A Norwegian population-based study published by the American Journal of Gastroenterology in October suggests early life infections may play a role in later development of celiac disease. Children with 10 or more infections by the time they turned 18 months old had a significantly greater risk for later development of celiac disease compared with children who had four or fewer infections.
At this time, this study raises more questions than it answers since it is indicating correlation and not causation. It could be that the population that is more susceptible to the development of autoimmune diseases is also more susceptible to infections. This research could also support Alessio Fasano’s research into intestinal permeability that indicates that all autoimmune conditions (including celiac disease) require leaky gut (as well as genetic markers and the environmental catalyst). Infections do result in an increase in intestinal permeability which could be the precipitating force in the development of leaky gut as the precursor to the development of autoimmune conditions (celiac disease, in this case). Or it could be that the high infection rate is the result of leaky gut and has nothing to do with the development of celiac disease in which both infection and autoimmune conditions are correlated with gut permeability.
There is some supporting research that dysbiosis and infection may be a precipitating force in the development of celiac disease through upregulating tissue transglutaminase. In fact, a study published in March indicates a candida overgrowth could contribute to the development of celiac disease. Candida expresses a protein (Hwp1) that binds tissue transglutaminase (like gliadin does), potentially leading to immune activation and cross-reactivity with gluten. The study population of those with celiac disease and those without that had a candida overgrowth both produced anti-gliadin antibodies as well as the anti-Hwp1 antibodies.
What does this mean for us?
Even a correlation between celiac disease and dysbiosis is a reason to support healthy gut bacteria levels in infants, children and adults. Extra care should be taken for infants born by c-section which prevents the transfer of healthy gut bacteria between mother and child during vaginal birth.
A research review published in September implicates gram-negative bacteria (the bad bacteria) in the GI tract as exacerbating celiac symptoms through inflammation and increased gut permeability. The same review finds that gram-positive bacteria (which is what is found in probiotics) supports the release of anti-inflammatory proteins by immune cells, prevents the inflammation induced by gram-negative bacteria, decreases permeability and supports immune function. This could indicate that probiotics and fermented foods may have a protective affect against the development of celiac disease.