Introduction of Gluten, HLA Status, and the Risk of Celiac Disease in Children

• Published in: The New England journal of medicine Vol. 371; no. 14; pp. 1295 - 1303
• Main Authors: Lionetti, Elena, Castellaneta, Stefania, Francavilla, Ruggiero, Pulvirenti, Alfredo, Tonutti, Elio, Amarri, Sergio, Barbato, Maria, Barbera, Cristiana, Barera, Graziano, Bellantoni, Antonella, Castellano, Emanuela, Guariso, Graziella, Limongelli, Maria Giovanna, Pellegrino, Salvatore, Polloni, Carlo, Ughi, Claudio, Zuin, Giovanna, Fasano, Alessio, Catassi, Carlo
• Format: Journal Article
• Language: English
• Published: Waltham, MA Massachusetts Medical Society 02.10.2014
• Subjects: Age; Age Factors; Age of Onset; Autoantibodies - blood; Autoimmune diseases; Autoimmunity; Biological and medical sciences; Breast Feeding; Celiac disease; Celiac Disease - diagnosis; Celiac Disease - genetics; Celiac Disease - prevention & control; Child; Child, Preschool; Children; Children & youth; Diet; Dietary Proteins - administration & dosage; Feeding; Female; Gastroenterology. Liver. Pancreas. Abdomen; General aspects; Genes; Genotype; Genotypes; Gliadin - immunology; Gluten; Glutens - administration & dosage; GTP-Binding Proteins - immunology; Histocompatibility antigen HLA; HLA Antigens - genetics; Humans; Infant; Infant, Newborn; Infants; Intestine; Intestine, Small - pathology; Kaplan-Meier Estimate; Male; Medical sciences; Neonates; Other diseases. Semiology; Prospective Studies; Risk; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Transglutaminases - immunology; Italy; Human; Medicine; Immunopathology; HLA-System; Intestinal malabsorption; Risk factor; Digestive diseases; Intestinal disease; Coeliac disease; Child
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa1400697

A total of 832 newborns with a familial risk of celiac disease underwent genotyping and were assigned to introduction of dietary gluten at 6 or 12 months of age. There was no between-group difference in the prevalence of the disease at 5 years of age. Celiac disease is a systemic immune-mediated disorder caused by the ingestion of gluten-containing grains (wheat, rye, and barley) in genetically susceptible persons. It is one of the most common lifelong disorders, affecting approximately 1% of the population in Europe and North America 1 , 2 ; the prevalence of this disease is higher among persons who have first-degree relatives with celiac disease (10 to 15%). 3 , 4 The prevalence of celiac disease has increased in developed countries over recent decades; this finding points to the role of one or more possible environmental triggers other than gluten. 5 Genetic background plays a key role in . . .