1. Influence of HLA-DQ2.5 Dose on Clinical Picture of Unrelated Celiac Disease Patients.
- Author
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Airaksinen L, Laurikka P, Huhtala H, Kurppa K, Salmi T, Saavalainen P, Kaukinen K, and Lindfors K
- Subjects
- Adolescent, Adult, Aged, Alleles, Celiac Disease immunology, Child, Child, Preschool, Cohort Studies, Female, Finland, Follow-Up Studies, Humans, Infant, Male, Middle Aged, Young Adult, Celiac Disease blood, Celiac Disease diet therapy, Diet, Gluten-Free methods, HLA-DQ Antigens blood, HLA-DQ Antigens immunology
- Abstract
The clinical phenotype of celiac disease varies considerably among patients and the dosage of HLA-DQ2.5 alleles has been suggested to be a contributing factor. We investigated whether HLA-DQ2.5 allele dosage is associated with distinct clinical parameters at the time of diagnosis and with patients' response to a gluten-free diet. The final cohort included 605 carefully phenotyped non-related Finnish celiac disease patients grouped as having 0, 1 or 2 copies of HLA-DQ2.5. Clinical data at the time of diagnosis and during gluten-free diet were collected systematically from medical records and supplementary interviews. An increasing HLA-DQ2.5 dose effect was detected for celiac disease antibody positivity at diagnosis ( p = 0.021) and for the presence of any first-degree relatives with celiac disease ( p = 0.011 and p = 0.031, respectively). Instead, DQ2.5-negative patients were suffering most often from classical symptoms at diagnosis ( p = 0.007 between HLA groups). In addition, during follow-up they were most often symptomatic despite a gluten-free diet ( p = 0.002 between groups). Our results thus suggest that increasing HLA-DQ2.5 dose only has a minor effect on the clinical picture of celiac disease. However, HLA-DQ2.5-negative patients should not be overlooked in clinical practice and particular attention should be paid to this patient group during gluten-free diet.
- Published
- 2020
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