89.    Epidemiological study of Celiac Disease in Chivilcoy, Buenos Aires Province

Celiac disease (CD) is a serious, genetic autoimmune disorder triggered by the intake of gluten, a protein which is found in wheat, barley and rye. When susceptible individuals eats gluten, the protein interferes with the absorption of nutrients from food by damaging a part of the small intestine. The immune reaction is triggered by
gliadin, a protected fraction of wheat gluten,. Damaged villi make it nearly impossible for the body to absorb nutrients leading to malnourishment and a host of other problems including some cancers, thyroid disease, osteoporosis, infertility and other autoimmune diseases. Currently, it is estimated that the CD affects between
0.6 to 1.0% of the world population, with very important regional differences, for reasons not yet established. In Argentina, it is estimated that more than 400000 person has the disease. However, despite the fact that a more precise and rational diagnostic evaluation is now possible, we do not have national statistics and the CD remains an underdiagnosed entity. The discovery of transglutaminase (Tg) as the main autoantigen of the endomysium led to the development of a test for the detection of autoantibodies of the IgA and IgG anti-Tg type, which represents an important tool for the diagnosis and monitoring of the disease To date, it has been possible to obtain samples of 508 volunteers from the city of Chivilcoy, Province of Buenos Aires. Each person signed a consent along with a survey in which he/she is asked for information related to their clinical and dietary backgrounds, which were uploaded in a software developed for this purpose, by the Computer Center of the
University of Luján (CIDETIC).This system allows an association between environmental and clinical data and the appearance of symptoms compatible with celiac disease. The anti-transglutamine antibody (aTg) was measured by the use of an ELISA developed in our laboratory (CELISAR). The analytical performance of the CELISAR method was evaluated taking the Orgentec commercial method as a reference, with a good correlation. The population studied (n = 508) consisted of 392 women and y 116 men. Their ages ranged between 18 and 70 years. Of the 508 volunteers studied, 8.8% (n = 45) were aTg positive, suggesting a high incidence of the marker in the population studied. The software developed allowed us to evaluate other associated pathologies, observing that from the 45 volunteers with positive aTg, 4 had a diagnosis of CD, 13 had thyroiditis, 12 had anemia of different types, 3 persons had osteoporosis and 2 diabetes. We are currently studying the impact of environmental variables such as water consumption, socioeconomic status, and area of residence among other factors that could impact the incidence of CD. At the same time, we are evaluating other genetics (DQ2 / DQ8) and immunological markers (PGD). The local development of the CELISAR kit allowed us to carry out a more exhaustive analysis of the presence of the anti-Tg antibody in the population studied and given the low cost of this kit, we projected that can be implemented in hospitals and health centers in the area allowing access to this study to a greater number of people increasing the epidemiological study of DC.