Getreidebrei ja! – Aber ab wann?

Zusammenfassung

Zöliakie ist eine autoimmune Multiorganerkrankung, die sich nicht nur im Darm manifestiert, sondern auch Knochen, Haut, Herz, Gehirn und die Fertilität betreffen kann. Die Krankheit kann sicher durch den Nachweis von Zöliakie spezifischen Antikörpern sowie durch einen Zottenschaden in Duodenalbiopsien diagnostiziert werden. Für die Ätiologie spielen neben der Genetik auch Umweltfaktoren eine Rolle. Möglicherweise beeinflusst die Ernährung im Säuglingsalter bei Kindern mit erhöhtem Zöliakierisiko den Ausbruch der Krankheit. Den WHO-Empfehlungen zufolge sollten Säuglinge mindestens sechs Monate ausschließlich gestillt werden. Neue Beobachtungsstudien und epidemiologische Daten sprechen dafür, dass die Zufuhr kleiner Mengen Gluten zwischen dem fünften und sechsten Lebensmonat bei gleichzeitigem Stillen das Risiko für eine Zöliakie um 50 % senkt. In diesem Zeitfenster scheint die Toleranzentwicklung günstiger zu sein als zu früheren oder späteren Zeitpunkten. Diese Hypothese wird derzeit im Rahmen der europaweiten Interventionsstudie Prevent Celiac Disease (CD) an über 1000 Zöliakie-Risikokindern überprüft.

Abstract

Celiac disease is an autoimmune multiorgan disorder that manifests not only in the bowel but can also affect bones, skin, heart, brain, and fertility. The disorder can be diagnosed by confirming celiac-disease specific antibodies and damage to the intestinal villi in duodenal biopsy specimens. In addition to genetics, environmental factors play a role in the etiology of the disease. It is possible that nutrition in infancy influences the onset of the disease in babies at increased risk for celiac disease. According to recommendations from the World Health Organization, infants up to the age of 6 months should be exclusively breast fed. New observational studies and epidemiological data indicate that introducing small amounts of gluten between the 4th and 6th months of life in addition to continued breast feeding lowers the risk of celiac disease by 50 %. In this time window, the development of tolerance seems to be more favorable than at earlier or later points in time. This hypothesis is currently being studied in more than 1000 children at risk for celiac disease in the context of the Europe-wide intervention study Prevent Celiac Disease (CD).

Schlüsselwörter

Diagnostik - TEDDY-Studie - Epidemie - Schweden - Gluteneinführung - Stillen - Toleranzentwicklung - Prevent CD

Keywords

diagnostic evaluation - TEDDY Study - epidemic - Sweden - gluten introduction - breast feeding - development of tolerance - Prevent CD

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