Certain stomach viruses sharply increase celiac disease risk. Photo: CC--Vincent Tcheng Chang

Celiac.com 07/27/2016 - Celiac disease is an immune-based disorder triggered by an adverse immune reaction to gluten proteins in genetically susceptible people. A new study shows that certain viral diseases may increase celiac risk, and confirms a link between intestinal viral infections and celiac disease.

Reinhard Hinterleitner earned his PhD from the Medical University of Innsbruck in molecular cell biology and oncology at the group of Gottfried Baier at the Department of Medical Genetics, Molecular and Clinical Pharmacology. He is currently doing postdoctoral research at the University of Chicago as part of an Erwin Schrödinger Fellowship.

Dr. Hinterleitner looked at blood samples and 150 small-intestine biopsies from celiac patients and compared them with those of a healthy control group. He found that intestinal viruses can trigger a sort of long-term false alarm in celiac patients by upsetting the small intestine and transforming regulatory T lymphocytes into pro-inflammatory T lymphocytes.

"The dendritic cells are also alerted by the infection. If gluten...is consumed at the same time as a viral infection occurs, the already alerted dendritic cells also present gluten antigens to the T lymphocytes," said Dr. Hinterleitner.

This can result in the transmission of incorrect information, and can trigger an inflammatory response in T lymphocytes that attacks both the virus and the gluten. They have seen as much in genetically engineered celiac mouse models, wherein a reoviral infection of the small intestine of mice triggers clinical symptoms similar to those experienced by celiac patients who consume gluten.

This might also explain why infants who have already had a rotavirus infection are more likely to develop celiac disease. Because if an infant is suffering from a viral infection at the same time, the first intake of gluten, which is supposed to establish oral tolerance to gluten, might in fact have the opposite effect.

If this is true, early vaccination against intestinal viruses such as rota- and reovirus in early childhood might reduce the incidence of celiac disease.

They estimate that introducing gluten at the same time as intestinal virus infection results in a long-term loss of oral tolerance to gluten in the 20 percent of the population with the genetic predisposition for celiac disease, especially in patients who respond more strongly to virus infections.

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