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Timing of Gluten Exposure in Infants at Risk for Celiac Disease

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Celiac disease is a unique autoimmune disorder in which certain genetic markers (HLA-DQ2 and/or HLA-DQ8) are present that create particular immune responses when gluten (proteins found in wheat, barley, and rye) is consumed. Only individuals who possess one or both of the genetic markers are prone to developing celiac disease; however, not everyone who is predisposed to celiac develops it.

A study conducted by the University of Maryland School of Medicine found that infants who were delayed exposure to gluten did not develop antibodies that trigger immune responses present in celiac disease. The study looked at 47 infants who are first degree relatives of patients with biopsy-proven celiac disease and who entered the study before weaning (between birth and six months, all of whom were breastfed). According to the study, 34 of the infants tested positive for the genotypes HLA-DQ2 and/or HLA-DQ8, and 26 infants were divided equally into two groups: Group A, who were fed a strict gluten-free diet until 12 months old; and Group B, who were fed a gluten-containing diet from the moment they were weaned. Eight infants from each group were also selected for microbiota and metabolome analysis, which looked at the stool samples of the infants up to the age of 24 months.

The results of the study showed that none of the eight infants in Group A developed the TTG antibodies, an indicator of celiac disease, when gluten was introduced into their diet after they reached 12 months of age. However, one infant in Group B (12.5%) developed celiac-related antibodies and was immediately placed on a gluten-free diet. When all 26 infants were introduced to a gluten-containing diet, a higher percentage of infants in Group B tested positive for IgA antibodies, a biomarker for celiac disease, than infants in Group A. According to the article, the findings also indicate that microbiota and metabolome analysis could be another testing mechanism for individuals genetically at-risk for celiac disease.

Read the full article: Proof of Concept of Microbiome-Metabolome Analysis and Delayed Gluten Exposure on Celiac Disease Autoimmunity in Genetically At-Risk Infants.

Note: NFCA maintains the position that views and information presented on articles and websites we link to are those of the authors, and not necessarily those of NFCA.

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