Skip to main content
PMC home page
Gut logoLink to Gut
. 1996 Jul;39(1):60–62. doi: 10.1136/gut.39.1.60

Adult coeliac disease and cigarette smoking.

J A Snook 1, L Dwyer 1, C Lee-Elliott 1, S Khan 1, D W Wheeler 1, D S Nicholas 1
PMCID: PMC1383232  PMID: 8881810

Abstract

BACKGROUND: Genetic predisposition and gliadin exposure are known to be crucial factors in the development of coeliac disease. Circumstantial evidence suggests that other unidentified environmental factors may also be of pathogenetic importance. AIM: To define the relation between cigarette smoking and the risk of development of symptomatic adult onset coeliac disease. SUBJECTS: Eighty six recently diagnosed adult coeliac disease patients and 172 controls matched for age and sex. METHOD: Matched case control study, using a simple questionnaire to determine smoking history, and in particular smoking status at the time of diagnosis of coeliac disease. RESULTS: At the time of diagnosis, the proportion of current smokers was 7% in the coeliac group, and 32.6% in the control group, giving a matched odds ratio of 0.15 (95% confidence intervals 0.06, 0.38). The difference could not be accounted for by social class, nor by coeliac patients giving up smoking after the onset of symptoms as most non-smokers in the coeliac group had never smoked. CONCLUSION: Cigarette smoking, or a factor closely linked to it, seems to exert a major protective effect against the development of symptomatic adult onset coeliac disease. The implication is that gliadin exposure is not the only important environmental factor involved in the pathogenesis of this condition.

Full text

PDF
60

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bartalena L., Martino E., Marcocci C., Bogazzi F., Panicucci M., Velluzzi F., Loviselli A., Pinchera A. More on smoking habits and Graves' ophthalmopathy. J Endocrinol Invest. 1989 Nov;12(10):733–737. doi: 10.1007/BF03350047. [DOI] [PubMed] [Google Scholar]
  2. Barton J. R., Riad M. A., Gaze M. N., Maran A. G., Ferguson A. Mucosal immunodeficiency in smokers, and in patients with epithelial head and neck tumours. Gut. 1990 Apr;31(4):378–382. doi: 10.1136/gut.31.4.378. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Carter M. J., Willcocks M. M., Mitchison H. C., Record C. O., Madeley C. R. Is a persistent adenovirus infection involved in coeliac disease? Gut. 1989 Nov;30(11):1563–1567. doi: 10.1136/gut.30.11.1563. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Cope G. F., Heatley R. V. Cigarette smoking and intestinal defences. Gut. 1992 Jun;33(6):721–723. doi: 10.1136/gut.33.6.721. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Donaghy M., Rees A. J. Cigarette smoking and lung haemorrhage in glomerulonephritis caused by autoantibodies to glomerular basement membrane. Lancet. 1983 Dec 17;2(8364):1390–1393. doi: 10.1016/s0140-6736(83)90923-6. [DOI] [PubMed] [Google Scholar]
  6. Ferguson A., Arranz E., O'Mahony S. Clinical and pathological spectrum of coeliac disease--active, silent, latent, potential. Gut. 1993 Feb;34(2):150–151. doi: 10.1136/gut.34.2.150. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Ferson M., Edwards A., Lind A., Milton G. W., Hersey P. Low natural killer-cell activity and immunoglobulin levels associated with smoking in human subjects. Int J Cancer. 1979 May 15;23(5):603–609. doi: 10.1002/ijc.2910230504. [DOI] [PubMed] [Google Scholar]
  8. Hamilton I., Cobden I., Rothwell J., Axon A. T. Intestinal permeability in coeliac disease: the response to gluten withdrawal and single-dose gluten challenge. Gut. 1982 Mar;23(3):202–210. doi: 10.1136/gut.23.3.202. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Hazes J. M., Dijkmans B. A., Vandenbroucke J. P., de Vries R. R., Cats A. Lifestyle and the risk of rheumatoid arthritis: cigarette smoking and alcohol consumption. Ann Rheum Dis. 1990 Dec;49(12):980–982. doi: 10.1136/ard.49.12.980. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Hersey P., Prendergast D., Edwards A. Effects of cigarette smoking on the immune system. Follow-up studies in normal subjects after cessation of smoking. Med J Aust. 1983 Oct 29;2(9):425–429. [PubMed] [Google Scholar]
  11. Kagnoff M. F., Paterson Y. J., Kumar P. J., Kasarda D. D., Carbone F. R., Unsworth D. J., Austin R. K. Evidence for the role of a human intestinal adenovirus in the pathogenesis of coeliac disease. Gut. 1987 Aug;28(8):995–1001. doi: 10.1136/gut.28.8.995. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Lindberg E., Tysk C., Andersson K., Järnerot G. Smoking and inflammatory bowel disease. A case control study. Gut. 1988 Mar;29(3):352–357. doi: 10.1136/gut.29.3.352. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Logan R. F., Tucker G., Rifkind E. A., Heading R. C., Ferguson A. Changes in clinical features of coeliac disease in adults in Edinburgh and the Lothians 1960-79. Br Med J (Clin Res Ed) 1983 Jan 8;286(6359):95–97. doi: 10.1136/bmj.286.6359.95. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Miller L. G., Goldstein G., Murphy M., Ginns L. C. Reversible alterations in immunoregulatory T cells in smoking. Analysis by monoclonal antibodies and flow cytometry. Chest. 1982 Nov;82(5):526–529. doi: 10.1378/chest.82.5.526. [DOI] [PubMed] [Google Scholar]
  15. Mäki M., Holm K., Lipsanen V., Hällström O., Viander M., Collin P., Savilahti E., Koskimies S. Serological markers and HLA genes among healthy first-degree relatives of patients with coeliac disease. Lancet. 1991 Nov 30;338(8779):1350–1353. doi: 10.1016/0140-6736(91)92234-s. [DOI] [PubMed] [Google Scholar]
  16. Polanco I., Mearin M. L., Larrauri J., Biemond I., Wipkink-Bakker A., Peña A. S. Effect of gluten supplementation in healthy siblings of children with celiac disease. Gastroenterology. 1987 Mar;92(3):678–681. doi: 10.1016/0016-5085(87)90017-5. [DOI] [PubMed] [Google Scholar]
  17. Prytz H., Benoni C., Tagesson C. Does smoking tighten the gut? Scand J Gastroenterol. 1989 Nov;24(9):1084–1088. doi: 10.3109/00365528909089259. [DOI] [PubMed] [Google Scholar]
  18. Rotter J. I., Landaw E. M. Measuring the genetic contribution of a single locus to a multilocus disease. Clin Genet. 1984 Dec;26(6):529–542. doi: 10.1111/j.1399-0004.1984.tb01100.x. [DOI] [PubMed] [Google Scholar]
  19. Shine B., Fells P., Edwards O. M., Weetman A. P. Association between Graves' ophthalmopathy and smoking. Lancet. 1990 May 26;335(8700):1261–1263. doi: 10.1016/0140-6736(90)91315-2. [DOI] [PubMed] [Google Scholar]
  20. Srivastava E. D., Barton J. R., O'Mahony S., Phillips D. I., Williams G. T., Matthews N., Ferguson A., Rhodes J. Smoking, humoral immunity, and ulcerative colitis. Gut. 1991 Sep;32(9):1016–1019. doi: 10.1136/gut.32.9.1016. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Tobin M. V., Logan R. F., Langman M. J., McConnell R. B., Gilmore I. T. Cigarette smoking and inflammatory bowel disease. Gastroenterology. 1987 Aug;93(2):316–321. doi: 10.1016/0016-5085(87)91021-3. [DOI] [PubMed] [Google Scholar]
  22. Townsend J., Roderick P., Cooper J. Cigarette smoking by socioeconomic group, sex, and age: effects of price, income, and health publicity. BMJ. 1994 Oct 8;309(6959):923–927. doi: 10.1136/bmj.309.6959.923. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES