Ethnic differences in coeliac disease autoimmunity in childhood: the Generation R Study

Jansen, Michelle A. E.; Beth, Sytske A.; Heuvel, Diana van den; Jong, Jessica C. Kiefte‐de; Raat, Hein; Jaddoe, Vincent W. V.; Zelm, Menno C. van; Moll, Henriëtte A.

doi:10.1136/archdischild-2016-311343

Cited by 15 publications

(14 citation statements)

References 43 publications

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“…The associations between a priori-or a posteriori-derived early-life dietary pattern adherence scores and celiac disease autoimmunity were analyzed using separate logistic regression models for each of the 5 dietary patterns considered, with the continuous adherence Z score as independent variable and child celiac disease autoimmunity (TG2A negative vs TG2A positive) as dependent variable. The final confounder selection was based on known associations of the covariates with diet and with celiac disease, following principles of causal inference, 2,[30][31][32][33] and also by taking the change in regression coefficient into consideration after including each of the covariates in the regression analysis. On the basis of the latter, 2 regression models were considered for each dietary pattern: a crude model (model 1) and a model adjusted for age at dietary assessment, age of TG2A assessment, sex, and ethnicity (model 2).…”

Section: Discussionmentioning

confidence: 99%

“…The ethnicity of the child was determined on the basis of the country of birth of the parents and classified as Western or non-Western, according to the criteria used in a previous study. 30 Maternal age, pre-pregnancy body mass index (BMI), and parity (categorized as nulliparous or multiparous) were assessed at the time of enrollment. TG2A levels of the mother were measured during pregnancy and categorized as TG2A positive or TG2A negative, as described for children.…”

Section: Covariatesmentioning

confidence: 99%

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Dietary Patterns After the Weaning and Lactation Period Are Associated With Celiac Disease Autoimmunity in Children

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Section: Covariatesmentioning

confidence: 99%

Dietary Patterns After the Weaning and Lactation Period Are Associated With Celiac Disease Autoimmunity in Children

et al. 2018

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“…Serum antibodies to CMV, EBV were found to be lower in CD patients compared to healthy controls [81]. Jansen et al, found that anti-CMV, EBV, and or HSV-1 IgG levels were inversely correlated with transglutaminase type 2 antibody (TG2A) levels, suggesting a protective impact of these viruses in the pathogenesis of CD [82,83]. The protective role of infections in autoimmunity supports the “hygiene hypothesis”, which proposes that cleaner living environment leads to higher incidence of autoimmune disorders [80].…”

Section: Viral Infections and Induction Of Autoimmunitymentioning

confidence: 99%

Viruses and Autoimmunity: A Review on the Potential Interaction and Molecular Mechanisms

Smatti

Cyprian

Nasrallah

et al. 2019

Viruses

436

318

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For a long time, viruses have been shown to modify the clinical picture of several autoimmune diseases, including type 1 diabetes (T1D), systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), Sjögren’s syndrome (SS), herpetic stromal keratitis (HSK), celiac disease (CD), and multiple sclerosis (MS). Best examples of viral infections that have been proposed to modulate the induction and development of autoimmune diseases are the infections with enteric viruses such as Coxsackie B virus (CVB) and rotavirus, as well as influenza A viruses (IAV), and herpesviruses. Other viruses that have been studied in this context include, measles, mumps, and rubella. Epidemiological studies in humans and experimental studies in animal have shown that viral infections can induce or protect from autoimmunopathologies depending on several factors including genetic background, host-elicited immune responses, type of virus strain, viral load, and the onset time of infection. Still, data delineating the clear mechanistic interaction between the virus and the immune system to induce autoreactivity are scarce. Available data indicate that viral-induced autoimmunity can be activated through multiple mechanisms including molecular mimicry, epitope spreading, bystander activation, and immortalization of infected B cells. Contrarily, the protective effects can be achieved via regulatory immune responses which lead to the suppression of autoimmune phenomena. Therefore, a better understanding of the immune-related molecular processes in virus-induced autoimmunity is warranted. Here we provide an overview of the current understanding of viral-induced autoimmunity and the mechanisms that are associated with this phenomenon.

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“…32 Ethnicity was based on the country where parents were born, according to criteria used in a previous study. 33 Data on maternal income and education level were obtained at enrollment through questionnaires. Classification of income and educational level was based on the classification of Statistics Netherlands.…”

Section: Covariatesmentioning

confidence: 99%

Celiac Disease Autoimmunity and Emotional and Behavioral Problems in Childhood

Wahab

Beth

Derks³

et al. 2019

Pediatrics

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BACKGROUND AND OBJECTIVES: Celiac disease (CeD) is associated with psychopathology in children. It is unknown whether this association is present in children with celiac disease autoimmunity (CDA) identified by screening. We examined the associations between subclinical CDA and emotional and behavioral problems in children without previous CeD diagnosis. METHODS: In a population-based cohort study of 3715 children (median age: 6 years), blood titers of tissue transglutaminase autoantibodies were analyzed. CDA was defined as a measurement of tissue transglutaminase autoantibodies $7 U/mL (n = 51). Children with previous CeD diagnosis or children on a gluten-free diet, were excluded. The Child Behavior Checklist (CBCL) was filled in by parents and was used to assess behavioral and emotional problems of children at a median age of 5.9 years. Multiple linear regression models were applied to evaluate the cross-sectional associations between CDA and CBCL scores. Sensitivity analyses were done in a subgroup of children who were seropositive carrying the HLA antigen risk alleles for CeD. RESULTS: In basic models, CDA was not associated with emotional and behavioral problems on the CBCL scales. After adjustment for confounders, CDA was significantly associated with anxiety problems (b = .29; 95% confidence interval 0.02 to 0.55; P = .02). After exclusion of children who did not carry the HLA-DQ2 and/or HLA-DQ8 risk alleles (n = 4), CDA was additionally associated with oppositional defiant problems (b = .35; 95% confidence interval 0.02 to 0.69). Associations were not explained by gastrointestinal complaints. CONCLUSIONS: Our results reveal that CDA, especially combined with the HLA-DQ2 and HLA-DQ8 risk alleles, is associated with anxiety problems and oppositional defiant problems. Further research should be used to establish whether behavioral problems are a reflection of subclinical CeD. WHAT'S KNOWN ON THIS SUBJECT: Diagnosed celiac disease (CeD) has been linked with several emotional and behavioral problems in children, including anxiety, depression, and aggressive behavior. However, whether this association is already present in children with subclinical CeD identified by screening is unknown. WHAT THIS STUDY ADDS: Screening-based celiac disease autoimmunity is associated with anxiety and oppositional defiant problems in children with subclinical CeD identified by screening, independent of gastrointestinal complaints.

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Ethnic differences in coeliac disease autoimmunity in childhood: the Generation R Study

Abstract: Ethnic differences in children with CDA are present in childhood. Socioeconomic position, daycare attendance and CMV seropositivity partly explained these differences, which may serve as targets for prevention strategies for CDA.

Cited by 15 publications

References 43 publications

Dietary Patterns After the Weaning and Lactation Period Are Associated With Celiac Disease Autoimmunity in Children

Dietary Patterns After the Weaning and Lactation Period Are Associated With Celiac Disease Autoimmunity in Children

Viruses and Autoimmunity: A Review on the Potential Interaction and Molecular Mechanisms

Celiac Disease Autoimmunity and Emotional and Behavioral Problems in Childhood

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