Abstract
Celiac disease is a systemic immune-mediated disorder caused by the ingestion of gluten in genetically susceptible persons. It is the result of the interplay between genetic and environmental factors in a model of a complex multifactorial disease. It has been hypothesized that early infant nutrition, intestinal infections, intestinal microbiota, use of antibiotics, and other drugs can all represent possible triggers of the switch to an abnormal immune response to gluten. Two recent randomized controlled trials have been performed to clarify the relationship between early infant nutrition and the risk of celiac disease. Both trials showed that timing of gluten introduction does not modify the risk of celiac disease, and that breastfeeding duration or gluten introduction during breastfeeding have no effect on the risk of celiac disease. Further studies are needed to explore other environmental factors for primary prevention of celiac disease.
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