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Subject:
From:
Jack & Felice Cohen-Joppa <[log in to unmask]>
Reply To:
Jack & Felice Cohen-Joppa <[log in to unmask]>
Date:
Sun, 4 Oct 2015 07:03:48 -0700
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<<Disclaimer: Verify this information before applying it to your situation.>>

Well, it is flattering to have several replies stating “great question”!
Thanks!

My question being:
> In light of 
> 1) what we know about celiacs having a genetic predisposition and hypothesized triggering event, and
> 2) anecdotal reports (people I know or have heard about at support groups) of an intimate partner developing and being diagnosed with celiac disease some time after the other partner, and 
> 3) growing awareness of the influence of an individual’s microbiota on their overall health and some specific conditions, and 
> 4) the fact that intimate partners have more in common in their microbiomes than two random unrelated, non-intimate people;
> does anyone know of any scientific study indicating that intimate partners are also more likely than average to develop celiac disease, as we know blood-relatives are?

One person was good to refer me to this article http://www.medscape.com/viewarticle/847625
(free registration for access) about a study which touches on but is not specific to my question, and admits to limits regarding the significance of the conclusion. (Abstract text, below, for those who don’t care to register at medscape.com) 

The large-scale study specifically looked at rates of specified non-celiac autoimmune diseases in both first-degree relatives and spouses of people with celiac disease. It concluded a slight increase in risk rates for spouses, but not so significant as to overcome possibility that the sample was weighted to those more attuned to possible risk and thus diagnosis because they have a spouse with celiac.
The authors also speculate that common environmental factors may account for the increased rates, but do not discuss specific factors such as gut microbiome. 

http://www.cghjournal.org/article/S1542-3565(15)00112-3/abstract
Background & Aims
First-degree relatives of individuals with celiac disease are at increased risk for this disorder, but little is known about their risk for other autoimmune diseases. We assessed the risk of nonceliac autoimmune disease in first-degree relatives and spouses of people with celiac disease.

Methods
We identified individuals with celiac disease by searching computerized duodenal and jejunal biopsies, collected from 1969 through 2008, at 28 pathology departments in Sweden. Celiac disease was identified based on biopsy reports of villous atrophy (equal to Marsh grade 3; n = 29,096). Individuals with celiac disease were matched with up to 5 controls (people without celiac disease) for sex, age, county, and calendar year (total, 144,522 controls). Through Swedish health care registries, we identified all first-degree relatives (fathers, mothers, siblings, and offspring) and spouses of individuals with celiac disease (n = 84,648) and controls (n = 430,942). We used Cox regression analysis to calculate hazard ratios (HRs) for nonceliac autoimmune disease (Crohn’s disease, type 1 diabetes mellitus, hypothyroidism, hyperthyroidism, psoriasis, rheumatoid arthritis, sarcoidosis, systemic lupus erythematosus, or ulcerative colitis) in these groups.

Results
During the follow-up period (median, 10.8 y), 3333 of the first-degree relatives of patients with celiac disease (3.9%) and 12,860 relatives of controls (3.0%) had an autoimmune disease other than celiac disease. First-degree relatives of people with celiac disease were at increased risk of nonceliac autoimmune disease, compared with controls (HR, 1.28; 95% confidence interval, 1.23–1.33), as were spouses (HR, 1.20; 95% confidence interval, 1.06–1.35). Risk estimates for nonceliac autoimmune disease did not differ between first-degree relatives and spouses of individuals with celiac disease (interaction test: P = .11). HRs for nonceliac autoimmune disease were highest in the first 2 years of follow-up evaluation.

Conclusions
First-degree relatives and spouses of individuals with celiac disease are at increased risk of nonceliac autoimmune disease. In addition to genetic factors, environmental factors and ascertainment bias might contribute to the increased risk of autoimmunity in first-degree relatives of individuals with celiac disease.

Another listmate referred to studies showing we pick partners based on smell, and may be drawn to the subtle differences more like our own family that correspond to celiac, thus increasing the odds our partner may develop celiac as well. And another noted their view, with some support from experts, that gluten is toxic to everyone to varying degrees, which is why there is not a definitive a test for non-celiac gluten sensitivity. 

Thanks again to all who responded!

Jack Cohen-Joppa


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