Many of us who have children with celiac disease may wonder if there is something they could have done to prevent the trigger or onset. I often think about how my Emma got it so quickly (15 mos.) and our younger daughter has been tested three times in her 9 years and doesn’t show any signs.
Three current studies are looking into what happens during that first year that could trigger celiac.
Researching the Cause of Celiac Disease
A report in the November Issue of Gastroenterology and Endoscopy News discusses research that is asking the question “can celiac disease be prevented…”? Specifically the research believes there are three components here that are involved in getting or triggering celiac disease:
- The Gene: People with HLA-DQ8 and HLA-DQ2. The article says “those HLA molecules display gluten fragments to T-cells, which then direct an attack on the intestinal lining.” the article quotes Frits Koning, PhD at Leiden University Medical Center and CEO of the Celiac Disease Consortium as saying, “…you will almost never develop celiac when you are HLA-DQ2 or HLA-DQ8 negative.”
- The Environment: Researchers believe environment plays a significant role. Dr. Peter Green of the Columbia University Celiac Center agrees that “enhanced amounts of gluten in our diets and, especially, the excess exposure to heavily processed forms of gluten may contribute to the increasing rates of celiac disease.”
- The Immune Response: Leaky gut syndrome may also contribute. This is a more complicated explanation…Dr. Alessio Fasano of the University of Maryland’s Center for Celiac Research says, “…the enhanced intestinal permeability in celiac disease patients that allows gluten…to seep out of the gut and to interact freely with genetically-sensitized elements of the immune system”.
Current Research Could Find Ways to Ward Off Future Cases of Celiac
The report lists three specific studies involving children — beginning when they’re first born.
The first study in Europe asks whether by giving small amounts of gluten early on–could prevent onset of celiac later in life. The study is looking at 1,000 children from families who have celiac disease. Children are enrolled in the study at birth and then breastfed. Starting at four months, some will be given 100 mgs of gluten, and others will be given a placebo. These children will be followed for 3 years. Dr. Koning said “The theory is that if small amounts of a substance are administered gradually, the immune system will learn not to respond to to this substance.”
The second study going on now from the Celiac Disease Infant Nutrition Cosortium wonders if the HLA-DQ2 and DQ8 genes actually create an environment more likely to trigger celiac. In this research newborns are immediately tested for the genes. If they have them, they will be “randomized at 6 months to receive either a gluten free diet or a gluten containing diet of 3-5 grams until 1 year old. Then all children will go on a regular gluten-containing diet and studied for another year. Children can be formula or breast fed during that first year.
But what they’ve already found is interesting and it appears to involve bacteria in the gut. There is a difference between HLA-DQ2 and DQ8 babies and those who are negative of those genes. “Members of the Bacteriodetes phylum are lacking or absent from the GI microbiota in children with HLA-DQ2 and DQ8 up to 24 months [old].” But the bacteria are predominant in children without the genes. Dr. Stefano Guandalini, of the University of Chicago says, “We speculate that perhaps manipulations of the microflora could be useful in genetically predisposed infants as a potential method of preventing celiac.”
And the third study going on now in Italy studies the effects of exposing children to gluten between the ages of 4 and 6 months versus being gluten-free for the first year. Early research shows about 10% of EACH group developed biopsy-proven celiac by age 5. This report didn’t mention if doing either one delayed onset of celiac.
I am happy to hear about all of the research going on in the area of celiac disease and prevention. I can’t wait to hear more.