Relatives and Spouses of Celiac Patients Face Higher Autoimmune Risk

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Family members -- including spouses -- of Celiac patients have a higher risk of autoimmune disease. istockphoto

A study published in 2015 found that the first-degree relatives—and spouses—of people with Celiac disease are at greater long-term risk for developing autoimmune diseases including Crohn’s disease, and thyroid disorders.

While the development of autoimmune conditions among close relatives is not surprising, this research suggests the health of spouses is affected by proximity to a partner with Celiac disease.

What is Celiac Disease?

Celiac disease (CD) is a condition where your immune system mistakes gluten passing through your digestive system for an antigen—a dangerous foreign molecule in your body.  When the body mistakes gluten, commonly found in wheat and cereal products, as an invader, it launches an immune response against the gluten—leading to long-term inflammatory symptoms and potential injury to your small intestine.

Celiac disease is believed to affect one in 100 people in the United States.  The Celiac Disease Foundation estimates more at a minimum than two million people are undiagnosed—putting them at risk for a host of seemingly unrelated symptoms that can cause lasting damage.

In looking at the link between digestive symptoms and immune disorders like Celiac disease, researchers wondered if there was any connection between Celiac disease and non-Celiac autoimmune disorders in relatives, even partners.

Non-Celiac Autoimmune Conditions in Relatives

In the study published in Clinical Gastroenterology and Hepatology, European researchers used the Swedish Multi-Generation Register to evaluate the emergence of autoimmune disorders in first-degree relatives, like parents, siblings, and offspring, of people with Celiac disease.

  Taking their long-term observational study further, scientists also looked at the occurrence of these conditions in spouses. 

Funded by the Swedish Research Council, the study investigated occurrence of non-Celiac conditions including:

The study reviewed records of approximately 84,000 first-degree relatives and spouses of patients with Celiac disease and more than 400,000 control subjects for comparison.

Louise Emilsson, MD, Ph.D., from Oslo University, and study author, noted, “The prevalence of celiac disease in first-degree relatives of individuals with celiac is approximately 10 percent. Despite these findings, little is known about the risk of nonceliac autoimmune disease in these individuals.” 

Researchers also sought to investigate the potential risks faced by spouses—and what that risk might be.

Spouses of Celiac Patients Face Increased Risk

In discussing the research, Dr. Emilsson, notes, “We found convincing results that close relatives are also at risk for these conditions, but more surprisingly, we found that spouses may also be at risk.”

During the roughly ten year study period, 4.3 percent of relatives of Celiac disease patients developed an autoimmune disorder.  This compares to 3.3 percent in the control group.  In the study, the most common non-Celiac immune disorders suffered by relatives and spouses include sarcoidosis, Type 1 diabetes, and systemic lupus.

The research does not offer conclusions about how, or why, spouses of CD patients are at a higher risk for developing serious autoimmune disorders.  Potential reasons suggested include:

  • Ascertainment bias:  The general community of someone with Celiac disease becomes aware of the symptoms and processes of the disorder.  Because of this heightened awareness, relatives, spouses, and physicians may be more likely to test close relatives to ascertain whether they are affected by the condition too.
  • Genetic inheritance:  For relatives, the emergence of an autoimmune disorder, could be due to a common genetic inheritance.
  • Environmental influence: Close environmental or physical proximity to a patient with Celiac disease may influence the development of an autoimmune disorder.  Because they live together, partners may share common features of their microbiota—the collective gut bacteria that support and protect immune function and aid in digestion, among other roles. There could be as-yet-unknown factors -- such as toxic exposures -- shared between partners that influence development and emergence of autoimmune conditions.

The potential for environmental passage of a susceptibility to immune dysfunction between partners has broad implications.  While this research suggests possible causes, future studies will likely explore processes by which an immune disorder could be communicated—or whether the correlation is caused by a greater tendency among relatives to seek medical assessment when a spouse or sibling is diagnosed.

Note: For more information on the autoimmune disease, I recommend the American Autoimmune Related Diseases Foundation site, located at http://www.aarda.org. This group explores the more than 80 autoimmune diseases, and funds patient-oriented research into the prevention, causes, diagnosis,a and treatment of autoimmune conditions. 

Source:

Emilsson, Louise et al. "Autoimmune Disease in First-Degree Relatives and Spouses of Individuals With Celiac Disease." Clinical Gastroenterology and Hepatology , Volume 13 , Issue 7 , 1271 - 1277.e2, Abstract

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