Experts believe healthy gut microbes might protect children at risk for celiac. The microbiome undergoes complex changes during infancy as bacteria colonize the gut. This is an important time for the child’s immune system because it responds to both beneficial and virulent strains. A Spanish study of infants is among the first to record how the microbiome develops differently before the onset of celiac.
Previous studies noticed abnormal bacteria in celiac patients after diagnosis, but the disease itself could have caused this condition. Researchers needed to study the microbiome in healthy individuals to see how it behaved in those who remained healthy compared with those who developed the disease. The Celiac Disease Genomic Environmental Microbiome and Metabolomic (CDGEMM) study is currently recruiting participants in the U.S. to study newborns at risk.
The Spanish group identified more than 200 infants with a family history of celiac and tracked their history. They compared 10 who eventually developed celiac with 10 similar children who did not. They collected fecal samples at 4 and 6 months of age, analyzing what kinds of bacteria appeared and what antibodies the infants produced in response.
In healthy children, microbial diversity increased significantly between 4 and 6 months. In contrast, those later diagnosed with celiac showed a prematurely high microbial diversity that did not increase during that period. Bifidobacterium longum was relatively abundant in normal development, while other bacteria were associated with celiac. The two groups showed a distinct difference in immune response, suggesting microbial differences influenced how their immune systems developed.
The test matched each celiac patient with healthy children who had similar birth delivery (vaginal versus caesarean section), breastfeeding and early feeding practices. All the children were genetically susceptible to celiac. The comparison showed none of these factors caused an unhealthy microbiome.
The study was small and lacked enough data to explain what disturbed normal microbial colonization. However, these early findings encourage larger studies of the infant microbiome.
Olivares M, Walker AW, Capilla A, Benítez-Páez A, Palau F, Parkhill J, Castillejo G and Sanz Y, “Gut microbiota trajectory in early life may predict development of celiac disease,” Microbiome, 2018;6:36, doi:10.1186/s40168-018-0415-6.
Parents who are interested in enrolling their infant can visit the study’s website at www.cdgemm.org to see how their little ‘GEMM’ can help make celiac history. To enroll or inquire about enrollment, contact a participating center nearest you.
Want more information on celiac and kids? Check out our Kids section.