Risk of Celiac Disease Autoimmunity and Timing of Gluten Introduction in the Diet of Infants at Increased Risk of Disease
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چکیده
CELIAC DISEASE, ALSO CALLED gluten-sensitive enteropathy, is characterized by chronic inflammation in the small intestine, resulting in villous atrophy and flattening of the mucosa, induced by prolamins (gluten) present in wheat, barley, or rye. The classic form of celiac disease typically presents in early childhood with abdominal pain and diarrhea, malabsorption, and nutrient deficiencies. Most patients with celiac disease carry the human leukocyte antigen HLA-DRB1*03 allele (usually associated with HLA-DQ2) or HLA-DRB1*04 (associated with HLA-DQ8). These alleles also confer increased risk for type 1 diabetes; thus, individuals with type 1 diabetes and their first-degree relatives have increased risk of celiac disease. However, few genetically susceptible individuals develop ce-
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