<<Disclaimer: Verify this information before applying it to your situation.>> The following private email is being posted with Dr. Reichelt's permission. It was sent in reply to a question about whether the problem with casein and gluten in autism is an "allergy" or an "intolerance". He was also asked whether soy protein is also typically a problem in autism. From: K.L.Reichelt @ rh.uio.no (Kalle Reichelt) Date: 03/25/96 08:27:04 AM Subject: Food allergy vs. intolerance, soy and autism. 1: It is not allergy but intolerance which is the problem. That is peptides formed from taken up proteins and peptides taken directly from the gut are the root of the problem. Therefore only some of the children with autism show IgA antibodies. Smaller peptides, which sometimes dominate, do not cause antibody formation. However, peptides with different chain length can still have the same effect. Typically beta endorphin is 32 or 26 amino acids long and is an opioid, while shorter fragments like enkephalin (5 amino acids) etc have similar effects. 2: Soy proteins sometimes cross react with antibodies against casein. So far opioids have not been found from soy protein. However, if increased levels of peptides and proteins generally are taken up, also peptides without specific action can still inhibit the break down of other peptides such as endogenous peptides (1). That is innocuous peptides from soy protein can inhibit the break down of say endogenous opioids. Opioids (exorphins) are part of the problem and some other peptides with bioactivities directly and indirectly. 3: It sometimes takes a long time to see an effect of diet (as in celiac disease at times) and the diet must be strict. One molecule of gluten contains 15 opioid sequences. There are other causes of autism besides peptides, although maybe as much as 80% are peptide mediated. We therefore examine the urinary peptides and the antibodies before starting diet. It is also essential that your local MD should be in charge because of the many other possibilities. Avoiding malnutrition is important too. 4: Several immunomodulating peptides are formed from casein (2) and therefore removal of casein will change the immune responses of the body. However, I think many of these are transient. Immunocompetent lymphocytes are thus modulated by opioids (3). It is quite frequent thus that also in celiac disease not only is gluten removed, but also milk and then gently reintroduced at a later date. Reequilibration takes time. 5: Occasionally too much structural damage has been done to the CNS so that we are too late: This is not strange because opioids are inhibitory to Central nervous development (4). However, before puberty it should always ameliorate the disease. Nice aunts and grandmothers often pity the children and let them have "just a little" and therefore cancel out the strenuous efforts of the parents. This in not uncommon. References: 1: La Bella et al (1985) Peptides 6: 645-660. 2: Migliore-samour D and Jollet P (1988) Experientia 44: 88-93. 3: Morgan EL et al (1990) J neuroimmunol 28: 209-217. 4: Zagon IS and Mclaughlin PJ (1987) Brain Res 412: 68-72. All the best Cheers TINY K. Reichelt Pediatric Research Institute