A new study opens up the possibility that celiac disease is an umbrella for different things, because researchers found that certain viral diseases could be associated with its increased incidence.
This could also explain why infants who have already had a rotavirus infection are more likely to develop celiac disease: if the child is suffering from a viral infection at the same time, the first intake of gluten by infants, which is supposed to establish oral tolerance to gluten, can have the opposite effect. If so, vaccination against intestinal viruses such as rota- and reovirus in early childhood could reduce the incidence of celiac disease.
SUSPICIOUS VIRUSES AT THE CRIME SCENE
The study confirmed a link between intestinal viral infections and celiac disease. The team analyzed samples of blood serum and 150 small-intestine biopsies from celiac patients and compared them with those of a healthy control group.
"The focus was on intestinal viruses, for example the noro-, rota- and reoviruses. Our analysis of the reovirus showed that celiac patients had significantly more antibodies against this virus and these correlated with virus-associated markers in the biopsies. This means that it is highly probable that the celiac patients had suffered from a recent or chronic intestinal viral infection," Hinterleitner Dr. Reinhard Hinterleitner, a postdoctoral fellow at the University of Chicago.
They found that viruses can become the trigger of the long-term false alarm in coeliac patients: "Intestinal viruses upset the small intestine and regulatory T lymphocytes can be transformed into pro-inflammatory T lymphocytes as a result," according to Hinterleitner. "The dendritic cells are also alerted by the infection. If gluten containing food is consumed at the same time as a viral infection occurs, the already alerted dendritic cells also present gluten antigens to the T lymphocytes."
This can result in the transmission of incorrect information and the T lymphocytes react with an inflammatory response, which is aimed not only at the virus but also at the gluten.
They observed this process in a genetically engineered celiac mouse model: "In the case of a reoviral infection of the small intestine of mice, similar clinical symptoms to those experienced by celiac patients arose when gluten was consumed at the same time."
The timing could result in a long-term loss of oral tolerance to gluten in the 20 percent of the population with the genetic predisposition for celiac disease, and particularly in patients who respond more strongly to virus infections.