Serena Gloria, Leonard Maureen M, Camhi Stephanie, Huedo-Medina Tania B, Fasano Alessio
Center for Celiac Research, Massachusetts General Hospital for Children, Boston, USA - Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Division of Pediatric Gastroenterology and Nutrition, Massachusetts General Hospital for Children, Boston, USA.
Allied Health Sciences Department, University of Connecticut, Storrs, USA.
Recenti Prog Med. 2016 Jun;107(6):320-7. doi: 10.1701/2296.24694.
Over recent years we have seen rising many clinical and scientific innovations about celiac disease (CE), however the most important innovation that will contribute to change the future of the research and clinic in this field is the natural history of the disease. For many years it has been though that a genetic predisposition and the exposure to gluten were necessary and sufficient to develop CE. Recent studies, however, suggest that the loss of tolerance to gluten may occur in any moment of life upon certain conditions. Furthermore, several environmental factors known to play a role in shaping the intestinal microflora have also been considered related to the development of CE. Delivery mode, the infant diet and the use of antibiotics are included among these factors. To this day no large scale studies have determined if and how the microbiome composition and its metabolomic profile may influence the loss of tolerance to gluten and the consequent development of CE. In this paper we describe a prospective, multi-centric and longitudinal study on infants at risk for CE that will use different techniques to better understand the role of the microbome during the first steps in the development of the autoimmune disease.
近年来，我们看到了许多关于乳糜泻（CE）的临床和科学创新，然而，将有助于改变该领域研究和临床未来的最重要创新是该疾病的自然史。多年来，人们一直认为遗传易感性和接触麸质是发生乳糜泻的必要且充分条件。然而，最近的研究表明，在某些条件下，对麸质的耐受性丧失可能在生命的任何时刻发生。此外，已知在塑造肠道微生物群方面起作用的几个环境因素也被认为与乳糜泻的发展有关。这些因素包括分娩方式、婴儿饮食和抗生素的使用。到目前为止，还没有大规模研究确定微生物组组成及其代谢组学特征是否以及如何影响对麸质的耐受性丧失以及随之而来的乳糜泻的发展。在本文中，我们描述了一项针对有乳糜泻风险婴儿的前瞻性、多中心纵向研究，该研究将使用不同技术，以更好地了解微生物群在自身免疫性疾病发展的最初阶段所起的作用。
