A small study carried out in Norway has uncovered a link between enterovirus (a common intestinal virus) in early childhood and the subsequent development of coeliac disease in children who have a genetic predisposition to the condition.
From 2001 to 2007, researchers recruited 220 children who all carried both the HLA DQ2 and the DQ8 genetic makeup, either one of which indicates a genetic predisposition to coeliac disease.
The researchers collected monthly stool samples from age 3 to 36 months and used real time PCR techniques to detect both enterovirus and adenovirus (another common intestinal virus). Blood samples were collected and tested for coeliac disease antibodies at age 3, 6, 9 and 12 months, and then yearly until 2016. After an average of nearly 10 years, 25 of the children were diagnosed with coeliac disease. Each of these children were then matched to two healthy controls.
There was a significant association between exposure to enterovirus and later risk of developing coeliac disease. The association was only found in relation to infections after gluten had been introduced into the child’s diet, with higher levels of the virus in the stool samples, and long lasting infections producing higher risk estimates. Enterovirus infections caught before introducing gluten to the diet were not associated with the development of coeliac disease, suggesting that the infection itself was the disease trigger.
No association was found between adenovirus and coeliac disease.
As the study was carried out on a small scale, the researchers apply many caveats to broader interpretation of the results. However, they suggest that if enterovirus is confirmed as a causal factor, vaccination could reduce the risk of development of coeliac disease.
Reference: Kahrs et al. 2019. BMJ. DOI: 10.1136/bmj.l231
This is an Open Access article.
Additional reporting: ScienceDaily