Another frustrating, tantalising paper.
Expert Rev Clin Immunol. 2015 Oct 16:1-11. [Epub ahead of print]
Autoimmune diseases and celiac disease which came first: genotype or gluten?
Diamanti A1, Capriati T1, Bizzarri C2, Ferretti F3, Ancinelli M1, Romano F1, Perilli A1, Laureti F1, Locatelli M4.
1a 1 Artificial Nutrition Unit, Epato-Gastroenterology and Nutrition, Pediatric Hospital "Bambino Gesù", Rome, Italy.
2b 2 Endocrinology Unit, Pediatric Hospital "Bambino Gesù", Rome, Italy.
3c 3 Hepato-Metabolic Disease Unit, Pediatric Hospital "Bambino Gesù", Rome, Italy.
4d 4 Scientific Directorate, Pediatric Hospital "Bambino Gesù", Rome, Italy.
Celiac disease (CD) is associated with several autoimmune diseases (ADs) and, in particular, thyroid autoimmunity (TA) and Type 1 diabetes (T1D). TA and T1D are defined as 'associated conditions' to CD (conditions at increased prevalence in CD but not directly related to gluten ingestion). The diagnosis of CD may precede or follow that of TA/T1D. To date, the available evidence suggests that the common genetic background is the main factor determining the high prevalence of the association. Conversely, no conclusive findings clarify whether extrinsic gluten-related factors (age at the first introduction, concomitant breastfeeding, length of gluten exposure and gluten-free diet) may link CD to the ADs. The aim of this review is to evaluate whether genetic background alone could explain the association between CD and ADs or if gluten-related factors ought to be considered. The pathophysiological links clarifying how the gluten-related factors could predispose to ADs will also be discussed.
adolescent; autoimmune diseases; celiac disease; child; thyroid autoimmunity; type 1 diabetes
[PubMed - as supplied by publisher]