Coeliac disease, enamel defects and HLA typing

Area of Science:

• Pediatric Gastroenterology
• Dental Medicine
• Immunogenetics

Background:

• Coeliac disease (CD) is an autoimmune disorder triggered by gluten ingestion.
• Dental enamel defects are observed in CD patients, but their association with specific genetic markers and clinical factors requires further investigation.
• Understanding these associations can aid in early diagnosis and management of CD.

Purpose of the Study:

• To investigate the prevalence of dental enamel defects in Italian children with CD.
• To explore the relationship between enamel defects and hypocalcemia or specific human leukocyte antigen (HLA) genotypes.
• To identify predictors for dental enamel defects in CD patients.

Main Methods:

• A case-control study involving 82 Italian children diagnosed with CD and 189 healthy controls.
• Dental enamel defects (demarcated opacities, hypoplasia) were assessed.
• Patients were genotyped for HLA class I and II antigens.
• Serum calcium levels and age at diagnosis were recorded.

Main Results:

• Dental enamel defects were significantly more frequent in CD patients (28.0%) compared to controls (14.8%).
• No significant differences in age at diagnosis or serum calcium levels were found between CD patients with and without enamel defects.
• Presence of HLA DR3 antigen significantly increased the risk of dental lesions, while HLA DR5,7 genotype appeared protective.
• Logistic regression indicated that HLA DR antigens were the sole significant discriminator between CD patients with and without enamel defects.

Conclusions:

• Dental enamel defects are a significant clinical finding in children with coeliac disease.
• HLA genotype, specifically DR3 and DR5,7, plays a crucial role in the susceptibility or protection against dental enamel defects in CD.
• HLA typing may serve as a valuable tool in identifying CD patients at higher risk for dental anomalies.