FROM PEDIATRICS
The frequency of respiratory infections in the first 2 years of life could distinguish children who will develop celiac disease (CD) from those who will not in those with a family history of CD, according to Renata Auricchio, MD, University of Naples (Italy) Federico II, and her associates.
In a prospective cohort study, 373 newborns from families with at least one relative with CD were recruited. The cumulative incidence of new cases of CD was 6% at 3 years and 13.5% at 5 years of age, the researchers noted. In the first year when no child produced anti-tissue transglutaminase (anti-tTG) antibodies, respiratory infections (upper and lower tract) were more common among the case patients than among the controls (58% vs. 40%). During the second year, respiratory infections were again more frequent among the case patients than among controls (52% vs. 32%). And in the third year of life when most of the case patients were diagnosed with CD, no clinical event was more frequent in the case patients than in the control group.
In a multivariate analysis, the researchers found that only respiratory infections in the second year of life were associated with a twofold increase in the risk of developing CD (odds ratio, 2.25; P = .04). The second variable was respiratory infections in the first year of life, which had a score of 1.58. Results from the stepwise discriminant analysis suggested respiratory infections in the first and second years of life significantly contributed to the index of discrimination between the case patients and the controls.
“In this study, we report that early infections significantly contribute to the risk of developing CD,” Dr. Auricchio and her associates concluded. “It is possible that the exposure to early infection stimulates a genetically predisposed immune profile, which contributes to the switch from tolerance to intolerance to gluten, which is a common food antigen.”
Read the full study in Pediatrics (doi: 10.1542/peds.2016-4102).
