Sex differences in abnormal gluten response and predictors of gluten sensitivity in patients with schizophrenia.
Level 4 - case-series / case-control
Case-control cross-sectional biomarker study.
PubMed 41262244 · doi:10.3389/fimmu.2025.1696763
What was done
Serum biomarkers of gluten sensitivity (anti-gliadin antibodies [AGA] IgA/IgG, deamidated gliadin peptide [dGP] IgG, tissue transglutaminase [tTG] IgA), intestinal integrity (anti-Saccharomyces cerevisiae antibodies [ASCA]), and systemic inflammation (high-sensitivity C-reactive protein [hs-CRP]) were measured in 102 individuals with schizophrenia and 60 healthy controls. The study analyzed sex differences and clinical/biomarker predictors of positive gluten antibody titers in the schizophrenia cohort.
What was found
Elevated AGA IgA was detected in 26% of schizophrenia patients versus 22% of healthy controls, and elevated AGA IgG in 30% of patients versus 20% of controls. Men had higher overall IgG levels than women regardless of diagnosis. Among schizophrenia patients, men had significantly higher concentrations of AGA IgG and dGP IgG than women. In patients, AGA IgA positivity was associated with tTG IgA levels, hs-CRP levels, and age; AGA IgG positivity was associated with dGP and ASCA antibody levels, negative symptoms, and age of onset.
Why it matters
This study highlights sex-specific immune responses to gluten in schizophrenia, showing that male patients exhibit stronger antibody responses that associate with gut barrier markers and negative psychiatric symptoms.
Limits
The cross-sectional design cannot establish causality between gluten reactivity and psychiatric symptoms. The sample size is modest (102 patients, 60 controls), and the abstract does not provide exact p-values, odds ratios, or data controlling for dietary intake and antipsychotic medications.
Cited by
- context Approximately 17% of people with schizophrenia have elevated gluten antibodies.