Early‐life exposure to common virus infections did not differ between coeliac disease patients and controls

Abstract

Aim Our aim was to compare the presence of various common viruses (rhinovirus, enterovirus, adenovirus, Epstein–Barr virus, cytomegalovirus, norovirus, parechovirus) in stool and nasal swab samples as well as virus‐specific antibodies in serum samples between children who developed coeliac disease and controls. Methods A case–control study was established based on the DIABIMMUNE Study cohorts. During the study, eight Estonian children and 21 Finnish children aged 1.5 years to five years developed coeliac disease and each was matched with a disease‐free control. Nasal swabs and stool samples were taken at the age of three to six months and the serum samples at the time of diagnosis. Results Rhinovirus ribonucleic acid was detected in the nasal swabs from five coeliac disease children, but none of the control children (p = 0.05). There were no statistically significant differences in the level of viral antibodies between cases and controls. Enterovirus immunoglobulin G class antibodies were found more frequently in the Estonian than in the Finnish children (63% versus 23%, p = 0.02). Conclusion This study did not find any marked overall differences in laboratory‐confirmed common viral infections between the children who developed coeliac disease and the controls. However, rhinovirus infections were detected slightly more often in those patients who developed coeliac disease.

Metagenomics of the faecal virome indicate a cumulative effect of enterovirus and gluten amount on the risk of coeliac disease autoimmunity in genetically at risk children: the TEDDY study

“…In addition, enteroviruses have previously been detected in the small bowel mucosa of coeliac disease patients 26. Moreover, enteroviral infections prior to 1 year of age were not associated with increased risk of coeliac disease, while those occurring after the age of 1 year increased the risk 12 27. Our findings are consistent with both of these previous studies.…”

Parechovirus Infection in Early Childhood and Association With Subsequent Celiac Disease

“…One small prior study investigating parechovirus and CD did not detect any parechovirus measured in stool at 3 and 6 months of age. [35] In our data, parechovirus prevalence was very low in this age-group (e.g. 1.0% at ≤4 months of age) which would limit statistical power for analyses restricted to this age-group.…”

Review article: exposure to microbes and risk of coeliac disease

“…In cross‐sectional studies investigating enterovirus in duodenal biopsies by RT‐PCR, in situ hybridisation and immunohistochemistry, one study found neither cases with CD nor controls to be positive 46 whereas another study found slightly higher frequencies in cases with CD compared to controls (Table 2). 47 Furthermore, neither cases nor controls had enterovirus in nasal/stool swabs restricted to the first 6 months of life, and antibodies against enterovirus at diagnosis did not differ between cases and matched controls 48 . These findings are not surprising because enterovirus infections are uncommon in early infancy but nearly ubiquitous before the age of three.…”

“…After seasonal or pandemic influenza an increased risk of a new diagnosis of CD was found in a nation‐wide register‐based study (HR 1.29 (95% CI, 1.21‐1.38) 63 . In a prospective matched case‐control study with PCR of nasal swabs collected at 3‐6 months, rhinovirus was found in 5/18 children with CD (28%) compared to 0/16 in controls ( P = 0.05) 48 …”