PMID- 31232884
OWN - NLM
STAT- MEDLINE
DCOM- 20200915
LR  - 20200915
IS  - 1536-4801 (Electronic)
IS  - 0277-2116 (Linking)
VI  - 69
IP  - 1
DP  - 2019 Jul
TI  - HLA-DQ Genotyping, Duodenal Histology, and Response to Exclusion Diet in Autistic 
      Children With Gastrointestinal Symptoms.
PG  - 39-44
LID - 10.1097/MPG.0000000000002293 [doi]
AB  - OBJECTIVES: A correlation between autism spectrum disorders (ASDs) and 
      gastrointestinal (GI) problems, and a possible link between gluten consumption 
      and ASD have been increasingly reported. Gluten/casein-free diet (GCFD) is often 
      undertaken, with conflicting results. This study aimed at evaluating the 
      distribution of human leukocyte antigen (HLA)-DQ2/DQ8 typing among patients with 
      ASD with GI symptoms, together with its correlation with duodenal histology and 
      response to GCFD. METHODS: Between 2002 and 2015 all patients with ASD with GI 
      symptoms referred to our outpatient clinic, displaying clinical, laboratory, or 
      ultrasound findings suggestive of organic disease, underwent endoscopy, celiac 
      disease (CD) serum antibodies testing and HLA-DQ2/DQ8 genotyping. Patients were 
      prescribed a 6-month GCFD, and then clinically reassessed. RESULTS: Among 151 
      enrolled patients, 134 (89%) were negative for CD-specific antibodies; 72 (48%) 
      were positive for HLA-DQ2/DQ8; and 56 (37%) showed duodenal microscopic 
      inflammation. Clinical improvement was observed in non-CD patients irrespective 
      of the rigorous or partial adherence to the diet, being the difference 
      nonstatistically significant. Response to diet was related to the presence of 
      histological duodenal alterations at baseline (odds ratio 11.323, 95% confidence 
      interval 1.386-92.549 for Marsh 2 pattern), but not to HLA-DQ2/DQ8 positivity 
      (odds ratio 1.120, 95% confidence interval 0.462-2.716). CONCLUSIONS: Our data 
      suggest that children with ASD with GI symptoms have a high prevalence of 
      duodenal intraepithelial lymphocytic infiltration, which seems to be linked to a 
      mechanism other than autoimmune response to gluten consumption. Alteration of 
      duodenal histology, but not the HLA-DQ2/DQ8 status, was associated with clinical 
      response to the diet.
FAU - Alessandria, Carlo
AU  - Alessandria C
AD  - Division of Gastroenterology and Hepatology, Citta Della Salute e Della Scienza 
      di Torino Hospital.
FAU - Caviglia, Gian P
AU  - Caviglia GP
AD  - Department of Medical Sciences, University of Turin, Turin, Italy.
FAU - Campion, Daniela
AU  - Campion D
AD  - Division of Gastroenterology and Hepatology, Citta Della Salute e Della Scienza 
      di Torino Hospital.
FAU - Nalbone, Federica
AU  - Nalbone F
AD  - Division of Gastroenterology and Hepatology, Citta Della Salute e Della Scienza 
      di Torino Hospital.
FAU - Sanna, Claudia
AU  - Sanna C
AD  - Division of Gastroenterology and Hepatology, Citta Della Salute e Della Scienza 
      di Torino Hospital.
FAU - Musso, Alessandro
AU  - Musso A
AD  - Division of Gastroenterology and Hepatology, Citta Della Salute e Della Scienza 
      di Torino Hospital.
FAU - Abate, Maria L
AU  - Abate ML
AD  - Department of Medical Sciences, University of Turin, Turin, Italy.
FAU - Rizzetto, Mario
AU  - Rizzetto M
AD  - Division of Gastroenterology and Hepatology, Citta Della Salute e Della Scienza 
      di Torino Hospital.
FAU - Saracco, Giorgio M
AU  - Saracco GM
AD  - Division of Gastroenterology and Hepatology, Citta Della Salute e Della Scienza 
      di Torino Hospital.
AD  - Department of Medical Sciences, University of Turin, Turin, Italy.
FAU - Balzola, Federico
AU  - Balzola F
AD  - Division of Gastroenterology and Hepatology, Citta Della Salute e Della Scienza 
      di Torino Hospital.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Pediatr Gastroenterol Nutr
JT  - Journal of pediatric gastroenterology and nutrition
JID - 8211545
RN  - 0 (Caseins)
RN  - 0 (HLA-DQ Antigens)
RN  - 0 (HLA-DQ2 antigen)
RN  - 0 (HLA-DQ8 antigen)
SB  - IM
MH  - Abdominal Pain/etiology
MH  - Adolescent
MH  - Autism Spectrum Disorder/complications/*genetics
MH  - Caseins/administration & dosage
MH  - Celiac Disease/diet therapy/genetics
MH  - Child
MH  - Child, Preschool
MH  - Constipation/etiology
MH  - Diet, Gluten-Free
MH  - Duodenitis/complications/*diet therapy/*genetics/pathology
MH  - Duodenum/*pathology
MH  - Female
MH  - Genotype
MH  - HLA-DQ Antigens/genetics
MH  - Humans
MH  - Malabsorption Syndromes/etiology
MH  - Male
EDAT- 2019/06/25 06:00
MHDA- 2020/09/17 06:00
CRDT- 2019/06/25 06:00
PHST- 2019/06/25 06:00 [entrez]
PHST- 2019/06/25 06:00 [pubmed]
PHST- 2020/09/17 06:00 [medline]
AID - 00005176-201907000-00008 [pii]
AID - 10.1097/MPG.0000000000002293 [doi]
PST - ppublish
SO  - J Pediatr Gastroenterol Nutr. 2019 Jul;69(1):39-44. doi: 
      10.1097/MPG.0000000000002293.