Vitiligo, an autoimmune disease, causes the loss of pigment in the skin. Celiac disease, another autoimmune disorder, is triggered by gluten, proteins in wheat, barley and rye. In celiacs, strict adherence to a gluten-free diet usually reverses damage and eliminates symptoms. When vitiligo and celiac disease occur together, some evidence suggests that a gluten-free diet might clear up both, and if one expert's theory about the common roots of all autoimmune disease is correct, it could explain why.
Vitiligo doesn't kill its victims, but when depigmentation affects the face, as it often does, the disease can maim, psychologically and socially. Especially obvious on people with darker skin tones, vitiligo is estimated to affect up to 1 percent of the population. Even though it isn't contagious, vitiligo can carry a heavy stigma. In India, it is commonly referred to as "white leprosy," and people who have it, and their families, frequently are ostracized. At present, no cure exists and the only treatment options involve concealment, including bleaching all pigment out of the skin. The late pop star Michael Jackson had vitiligo.
Celiac Disease Connection
In the past, vitiligo was assumed to have an autoimmune component, but a study published in "The New England Journal of Medicine" on April 21, 2010, proved that it was an autoimmune disease in the same family as celiac disease. Of 14 genes identified as being linked to vitiligo, 13 were directly involved in regulating immune function or implicated in other autoimmune conditions. Another paper published in the 2011 "Turkish Journal of Gastroenterology" left little room for doubt about the close connection between the two diseases. Researchers tested the blood of 61 people with vitiligo for the presence of antibodies indicating celiac disease and got positive readings for 23.8 percent of the children and 15 percent of the adults.
A paper published in the March 2011 "Pediatric Dermatology" sparked great interest among people with vitiligo, celiac disease, and both. Spanish doctors reported that after a girl with both conditions went on a gluten-free diet, the color returned to her vitiligo lesions. According to the National Vitiligo Foundation, the disease has never attracted much research funding because it is widely considered to be a "cosmetic" problem. Scientific evidence always is preferable to anecdotal evidence, but while they're waiting for it, many people with vitiligo have been experimenting with gluten-free diets and posting online reports, some claiming significant improvements. The general attitude seems to be that since it might help and can't hurt, a gluten-free diet is worth a try.
Dr. Alessio Fasano, director of the University of Maryland Center for Celiac Research, believes that three common factors come into play in many and perhaps all autoimmune diseases: genetic predisposition, an environmental trigger and an abnormally "leaky" intestinal wall. Zonulin, a protein elevated in people with various autoimmune diseases, is believed to be responsible for this increased intestinal permeability. In an article published in the August 2009 "Scientific American," Fasano wrote that clinical trials of larazotide, a drug that inhibits zonulin production, had restored gluten tolerance to celiacs. The next phase of clinical trials will investigate larazotide's usefulness for treating other autoimmune disorders. Larazotide is not yet on the market.