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Genes That Predispose for Coeliac Disease

Each person has two copies of every human gene, one from each parent. Coeliac disease is characterized by damage to the small intestine with the ingestion of gluten in wheat, barley or rye. According to gastroenterologist Kenneth Fine, M.D., genetic gluten sensitivity, or gluten intolerance, underlies the development of celiac disease.

  1. Identification

    • Genes that predispose to gluten sensitivity are human leukocytic antigen (HLA), or HLA-DQ. Markers (DQ1 through DQ4), and subtypes (DQ5 through DQ9), determine the gene's biological action. Only DQ4,4 is not associated with genetic predisposition to coeliac disease.

    Significance

    • HLA-DQ2 and/or HLA-DQ8 are the main coeliac genes, according to Martin Kagnoff of the University of California at San Diego. For gluten sensitivity to result in coeliac disease, other genes must be present.

    Effects

    • Certain genetic combinations, such as DQ1,1 and DQ3,3 indicate more severe reactions to gluten, according to Dr. Fine. Gluten reactions are implicated in eczema, chronic fatigue syndrome, fibromyalgia, inflammatory bowel disease and insulin-dependent diabetes.

    Potential

    • A person with two predisposing genes can be certain both his parents and every one of his children will have at least one copy of these genes. They could get clinically significant gluten sensitivity or even coeliac disease.

    Treatment

    • The only treatment for gluten sensitivity/coeliac disease is strict avoidance of dietary gluten. This requires awareness of "hidden" sources of gluten in restaurant and processed foods as well as guarding against cross-contamination.

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