<<Disclaimer: Verify this information before applying it to your situation.>> A guest post from Kalle Reichelt, MD, PhD (in reply to the recent posts on this topic) Hi. I would like to draw your attention to a wee paper from us (1) on diet and schizophrenia ,where we followed completely blind 10 semichronic (not the best starting point) male schizophrenics for 1 year. We could conlcude : a) That both urinary peptide excretion and rating scales (Comprehensive Pyschopathological rating scale and Whitaker Index of schizophrenic thinking) as well as clinical state improved slowly on diet, with regression in those off. This was a crossover study. b) It is not unreasonable that changes will be slow because the kidneys are efficient peptide, aminoacid and protein preserving organs. c) The trophic changes in brain in schizophrenia established macroscopically and microscopically in a great many publications the last 10 years, would take time to correct if at all possible. Probably not completely being maturational defects to some extent ( 2).There is also the problem of an optimal timing for maturation of nerve cells as demonstrated in the visual cortex. This means that experiments on chronic cases is a poor way to test the hypothesis. Fairly fresh cases would be ideal. We have recently been able to demonstrate the presence of at least 5 (five) peptides with opioid activity in urines and dialysis fluid from schizophrenics that react to antibodies against bovine casomorphin 1-8.One of these cochromatogrpahs and has the same amino acid composition as bovine casomorphin 1-8.(Reichelt submitted ; as in autists (3)).The very fulminant psychosis seen in post-partum psychosis seems to be mediated by human casomoprhin (4) and demonstrates that such peptides do have access to the Central nervous system (CNS). Furthermore IgA antibodies against gliadin .beta-lactoglobulin and casein are increased in male schizophrenics (5)indicating a connection.NB: The biopsies were normal so that this is not coeliac disease, but a state with increased transmucosal protein/peptide transport. After all uptake in small amounts of intact protein and peptides is well documented (see earlier communications) WE think therefore that it is important to be gluten/gliadin free and milkprotein free if diet is to be used.The more so because gliadinomorphin and casomorphin are very similar and gliadinomorphin is part of the coeliac disease peptide B3142(6) Gliadinomorphin : Y-P-Q-P-Q-P-F Casomorphin(b) Y-P-F-P-G-P-I etc. There are a series og gluten derived opioids too. This is one of the reasons why we remove both protein sources in autistic syndromes too (2,7,8)with again long term but clearly measureable effects and regression in all who quit diet. The paper that was read to Dohan has been changed to : Can schizophrenia be reasonably explained by Dohan s hypothesis on genetic interaction with a dietary peptide overload? . It is hard ot get this published because it goes against the present trends. However, I think it extremely important so I keep trying ( I am of course rather partial to the hypothesis which makes it difficult). I find it remarkable that given the complete lack of aetiology directed treatment that a proper clinical trial should be so difficult to establish.After all also an American has published data along these lines (9) using our old urine screening assay.Our new technique based on Shattocks groups work in the UK but changed a little( Reichelt in prep) is of course available to anyone who is interested.It is fast and with fewer false positives.They are also wellcome here to learn by doing. Finally it should be stressed that opiods do have maturation inhibitory effects in rat brain (10),which would fit Crows(2) data quite nicely . References 1: Reichelt KL et al (1990) The effect of a gluten free diet on glycoprotein associated urinary peptide excretion in schizophrenia J Ort Mrd 5: 223-239. 2:Crow T(1994) Aetiology of schizophrenia .Current Opin.Psychiat7: 39-42 3:Reichelt Kl et al (1991) The probable etiology and possible treatment of childhood autism . Brain Dysfunct. 4:308-319. 4:Lindstr|m LH et al (1984) CSF and plasma beta-casomorphin-like opioid peptides in post-partum psychosis. Amer.j psychiat. 141:1059-1066. 5: Reichelt Kl and Landmark J (1995) Specific IgA antibody increases in schizophrenia. J Biol Psychiat37:410-413. 6. Wieser H et al (1984) Amino-acid sequence of the coleiac active peptide B 3142. Z Lebensmittel Untersuch Forsch 79:3371-3376. 7:Knivsberg A-M et al (1990) Dietary intervention in autistic syndromes. Brain Dysfun.3:315-327. 8: Knivbserg A-M et al (1995) Autistic syndromes and diet .A four year follow-up study of 15 subjects. Scand J Educat. Res : In press (accepted) 9: Cade R et al (1990)The effects of dialysis and diet in schizophrenia Psychiatry: A World prespective 3:494-500. 10:Zagon IS and Mclaughlin PJ (1987) Endogenous opioid systems regulate cell proliferation in the developing rat brain .Brain Res 412:68-72 K. Reichelt Pediatric Research Institute N-0027 Oslo, Norway Tel: +47 22 86 90 45 Fax: +47 22 86 91 17 E-mail: [log in to unmask]