• Anita Kondrashova, Kirsi Mustalahti, Katri Kaukinen, Hanna Viskari, Vera Volodicheva, Anna-Maija Haapala, Jorma Ilonen, Mikael Knip, Markku Mäki, Heikki Hyöty, and Epivir Study Group.
• Department of Virology, University of Tampere, Medical School, Tampere, Finland.
• Ann. Med. 2008 Jan 1; 40 (3): 223-31.

BackgroundThe populations in adjacent Russian Karelia and Finland are equally exposed to grain products and share partly the same ancestry, but live in completely different socioeconomic environments.AimThis creates an ideal epidemiological setting to study gene-environmental interactions in pathogenesis of celiac disease.MethodsThe prevalence of celiac disease and predisposing human leukocyte antigen (HLA) alleles was compared between Russian Karelia and Finland. Tissue transglutaminase antibodies and HLA-DQ alleles were screened from 1988 schoolchildren from Karelia and 3654 children from Finland. Children with transglutaminase antibodies were invited to small-bowel biopsy. Results. Transglutaminase antibodies were less frequent in Russian Karelia than in Finland (0.6% versus 1.4%, P = 0.005). Immunoglobulin class G (IgG) antigliadin antibodies were also less frequent in Russian Karelia (10.2% versus 28.3%, P<0.0001). Celiac disease was confirmed by duodenal biopsy in four of the eight transglutaminase antibody-positive Karelian children, giving a prevalence of 1 in 496 compared to 1 in 107 children in Finland. The same HLA-DQ alleles were associated with celiac disease and transglutaminase antibody positivity in both populations.ConclusionsThe prevalence of transglutaminase antibodies and celiac disease is lower in Russian Karelia than in Finland. This may be associated with a protective environment characterized by inferior prosperity and standard of hygiene in Karelia.

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