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Intervention strategies in early childhood to prevent celiac disease—a mini-review

A higher intake of gluten during childhood is associated with increased risk of celiac disease, and the incidence of celiac disease peaks shortly after the time point when associations with higher gluten intake during the second and third year of life occur. Additional environmental factors are most...

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Autores principales: Andrén Aronsson, Carin, Agardh, Daniel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9992640/
https://www.ncbi.nlm.nih.gov/pubmed/36911718
http://dx.doi.org/10.3389/fimmu.2023.1106564
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author Andrén Aronsson, Carin
Agardh, Daniel
author_facet Andrén Aronsson, Carin
Agardh, Daniel
author_sort Andrén Aronsson, Carin
collection PubMed
description A higher intake of gluten during childhood is associated with increased risk of celiac disease, and the incidence of celiac disease peaks shortly after the time point when associations with higher gluten intake during the second and third year of life occur. Additional environmental factors are most likely necessary for celiac disease to develop. It is hypothesized that gastrointestinal infections increase gut permeability and exposure to gluten. Alternatively, infections may lead to gut dysbiosis and chronic inflammation, with leakage of self-antigens that mimic gluten peptides that leads to an autoimmune-like response. Different gluten interventions to prevent celiac disease have been proposed. Early clinical studies suggested an optimal time point introducing gluten between 4 and 6 months of age while the infant is being breastfed. However, later clinical trials on reduced gluten intake given to infants have shown no protection from celiac disease if gluten introduction was delayed or if gluten was introduced in small amounts during the child’s first year of life. Still, more randomized clinical trials (RCTs) are warranted to answer the question if a reduced amount of gluten, not only at the time of introduction during infancy but also in a longer time frame, will prevent children at genetic risk from having lifelong celiac disease. It needs to be clarified whether dietary interventions are effective strategies to be proposed as future prevention of celiac disease in the general population. The present mini-review provides an overview of ongoing or completed RCTs that have focused on interventions during early childhood with the aim of preventing celiac disease.
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spelling pubmed-99926402023-03-09 Intervention strategies in early childhood to prevent celiac disease—a mini-review Andrén Aronsson, Carin Agardh, Daniel Front Immunol Immunology A higher intake of gluten during childhood is associated with increased risk of celiac disease, and the incidence of celiac disease peaks shortly after the time point when associations with higher gluten intake during the second and third year of life occur. Additional environmental factors are most likely necessary for celiac disease to develop. It is hypothesized that gastrointestinal infections increase gut permeability and exposure to gluten. Alternatively, infections may lead to gut dysbiosis and chronic inflammation, with leakage of self-antigens that mimic gluten peptides that leads to an autoimmune-like response. Different gluten interventions to prevent celiac disease have been proposed. Early clinical studies suggested an optimal time point introducing gluten between 4 and 6 months of age while the infant is being breastfed. However, later clinical trials on reduced gluten intake given to infants have shown no protection from celiac disease if gluten introduction was delayed or if gluten was introduced in small amounts during the child’s first year of life. Still, more randomized clinical trials (RCTs) are warranted to answer the question if a reduced amount of gluten, not only at the time of introduction during infancy but also in a longer time frame, will prevent children at genetic risk from having lifelong celiac disease. It needs to be clarified whether dietary interventions are effective strategies to be proposed as future prevention of celiac disease in the general population. The present mini-review provides an overview of ongoing or completed RCTs that have focused on interventions during early childhood with the aim of preventing celiac disease. Frontiers Media S.A. 2023-02-22 /pmc/articles/PMC9992640/ /pubmed/36911718 http://dx.doi.org/10.3389/fimmu.2023.1106564 Text en Copyright © 2023 Andrén Aronsson and Agardh https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Andrén Aronsson, Carin
Agardh, Daniel
Intervention strategies in early childhood to prevent celiac disease—a mini-review
title Intervention strategies in early childhood to prevent celiac disease—a mini-review
title_full Intervention strategies in early childhood to prevent celiac disease—a mini-review
title_fullStr Intervention strategies in early childhood to prevent celiac disease—a mini-review
title_full_unstemmed Intervention strategies in early childhood to prevent celiac disease—a mini-review
title_short Intervention strategies in early childhood to prevent celiac disease—a mini-review
title_sort intervention strategies in early childhood to prevent celiac disease—a mini-review
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9992640/
https://www.ncbi.nlm.nih.gov/pubmed/36911718
http://dx.doi.org/10.3389/fimmu.2023.1106564
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