Ibtissem Ghedira
Monastir University, Tunisia
Title: Type 1 Diabetes and Celiac disease: Pathogenesis overlap
Biography
Biography: Ibtissem Ghedira
Abstract
Patients with type 1 diabetes (T1D) are at high risk of developping other autoimmune diseases (AID). Celiac disease (CD) is one of the most common disorders occuring in T1D. The mean prevalence of CD in patients with T1D is about 8%. Screening for CD in T1D is currently advocated. Similarly, patients with CD have a two-to three-fold increased risk of developping T1D. The overall incidence of these two AID is increasing. Both T1D and CD result from a complex interplay between genetic, immune and environmental factors. T1D is characterized by immune-mediated damage to insulin-secreting cells from the pancreatic islets of Langerhans. CD is characterized by immune-mediated damage to the small intestinal mucosa. Both T1D and CD are associated with not only the major histocompatibility complex class II antigen DQ2 encoded by the alleles, DQA1*501 and DQB1*201 but also DQ8 and non-HLA loci. Gluten is one the environmental factors which trigger both CD and T1D. High consumption of gluten results in high zonulin secretion and altered gut permeability in both diseases. Significant differences in the composition of the gut microbiota between patients with T1D or active CD and healthy controls are demonstrated. Vitamine D deficiency is both a consequence of malabsorption secondary to CD and a risk factor for T1D. Both in T1D and in CD there is increased oxidative stress. The accumulation of inflammatory cytokines is found in both T1D and active CD. Patients with both CD and T1D have more severe complications than patients presenting T1D or CD only.