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Roy Jamron posted an article in Celiac Disease & Gluten Intolerance ResearchCeliac disease is known to be triggered, at least in part, by environmental factors. These factors can even affect one identical twin and not the other and seem to have their greatest impact during infancy when gluten is first introduced to the diet. Gut flora makeup and vitamin D levels are 2 factors which differ in infants and could affect the development of the immune system in ways leading to celiac disease. Recent research has shown that gut Bifidobacterium levels are lower in both treated and untreated celiac disease patients. Bifidobacterium species have properties which are beneficial to the immune system such as increasing IL-10 secretion and decreasing intestinal permeability. But other microbiota species may also have important effects and benefits to the developing immune system. Scientists are only beginning to scratch the surface both in cataloging the microbiota species found in the gut and understanding how environmental factors, such as antibiotics, affect their makeup and, in turn, how the makeup of gut microbiota affects human health. A new article on Medscape.com discusses the current state of this research and is excellent reading: Gut Reaction: Environmental Effects on the Human Microbiota Melissa Lee Phillips Published on Medscape.com: 07/15/2009 http://www.medscape.com/viewarticle/705512_print It may be years before research fully understands how gut microbiota and vitamin D deficiency may be involved in triggering celiac disease. Both vitamin D and probiotic supplements (such as Bifidobacterium infantis) are cheap, readily available, and generally safe. There is much current research showing how important vitamin D is for overall health. Your infant's health is a matter of immediate concern and cannot wait 5 or 10 years for research to confirm whether such supplements can help prevent celiac disease. It would seem prudent to make use of these supplements now in both mother and infant during pregnancy, while breast-feeding, and prior to introducing gluten to your baby. Consult with your physician about how much is the right dose.
Jefferson Adams posted an article in Celiac Disease Diagnosis, Testing & TreatmentCeliac.com 06/29/2010 - Properly diagnosing children with celiac disease in conditions where there may be environmental or other causes for classic celiac-associated symptoms, such as malnutrition, diarrhea, and failure to thrive, can present challenges to clinicians. A clinical team conducted an assessment of celiac disease blood screens in symptomatic 12 to 36 month-old children. The research team included Inês Cristina Modelli; Lenora Gandolfi; Rodrigo Coutinho de Almeida; Gloria Maria A. C. Araújo; Marilúcia de Almeida Picanço; and Riccardo Pratesi. They are associated with the Graduate Program in Health Sciences at the University of Brasilia School of Health Sciences, the Pediatric Department at the Brasilia University Hospital, and the Pediatric Research Center and Celiac Disease Investigation Center at the University of Brasilia School of Medicine in Brazil. The clinicians wanted to assess rates of celiac disease in a group of 12 to 36 month-old children using immunoglobulin antibodies against gliadin (IgG and IgA-AGA), against endomysium (IgA-EMA), and anti-human tissue transglutaminase (IgA-tTG) screens. For the study, the team enrolled 114 boys and 100 girls, aged 12 to 36 months, all following a gluten-containing diet. The team performed IgG and IgA-AGA, IgA-tTG and IgA-EMA blood tests for each patient. The team took biopsies from all children who showed one or more positive blood test, except those for whom IgG-AGA was the only positive result. In cases where IgG-AGA was the only positive result, the team used polymerase chain reaction (PCR) HLA genotyping to identify the celiac disease predisposing alleles. HLA genotyping also allowed the team to confirm diagnosis in children flagged as celiac by means of positive serologic testing and compatible biopsy results. The team found that 131 kids showed normal results. PCR showed the presence of celiac disease predisposing alleles in ten out of 68 children who tested positive on just the IgG-AGA test. Four kids had positive results on all four blood tests, while a fifth child showed positive results IgG and IgA-AGA and IgA-tTG, but showed negative results for IgA-EMA. All five children submitted to jejunal biopsies, which showed classic celiac lesions. Symptomatic children from 12- to 36-months old that had not been previously diagnosed with celiac disease showed celiac prevalence of 2.3%. This study shows several things. First, the data reflect the challenges of diagnosing celiac disease in areas where environmental or other causes for classic celiac-associated symptoms might interfere with proper diagnosis. The results also show the advantages of considering biopsies in cases of conflicting or incomplete blood screens in symptomatic children who may be subject to environmental and other mitigating factors. That such symptomatic children show celiac disease rates that are more than double the general population shows that clinicians attempting diagnosis under such circumstances should be both diligent and exhaustive in their efforts. As it is, symptomatic children with celiac disease are going undiagnosed. To properly diagnose such cases, clinicians should consider any environmental or other causes for classic celiac-associated symptoms that might interfere with proper diagnosis. There is no reason to assume that these results are exclusive to Brazil. There's no reason to assume these results wouldn't apply anyplace where environmental and other causes might interfere with diagnosis of celiac disease in symptomatic children, including regions of rural and urban poverty. Source: PEDIATRIC GASTROENTEROLOGY GASTROENTEROLOGIA PEDIÁTRICA vol.47 no.1 São Paulo