Institute of Biotechnology and Genetic Engineering, University of Sindh.
Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan.
Medicine (Baltimore). 2021 Mar 19;100(11):e24954. doi: 10.1097/MD.0000000000024954.
Celiac disease (CD) is an autoimmune enteropathy triggered by ingestion of gluten present in wheat, barley, and rye. Gluten along with environmental trigger starts an inflammatory reaction which results in damage to small intestine. Human leukocyte antigen (HLA)-DQA1∗05, -DQB1∗02, and -DQB1∗03:02 are the known risk alleles of CD. The diagnostic method for CD involves serological or intestinal biopsy, but genetic test could be implemented. HLA typing precludes the need for further diagnosis and it has high negative predictive value. The aim of this study was to make aware of HLA molecular typing for celiac disease among local laboratories and healthcare professionals. The prevalence and frequency distribution of HLA-DQ2 and -DQ8 haplotypes in 175 pediatric unrelated healthy controls, celiac patients, and CD with concurrent diabetes mellitus type 1 (DM1) was evaluated. The most common haplotype was DQ2 followed by DQ8. In control group only DQ2 was observed with frequency of 8.5%. In celiac patients 85.7% were DQ2, 11.4% were DQ8, and rest were DQ2/DQ8 (2.8%), and all had CD. In the group of CD with DM1, 31.4% had DQ2, 25% had DQ8, and 34% having both the haplotypes; while only 9 of these patients were suffering from CD. It was concluded that Celiac disease is frequently unrecognized by physicians, in part because of its variable clinical presentation and symptoms. Thus genetic testing for celiac disease could be an additive tool for diagnosis to exclude ambiguity.
乳糜泻(CD)是一种由食用小麦、大麦和黑麦中存在的麸质引起的自身免疫性肠病。麸质与环境触发因素一起引发炎症反应,导致小肠损伤。人类白细胞抗原(HLA)-DQA1∗05、-DQB1∗02 和 -DQB1∗03:02 是 CD 的已知风险等位基因。CD 的诊断方法包括血清学或肠道活检,但也可以进行基因测试。HLA 分型可排除进一步诊断的需要,且具有高阴性预测值。本研究旨在提高当地实验室和医疗保健专业人员对乳糜泻 HLA 分子分型的认识。评估了 175 名无关的儿科健康对照者、乳糜泻患者和并发 1 型糖尿病(DM1)的乳糜泻患者中 HLA-DQ2 和 -DQ8 单倍型的流行率和频率分布。最常见的单倍型是 DQ2,其次是 DQ8。在对照组中,仅观察到 DQ2,频率为 8.5%。在乳糜泻患者中,85.7%为 DQ2,11.4%为 DQ8,其余为 DQ2/DQ8(2.8%),均患有乳糜泻。在 CD 合并 DM1 组中,31.4%有 DQ2,25%有 DQ8,34%有两种单倍型;而这些患者中只有 9 人患有 CD。研究结论认为,乳糜泻常被医生漏诊,部分原因是其临床表现和症状多变。因此,对乳糜泻进行基因检测可能是一种额外的诊断工具,可排除不确定性。