Editorial
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 14, 2017; 23(18): 3205-3213
Published online May 14, 2017. doi: 10.3748/wjg.v23.i18.3205
Immune response to vaccines in children with celiac disease
Caterina Anania, Francesca Olivero, Alessandra Spagnolo, Claudio Chiesa, Lucia Pacifico
Caterina Anania, Francesca Olivero, Lucia Pacifico, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, Italy
Alessandra Spagnolo, Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00161 Rome, Italy
Claudio Chiesa, Institute of Translational Pharmacology, National Research Council, 00133 Rome, Italy
Author contributions: Anania C, Chiesa C and Pacifico L designed the study, analyzed the data and wrote the manuscript; Olivero F and Spagnolo A collected the data; all the authors participated in the critical review and in the final approval of the manuscript.
Conflict-of-interest statement: There are no potential conflicts of interest relevant to this article
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Lucia Pacifico, MD, Policlinico Umberto I, Sapienza University of Rome, 324 Viale Regina Elena, 00161 Rome, Italy. lucia.pacifico@uniroma1.it
Telephone: +39-6-49979215 Fax: +39-6-49979216
Received: January 23, 2017
Peer-review started: January 28, 2017
First decision: February 23, 2017
Revised: March 7, 2017
Accepted: April 12, 2017
Article in press: April 12, 2017
Published online: May 14, 2017
Abstract

Celiac disease (CD) is an immune-mediated systemic condition evoked by ingestion of gluten and related prolamines in genetically susceptible subjects. The disease is featured by a variable combination of clinical signs, specific antibodies, HLA-DQ2 and HLA-DQ8 haplotypes, and enteropathy. Vaccination is the most potent intervention for infectious disease prevention. Several factors including age, gender, ethnicity, quality and quantity of vaccine antigen, doses, and route of administration can influence immune response to vaccination, although the main cause of variation in the responsiveness among vaccine recipients is host genetic variability. The HLA system has a fundamental role in identifying the antigens introduced into the host with the vaccines and in the development of specific antibodies, and some HLA phenotypes have been associated with a less effective immunological response. The available literature indicates that the immunological response to vaccines in CD children does not differ markedly from that of general population and antibody titres are high enough to provide long-term protection, except for hepatitis B virus vaccine. In this article, we review and discuss the scarce literature in this field in order to provide clinical practice guidelines to achieve the most efficient monitoring of the response to vaccines in pediatric CD patients.

Keywords: Celiac disease, Children, Infection, Vaccines, Hepatitis B vaccine, HLA, Gluten free diet

Core tip: The available literature indicates that the immunological response to vaccines in children with celiac disease (CD) does not differ markedly from that of general population and antibody titres are high enough to provide long-term protection, except for hepatitis B virus (HBV) vaccine. Because the majority of persons with CD has the HLA-DQ2 haplotype, it has been hypothesized that such genetic profile could have an important part in predisposing CD subjects to a less degree of immunity following HBV vaccination. New vaccination strategies have been proposed to give protection to all of these CD patients.