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Parechovirus Infection in Early Childhood and Association With Subsequent Celiac Disease

German Tapia1, Kateřina Chudá, Christian R Kahrs

  • 11Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway; 2Department of Paediatric, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic; 3Department of Pediatrics, Østfold Hospital Trust, Grålum, Norway; 4Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg and Queen Silvia Children's Hospital, Gothenburg, Sweden; 5Division of Institute Resources, Department of IT and e-health, Norwegian Institute of Public Health, Oslo, Norway; 6Department of Pediatric Research, Oslo University Hospital, Oslo, Norway.

The American Journal of Gastroenterology
|May 13, 2021
PubMed

Insights

Early-life parechovirus infections were linked to a higher risk of developing celiac disease (CD) in children genetically predisposed to the condition. This study highlights parechovirus as a potential factor in celiac disease development.

Area of Science:

  • Virology
  • Gastroenterology
  • Immunology

Background:

  • Celiac disease (CD) is an autoimmune disorder triggered by gluten ingestion in genetically susceptible individuals.
  • Enteric viruses are common in early childhood, and their role in immune-mediated diseases is under investigation.
  • Previous research suggests a potential link between viral infections and the development of autoimmune conditions.

Purpose of the Study:

  • To investigate the association between parechovirus and anellovirus infections and the subsequent development of celiac disease (CD).
  • To determine if increased frequency of parechovirus infections precedes the development of transglutaminase 2 (TG2) antibodies in children who later develop CD.
  • To explore anellovirus as a potential marker of immune status in relation to CD development.

Main Methods:

  • A matched case-control study nested within a longitudinal birth cohort (MIDIA study) of genetically at-risk children.
  • Retrospective analysis of blood samples for TG2 antibody development and monthly stool samples for viral quantification using real-time PCR.
  • Matching of 25 CD cases with 50 control children based on follow-up time, birthdate, and county of residence.

Main Results:

  • Parechovirus was detected more frequently in stool samples from children who later developed CD, particularly before TG2 antibody development (adjusted odds ratio 1.67, P = 0.01).
  • The association was stronger when samples were positive for both parechovirus and enterovirus (adjusted odds ratio 4.73, P = 0.02).
  • Anellovirus was detected frequently but showed no significant difference between CD cases and controls.

Conclusions:

  • Early-life parechovirus infections are associated with an increased risk of developing celiac disease in genetically predisposed children.
  • Parechovirus may play a role in the pathogenesis of celiac disease.
  • Anellovirus does not appear to be a significant factor or marker in the development of CD in this cohort.
Abstract

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