Short summary

There is evidence that the gut microbiome may modulate the immune system and lead to chronic inflammatory diseases. Celiac disease (CD) is an enteropathy with autoimmune components and non-celiac gluten sensitivity (NCGS) has recently been suggested as a common chronic inflammatory disease of the gut. An aim of this project is to investigate the gut microbiome in CD and in NCGS. 

Rationale

Celiac disease (CD) is an autoimmune disease which involves an undesirable response to gluten in the small intestine. Among children and adolescent's CD causes various symptoms such as abdominal pain, diarrhoea and failure to grow. Later in life CD increases the risk of colon cancer and osteoporosis. 

The global prevalence of CD is about one percent with large regional variation. Several studies from Sweden, which is one of the countries with a higher prevalence than average, indicates that the incidence of CD is increasing, however there are no similar data for Denmark.

The reason why some people develop CD and others don't is unknown, however recent studies suggest that the microbiome of the intestine, meaning the composition of bacteria in the intestines, is of significance. The treatment against CD is excluding gluten permanently from your diet. It stands to reason however, that further knowledge on what causes CD will result in a more diverse array of treatment methods. 

All over the world, more and more people without a CD diagnosis go on "gluten-free" diets for various health reasons. A few double randomized studies have shown the existence of a small group of people who possess symptoms of CD without having the typical changes in the intestines, their symptoms disappear when put on a gluten free diet, and reappears when gluten is reintroduced. Hence the emergence of a new "disease" called "non-celiac gluten sensitivity" (NCGS), which has not yet been very well studied though.

Despite many years of research in CD, there are still a lot of unresolved issues, that this study will try and resolve.

The purpose of this study is specifically:

1. To determine the prevalence of CD amongst Danish children and adolescents.

2. To determine the prevalence of NCGS amongst Danish children and adolescents.

3. To determine the bacterial composition (microbiome) of the intestines amongst Danish children and adolescents with CD or NCGS.

4. To clarify the risks of developing CD or NCGS.

Description of the cohort

The study is a prospective cohort study, and the study population consists of an unselected cohort of children and adolescents (approx. 15-21 years of age) from the island of Funen, Denmark, with both rural and urban populations. These individuals constitute a part of the Danish national birth cohort (DNBC) the "Better Health in Generations" cohort with a total of approximately 100,000 participants. The birth year of the individuals from Fyn are distributed as follows: year 1998: 21; 1999: 1337; 2000: 2205; 2201: 1977; 2002: 1726; 2003: 384. Total 7670

Data and biological material

15 ml of blood, a fecal sample and a oral swab

height, weight, abdominal size, blood pressure

questionnaires about abdominal symptoms and autoimmune diseases

Collaborating researchers and departments

Department of Public Health, University of Copenhagen

• Professor Anne-Marie Nybo Andersen

Department for Metabolic Genetics, University of Copenhagen

• Professor Oluf Borbye Pedersen

Department of Clinical Immunology, Odense University Hospital

• Clinical lector, Søren Thue Lillevang, PhD

Department of Gynaecology and Obstetrics, Odense University Hospital

• Professor Ellen Aagaard Nøhr