Gastrointestinal infection leads to celiac disease in childhood


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Recent research, published in The BMJ, has found that a childhood stomach bug may cause celiac disease later in life. These discoveries could pave the way for a vaccine to defend against the disease.

Celiac disease is a significant medical state which can cause serious complications if it is not detected and treated properly.

Celiac disease, sometimes called sprue or coeliac, is an autoimmune disorder. In this condition, the small intestine becomes swollen and could not properly absorb nutrients. The disorder can present at any age, having symptoms like bloating and abdominal pain, as well as diarrhea.

Symptoms of celiac disease

The symptoms of this disorder can vary from mild to severe. Common symptoms of celiac disease in children include;

  • Diarrhea
  • Poor appetite
  • A bloated or painful belly
  • Weight loss or difficulty gaining weight

The symptoms can begin at any stage after an individual is eating gluten-containing foods, from infancy to adulthood.

Its symptoms are brought on by consuming gluten. Gluten is a common plant-based protein found in pasta, bread, cake, pastry, cereals, pizza, and beer made from barley. Presently, there is no proper treatment for celiac disease. Hence, the only way to manage this state is to eliminate all gluten products from the diet.

Currently, the cause of celiac disease is not known. Nowadays, longitudinal research carried out by the Norwegian Institute of Public Health has proposed that enterovirus may precipitate the disorder.

Actually, enteroviruses are a group of viruses which characteristically cause mild infectious diseases but can cause serious illness if it infects the central nervous system.

Echovirus and coxsackievirus are the two most common enteroviruses, with some other viruses causing polio and hand, foot and mouth disease. Infections due to these viruses are common in children under the age of 3, but most adults are immune to it.

On the basis of research, it has been considered that enterovirus causes “impaired barrier function, which in turn may lead to the increased risk of celiac disease.”

Findings of the study

The research involved taking fecal samples on monthly basis from 220 children between 3 months of age up to 10 years. A test was performed to check the presence of enterovirus and adenovirus. The researchers of the study found that both viruses normally present before the development of celiac disease antibodies.

It was found that enterovirus was present in 370 of 2135 stool samples, making up around 17% of samples collected. Also, 73 children had at least one positive sample, with viral counts climaxing in autumn months.

Adenovirus was found in 258 of 2006 stool samples, making up 13% of the samples collected. 61 children had at least 1 adenovirus-positive sample. But in the case of enterovirus, prevalence did not appear to be affected by season. This lead to the deduction that adenovirus was not related to the development of celiac disease.

Current research demonstrates that celiac disease occurs exclusively in individuals with HLA-DQ2 or HLA-DQ8 haplotype, that is found in around 40% of the population. However, predicting the possibility of the celiac disease developing in groups of people with these haplotypes is not reliable.

Whereas the researchers claim that they avoided the “reverse causality which may bias studies of infections at or after diagnosis of celiac disease”.

They state that they cannot make conventions about the link between enterovirus and celiac disease outside of the HLA-DQ2/DQ8 haplogroups. In spite of this, they believe that their results are “expected to apply to an ample proportion of patients with celiac disease.”

Overall, the outcomes of the research proposed that enterovirus infections in early life could be one among various key risk factors for disease development with lifelong consequences. And that several types of enterovirus, high titer, and long period infections in the period after introduction of gluten were involved.

Source

https://www.bmj.com/content/364/bmj.l231

 


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Areeba Hussain
The author is a Medical Microbiologist and healthcare writer. She is a post-graduate of Medical Microbiology and Immunology. She covers all content on health and wellness including weight loss, nutrition, and general health.

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