Celiac disease primary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
There are no established measures for the primary prevention of [disease name].
OR
There are no available vaccines against [disease name].
OR
Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].
OR
[Vaccine name] vaccine is recommended for [patient population] to prevent [disease name]. Other primary prevention strategies include [strategy 1], [strategy 2], and [strategy 3].
Primary Prevention
- There are no established measures for the primary prevention of [disease name].
- There are no available vaccines against [disease name].
OR
- Effective measures for the primary prevention of [disease name] include:
- [Measure1]
- [Measure2]
- [Measure3]
OR
- [Vaccine name] vaccine is recommended for [patient population] to prevent [disease name]. Other primary prevention strategies include:
- [Strategy 1]
- [Strategy 2]
- [Strategy 3]
Risk modifiers
There are various theories as to what determines whether a genetically susceptible individual will go on to develop coeliac disease. Major theories include infection by rotavirus[1] or human intestinal adenovirus.[2] Some research has suggested that smoking is protective against adult onset coeliac disease.[3]
A 2005 prospective and observational study found that timing of the exposure to gluten in childhood was an important risk modifier. People exposed to wheat, barley, or rye before the gut barrier has fully developed (three months after birth) had five times the risk of developing coeliac disease over those exposed at 4 to 6 months. Those exposed later had a slightly increased risk relative to those exposed at 4 to 6 months.[4] However a 2006 study with similar numbers found just the reverse, that early introduction of grains was protective.[5] Breastfeeding may also reduce risk. A meta-analysis indicates that prolonging breastfeeding until the introduction of gluten-containing grains into the diet was associated with a 52% reduced risk of developing coeliac disease in infancy; whether this persists into adulthood is not clear.[6]
References
- ↑ Stene L, Honeyman M, Hoffenberg E, Haas J, Sokol R, Emery L, Taki I, Norris J, Erlich H, Eisenbarth G, Rewers M (2006). "Rotavirus infection frequency and risk of celiac disease autoimmunity in early childhood: a longitudinal study". Am J Gastroenterol. 101 (10): 2333–40. PMID 17032199.
- ↑ Kagnoff M, Paterson Y, Kumar P, Kasarda D, Carbone F, Unsworth D, Austin R (1987). "Evidence for the role of a human intestinal adenovirus in the pathogenesis of coeliac disease". Gut. 28 (8): 995–1001. PMID 2822550.
- ↑ Suman S, Williams E, Thomas P, Surgenor S, Snook J (2003). "Is the risk of adult coeliac disease causally related to cigarette exposure?". Eur J Gastroenterol Hepatol. 15 (9): 995–1000. PMID 12923372.
- ↑ Norris JM, Barriga K, Hoffenberg EJ, Taki I, Miao D, Haas JE, Emery LM, Sokol RJ, Erlich HA, Eisenbarth GS, Rewers M. (2005). "Risk of celiac disease autoimmunity and timing of gluten introduction in the diet of infants at increased risk of disease". JAMA. 293 (19): 2343–2351. PMID 15900004.
- ↑ Poole J, Barriga K, Leung D, Hoffman M, Eisenbarth G, Rewers M, Norris J (2006). "Timing of initial exposure to cereal grains and the risk of wheat allergy". Pediatrics. 117 (6): 2175–82. PMID 16740862.
- ↑ Akobeng A, Ramanan A, Buchan I, Heller R (2006). "Effect of breast feeding on risk of coeliac disease: a systematic review and meta-analysis of observational studies". Arch Dis Child. 91 (1): 39–43. PMID 16287899.