Prevention of celiac disease in Skåne (PreCiSE)

Celiac disease is a complex disease in which genetic heredity plays a major role in the development of the disease. To develop celiac disease, the individual must have a genetic predisposition and the individual’s food intake must contain gluten. The only available treatment of celiac disease is to keep a gluten free diet and since celiac disease is a chronic disease, the individual must keep a strict gluten-free diet for life. We have previously shown that the age of gluten introduction was not associated with a risk of celiac disease, but instead the amount of gluten consumed during the first 5 years of life was associated with increased risk of celiac disease. Children are often exposed to repeated gastrointestinal infections caused by various viruses. It has been shown that repeated gastrointestinal infections together with gluten exposure (early introduction and/or high gluten intake) increased the risk of celiac disease autoimmunity (a pre-clinical indicator) at-risk children. Repeated virous infections may lead to increased gut permeability and translocation of gluten to the gut and launch an activation of both adaptive and innate immune responses. Our hypothesis is that keeping a gluten free diet during the first years of life could allow the child’s immune system to mature and then slowly introduce gluten to the child’s diet may lead to an increased tolerance to gluten. Genetically predisposed infants are enrolled to the study before the age of 4 months. Study participants are randomized to keep a gluten free diet, or with not diet restriction but daily supplementation with a probiotic dietary supplement or placebo.