Is Celiac disease risk almost entirely genetic?

[Blue-Sky]

This is new information to me...and surprising.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1773191/

[trents]

"These data suggest that environmental factors, apart from gluten, have little or no effect on the pathogenesis of celiac disease."

Is this what you are reacting to? So, if I understand correctly the point being made by this study, it is saying that we have been incorrect in assuming that the development of active celiac disease depends on two factors: 1. Having one or more of the two genes that have been identified with celiac disease and 2. a triggering environmental stress factor.

It also seems to be saying that there are other corroborating genetic factors (besides DQ2 and DQ8) that have a major bearing on the development of celiac disease as opposed to environmental factors. And that we don't have good knowledge yet of what these other corroborating gene factors are:

"Consequently, it is likely that the large genetic load of celiac disease identified in this study may not be produced by a missing or “altered” gene but by a series of genetic characteristics which individually exert little effect but which collectively characterise a large gluten intolerant tribe that is spread throughout the gluten consuming world."

Is that how you read it? I would also point out that this study is 20 years old. A lot of research has been conducted since then and we know much more.

Edited June 27, 2022 by trents

[Blue-Sky]

Yes I think that is what it is saying.

We may not be incorrect in thinking that there is an external stress factor....but it seems one type of twin much more immune to that stress factor whatever it is. So it might basically be all almost all genetics?

I would expect the numbers to match more than that between the two types of twins.

[Blue-Sky]

30 minutes ago, trents said:

"These data suggest that environmental factors, apart from gluten, have little or no effect on the pathogenesis of celiac disease."

Is this what you are reacting to? So, if I understand correctly the point being made by this study, it is saying that we have been incorrect in assuming that the development of active celiac disease depends on two factors: 1. Having one or more of the two genes that have been identified with celiac disease and 2. a triggering environmental stress factor.

It also seems to be saying that there are other corroborating genetic factors (besides DQ2 and DQ8) that have a major bearing on the development of celiac disease as opposed to environmental factors. And that we don't have good knowledge yet of what these other corroborating gene factors are:

"Consequently, it is likely that the large genetic load of celiac disease identified in this study may not be produced by a missing or “altered” gene but by a series of genetic characteristics which individually exert little effect but which collectively characterise a large gluten intolerant tribe that is spread throughout the gluten consuming world."

Is that how you read it? I would also point out that this study is 20 years old. A lot of research has been conducted since then and we know much more.

 For (1) I think it is saying we are correct. For (2) It is saying that in this population that genes were the only major factor. 

But this doesn't mean there couldn't be a stress factor necessarily. Just that if there is a stress factor genes may also play a major role in that stress factor.

It is saying that other corroborating genetic rather than environmental factors have major bearing on the development of celiac disease.

It might be old research but the numbers did surprise me a bit.

 

[trents]

"But this doesn't mean there couldn't be a stress factor necessarily. Just that if there is a stress factor genes may also play a major role in that stress factor."

Excellent point. The corroborating genes may make us more susceptible to the environmental risk factors. We are "fearfully and wonderfully made" (Psalm 139:14).

[Russ H]

The key finding is that the concordance rate for non-identical twins is about 10% as against 75% for identical twins. Given the environmental commonality both prepartum and postpartum birth in both cases, this suggests that it is largely heritable.

There is another more recent twin study from Sweden below. They estimate a concordance rate of 50% for identical twins with a heritability of 75% and 25% environmental.

Heritability of non-HLA genetics in coeliac disease: a population-based study in 107 000 twins