Olives J-P
Gastroentérologie et Nutrition Pédiatriques, Hôpital des Enfants, 330 Avenue de Grande Bretagne, TSA70034, 31059 Toulouse cedex, France.
Arch Pediatr. 2010 Dec;17 Suppl 5:S199-203. doi: 10.1016/S0929-693X(10)70927-1.
Celiac disease (CD) is an auto-immune enteropathy, triggered in genetically predisposed individuals by the ingestion of dietary gluten. Gluten is the alcohol-soluble protein component of the cereals wheat, rye and barley. CD is a multifactorial condition, originating from the interplay of genetic and environmental factors. The necessary environmental trigger is gluten, while the genetic predisposition has been identified in the major histocompatibility complex region on chromosome 6, with over 90% of CD patients expressing HLA DQ2 and the remaining celiac patients express DQ8. The fact that only about 4 % of DQ2/8-positive individuals exposed to gluten develop CD, has led to the recognition that other genetic and environmental factors are also necessary. In the last few years, several epidemiological studies have suggested that the timing of the introduction of gluten, as well as the pattern of breastfeeding, may play an important role in the subsequent development of CD. Here, we present and review the most recent evidences regarding the effect of timing of gluten introduction during weaning, the amount of gluten introduced and simultaneous breastfeeding, on the development of CD.
乳糜泻(CD)是一种自身免疫性肠病,在具有遗传易感性的个体中,由摄入膳食麸质引发。麸质是小麦、黑麦和大麦等谷物中可溶于酒精的蛋白质成分。CD是一种多因素疾病,源于遗传和环境因素的相互作用。必要的环境触发因素是麸质,而遗传易感性已在6号染色体的主要组织相容性复合体区域中得到确认,超过90%的CD患者表达HLA DQ2,其余乳糜泻患者表达DQ8。仅有约4%暴露于麸质的DQ2/8阳性个体发生CD这一事实,促使人们认识到其他遗传和环境因素也是必要的。在过去几年中,多项流行病学研究表明,引入麸质的时间以及母乳喂养方式,可能在CD的后续发展中发挥重要作用。在此,我们展示并综述关于断奶期间引入麸质的时间、引入的麸质量以及同时进行母乳喂养对CD发生影响的最新证据。