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Celiac.com 07/18/2018 - Despite many studies on immune development in children, there still isn’t much good data on how a mother’s diet during pregnancy and infancy influences a child’s immune development. A team of researchers recently set out to assess whether changes in maternal or infant diet might influence the risk of allergies or autoimmune disease. The team included Vanessa Garcia-Larsen, Despo Ierodiakonou, Katharine Jarrold, Sergio Cunha, Jennifer Chivinge, Zoe Robinson, Natalie Geoghegan, Alisha Ruparelia, Pooja Devani, Marialena Trivella, Jo Leonardi-Bee, and Robert J. Boyle. They are variously associated with the Department of Undiagnosed Celiac Disease More Common in Women and Girls International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America; the Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom; the Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom; the Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom; the Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom; the Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, United Kingdom; and Stanford University in the USA. Team members searched MEDLINE, Excerpta Medica dataBASE (EMBASE), Web of Science, Central Register of Controlled Trials (CENTRAL), and Literatura Latino Americana em Ciências da Saúde (LILACS) for observational studies conducted between January 1946 and July 2013, and interventional studies conducted through December 2017, that evaluated the relationship between diet during pregnancy, lactation, or the first year of life, and future risk of allergic or autoimmune disease. They then selected studies, extracted data, and assessed bias risk. They evaluated data using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). They found 260 original studies, covering 964,143 participants, of milk feeding, including 1 intervention trial of breastfeeding promotion, and 173 original studies, covering 542,672 participants, of other maternal or infant dietary exposures, including 80 trials of 26 maternal, 32 infant, or 22 combined interventions. They found a high bias risk in nearly half of the more than 250 milk feeding studies and in about one-quarter of studies of other dietary exposures. Evidence from 19 intervention trials suggests that oral supplementation with probiotics during late pregnancy and lactation may reduce risk of eczema. 44 cases per 1,000; 95% CI 20–64), and 6 trials, suggest that fish oil supplementation during pregnancy and lactation may reduce risk of allergic sensitization to egg. GRADE certainty of these findings was moderate. The team found less evidence, and low GRADE certainty, for claims that breastfeeding reduces eczema risk during infancy, that longer exclusive breastfeeding is associated with reduced type 1 diabetes mellitus, and that probiotics reduce risk of infants developing allergies to cow’s milk. They found no evidence that dietary exposure to other factors, including prebiotic supplements, maternal allergenic food avoidance, and vitamin, mineral, fruit, and vegetable intake, influence risk of allergic or autoimmune disease. Overall, the team’s findings support a connection between the mother’s diet and risk of immune-mediated diseases in the child. Maternal probiotic and fish oil supplementation may reduce risk of eczema and allergic sensitization to food, respectively. Stay tuned for more on diet during pregnancy and its role in celiac disease. Source: PLoS Med. 2018 Feb; 15(2): e1002507. doi: 10.1371/journal.pmed.1002507
Jefferson Adams posted an article in Diabetes and Celiac DiseaseCeliac.com 07/13/2016 - A really interesting study about gluten-free diets in mice just popped up over at the medical journal Diabetes, that has implications for both diabetes and celiac disease. The study found that a maternal gluten-free diet reduces inflammation and diabetes rates in the offspring of non-obese diabetic mice. The study was conducted by a research team that included Camilla H.F. Hansen, Åukasz Krych, Karsten Buschard, Stine B. Metzdorff, Christine Nellemann, Lars H. Hansen, Dennis S. Nielsen, Hanne Frøkiær, Søren Skov, and Axel K. Hansen. They are variously affiliated with the Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark, the Department of Food Science, Faculty of Science, University of Copenhagen, Frederiksberg, the Bartholin Institute, Rigshospitalet, Copenhagen, Denmark, the Division of Toxicology and Risk Assessment, National Food Institute, Technical University of Denmark, Søborg, Denmark, and the Department of Biology, Faculty of Science, University of Copenhagen in Copenhagen, Denmark. Researchers have known for some time that early life interventions in the intestinal conditions have been shown to influence diabetes rates in mice. For example, a gluten-free diet in known to decrease type 1 diabetes incidence. Their team hypothesized that a gluten-free diet for pregnant mice only during pregnancy and lactation period would protect offspring mice against development of diabetes. The team fed pregnant non-obese diabetic (NOD) mice either a gluten-free or a standard diet, until all mice pups were weaned to standard diet. The early gluten-free mice showed significantly lower rates of diabetes and insulitis. Gut microbiota analysis by 16S rRNA gene sequencing showed significantly increased Akkermansia, Proteobacteria, and TM7 between both mothers and their offspring in the gluten-free diet group. Moreover, the gluten-free offspring showed increased pancreatic FoxP3 regulatory T cells, along with an increase in M2 macrophage gene markers and tight junction-related genes in the gut, coupled with lower intestinal gene expression of pro-inflammatory cytokines. Higher numbers of T cells in the pancreas expressing the mucosal integrin α4β7 suggests that the mechanism involve increased trafficking of gut-primed immune cells to the pancreas. This study supports the conclusion that a gluten-free diet during fetal and early postnatal life reduces development of diabetes. This may be due to changes in gut microbiota and better inflammatory and immunological conditions in the gut and pancreas. So, could it be that human mothers who eat a gluten-free diet through weening can impart the same kind of protection against diabetes? Clearly more studies need to be done until we can know for sure, but following a gluten-free diet while pregnant probably wouldn’t cause any harm to the mother or the baby. Source: Diabetes 2014 Apr; DB_131612.
High Levels of Maternal Dietary Antibodies Mean Higher Risk for Non-affective Psychosis in Offspring
Jefferson Adams posted an article in Schizophrenia / Mental Problems and Celiac DiseaseCeliac.com 02/13/2013 - A team of researchers wanted to determine whether levels of immunoglobulin G (IgG) were associated with a later diagnosis of a non-affective psychotic disorder. The researchers included H. Karlsson, Å. Blomström, S. Wicks, S. Yang, R.H. Yolken, and C. Dalman. They are affiliated with the Department of Neuroscience at the Karolinska Institute in Stockholm, Sweden. To accomplish their goal, the team analyzed archival dried blood spots taken from newborns in Sweden between 1975 and 1985 with verified register-based diagnoses of non-affective psychoses made between 1987 and 2003 and comparison subjects matched on sex, date of birth, birth hospital, and municipality. The team reviewed samples from a total of 211 case subjects and 553 comparison subjects who agreed to take part in the study. They pulled data for factors associated with maternal status, pregnancy, and delivery from the Swedish Medical Birth Register. They used enzyme-linked immunosorbent assay to analyze the results for levels of IgG directed at gliadin (a component of gluten) and casein (a milk protein) in eluates from dried blood spots. They then calculated odds ratios for levels of IgG directed at gliadin or casein for non-affective psychosis. Comparison subjects associated with non-affective psychosis showed levels of anti-gliadin IgG (but not anti-casein IgG) above the 90th percentile of levels observed (odds ratio=1.7, 95% CI=1.1-2.8). This connections was not affected by differences in maternal age, immigrant status, or mode of delivery. They also found that gestational age at birth, ponderal index, and birth weight were not associated with maternal levels of anti-gliadin IgG. From their study, they concluded that high levels of anti-gliadin IgG in the maternal circulation are associated with an elevated risk for the development of a non-affective psychosis in offspring. They point out that more research is needed to identify the mechanisms underlying this association in order to develop preventive strategies. Source: Am J Psychiatry. 2012 Jun;169(6):625-32. doi: 10.1176/appi.ajp.2012.11081197.