Celiac.com 04/07/2008 - No, this is not some kind of April Fool’s joke.When I read this report, I just about fell off my chair. New research indicates thatbeing poor and living in squalor might actually provide some benefitagainst the development of celiac disease.
A team of medicalresearchers recently set out to examine gene-environmental interactionsin the pathogenesis of celiac disease. The research team was made up ofA. Kondrashova, K. Mustalahti, K. Kaukinen, H. Viskari, V. Volodicheva,A. M. Haapala, J. Ilonen, M. Knip, M. Mäki, H. Hyöty, T. E. Group.Finland and nearby Russian Karelia have populations that eat about thesame amounts of the same grains and grain products. The two populationsalso have a high degree of shared genetic ancestry. The only majordifference between the populations of the two areas lies in theirsocioeconomic conditions.
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The region of Russian Karelia ismuch poorer than the neighboring areas in nearby Finland. Thesanitation levels in Russian Karelia are also distinctly inferior thanthey are in Finland. The researchers compared the prevalence of celiacdisease and predisposing human leukocyte antigen (HLA) alleles inpopulations from Russian Karelia and Finland. The team performedscreening for tissue transglutaminase antibodies (tTG) and HLA-DQalleles on 1988 school-age children from Karelia and 3654 children fromFinland. Children with transglutaminase antibodies were encouraged tohave a duodenal biopsy.
Interestingly, the patients fromRussian Karelia showed tTG antibodies far less often than their Finnishcounterparts (0.6% compared to 1.4%, P = 0.005). The patients fromRussian Karelia also showed Immunoglobulin class G (IgG) antigliadinantibodies far less frequently than their Finnish patients (10.2%compared to 28.3%, P<0.0001).
The researchers confirmed adiagnosis of celiac disease by duodenal biopsy in four of the eighttransglutaminase antibody-positive Karelian children, for an occurrencerate of 1 in 496 versus 1 in 107 Finnish children.
In bothgroups, the same HLA-DQ alleles were associated with celiac disease andthe presence of transglutaminase antibodies. The patients from RussianKarelia showed a much lower prevalence of transglutaminase antibodiesand celiac disease than the Finnish children.
The poorconditions and inferior hygienic conditions in Russian Karelia mightprovide some kind of protection against the development of celiacdisease. The value of studies like this aren’t to make us wax nostalgicfor poverty, or to encourage people to fend off celiac disease bybecoming poor and living in squalid conditions. The value of a studylike this lies in the idea that there may be more to the development ofceliac disease than simple biological factors. That environmentalconditions might play a key role in both the frequency ofceliac-related antibodies, and in the development of the disease itselfis quite intriguing and clearly warrants further and more comprehensivestudy.
Ann Med. 2008;40(3):223-31.
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