Epitope Selection for HLA-DQ2 Presentation: Implications for Celiac Disease and Viral Defense

AbstractObjectivesThe coexistence of celiac disease (CD) and obesity/overweight is not unusual. We investigate the prevalence and clinical presentation of CD, detected by screening, among children with excessive weight gain.MethodsWe enrolled 200 children referred for overweight/obesity to our outpatient clinic. Medical history during pregnancy and childhood and lifestyle variables were recorded. Patients were screened for CD with total immunoglobulin A (IgA), IgA anti-transglutaminase (tTG-IgA) and IgA anti-endomysial antibodies (EMA-IgA). In subjects with positive autoantibodies, esophagogastroduodenoscopy (EGDS) was performed and genetic testing for HLA DQ2 and/or DQ8 haplotypes was tested.ResultsCD positive antibodies (tTg-IgA and EMA-IgA) were detected in eight patients (4%); in all subjects CD diagnosis was confirmed by HLA-DQ2 and/or DQ8 compatibility and EGDS. No association between CD and medical history during pregnancy and childhood or lifestyle variables was noted; however, a dietary difference was identified with those testing positive for CD also reporting a lower weekly consumption of fruits and vegetables (p=0.04). Headache was reported more frequently in patients with than without CD (p=0.04). Familiar positivity for autoimmune diseases was revealed in CD patients (p=0.01).ConclusionCD should be considered in children with excessive weight gain. Familial predisposition to other autoimmune diseases may represent a risk factor for development of CD. Even though the relationship between headache and CD is not well defined, the patients with headache of unknown origin should be screened for CD.

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The Prevalence of Celiac Disease-Specific Auto-Antibodies in Type 1 Diabetes in a Moroccan Population

International Journal of Endocrinology ◽

10.1155/2019/7895207 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9

Author(s):

Ider Oujamaa ◽

Majda Sebbani ◽

Lahcen Elmoumou ◽

Aïcha Bourrahouate ◽

Rabiy El Qadiry ◽

...

Keyword(s):

Celiac Disease ◽

Tissue Transglutaminase ◽

Iga Deficiency ◽

Cross Sectional Study ◽

Biological Data ◽

Cross Sectional ◽

Systematic Screening ◽

Lower Height ◽

Hla Dq2

Objective. We aimed to determine the prevalence of specific auto-antibodies to celiac disease (CD) in Moroccan type 1 diabetic (T1D) patients and compare the clinical and biological characteristics of seropositive and seronegative cases. Patients and Methods. A cross-sectional study was carried out on 276 T1D patients including 109 adults and 167 pediatric cases. The screening for CD was performed by an Elisa IgA anti-tissue transglutaminase antibody (tTGA) testing, combined with IgA quantification by nephelometry. Positive-IgA-tTGA cases were secondly tested for anti-endomysial antibodies (EMA) using an immunofluorescence technique, and the IgA deficiency cases were screened for IgG-tTGA. Patients with low positive tTGA titers underwent HLA-DQ2/DQ8 typing. Sociodemographic and clinical data of the patients were collected using a hetero-administered questionnaire. The comparison of clinical and biological data between seropositive and seronegative diabetics was done using independent T, Mann–Whitney U, chi-squared, and Fisher tests, which were considered significant if p value <0.05. Results. The prevalence of CD-specific auto-antibodies was estimated to be 9.1% (IC = 95%), with 25 positive cases in tTGA and EMA testing. Eight cases displayed low titers of IgA-tTGA, among which 4 were positive for HLA-DQ2, 1 for HLA-DQ8, and 1 for both DQ2 and DQ8. The other 2 cases had a biopsy-proven CD. Compared to seronegative patients, seropositive cases had a higher percentage of associated autoimmune disorders (16% vs. 2.4%, p=0.008), with a significant lower height Z-scores (median: −0.90 (−3.93 to 0.95) vs. −0.51 (−4.54 to 2.18), p=0.029) and a higher HbA1c level (median: 11.30% (7.31 to 16.00) vs. 9.30% (4.40 to17.31), p=0.022). Conclusion. The current study gave evidence of a high prevalence of CD specific auto-antibodies in T1D population. The co-existence of these two conditions was associated with a poor glycemic control, a lower height, and other autoimmune diseases. These findings may suggest the necessity of a systematic screening of CD in T1D patients.

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Answer to Mejía-Leon ME and Calderón de la Barca AM. Prevalence of the HLA-DQ2 and DQ8 haplotypes that predispose to celiac disease in Mexico

Revista de Gastroenterología de México (English Edition) ◽

10.1016/j.rgmxen.2018.08.006 ◽

2019 ◽

Vol 84 (1) ◽

pp. 124-125

Author(s):

L. Uscanga

Keyword(s):

Celiac Disease ◽

Calderón De La Barca ◽

Hla Dq2

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A Phase I Study to Determine Safety, Tolerability and Bioactivity of Nexvax2® in HLA DQ2+ Volunteers With Celiac Disease Following a Long-Term, Strict Gluten-Free Diet

Gastroenterology ◽

10.1016/s0016-5085(11)61794-0 ◽

2011 ◽

Vol 140 (5) ◽

pp. S-437-S-438 ◽

Cited By ~ 23

Author(s):

Gregor J. Brown ◽

James Daveson ◽

Joanne K. Marjason ◽

Rose A. Ffrench ◽

Danielle Smith ◽

...

Keyword(s):

Celiac Disease ◽

Phase I ◽

Phase I Study ◽

Gluten Free Diet ◽

Gluten Free ◽

Hla Dq2

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HLA DQ2 HAPLOTYPE, EARLY ONSET OF GRAVES DISEASE, AND POSITIVE FAMILY HISTORY OF AUTOIMMUNE DISORDERS ARE RISK FACTORS FOR DEVELOPING CELIAC DISEASE IN PATIENTS WITH GRAVES DISEASE

Endocrine Practice ◽

10.4158/ep15700.or ◽

2015 ◽

Vol 21 (9) ◽

pp. 993-1000 ◽

Cited By ~ 2

Author(s):

Piotr Miskiewicz ◽

Agata Gos-Zajac ◽

Alina Kurylowicz ◽

Teresa Maria Plazinska ◽

Maria Franaszczyk ◽

...

Keyword(s):

Risk Factors ◽

Celiac Disease ◽

Family History ◽

Early Onset ◽

Positive Family History ◽

Autoimmune Disorders ◽

Graves Disease ◽

History Of ◽

Hla Dq2

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Adult Patients with Eosinophilic Esophagitis Do Not Show an Increased Frequency of the HLA-DQ2/DQ8 Genotypes Predisposing to Celiac Disease

Digestive Diseases and Sciences ◽

10.1007/s10620-010-1383-2 ◽

2010 ◽

Vol 56 (4) ◽

pp. 1107-1111 ◽

Cited By ~ 22

Author(s):

Alfredo J. Lucendo ◽

Ángel Arias ◽

Isabel Pérez-Martínez ◽

Antonio López-Vázquez ◽

Jesús Ontañón-Rodríguez ◽

...

Keyword(s):

Celiac Disease ◽

Eosinophilic Esophagitis ◽

Adult Patients ◽

Hla Dq2

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Celiac disease and its histopathology

Journal of Pathology of Nepal ◽

10.3126/jpn.v7i1.16948 ◽

2017 ◽

Vol 7 (1) ◽

pp. 1118-1123 ◽

Cited By ~ 1

Author(s):

S Pudasaini

Keyword(s):

Celiac Disease ◽

Wheat Gluten ◽

Duodenal Biopsy ◽

Inflammatory Disorder ◽

Small Intestinal Mucosa ◽

Positive Serology ◽

Chronic Inflammatory Disorder ◽

Immune Mediated ◽

Systemic Manifestations ◽

Hla Dq2

Celiac disease is gluten induced enteropathy and is a chronic inflammatory disorder of the small intestine characterized by malabsorption. It is a common immune mediated disorder which is triggered by consumption of wheat (gluten). It occurs in genetically predisposed individuals (carriers of HLA-DQ2 and DQ8 haplotypes). It is characterized by inflammation of the small-intestinal mucosa and myriad gastrointestinal and systemic manifestations. A duodenal biopsy with positive serology is the gold standard for the diagnosis of Celiac disease. As there are changing presentation for Celiac disease, communication of pathologist and gastroenterologists is essential for appropriate interpretation of duodenal biopsy.

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