Celiac Disease in Young People Linked to Endocrine-Disrupting Chemical Exposure

By Marilynn Larkin

May 19, 2020

NEW YORK (Reuters Health) - Children and young adults with high blood levels of toxic chemicals found in pesticides, nonstick cookware and fire retardants were more likely to be diagnosed with celiac disease in a pilot study.

"These findings are not surprising, given accelerating evidence that synthetic chemicals disrupt immune functions and may lead to misidentification of proteins as foreign, leading to inflammation and other responses," Dr. Leonardo Trasande of NYU Langone told Reuters Health by email.

Dr. Trasande and colleagues studied 30 patients with celiac disease (median age, six years; 63% female) and 58 without (median age, eight; 40% females), measuring blood levels of polybrominated diphenyl ether (PBDEs), perfluoroalkyl substances (PFASs), and p,p'-dichlorodiphenyldichloroethylene (DDE), as well as HLA-DQ genotype.

As reported in Environmental Research, after controlling for sex, race, age, BMI, and genetic susceptibility score, patients with higher serum DDE concentrations were twice as likely to be newly diagnosed with celiac disease as those without high levels.

After stratifying by sex, odds of celiac disease were higher in females with greater than normal serum concentrations of DDE (odds ratio, 13), PFOS (OR, 12.8), or perfluorooctanoic acid (OR, 20.6) - and in males with serum BDE153, a PBDE congener (OR, 2.28).

Dr. Trasande said a next step would be to study a larger more representative sample from across the U.S.

Meanwhile, he added, "There are safe and simple steps to reduce these exposures. Opening windows and recirculating air and using a wet mop can help reduce persistent organic pollutants that accumulate in household dust. Using cast-iron or stainless-steel pans can reduce exposure to the PFAS we studied."

Dr. Douglas Fishman, a pediatric gastroenterologist at Texas Children's Hospital, commented in an email to Reuters Health, "These are very interesting findings and challenge us to more strongly consider the role of the environment in patients with celiac disease. As gastroenterologists are not routinely asking about non-traditional exposures, this work...emphasizes a significant gap in our understanding of a very important topic."

"Celiac disease as an autoimmune disease may be a model in which to better understand the role of environment on dysregulation of the gastrointestinal system and other systemic diseases," he concluded.

SOURCE: https://bit.ly/2WI50Ow Environmental Research, online May 11, 2020.