Editorial in NEJM

In today’s issue of the New England Journal of Medicine [Oct 2], Professor Jonas Ludvigsson writes an editorial together with Professor Peter HR Green from Celiac Disease Center at Columbia University in New York.
The editorial comments on two randomised clinical trials exploring the timing of gluten introduction and breastfeeding duration on the risk of childhood celiac disease. The two trials (Vriezinga et al, and Lionetti et al) found no association between breastfeeding duration and timing of gluten introduction and later risk of celiac disease. These null findings contrast with earlier data (often from case-control studies) which have indicated an important role of infant nutrition and celiac disease. While Ludvigsson and Green do not question the importance of gluten in the pathogenesis of celiac disease, it does not seem that the exact timing of gluten introduction or breastfeeding is crucial for early celiac development.
The editorial has also been the subject of several interviews in for instance Wall Street Journal and in Dagens Medicin (Swedish language).