New Evidence in the Pathogenesis of Celiac Disease and Type 1 Diabetes Mellitus: A Systematic Review

Abstract

Celiac disease (CD) and type 1 diabetes mellitus (T1DM) are autoimmune diseases that coexist frequently. These illnesses share a common genetic background. This study aims to review the different pathophysiologic mechanisms that have been studied about the coexistence of CD and T1DM, to contrast them, and to summarize their specific role in these autoimmune diseases. We conducted a systematic review following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) checklist and used the Medical Subject Headings (MeSH) search strategy to obtain relevant articles. We found 585 papers which were reduced to 355 after removing duplicates. Later, the filters and inclusion/exclusion criteria were applied which ended the search with 78 articles. Finally, we reviewed the articles that contained information about the pathogenesis of CD and T1DM, their coexistence, and how the pathogenesis impacts clinical outcomes. The reviewed studies strongly conclude that the presence of human leukocyte antigen (HLA) genes DQ2 and DQ8 are high-risk for developing the coexistence of CD and T1DM. We found that killer immunoglobulin-like receptor (KIR) genes, enterovirus infection in gut cells, and gut microbiota dysbiosis with the predominance of Bacteroides spp. also play a role in the pathogenesis and development of symptoms of CD in patients with the previous diagnosis of T1DM. CD4+ and CD8+ cell levels vary among patients and studies, consequently, more study on this topic is needed.

Dietary Patterns and New-Onset Diabetes Mellitus in Southwest China: A Prospective Cohort Study in the China Multi-Ethnic Cohort (CMEC)

“…All participants gave written informed consent. In the present study, a total of 14,176 potential participants were screened for eligibility (Figure 1) and people with the following conditions were excluded at baseline: (1) those with self-reported diabetes; (2) those who had cardiovascular diseases or gastrointestinal disease [11,12] or cancer; (3) those who have extreme value of BMI (<14 or >45 kg/m 2 ); (4) those who were pregnant; (5) those without any food intake information; and (6) those with extreme energy intake (defined as <800 or >4800 Kcal per day for males and <500 or >4000 Kcal per day for females [13]).…”

Advances in Understanding the Human Gut Microbiota and Its Implication in Pediatric Celiac Disease—A Narrative Review

“…Celiac disease (CD) is an autoimmune-mediated, chronic systemic disease, triggered by alimentary exposure to gluten, in genetically predisposed individuals [1]. Although, in the past, CD was considered a rare disease, recent epidemiologic evidence offers proof of an increase in CD's incidence, both in adults and children, affecting 0.7% of the general population and almost 1% of the pediatric population [2,3]. The incidence of CD is twice as high in children compared to adults, with women being 1.5 times more likely to be affected than men [4].…”

Pathogenesis of Type 1 Diabetes: Established Facts and New Insights

“…Individuals with T1D are also more susceptible to other autoimmune diseases, such as Hashimoto's thyroiditis, coeliac disease, Addison's disease, vitiligo, and myasthenia gravis [1,5]. Moreover, the association of T1D with thyroid autoimmunity and coeliac disease may also be mechanistically determined [6][7][8].…”