/art.37967

-Induction of osteoarthritis and metabolic inflammation by a very high-fat diet in mice: Effects of short-term exercise
Timothy M. Griffin, Janet L. Huebner, Virginia B. Kraus, Zhen Yan and Farshid Guilak
Article first published online: 27 JAN 2012
DOI: 10.1002/art.33332

 
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Il sito ha carattere divulgativo. Gli articoli riportano sempre la fonte dello studio scientifico citato.
Ricette e diete suggerite tengono conto dei numerosi studi che vedono una correlazione tra specifici disagi ed alimentazione, tuttavia non vi è intenzione di offrire consigli di tipo medico. In caso di sospetta patologia è sempre necessario rivolgersi al proprio medico di fiducia.
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