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Celiac.com 03/31/2022 - A number of studies have associated celiac disease with increased mortality rates, partly due to celiac-related cancers. However, most studies assessing cancer risk used data from celiac patients diagnosed in an era before celiac disease diagnosis rates and access to gluten-free food become more common. What can we learn from a study of celiac patients diagnosed more recently? A team of researchers conducted a population-based study to assess cancer risk in celiac disease. The research team included Benjamin Lebwohl; Peter H.R. Green; Louise Emilsson; Karl Mårild; Jonas Söderling; Bjorn Roelstraete; and Jonas F. Ludvigsson. Defining celiac disease as duodenal/jejunal villus atrophy, and using the Epidemiology Strengthened by histoPathology Reports in Sweden cohort, the team gathered data on all celiac patients in Sweden. The team matched each patient to five or fewer controls by age, sex, and county. They then employed a stratified Cox proportional hazards model, and tracked patients from diagnosis until the first instance of cancer, or to December 31, 2016. After looking at nearly fifty thousand patients with celiac disease, the team found that nearly sixty-five percent were diagnosed since 2000. After an average follow-up of nearly twelve years, the rate of cancer was 6.5 and 5.7 per 1000 person-years in celiac disease patients and control subjects, respectively. The overall risk of cancer rose only in the first year after celiac disease diagnosis and not subsequently, although the risks for hematologic, lymphoproliferative, hepatobiliary, and pancreatic cancers continued. People over sixty showed the highest risk, while those diagnosed before age 40 showed no increase in cancer risk. The cancer risk was similar among those diagnosed with celiac disease before or after the year 2000. Bad news/Good news The bad news is that the team did find that celiac patients have an elevated risk of developing cancer. The good news is that the increased risk is found in people diagnosed with celiac disease after age 40, but it is mainly a factor within the first year of celiac diagnosis, and limited to certain gastrointestinal and hematologic cancers. However, this study is good news for anyone with celiac disease who might be worried about having an overall higher risk of cancer, as that does no seem to be the case, at least going by this data. Stay tuned for more on this and related stories. Read more in Clinical Gastroenterology & Hepatology The researchers are variously affiliated with the Celiac Disease Center, Department of Medicine, Columbia University Medical Center, New York, New York; the Department of Epidemiology, Mailman School of Public Health, Columbia University in New York, USA; School of Medical Science, University of Örebro, Örebro, Sweden; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; the Värmlands Nysäter Health Care Center and Centre for Clinical Research, County Council of Värmland, Sweden; the Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway; the Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden; the Department of Pediatric Gastroenterology, Queen Silvia Children’s Hospital, Gothenburg, Sweden; and the Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.

Celiac.com 02/23/2021 - People with celiac disease face a higher risk for developing pneumococcal pneumonia, and certain types of viral infections. Because of this, many people with celiac disease have wondered if they may have a higher risk of developing Covid-19, or of developing complications or severe Covid-19-related outcomes, if they do get it. The question was serious enough for a team of researchers to take a close look at the data to see whether people with celiac disease face an increased risk of hospitalization for Covid-19, intensive care unit admission, and/or death from Covid-19. The research team included Benjamin Lebwohl, Emma Larsson, Jonas Söderling, Bjorn Roelstraete, Joseph A Murray, Peter HR Green, and Jonas F Ludvigsson. They are variously affiliated with the Celiac Disease Center, Department of Medicine, Columbia University Medical Center, New York, NY, USA; the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; the Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden; the Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden; the Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA; and the Department of Pediatrics, Örebro University Hospital, Örebro University, Örebro, Sweden. To get the answers they needed, the team put together a population-based group study from data gathered by 28 Swedish pathology departments from 1969-2017. They first identified nearly 41,000 patients with celiac disease, defined as small intestinal villus atrophy, who were still alive on February 1, 2020. They then compared data for these patients against data for nearly 184,000 controls matched by sex, age, county, and calendar period. Using Cox proportional hazards with follow-up through July 31, 2020, they first assessed risk of hospital admission with a primary diagnosis of laboratory-confirmed Covid-19. They then assessed risk of a Covid-19 admission to intensive care unit and/or death attributed to Covid-19. They found that the overall risk of hospital admission for Covid-19 was 2.9 and 2.2 per 1000 person-years respectively. After adjusting for comorbidities, they found no significantly higher risk of hospitalization for Covid-19, or of severe Covid-19, among celiac patients. Lastly, they saw no significant difference in mortality between celiac patients and control subjects who were hospitalized with Covid-19. From this data, the team concludes that people with celiac disease are not at higher risk of hospitalization for Covid-19, or for Covid-19- related intensive care admission and/or death. Read more at DovePress.com

Celiac.com 02/07/2020 - Over the last couple of decades, celiac disease has increased significantly in some developed countries in recent decades. Possible risk factors listed in medical literature don't seem to offer a convincing reason for the rise in rates. This has led some researchers to hypothesize that there is a “missing environmental factor” that increases the risk of developing the disease. We've written previously about the possible link between vitamin D and celiac disease over the years, including the fact that vitamin D is one of the top ten risk factors for celiac disease. There's also some interesting evidence that people with celiac disease can recover normal vitamin D levels through a gluten-free diet, without requiring any supplementation. Based on evidence from medical literature, researcher Seth Scott Bittker of the Ronin Institute proposes that elevated plasma levels of 1,25-dihydroxyvitamin D [1,25(OH)2D] might be an overlooked risk factor for celiac disease. Bittker also proposes that significant oral vitamin D exposure is a “missing environmental factor” for celiac disease. Bittker notes that celiac patients often have elevated plasma levels of 1,25(OH)2D, especially when first diagnosed. He also notes that nine separate celiac-associated conditions raise plasma levels of 1,25(OH)2D. He cites a retrospective study showing that regular dose of oral vitamin D in infants are tied to a higher celiac disease risk later on, along with other studies that support the connection. It turns out that high doses of oral vitamin D increase activity in cytokines, chemokines, and toll-like receptors that are also active in celiac disease. Lastly, Bittker points to epidemiological connections, like the start of a celiac disease “epidemic” in Sweden, the increased prevalence of celiac disease in Finland and the U.S. in recent decades, oddly low rates of celiac disease in Germany, and differences in celiac rates between Finnish Karelians and Russian Karelians, may all be explained by oral vitamin D exposure increasing celiac disease risk. The same is true of some seemingly contradictory results in the literature on the effects of breastfeeding on celiac disease risk. If future research validates this hypothesis, reducing intake of oral vitamin D among those with genetic susceptibility may lower celiac risk for these people. Read more at DovePress.com

Celiac.com 12/16/2019 - Psoriasis is a skin condition associated with several immune-mediated inflammatory diseases, including celiac disease. Currently, however, researchers don't have much solid information regarding the chronology of psoriasis development. A team of researchers recently set out to investigate the chronology of immune-mediated inflammatory diseases relative to psoriasis. The research team included Yuki M.F. Andersen, MD, PhD, Jashin J. Wu, MD, Jacob P. Thyssen, MD, PhD, DMS, and Alexander Egeberg, MD, PhD. They are variously affiliated with the Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark; the Dermatology Research and Education Foundation, Irvine, California; and the Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark. The team reviewed data from Danish nationwide administrative registries to examine the occurrence of immune-mediated inflammatory diseases in 10,923 patients with psoriasis, and in 109,230 control subjects from the general population. They found that about 20% of psoriasis patients developed one or more immune-mediated inflammatory diseases, with risk that is five times greater than in the general population. Most patients received a diagnosis of immune-mediated inflammatory disease, except for psoriatic arthritis, before being diagnosed with psoriasis. Psoriasis patients were far more likely to have multiple immune-mediated inflammatory diseases. They were also far more likely to have human leukocyte antigen B27 positivity. This study was limited by the unavailability of clinical measurements. Still, the data show that immune-mediated inflammatory diseases are common in patients with psoriasis, and are usually diagnosed before psoriasis. This information could help researchers to better understand the factors influencing the development of psoriasis. Read more in the Journal of the American Academy of Dermatology

Celiac.com 07/12/2019 - In Italy, where gluten-rich pasta and pizza are king, the Italian Ministry of Health has presented its annual report on celiac disease to parliament. Celiac disease is a lifelong autoimmune condition in which people suffer an adverse reaction to gluten in wheat, rye or barley. The report contains some interesting details, especially in comparison to years past. The 2017 report showed that women account for 145,759 of the 206,561 total cases of celiac disease, while men account for just 60,802 cases. So, what explains the difference? Why do women account for two out of three cases of celiac disease in Italy, and in many other places? The government suggests that women may be more susceptible than men to the disease due to biological differences between the two sexes. Overall, researchers estimate that about one in 100 people have the condition. Common symptoms include stomach cramps, fatigue, constipation, diarrhea and vomiting, though more and more people was being diagnosed with few or no classical symptoms. Research has shown that the female immune response is more developed and aggressive than the male immune response. The Italian researchers suggest that the vigilance of the female immune system might be related to women's biological role as child-bearers. The idea being that women developed a quicker and more robust response to infectious agents as a means to cope with post-natal infections, according to study authors, Simona de Stefano from the Ministry of Health, and Marco Silano from the National Institute of Health. There is some research data that shows estrogen, the main female hormone, can play an active role against viruses, while testosterone, the main male hormone, can help to suppress inflammatory responses, the authors added. There is also some evidence that variations in X and Y chromosomes may play a role. The combination of two X chromosomes potentially leaves women at greater risk for autoimmune diseases; while Y and X combination leaves men more susceptible to immunodeficiencies. So, for now, according to the Italian Ministry of Health, the answer to the question of why women get celiac disease more often than men seems to be that women's immune systems leave them more genetically susceptible to celiac disease than men. "Women, who have more reactive immune systems than men, are more susceptible to coeliac disease," according to the Italian Ministry of Health. If, on the one hand, an immune system is so reactive and aggressive against infections, according to some scholars [it] can also more easily, and perhaps incorrectly modify itself in response to the infection," write the authors. This could result in excessive activation, which, over time, could lead to the development of autoimmune diseases, such as celiac disease, added de Stefano and Silano. Read more at Foodnavigator.com

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