Digesting Celiac Disease:
Examining Biological Components and Sex-Based Considerations
Celiac disease (CD), an autoimmune condition involving the body’s averse response to gluten proteins in wheat, barley, and rye, was once primarily prevalent in Europe and Australasia and was rarely studied or diagnosed in the United States (Kang, Kang, Green, Gwee, & Ho, 2013). However, prevalence and incidence rates of CD, especially in the United States, have increased over the past several decades (Catassi et al., 2010). Celiac disease affects approximately 1:140 people in the United States population (about 1%), and risk of developing CD increases near ten-fold with a first or second degree relative with the disease to between 1:22-1:39 (Fasano et al., …show more content…
The human leukocyte antigen complex (HLA) aids in protein distinction in the body, separating pathogenic proteins from innate proteins. Specific gene variants of HLA-DQA1/HLA-DQB1 (HLA-DQ2 or HLA-DQ8), trigger the immune system when exposed to gliadin protein, a derivative of gluten, and cause inflammation in the small intestines. HLA-DQ2 or HLA-DQ8 have been found in almost all genetically tested CD individuals, with HLA-DQ2 being much more prevalent (NLM, 2016). If someone tests negative for HLA-DQ2 and HLA-DQ8 during a diagnostic biopsy for CD, they most like do not have the disease (predictive value negative >98%) (Wakim-Fleming, …show more content…
This model is further warranted since genetic variations develop slowly, so environmental factors most likely contribute to more recent rises in incidence and prevalence. The “hygiene hypothesis,” increased immune system sensitivity resulting from lack of early environmental exposure (i.e. food with gluten, or a generally cleaner environment), is thought to contribute to surges in autoimmune disorders, especially in children, (Okada, Kuhn, Feillet, & Bach, 2010), but this does not explain why adult CD cases increased. One possible environmental risk factor in adults relates to changes in wheat production over the past several decades. For example, one study found that different fertilizers used in wheat production change the protein makeup of the grains (Grove, Hollung, Moldestad, Færgestad, & Uhlen, 2009), exposing the immune system to new protein combinations. In addition, newer types of industrialized wheat used in food production have varying levels of gluten proteins that cause sensitivities than older forms(Molberg et al., 2005). People most likely consume more gluten as well today than several decades ago, and the body may not be able to respond to heightened exposure. Finally, certain foodborne bacterial infections, have been shown to prime the immune system
Examining Biological Components and Sex-Based Considerations
Celiac disease (CD), an autoimmune condition involving the body’s averse response to gluten proteins in wheat, barley, and rye, was once primarily prevalent in Europe and Australasia and was rarely studied or diagnosed in the United States (Kang, Kang, Green, Gwee, & Ho, 2013). However, prevalence and incidence rates of CD, especially in the United States, have increased over the past several decades (Catassi et al., 2010). Celiac disease affects approximately 1:140 people in the United States population (about 1%), and risk of developing CD increases near ten-fold with a first or second degree relative with the disease to between 1:22-1:39 (Fasano et al., …show more content…
The human leukocyte antigen complex (HLA) aids in protein distinction in the body, separating pathogenic proteins from innate proteins. Specific gene variants of HLA-DQA1/HLA-DQB1 (HLA-DQ2 or HLA-DQ8), trigger the immune system when exposed to gliadin protein, a derivative of gluten, and cause inflammation in the small intestines. HLA-DQ2 or HLA-DQ8 have been found in almost all genetically tested CD individuals, with HLA-DQ2 being much more prevalent (NLM, 2016). If someone tests negative for HLA-DQ2 and HLA-DQ8 during a diagnostic biopsy for CD, they most like do not have the disease (predictive value negative >98%) (Wakim-Fleming, …show more content…
This model is further warranted since genetic variations develop slowly, so environmental factors most likely contribute to more recent rises in incidence and prevalence. The “hygiene hypothesis,” increased immune system sensitivity resulting from lack of early environmental exposure (i.e. food with gluten, or a generally cleaner environment), is thought to contribute to surges in autoimmune disorders, especially in children, (Okada, Kuhn, Feillet, & Bach, 2010), but this does not explain why adult CD cases increased. One possible environmental risk factor in adults relates to changes in wheat production over the past several decades. For example, one study found that different fertilizers used in wheat production change the protein makeup of the grains (Grove, Hollung, Moldestad, Færgestad, & Uhlen, 2009), exposing the immune system to new protein combinations. In addition, newer types of industrialized wheat used in food production have varying levels of gluten proteins that cause sensitivities than older forms(Molberg et al., 2005). People most likely consume more gluten as well today than several decades ago, and the body may not be able to respond to heightened exposure. Finally, certain foodborne bacterial infections, have been shown to prime the immune system