Timing of introduction of gluten into infant's diet associated with appearance of celiac disease

vestigation & Bioinformatics Core, and the General Clinical Research Centers Program, National Center for Research Resources.

Editorial: Infant Gluten and Celiac Disease - Too Early, Too Late, Too Much, Too Many Questions

In an accompanying editorial, Richard J. Farrell, M.D., of Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, discusses the findings by Norris et al.

"Long-term follow-up of this cohort may help clarify whether earlier exposure to gluten results in a real increased risk of celiac disease, an earlier presentation of the disease, or neither. Longitudinal data may also clarify whether earlier exposure to gluten simply leads to earlier appearance of tTG [tissue transglutaminase, an autoantigen] or whether all exposed at-risk children will eventually develop tTG."

"Ultimately, much larger, international prospective studies are required to unravel the complex interplay between multiple infant diet factors and an immature immune system in a genetically predisposed individual at risk for celiac disease. Only then will it be possible to know the true effect of exclusive vs. partial breastfeeding, gluten amount vs. gluten timing, and infant cereal vs. follow-up infant formula on celiac disease risk and presentation," Dr. Farrell writes.

(JAMA. 2005;293:2410-2412. Available post-embargo at JAMA.com)


Contact: Tonya Ewers
JAMA and Archives Journals

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