Vaccine for Celiac Disease

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

Key Findings:

  • 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:

SuperPoopers CCFA Team 2017

Quick Take: New Rotavirus Vaccine Stable without Refridgeration.

A recent study (S Isanaka et al. NEJM 2017; 376: 1121-30) shows that a new low-cost oral rotavirus vaccine is effective and importantly, it does not require refridgeration.

Here is a link to a 1:35 min quick take video summary: Efficacy of a Low-Cost, Heat-Stable Oral Rotavirus Vaccine in Niger

 

Rotavirus Vaccine: 4-year Savings One Billion Dollars and Preventing Lots of Suffering

A report from USA Today on the success of vaccination against rotavirus (Link: Pediatrics Rotavirus Study), here’s an excerpt:

Vaccines against a common cause of infant diarrhea have kept hundreds of thousands of children out of the hospital, saving nearly $1 billion in their first four years, a new study shows.

The study is one of three reports in today’s Pediatrics that show the far-ranging impact of childhood vaccinations. The papers are being published as the USA faces its largest number of measles cases – 334 – in two decades. Current measles outbreaks are being fueled by parents who skip vaccines or avoid them altogether, according to the Centers for Disease Control and Prevention.

The first of the new studies focuses on rotavirus, which causes severe diarrhea and dehydration. In the first four years they were available, vaccines against rotavirus prevented more than 176,000 hospitalizations, 242,000 emergency department visits, and 1.1 million doctor’s visits among children under 5, the study says. The vaccines saved an estimated $924 million during the same period, 2007 to 2011, according to the CDC study.”

While this study is not likely to change the ingrained beliefs of many who are opposed to vaccines (Parental Immunity (to Education) and Vaccine Decision …), perhaps humor will be more successful.  Here’s a terrific link from The Daily Show’s Samantha Bee: An Outbreak of Liberal Idiocy – The Daily Show – Video Clip …

Related blog postAlan Alda (aka Hawkeye Pierce) on Communicating Science