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Celiac.com 11/30/2020 - Despite some good data on childhood antibiotic exposure, researchers still don't know much about the possible connections between antibiotic exposure in the first two years of life, and the risk of childhood immunological, metabolic, and neurobehavioral health conditions. A team of researchers recently set out to see what they could learn about potential connections between antibiotic exposure in the first two years of life, and the risk of childhood immunological, metabolic, and neurobehavioral health conditions. The research team included Zaira Aversa, MD, PhD; Elizabeth J. Atkinson, MS; Marissa J. Schafer, PhD; Regan N. Theiler, MD, PhD; Walter A. Rocca, MD; Martin J. Blaser, MD, and Nathan K. LeBrasseur, PhD. They are variously affiliated with the Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN; the Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN; the Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN; the Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN; the Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN; and the Department of Neurology, Mayo Clinic, Rochester, MN; and the Center for Advanced Biotechnology and Medicine, Rutgers University, Piscataway, NJ. For their population-based study, the team used the Rochester Epidemiology Project medical records-linkage system to look at data from all children born in Olmsted County, Minnesota, between January 1, 2003, and December 31, 2011. They used the Rochester Epidemiology Project infrastructure to note demographic characteristics, antibiotic prescriptions, and diagnostic codes through June 30, 2017. They analyzed time-to-event to determine the influence of antibiotic exposure on the risk of numerous health problems. This study included 14,572 children, just over half of whom were boys. About 70% of the children had received at least 1 antibiotic prescription during the first 2 years of life. The team found that early antibiotic exposure was tied to an increased risk of childhood-onset asthma, allergic rhinitis, atopic dermatitis, celiac disease, overweight, obesity, and attention deficit hyperactivity disorder. The number, type, and timing of antibiotic exposure all influenced the connections. Moreover, children exposed to antibiotics had a higher odds of developing multiple conditions, especially if they had received multiple prescriptions. The team's data points out strong associations between early life antibiotic exposure and several childhood health disorders. The team calls for additional research to create practical guidelines for maximizing the benefits and minimizing the risk of antibiotics exposure in children. Read more at the Mayo Clinic Proceedings

Celiac.com 12/26/2019 - Earlier studies have suggested a relationship between infection, associated antibiotic exposure, and the risk of celiac disease. However, there hasn't been a comprehensive evaluation of those studies that might help to deliver a clear answer. To address this, a team of researchers recently conducted a meta-analysis to investigate the relationship between infection, associated antibiotic exposure, and celiac disease risk. They began looking for relevant studies by searching the PubMed, Embase, and Cochrane databases for articles published through April 2019. They used random effects models to determine overall pooled estimates and 95% confidence intervals (CIs). Their meta-analysis contained 19 observational studies, including 15 on infection and six on antibiotic exposure. They found that any infection was associated with an increased risk of celiac disease later in life. The heterogeneity among studies was high enough to put the I2 at 94%. An analysis of subgroups indicates that celiac risk is independent of infection type, timing of exposure, or site of infection. Antibiotic exposure was also associated with new celiac disease cases. These results provide strong evidence that early infection and/or antibiotic exposure increase the odds of developing celiac disease, and suggest that disruption of intestinal immune processes or gut microbiota may play a role in celiac disease development. These findings could eventually influence clinical treatment and help to prevent celiac disease. Certainly, the rise of antibiotic use to treat infections mirrors the rise in cases of celiac disease over the last six or seven of decades. However, further study is needed to fully eliminate non-causal explanations for these connections. That is, they haven't fully discounted the possibility that there is another cause for the connection. Stay tuned for more developments on this and related stories. Read more at: wiley.com The research team included Hai-yin Jiang, Xue Zhang, Yuan-yue Zhou, Chun-min Jiang, and Yu-dan Shi. They are variously affiliated with the Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, the Department of Child Psychiatry, Hangzhou Seventh People’s Hospital, Department of Pediatrics, The Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou and Department of Chinese Internal Medicine, Taizhou First People’s Hospital, Taizhou, China.

Celiac.com 08/01/2019 - Rates of celiac disease have climbed steeply in recent decades in some developed countries. However, there really isn't much in the current medical literature to clearly explain the increase. Researchers Seth Scott Bittker and Kathleen Roberta Bell recently set out to determine whether nine variables are associated with the development of celiac disease in children. They are variously affiliated with the Interdisciplinary Center for Innovative Theory and Empirics (INCITE), Columbia University, New York, New York, US; and the Ontario College of Teachers, Toronto, Ontario, Canada. The team looked at the following variables: "incidence of ear infection before 2 years old, courses of antibiotics before 2 years old, duration of breastfeeding, vitamin D drop exposure in infancy, vitamin D supplement exposure between 2–3 years old, age at gluten introduction into the diet, fat content of cow’s milk consumed between 2–3 years old, quantity of cow’s milk consumed between 2–3 years old, and type of water consumed at 2 years old." To gather their data, the team used an internet survey to quiz parents living in the US with at least one biological child between 3 and 12 years old. To recruit participants, the team used social media, websites, electronic newsletters, and advertisements. The team ended up with a total of 332 responses for children with celiac disease, and 241 responses from the non-celiac control group. The team's data showed that skim liquid cow’s milk consumed between 2–3 years old, vitamin D drops used for longer than 3 months, early doses of antibiotics, and early ear infection are all associated with later development of celiac disease in children. This study found a connection between skim milk consumption, and vitamin D drop use for more than 3 months, and later development of celiac disease. It also found evidence to support earlier data that early life exposure to antibiotics and early life infection, especially ear infection, are also associated with the development of celiac disease in children. Read more in Clinical and Experimental Gastroenterology

Celiac.com 11/07/2017 - Researchers still don't have much good data on the consequences of antibiotic use in early life and how that relates to the risk of certain autoimmune diseases. A team of researchers recently set out to test the association between early-life antibiotic use and islet or celiac disease autoimmunity in genetically at-risk children prospectively followed up for type 1 diabetes (T1D) or celiac disease. Their study is part of a larger study called The Environmental Determinants of Diabetes in the Young, or TEDDY, for short. The reasearch team enrolled HLA-genotyped newborns from Finland, Germany, Sweden, and the United States between November 20, 2004, and July 8, 2010, and analyzed data from November 20, 2004, to August 31, 2014. They also enrolled individuals from the general population, and those having a first-degree relative with T1D, with any 1 of 9 HLA genotypes associated with a risk for T1D. The team charted parental reports of the most common antibiotics, such as cephalosporins, penicillins, and macrolides, used between age 3 months and age 4 years. Islet autoimmunity and celiac disease autoimmunity were defined as being positive for islet or tissue transglutaminase autoantibodies at 2 consecutive clinic visits at least 3 months apart. The team used Cox proportional hazards regression models to assess the relationship between antibiotic use in early life before seroconversion and the development of autoimmunity, and to calculate hazard ratios and 95% CIs. The team conducted tests for islet and tissue transglutaminase autoantibodies on 8,495 children (49.0% female), and 6,558 children (48.7% female) who were enrolled in the TEDDY study, and they found that antibiotic exposure and frequency of use in early life or before seroconversion did not influence the risk of developing islet autoimmunity or celiac disease autoimmunity. Additionally, cumulative use of any antibiotic during the first 4 years of life was not tied to the appearance of any autoantibody (hazard ratio , 0.98; 95% CI, 0.95-1.01), multiple islet autoantibodies (HR, 0.99; 95% CI, 0.95-1.03), or the transglutaminase autoantibody (HR, 1.00; 95% CI, 0.98-1.02). Using any of the most common antibiotics during the first 4 years of life, in any geographic region, did not influence the later development of autoimmunity for T1D or celiac disease. Based on these results, the team concluded that doctors recommending antibiotics for young children at risk for T1D or celiac disease need not be concerned that the use will lead to islet or tissue transglutaminase autoimmunity. Source: JAMA Pediatr. Published online October 9, 2017. doi:10.1001/jamapediatrics.2017.2905 The research team included Kaisa M. Kemppainen, PhD; Kendra Vehik, PhD; Kristian F. Lynch, PhD; Helena Elding Larsson, MD, PhD; Ronald J. Canepa, BSc; Ville Simell, MSc; Sibylle Koletzko, MD, PhD; Edwin Liu, MD; Olli G. Simell, MD, PhD; Jorma Toppari, MD, PhD; Anette G. Ziegler, MD, PhD; Marian J. Rewers, MD, PhD; Åke Lernmark, PhD; William A. Hagopian, MD, PhD; Jin-Xiong She, PhD; Beena Akolkar, PhD; Desmond A. Schatz, MD; Mark A. Atkinson, PhD; Martin J. Blaser, MD; Jeffrey P. Krischer, PhD; Heikki Hyöty, MD, PhD; Daniel Agardh, MD, PhD; and Eric W. Triplett, PhD; for The Environmental Determinants of Diabetes in the Young (TEDDY) Study Group. They are variously affiliated with the Department of Microbiology and Cell Science, Institute of Food and Agricultural Sciences, University of Florida, Gainesville; the Health Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa; the Department of Clinical Sciences, Lund University Clinical Research Center, Skåne University Hospital, Malmö, Sweden; the MediCity Laboratory, University of Turku, Turku, Finland; the Division of Paediatric Gastroenterology and Hepatology, Dr von Hauner Children's Hospital, Ludwig Maximilian University, München, Germany; the Digestive Health Institute, Children's Hospital Colorado, Anschutz Medical Campus, University of Colorado Denver, Aurora; the Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; the Department of Pediatrics, University of Turku, Turku University Hospital, Turku, Finland; the Department of Physiology, Institute of Biomedicine, University of Turku, Turku, Finland Institute of Diabetes Research, Helmholtz Zentrum München, München, Germany; the Klinikum Rechts der Isar, Technische Universität München, München, Germany; the Forschergruppe Diabetes e.V., Neuherberg, Germany; the Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, Aurora; the Pacific Northwest Diabetes Research Institute, Seattle, Washington; the Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, Augusta National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland; the Department of Pediatrics, College of Medicine, University of Florida, Gainesville; the Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville; the Department of Medicine and Microbiology, New York School of Medicine, New York; the Department of Virology, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland; and with Fimlab Laboratories, Pirkanmaa Hospital District, Tampere, Finland.