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Published on: December 15, 2011
Respiratory Infections and the Risk of Celiac Disease
Renata Auricchio1,2, Donatella Cielo3, Renato de Falco1
1Department of Translational Medical Science and.
Insights
Respiratory infections in the first two years of life are linked to developing celiac disease (CD) in genetically predisposed infants. Early infections may signal a higher risk for this autoimmune condition.
Area of Science:
- Pediatric immunology
- Autoimmune disease research
- Infectious disease epidemiology
Background:
- Celiac disease (CD) incidence is rising, suggesting environmental factors like infections may trigger autoimmune responses in susceptible individuals.
- Understanding early life events is crucial for predicting and potentially preventing CD development in genetically predisposed infants.
Purpose of the Study:
- To investigate the association between early clinical events and the subsequent development of celiac disease in infants with a genetic predisposition.
- To identify specific early life factors that may predict celiac disease onset.
Main Methods:
- Recruited 373 newborns from families with a history of celiac disease, focusing on human leukocyte antigen (HLA) DQ2/DQ8 positive infants.
- Utilized clinical and serological evaluations, cross-tabulation, odds ratios, logistic regression, and stepwise discriminant analysis to identify risk factors.
- Analyzed adverse events, specifically infections, in relation to celiac disease development.
Main Results:
- The cumulative incidence of celiac disease was 6% at 3 years and 13.5% at 5 years, with 14% developing CD before age six.
- Children who developed celiac disease showed a higher frequency of respiratory tract infections within the first 24 months of life.
- Stepwise discriminant analysis identified respiratory infections in the first and second years of life as significant predictors distinguishing celiac disease cases from controls.
Conclusions:
- The frequency of respiratory infections during the first two years of life can effectively distinguish infants who will develop celiac disease from those who will not.
- Early respiratory infections represent a key clinical event associated with celiac disease development in genetically predisposed children.
Background And Objectives:
The increasing incidence of celiac disease (CD) suggests that common infections before the onset of autoimmune diseases could be an important factor in switching the immune response. We aimed to explore the relationship between early clinical events and the development of CD in genetically predisposed infants.
Methods:
In this study, 373 newborns from families with at least 1 relative with CD were recruited, and human leukocyte antigen DQ2- or DQ8-positive infants were followed up with clinical and serological evaluations. Cross tabulation and odds ratios were used to explore the risk associated with single variables, and logistic regression analysis was performed to determine the variables that contributed to the risk of developing CD. Stepwise discriminant analysis was used to determine which variables could distinguish case patients from controls before diagnosis.
Results:
The cumulative incidence of CD in this cohort was 6% at 3 years and 13.5% at 5 years of age, and l34 children (14%) developed CD before the sixth year of life. An analysis of adverse events showed a higher frequency of respiratory tract infections among CD patients during the first 24 months of life. In a stepwise discriminant analysis, which included sex and human leukocyte antigen risk class, only respiratory infections in the second and first years of life significantly contributed to discrimination of case patients versus controls.
Conclusions:
A multivariate model of discriminant analysis showed that the frequency of respiratory infections in the first 2 years of life could distinguish children who developed CD from those who did not.
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