Exposure to systemic antibiotics in the first year of life may be a risk factor for later development of celiac disease, according to results of an observational study published in Gastroenterology.
Stine Dydensborg Sander, MD, PhD, of Hans Christian Andersen Children’s Hospital in Denmark, and colleagues wrote that researchers have started looking at the gut microbiota as a potential pathogenesis for autoimmune diseases like celiac disease, particularly early in life.
“The gut microbiota evolves dramatically in the first years of life and stabilizes at 2 to 3 years of age,” they wrote. “The gut microbiota in early life influences the maturation of the immune system and plays a role in the degradation of gluten in the gastrointestinal tract and may thereby affect the immunogenicity of gluten peptides.”
Researchers conducted the study using two nationwide cohorts, one comprising 1,168,656 children born in Denmark between 1995 and 2012, and the other comprising 537,457 children born in Norway between 2004 and 2012. In the Danish cohort, 451,196 children without celiac disease (38.7%) were exposed to antibiotics compared with 622 with celiac disease (43.6%). In the Norwegian cohort, 98,538 children without celiac disease (18.4%) were exposed to antibiotics compared with 390 children with celiac disease (20.3%).
Investigators determined that exposure to systemic antibiotics was associated with diagnosed celiac disease in both cohorts (pooled OR = 1.26; 95% CI, 1.16–1.46), and dose-dependent relationship between an increasing number of antibiotics and celiac disease (pooled OR = 1.08; 95%, 1.05–1.11). The association remained after controlling for hospitalizations for an infectious disease. They found no specific antibiotic or age period with higher risk within the first year.
Sander and colleagues wrote that their findings suggest that antibiotics could be an important component of celiac disease risk, but they should not be regarded as the main factor.
“Future studies should attempt to separate the effect of infections and antibiotics by using more detailed information on indication for use of antibiotics and type of infections preferably by using biomarkers; and to elaborate on types and ages of exposure and interaction between risk factors and if the effect of antibiotic differs between risk groups,” they wrote. – by Alex Young
Disclosures: The authors report no relevant financial disclosures.