MedicalResearch.com Interview with:
Louise Emilsson, MD PhD, Postdoc
Primary Care Research unit
Vårdcentralen Värmlands Nysäter and Institute of Health and Society
University of Oslo
MedicalResearch: What is the background for this study?
Dr. Emilsson: Genetics is considered an important factor in the development of celiac disease and other autoimmune diseases. For e.g. the prevalence of celiac disease is about 10% in first-degree relatives of celiac patients compared to about 1% in the general population. Several earlier genome-wide association study (GWAS) studies have established shared genetic features also in-between different autoimmune diseases, however, very little is known about the risk of developing other autoimmune diseases in relatives of celiac patients. Therefore we assessed the risk of several other non-celiac autoimmune diseases (Crohn’s disease, type 1 diabetes mellitus, hypothyroidism, hyperthyroidism, psoriasis, rheumatoid arthritis, sarcoidosis, systemic lupus erythematosus or ulcerative colitis) in all first degree relatives and spouses of Swedish celiac patients.
MedicalResearch: What are the main findings?
Dr. Emilsson: The main finding is that both first-degree relatives (+28%) and spouses (+20%) are at increased risk of other autoimmune diseases. There are several plausible explanations for these findings. One is of course that individuals with celiac disease and their first-degree relatives share a genetic autoimmune predisposition, another potential explanation involves shared environment (relevant for both first-degree relatives and spouses) but finally we cannot rule out that a certain degree of increased awareness of signs and symptoms in both first-degree relatives and spouses might lead to more examinations and thereby diagnoses (so-called ascertainment bias). Probably all these mechanisms contributed to the finding.
MedicalResearch: What should clinicians and patients take away from your report?
Dr. Emilsson: Clinicians could benefit from knowing that the genetic predisposition for celiac disease in celiac first-degree relative also implies a higher risk of other autoimmune diseases. For the patients the most important message is that it seems that both genetic and environmental factors contribute to development of autoimmune diseases.
MedicalResearch: What recommendations do you have for future research as a result of this study?
Dr. Emilsson: The findings open up for future research on which shared environmental factors confer an increased risk of autoimmune diseases. Such knowledge would of course be of high clinical importance if they also mean that prevention is possible. It would also be interesting to see if future GWAS studies on shared genetics in-between celiac disease and systemic lupus erythematosus would yield some new loci of shared genetic traits.
Louise Emilsson, Cisca Wijmenga, Joseph A. Murray, Jonas F. Ludvigsson. Autoimmune Disease in First-Degree Relatives and Spouses of Individuals With Celiac Disease. Clinical Gastroenterology and Hepatology, 2015; 13 (7): 1271 DOI: 10.1016/j.cgh.2015.01.026
Louise Emilsson, MD PhD, Postdoc Primary Care Research unit (2015). Celiac Disease Implies Higher Risk of Other Autoimmune Diseases