%0 Journal Article
%T Celiac disease in type 1 diabetes mellitus
%A Maria Camarca
%A Enza Mozzillo
%A Rosa Nugnes
%A Eugenio Zito
%A Mariateresa Falco
%A Valentina Fattorusso
%A Sara Mobilia
%A Pietro Buono
%A Giuliana Valerio
%A Riccardo Troncone
%A Adriana Franzese
%J Italian Journal of Pediatrics
%D 2012
%I BioMed Central
%R 10.1186/1824-7288-38-10
%X Type 1 Diabetes Mellitus (T1D) is frequently associated to other autoimmune conditions. These conditions can severely affect clinical management of the disease, especially in paediatric age.The most frequent are autoimmune thyroid disease (AIT), celiac disease (CD), Addison's disease (AD) and vitiligo. These diseases are associated with organ-specific autoantibodies: AIT with thyroid peroxidase (TPO) and thyroglobulin autoantibodies (TG), CD with endomysial (EMA) and transglutaminase (TTG) autoantibodies, and AD with adrenal autoantibodies. Using these autoantibodies, organ-specific autoimmunity may be often detected before the development of clinical disease, in order to prevent significant morbidity related to unrecognized disease [1]. These diseases are very often clustered in the same individual and a shared genetic background probably explains this association [2].The majority of autoimmune endocrine diseases, including T1D, are inherited as complex genetic traits. Multiple genetic and environmental factors interact with each other to confer susceptibility to these disorders. Genetic risk factors associated with T1D, ATD, CD and AD include HLA genes and non-HLA genes.HLA DR4 and DR3 are strongly associated with T1D and approximately 30-50% of patients are DR3/DR4 heterozygotes. The DR3/DR4 genotype confers the highest diabetes risk with a synergic mode of action, followed by DR4 and DR3 homozygosity, respectively. The HLA-DQ (particularly DQ 2 and DQ8) locus has been found to be the most important determinant of diabetes susceptibility. Approximately 90% of individuals with T1D have either DQ2 or DQ8, compared to 40% of the general population [3]. So, the highest-risk human leukocyte antigen (HLA) genotype for T1D is DR3-DQ2, DR4-DQ8.DR3-DQ2 shows a strong association with CD; homozygosity for DR3-DQ2 in a population with T1D carries a 33% risk for the presence of TTG autoantibodies [4].Non-HLA genes are also involved in the predisposition to T1D and other auto
%K Diabetes
%K Celiac disease
%K Genetic background
%K HLA
%K Dietetic compliance
%K Glycaemic index
%K Gluten free diet
%K Quality of life
%U http://www.ijponline.net/content/38/1/10