Randomized Feeding Intervention in Infants at High Risk for Celiac Disease

Vriezinga, Sabine L.; Auricchio, Renata; Bravi, E.; Castillejo, Gemma; Chmielewska, Anna; Escobar, Paula Crespo; Kolaček, Sanja; Koletzko, Sibylle; Korponay-Szabó, Ilma Rita; Mummert, Eckart; Polanco, Isabel; Putter, Hein; Ribes-Koninckx, Carmen; Shamir, Raanan; Szajewska, Hania; Werkstetter, Katharina; Greco, Luigi; Gyimesi, Judit; Hartman, Corina; Esch, CE Hogen; Hopman, Erica; Ivarsson, Anneli; Koltai, Tunde; Koning, Frits; Martínez-Ojinaga, Eva; Marvelde, C. te; Pavić, Ana Močić; Romanos, Jihane; Stoopman, Els; Villanacci, Vincenzo; Wijmenga, Cisca; Troncone, Riccardo; Mearin, M. Luisa

doi:10.1056/nejmoa1404172

Cited by 411 publications

(475 citation statements)

References 40 publications

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“…Some epidemiological studies have proposed that milk feeding practices and intestinal infections could play a role as predisposing factors, but to date, a causal relationship remains unconfirmed. 3 , 35 , 36 In the present study, we have assessed the prevalence of six potential pathogenic bacteria and two viruses causing gastrointestinal infections in healthy infants at familial risk of developing CD. Overall, we found that some pathogenic bacteria are specifically associated with the formula feeding pattern ( C .…”

Section: Discussionmentioning

confidence: 99%

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Increased prevalence of pathogenic bacteria in the gut microbiota of infants at risk of developing celiac disease: The PROFICEL study

et al. 2018

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Celiac disease (CD) is an immune-mediated enteropathy involving genetic and environmental factors, whose interaction influences disease risk. The intestinal microbiota, including viruses and bacteria, could play a role in the pathological process leading to gluten intolerance. In this study, we investigated the prevalence of pathogens in the intestinal microbiota of infants at familial risk of developing CD. We included 127 full-term newborns with at least one first-degree relative with CD. Infants were classified according to milk-feeding practice (breastfeeding or formula feeding) and HLA-DQ genotype (low, intermediate or high genetic risk). The prevalence of pathogenic bacteria and viruses was assessed in the faeces of the infants at 7 days, 1 month and 4 months of age. The prevalence of Clostridium perfringens was higher in formula-fed infants than in breast-fed over the study period, and that of C. difficile at 4 months. Among breastfed infants, a higher prevalence of enterotoxigenic E. coli (ETEC) was found in infants with the highest genetic risk compared either to those with a low or intermediate risk. Among formula-fed infants, a higher prevalence of ETEC was also found in infants with a high genetic risk compared to those of intermediate risk. Our results show that specific factors, such as formula feeding and the HLA-DQ2 genotype, previously linked to a higher risk of developing CD, influence the presence of pathogenic bacteria differently in the intestinal microbiota in early life. Further studies are warranted to establish whether these associations are related to CD onset later in life.

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Section: Discussionmentioning

confidence: 99%

“…2 In spite of this generalized exposure to dietary gluten of the population, not all the individuals carrying the HLA-DQ risk genotype finally develop CD, which means that additional genetic and environmental factors are needed to trigger disease onset. 3 , 4 …”

Section: Introductionmentioning

confidence: 99%

Increased prevalence of pathogenic bacteria in the gut microbiota of infants at risk of developing celiac disease: The PROFICEL study

et al. 2018

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“…Although wheat allergy and celiac disease are two different types of immune-mediated hypersensitivity reactions, a meta-analysis has shown a 25% increased risk of developing celiac disease if gluten is introduced after 6 months of age, as compared with introduction between 4 and 6 months of age [38]. On the other hand, the timing of introduction of gluten was not found to affect the development of celiac disease in two large randomized controlled trials of high-risk infants [39,40]. …”

Section: Discussionmentioning

confidence: 99%

Late introduction of fish and eggs is associated with increased risk of allergy development – results from the FARMFLORA birth cohort

Jönsson

Barman

Brekke

et al. 2017

Food & Nutrition Research

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The prevalence of allergy is markedly low in children growing up on farms. An increasing number of studies indicate that the timing of food introduction may affect allergy development. We aimed to investigate if protection against allergy in farm environments may be mediated through differences in food-introduction practices between farm and non-farm families, using an explorative approach. Twenty-eight farm and 37 non-farm children were included in the FARMFLORA birth cohort. Practices of breastfeeding and introduction of formulas and complementary foods were collected by questionnaires at 6, 12, and 18 months of age. Allergy was diagnosed by pediatricians at 3 years of age. The only difference in food-introduction practices observed between farm and non-farm children was an earlier introduction of nuts in farmers (median month: 11 [IQR: 8–6] in farmers, 15 [12–19] in non-farmers). One farm child (4%) and 10 non-farm children (27%) were allergic at 3 years of age. Lower risk of allergy development was associated with early exclusive breastfeeding (continuous variable; OR = 0.59, 95% CI: 0.39–0.89), but also having received eggs (OR = 0.08, 95% CI: 0.13–0.54) and fish (logistic regression not applicable, P = 0.01 in likelihood ratio testing [χ2]) at 10 months of age or earlier compared to later. Our results were not affected by reverse causation, as judged by a questionnaire sent to the families in retrospect. Timing of introduction of complementary foods is unlikely to contribute to the lower risk of allergy among farm children. Although early exclusive breastfeeding was associated with a lower rate of allergy development, postponed introduction of complementary foods might increase the risk of developing allergy. Owing to the limited sample size, our results are only indicative, but support prior findings.

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“…В 2014 г. был завершен проект PreventCD -мультицентровое рандоми-зированное двойное слепое интервенционное исследова-ние [48]. Работа была проведена в 8 странах и включала более 900 детей из группы риска, являющихся носителями Table 5.…”

Section: особенности введения прикорма при целиакииunclassified