Enterovirus in early childhood could be a trigger for later coeliac disease in children at increased genetic risk of the condition, suggests a small study published in the BMJ.
The case-control study included 220 children in Norway carrying the HLA-DQ2/DQ8 genotype who were recruited from 2001 to 2007. Monthly stool samples were collected from age 3-36 months and tested for nucleic acid of enterovirus and adenovirus. Plasma samples were tested for coeliac disease antibodies at age three, six, nine and 12 months, and then annually until 2016.
After a mean follow-up of 9.9 years, 25 children were diagnosed with coeliac disease after screening and were matched to two controls each. Enterovirus was detected in 17 per cent of stool samples and was significantly more frequent in samples collected before the development of coeliac disease antibodies in cases than in controls (adjusted odds ratio 1.49; 95% CI 1.07-2.06; P=.02). Adenovirus infections were not linked to the development of coeliac disease.
The authors suggest identification of specific viruses as triggers of coeliac disease may have implications for preventive strategies and justify future studies to clarify mechanisms. “If enterovirus is confirmed as a trigger factor, vaccination could reduce the risk of development of coeliac disease,” they conclude.