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Enterovirus Infections Are Associated With the Development of Celiac Disease in a Birth Cohort Study

Maarit Oikarinen1, Leena Puustinen1, Jussi Lehtonen1

  • 1Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.

Frontiers in Immunology
|February 19, 2021
PubMed

Insights

Enterovirus infections, but not adenovirus, were more common in children who later developed celiac disease. This suggests enteroviruses may play a role in the onset of celiac disease in susceptible children.

Area of Science:

  • Gastroenterology
  • Virology
  • Immunology

Background:

  • Celiac disease is an autoimmune disorder triggered by gluten ingestion.
  • Previous studies suggest viral infections may be environmental risk factors for celiac disease.
  • Enteroviruses and adenoviruses are common childhood viruses with proposed links to celiac disease.

Purpose of the Study:

  • To investigate the association between enterovirus and adenovirus infections and the development of biopsy-proven celiac disease in children.
  • To determine if viral infections precede the onset of celiac disease autoimmunity.

Main Methods:

  • Prospective cohort study of children from birth.
  • Case group: 41 children with biopsy-proven celiac disease.
  • Control group: 53 matched children.
  • Viral infections diagnosed via enzyme immunoassay (EIA) for seroconversion in longitudinally collected sera.
  • Analysis of enterovirus and adenovirus infection frequency before celiac disease diagnosis or autoantibody appearance.

Main Results:

  • Enterovirus infections were significantly more frequent in children who developed celiac disease prior to the appearance of tissue transglutaminase autoantibodies (odds ratio 6.3, p = 0.005).
  • No significant difference in adenovirus infection frequency was observed between cases and controls.
  • The association was specific to the period preceding celiac disease autoimmunity.

Conclusions:

  • Enterovirus infections appear to be more frequent in children who develop celiac disease, suggesting a potential role in disease pathogenesis.
  • Adenovirus infections were not associated with celiac disease development in this cohort.
  • Further research is warranted to elucidate the mechanisms by which enteroviruses may contribute to celiac disease onset.

Keywords:
Finnish Diabetes Prediction and Prevention studyceliac diseaseconditional logistic regressionenterovirusenzyme immunoassay (EIA)tissue transglutaminase autoantibodies

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