Celiac Disease On Rise, Especially Among Seniors

U.S. study suggests environmental factors may cause people to lose gluten tolerance

- CBC News September 27, 2010

Celiac disease is on the rise, especially among the elderly, according to researchers who say their findings challenge the assumption the autoimmune disorder usually develops in childhood.

In a study published Monday in the Annals of Medicine, researchers led by a team at the University of Maryland in Baltimore followed more than 3,500 adults over 15 years, taking samples at regular intervals of blood proteins that signal the disease.

As study participants aged, the incidence of celiac disease rose, suggesting environmental factors may cause people over time to lose their tolerance for gluten, which triggers the disease.

The researchers found the blood protein markers for celiac disease increased steadily from one in 501 in 1974 to one in 219 in 1989.

In 2003, a widely cited study conducted by the university's celiac research centre placed the number of people with the disease in the U.S. at one in 133.

The findings dovetail with a 2008 Finnish study that found the prevalence of celiac disease in the elderly to be nearly two and a half times higher than in the general population.

Eating gluten — found in wheat, barley and rye — triggers celiac disease. Symptoms include diarrhea, intestinal bloating and stomach cramps. Without treatment, people with the disease can't properly absorb nutrients, and they experience damage to their small intestines.

Although researchers have identified specific genetic markers for the development of celiac disease, exactly how and why a person loses tolerance to gluten is unknown.

"Even if you have these genetic markers, it's not your destiny to develop an autoimmune disease," said Fasano.

"Our study shows that environmental factors cause an individual's immune system to lose tolerance to gluten, given the fact that genetics was not a factor in our study since we followed the same individuals over time."

The researchers say they hope identifying those environmental factors will eventually lead to treatment and possible prevention of celiac disease and other autoimmune disorders, including type 1 diabetes, rheumatoid arthritis and multiple sclerosis.