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Gut Microbes. 2018 Nov 2;9(6):551-558. doi: 10.1080/19490976.2018.1451276. Epub 2018 May 9.

Increased prevalence of pathogenic bacteria in the gut microbiota of infants at risk of developing celiac disease: The PROFICEL study.

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a Microbial Ecology, Nutrition & Health Research Unit. Institute of Agrochemistry and Food Technology, Spanish National Research Council (IATA-CSIC) , Valencia , Spain.
b Genetics and Molecular Medicine Unit. Institute of Biomedicine of Valencia, Spanish National Research Council (IBV-CSIC) , Valencia , Spain.
c Institute of Food Science, Technology and Nutrition, Spanish National Research Council (ICTAN-CSIC) , Madrid , Spain.
d Universitary Hospital Sant Joan of Reus, URV, IISPV , Tarragona , Spain.
e Gastroenterología, Nutrición y Hepatología Pediátrica, Hospital Universitario Sant Joan de Deu, and Instituto de Gastroeneterología y Nutrición Pediátrica de Barcelona , Barcelona , Spain.
f Research Unit and Paediatric Service, Hospital Clínico Universitario , Valladolid , Spain.
g Servicio de Gastroenterología y Nutrición Pediátrica, Hospital Universitario La Paz , Madrid , Spain.
h Unidad de Gastroenterología, Hospital Infantil Universitario La Fe , Valencia , Spain.
i Unidad de Gastroenterologia, Hepatología y Nutrición Pediátrica, Hospital Universitario Nuestra Señora de Candelaria , Santa Cruz de Tenerife, Canary Islands , Spain.


Celiac disease (CD) is an immune-mediated enteropathy involving genetic and environmental factors, whose interaction influences disease risk. The intestinal microbiota, including viruses and bacteria, could play a role in the pathological process leading to gluten intolerance. In this study, we investigated the prevalence of pathogens in the intestinal microbiota of infants at familial risk of developing CD. We included 127 full-term newborns with at least one first-degree relative with CD. Infants were classified according to milk-feeding practice (breastfeeding or formula feeding) and HLA-DQ genotype (low, intermediate or high genetic risk). The prevalence of pathogenic bacteria and viruses was assessed in the faeces of the infants at 7 days, 1 month and 4 months of age. The prevalence of Clostridium perfringens was higher in formula-fed infants than in breast-fed over the study period, and that of C. difficile at 4 months. Among breastfed infants, a higher prevalence of enterotoxigenic E. coli (ETEC) was found in infants with the highest genetic risk compared either to those with a low or intermediate risk. Among formula-fed infants, a higher prevalence of ETEC was also found in infants with a high genetic risk compared to those of intermediate risk. Our results show that specific factors, such as formula feeding and the HLA-DQ2 genotype, previously linked to a higher risk of developing CD, influence the presence of pathogenic bacteria differently in the intestinal microbiota in early life. Further studies are warranted to establish whether these associations are related to CD onset later in life.


HLA genotype; PCR; celiac disease; gut microbiota; pathogenic bacteria

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