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Common ground: shared risk factors for type 1 diabetes and celiac disease

Nature Immunology volume 19, pages 685–695 (2018)Cite this article

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Abstract

Risk factors for most autoimmune diseases are multifactorial genetic variants modified by environmental risk factors. Type 1 diabetes and celiac disease share high-risk HLA haplotypes, and the prevalence of both diseases has increased in many regions during the past half century. Unknown environmental factors are suspected to have increased the disease penetrance. Celiac disease depends on immune responses to dietary gluten, whereas the environmental risk factors for type 1 diabetes are not yet clear. Here, we consider the shared heritable genetic factors and review evidence of the dietary and microbial exposures, particularly in early life, that might influence the pathogenesis of one or both diseases. A deeper mechanistic understanding of the environmental factors responsible for increased risk of these diseases should provide opportunities to manipulate exposure in children carrying defined risk markers and thus prevent and attenuate disease, as well as to identify new therapeutic strategies for patients.

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Fig. 1: Pathogenesis of T1D.
Fig. 2: Pathogenesis of celiac disease.
Fig. 3: Model of common features of immunological pathogenesis in T1D and CeD.

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Acknowledgements

J.S.D. is supported by the Juvenile Diabetes Research Foundation; by the Canadian Institutes of Health Research (CIHR); as the Anne and Max Tanenbaum Chair in Molecular Medicine, University of Toronto; and by the Hospital for Sick Children (SickKids) Foundation. E.F.V. is supported as a Canada Research Chair and by CIHR #142773.

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada

    Elena F. Verdu

  2. The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada

    Jayne S. Danska

  3. Departments of Immunology and of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada

    Jayne S. Danska

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Correspondence to Jayne S. Danska.

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Verdu, E.F., Danska, J.S. Common ground: shared risk factors for type 1 diabetes and celiac disease. Nat Immunol 19, 685–695 (2018). https://doi.org/10.1038/s41590-018-0130-2

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