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Verma AK, Mechenro J, Monachesi C, Venugopal G, Catassi GN, Lionetti E, Ramakrishna BS, Catassi C. Distribution of celiac disease predisposing genes HLA-DQ2 and HLA-DQ8 in the native population of southern India. Indian J Gastroenterol 2022; 41:240-246. [PMID: 35767211 DOI: 10.1007/s12664-022-01251-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 01/31/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Celiac disease (CD) is an intestinal inflammatory condition caused by the ingestion of gluten peptides in wheat and related grains in individuals carrying HLA-DQ2 and/or HLA-DQ8 genes. In comparison to HLA-DQ8, a higher HLA-DQ2 prevalence is reported in European population where wheat has been the staple food for thousands of years. In non-European population, this pattern of HLA-DQ CD-predisposing gene distribution has not always been found. The aim of this study was to evaluate the HLA-DQ2 and HLA-DQ8 distribution in the native low-gluten consuming southern Indian population. METHODS Overall, 211 dried blood spots (DBS) were collected from native southern Indian individuals. HLA-DQ characterization and the determination of homozygous/heterozygous status were performed using commercially available HLA-DQ typing kits. RESULTS Of 211 collected DBS, 88 (42%, 95% CI: 36-48) were positive for HLA-DQ2 and/or HLA-DQ8 heterodimers. Overall, 40 (19%, 95% CI: 14-24) samples typed positive for HLA-DQ2 and 48 (23%, 95% CI: 18-28) typed positive for HLA-DQ8 genotypes. Of 40 HLA-DQ2-positive individuals, only one subject tested homozygous for the DQB1*02 allele. CONCLUSIONS In the southern Indian native general population, the prevalence of HLA-DQ8 is higher in comparison to HLA-DQ2 prevalence. This finding could be related to the delayed introduction of wheat in the diet of the southern Indian population.
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Affiliation(s)
- Anil K Verma
- Celiac Disease Research Laboratory, Department of Pediatrics, Università Politecnica delle Marche, 60123, Ancona, Italy.
| | - John Mechenro
- SRM Institute of Gastroenterology, Hepatobiliary Sciences and Transplantation, SIMS Hospital, Jawaharlal Nehru Road, Vadapalani, Chennai, 600 026, India.,Department of Medical Research, SRM Medical College Hospital and Research Centre, Kancheepuram District, Kattankulathur, 603 211, India
| | - Chiara Monachesi
- Celiac Disease Research Laboratory, Department of Pediatrics, Università Politecnica delle Marche, 60123, Ancona, Italy
| | - Giriprasad Venugopal
- SRM Institute of Gastroenterology, Hepatobiliary Sciences and Transplantation, SIMS Hospital, Jawaharlal Nehru Road, Vadapalani, Chennai, 600 026, India.,Department of Medical Research, SRM Medical College Hospital and Research Centre, Kancheepuram District, Kattankulathur, 603 211, India
| | - Giulia Naspi Catassi
- Department of Pediatrics, Università Politecnica delle Marche, 60123, Ancona, Italy
| | - Elena Lionetti
- Department of Pediatrics, Università Politecnica delle Marche, 60123, Ancona, Italy
| | - Balakrishnan S Ramakrishna
- SRM Institute of Gastroenterology, Hepatobiliary Sciences and Transplantation, SIMS Hospital, Jawaharlal Nehru Road, Vadapalani, Chennai, 600 026, India.,Department of Medical Research, SRM Medical College Hospital and Research Centre, Kancheepuram District, Kattankulathur, 603 211, India
| | - Carlo Catassi
- Department of Pediatrics, Università Politecnica delle Marche, 60123, Ancona, Italy.,The Division of Pediatric Gastroenterology and Nutrition and Center for Celiac Research, Mass General Hospital for Children, Boston, MA, 02114, USA
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Franceschini E, Lionetti ME, D'Adamo G, D'Angelo E, Gatti S, Naspi Catassi G, Malamisura B, Catassi C. Misuse of serological screening tests for celiac disease in children: A prospective study in Italy. Dig Liver Dis 2019; 51:1547-1550. [PMID: 31383458 DOI: 10.1016/j.dld.2019.06.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 06/17/2019] [Accepted: 06/18/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Despite a well-established diagnostic algorithm for celiac disease, it remains unclear whether prescriptions for celiac serological tests comply with the current pediatric guidelines. AIM To analyze the appropriateness of test prescription in children investigated for celiac disease in Italy, compared to the current European pediatric guidelines. METHODS All children who had performed a first evaluation for celiac disease were prospectively enrolled. Prescribed tests and related indications for testing were recorded, and compared to the European pediatric guidelines. RESULTS Overall, 202 children were enrolled (females 59%, mean age 7.1 years ±4.1) in two centers. The reasons for celiac disease testing were typical, atypical symptoms or celiac disease-associated conditions in 46.5%, 49%, and 4.5% of cases, respectively. First-line tests were IgA and IgG anti-transglutaminase antibodies in 88.1% and 29.7% of children, IgA and IgG anti-deamidated gliadin peptide antibodies in 43% and 47%, IgA and IgG anti native gliadin in 15.8%, IgA anti-endomysium antibodies in 44.5%, HLA predisposing genes in 10% of patients. Test redundancy was very common, and the current diagnostic guidelines were correctly followed only in 23/202 patients (11.4%). CONCLUSIONS Diagnostic European guidelines for celiac disease screening are often disregarded in Italy. Intervention to implement adherence to these guidelines is needed, with the aim of improving resource utilization, and quality of patient care.
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Affiliation(s)
- Elisa Franceschini
- Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy
| | | | - Grazia D'Adamo
- Department of Pediatrics, University Hospital of Salerno, Salerno, Italy
| | - Elisa D'Angelo
- Department of Pediatrics, University Hospital of Salerno, Salerno, Italy
| | - Simona Gatti
- Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy
| | | | - Basilio Malamisura
- Department of Pediatrics, University Hospital of Salerno, Salerno, Italy
| | - Carlo Catassi
- Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy; Center for Celiac Research and Treatment, Mass General Hospital for Children, Boston, MA 02114, USA.
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