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Subject:
From:
L and N Matsui <[log in to unmask]>
Date:
Wed, 5 Jun 2002 18:46:04 +0000
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<<Disclaimer: Verify this information before applying it to your situation.>>

This is from Pediatrics, Vol. 109, No. 5, 5/02, "Diabetes and CD are both
autoimmune disorders, sharing the same high-risk HLA DQ2 genotype.  One
third of type 1 diabetes patients with the CD-associated HLA DQ2 genotype
tested serologically positive for CD compared with <2% of patients lacking
DQ2.  Other autoimmune diseases associated with CD and type 1 diabetes
include autoimmune thyroiditis, pernicious anemia, Sjogren syndrome,
Addison's disease, alopecia areata, and rheumatoid arthritis.  The reasons
for these associations may be that CD and these other disorders share a
similar autoimmune pathogenic mechanism, or that the same gene is
responsible for a proportion of these disorders.  It is possible that
chronic lymphocyte stimulation in the intestine in CD could result in an
increase in autoantibody production and therefore stimulate the development
of other autoimmune disorders.  Older, untreated CD patients have a higher
prevalence of autoantibodies that younger patients, suggesting that duration
of gluten exposure increases the risk of developing autoantibodies.  In some
individuals with rehematoid arthritis and pericarditis, the conditions
disappeared when the patients followed gluten-free diets.  Although type 1
diabetes is occasionally identified in previously diagnosed individuals with
CD, in most cases CD antibodies are present at the time of or after
diagnosis of type 1 diabetes.  Diabetic autoantibodies generally precede the
onset of clinical diabetes by an average of 3 years.  .... There is ,
however, no evidence that treating CD with a gluten-free diet prevents type
1 diabetes."

The following quote is from the Journal of Pediatrics and Child Health,
Vol. 37, Issue 3, Page 218, 6/01: "Approximately 40% of the genetic
susceptibility in Caucasians is explained by the high risk alleles HLA
DR3-DQ2 and HLA DR4-DQ8. The HLA DR2 locus confers dominant protection.
One of these susceptibility alleles HLA DR3-DQ2 (A1*501,  B1*0201) has
interesting associations. It is associated with type 1 diabetes in
congenital rubella, coeliac disease and selective IgA deficiency; the
latter two conditions show high antibodies to cows milk protein. It has
also been associated with higher levels of antibodies to GAD in at-risk
subjects for type 1 diabetes and with increased immunity to cows milk
protein in diabetic patients and controls. It seems possible that this
haplotype  and/or other haplotypes predispose an individual to
sensitization to dietary and viral antigens and thereby increase the
risk of autoimmune disease. It is also possible that an alteration in
gut mucosal immune function in genetically susceptible individuals, the
gut mucosa being the major immunoregulatory barrier in the infant,
underlies an effect of dietary or viral proteins on islet autoimmunity
in early life."

Laura

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