A recent study (KM Kemppainen et al. Clin Gastroenterol Hepatol 2017; 15: 694-702, editorial 703-5) showed that gastrointestinal infections can trigger celiac disease (CD) and that immunization with the rotavirus vaccine was protective against developing CD.
This study is part of the TEDDY study: The Environmental Determinants of Diabetes in the Young. The TEDDY cohort involves more than 8000 children who are part of an international prospective cohort who carry genes (HLA-DR-DQ genotypes) with increased risk for diabetes and CD. In this particular group, the authors identified 6327 children who were 4 yrs old by March 2015.
Key Definition: CD autoimmunity (CDA) -children who tested positive for tTG IgA at their annual visit and remained persistently positive 3 months later
- Gastointestinal infections (n=13,881) but not respiratory infections (n=79,816) were associated with an increased risk of CDA. CDA risk was increased within the 3 months of the GI infection.
- 732 of 6327 (11.6%) developed CDA. In this cohort, 318 underwent duodenal biopsy and 283 (90%) had biopsy indicative of CD (Marsh score >1). Thus, in their cohort, there is variability in the onset of CD from the onset of CDA.
- Risk of CDA was reduced in children vaccinated against rotavirus and introduced to gluten before age 6 months (HR =0.57).
- The exact risk depending on interaction with multiple factors including breastfeeding, HLA genotype, seasonality of birth, and timing of gluten introduction. Timing of infection plays a role as well, as earlier exposure to GI infections earlier in life was associated with a decreased risk of celiac disease.
This reference should be kept handy for vaccine advocates. Not only can vaccines prevent infections, but they have now been shown to prevent an autoimmune disease (CD). In addition, previous studies have shown that vaccines can prevent cancers, including hepatocellular carcinoma and cervical cancer.
My take (modified from editorial): This study “demonstrates the power of rigorously conducted prospective studies to reveal complex interactions among genetic and environmental factors.” In addition, this study shows that preventing rotavirus infection with vaccination lowers the risk of celiac disease.
Related blog posts:
- Celiac Disease Risk –TEDDY study
- Celiac Disease and Mode of Delivery -Perhaps Not Very Consequential
- Celiac disease and diabetes
- Celiac disease and psychological problems
- How Birth Can Affect Your GI Tract | gutsandgrowth
- How to Protect Children From Celiac Disease
- Why are we seeing so many more cases | gutsandgrowth
- Why is Celiac Disease Becoming More Prevalent?