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Just how closely are diabetes type 1 and celiac disease linked?  First a
study shows HLA DQ2 and DR4 are so similar in diabetes type 1 patients with
or without celiac disease that HLA typing cannot be used to screen for
celiac disease in diabetic type 1 patients.  Now a study shows that wheat
causes villous atrophy in non-obese diabetic mice.  It is theorized by some
that autoimmune disorders have a common cause and a common cure.  These
studies add credibility to this theory.

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Diabetologia. 2005 Apr 14; [Epub ahead of print]

Small intestinal enteropathy in non-obese diabetic mice fed a diet
containing wheat.

Maurano F, Mazzarella G, Luongo D, Stefanile R, D'Arienzo R, Rossi M,
Auricchio S, Troncone R.

Institute of Food Science, CNR, via Roma 52 A/C, 83100, Avellino, Italy,
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AIMS/HYPOTHESIS: A deranged mucosal immune response and dietary factors may
play an important role in the pathogenesis of type 1 diabetes. The aims of
our work were to look for the presence of small intestinal enteropathy in
non-obese diabetic (NOD) mice in relation to the presence of wheat proteins
in the diet, and to assess their role in the risk of developing diabetes.
METHODS: Female NOD mice were fed a standard or gluten-free diet or a
gluten-free diet with the addition of wheat proteins (MGFD). Small
intestine architecture, intraepithelial CD3(+) infiltration, epithelial
expression of H2-IA, mRNA for IFN-gamma and IL-4 were assessed. RESULTS:
NOD mice fed a standard diet showed reduced villous height, increased
intraepithelial infiltration by CD3(+) cells and enhanced expression of H2-
IA and IFN-gamma mRNA when compared with mice on the gluten-free diet. The
cumulative diabetes incidence at 43 weeks of age was 65% in the latter and
97% in the former (p<0.01). Mice on MGFD also showed increased epithelial
infiltration and a higher incidence of diabetes.
CONCLUSIONS/INTERPRETATION: Mice fed a wheat-containing diet showed a
higher incidence of diabetes, signs of small intestinal enteropathy and
higher mucosal levels of proinflammatory cytokines.

PMID: 15830185 [PubMed - as supplied by publisher]

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Diabetes Care. 2005 Apr;28(4):806-9.

Use of HLA Typing in Diagnosing Celiac Disease in Patients With Type 1
Diabetes.

Doolan A, Donaghue K, Fairchild J, Wong M, Williams AJ.

Department of Clinical Immunology, Royal Prince Alfred Hospital,
Camperdown, New South Wales 2050, Australia.
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OBJECTIVE: This study examines the use of HLA typing for the diagnosis of
celiac disease in a group of Australians with type 1 diabetes. RESEARCH
DESIGN AND METHODS: Subjects included 131 sequential patients with type 1
diabetes (mean age 17 years [range 10-37]), 77 patients with biopsy-proven
celiac disease (mean age 52 years [range 12-84]), and 162 healthy control
subjects (mean age 17 years [range 2 months to 56 years]). Subjects were
prospectively screened for celiac disease using endomysial antibodies
(EMAs), tissue transglutaminase antibodies (TTGAs), and celiac disease-
specific HLA typing. RESULTS: Celiac disease was diagnosed in 11 subjects
after an intestinal biopsy (prevalence 8.4%). There was 95% agreement
between TTGA and EMA for positive results and 100% for negative results.
There was no significant difference for HLA DQ2 and DR4 among patients with
type 1 diabetes with or without celiac disease. CONCLUSIONS: The prevalence
of celiac disease among patients with type 1 diabetes is higher than
previously estimated in Australia. TTGA is a valuable diagnostic tool that
can be used for screening celiac disease in patients with type 1 diabetes.
HLA typing should not be used in the diagnosis of celiac disease in
patients with type 1 diabetes because of the similarities of HLA types
between patients with type 1 diabetes and those with celiac disease.

PMID: 15793177 [PubMed - in process]

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