{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T20:28:04Z","timestamp":1774988884382,"version":"3.50.1"},"reference-count":44,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,12,10]],"date-time":"2019-12-10T00:00:00Z","timestamp":1575936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81601186"],"award-info":[{"award-number":["81601186"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>There is evidence of a relationship between infection (and the associated antibiotic exposure) and the risk of celiac disease (CD). This study performed a meta\u2010analysis to investigate this relationship.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>To identify relevant studies, we conducted systematic searches of the PubMed, Embase, and Cochrane databases for articles published up to April 2019. Random effects models were used to determine overall pooled estimates and 95% confidence intervals (CIs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The meta\u2010analysis included 19 observational studies (15 on infection and six on antibiotic exposure). Our results showed that any infection was associated with an increased risk of CD later in life (odds ratio, 1.37; 95% CI: 1.2\u20131.56; <jats:italic>P<\/jats:italic> &lt; 0.001). The <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> was 94% (high heterogeneity among studies). Subgroup analyses suggested that the risk of CD is not affected by the type of infectious agent, timing of exposure, and site of infection. Exposure to antibiotics was also associated with new\u2010onset CD (odds ratio, 1.2; 95% CI: 1.04\u20131.39; <jats:italic>P<\/jats:italic> &lt; 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Exposure to early infection or antibiotic appears to increase the odds of developing CD, suggesting that intestinal immune or microbiota dysbiosis may play a role in the pathogenesis of CD. These findings may influence clinical management and primary prevention of CD. However, noncausal explanations for these positive associations cannot be excluded.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.14928","type":"journal-article","created":{"date-parts":[[2019,11,16]],"date-time":"2019-11-16T15:55:03Z","timestamp":1573919703000},"page":"557-566","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Infection, antibiotic exposure, and risk of celiac disease: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"35","author":[{"given":"Hai\u2010yin","family":"Jiang","sequence":"first","affiliation":[{"name":"Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine Zhejiang University  Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xue","family":"Zhang","sequence":"additional","affiliation":[{"name":"Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine Zhejiang University  Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan\u2010yue","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Child Psychiatry Hangzhou Seventh People's Hospital  Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun\u2010min","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, The Affiliated Hangzhou First People's Hospital Zhejiang University School of Medicine  Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3858-4817","authenticated-orcid":false,"given":"Yu\u2010dan","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Chinese Internal Medicine Taizhou First People's Hospital  Taizhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,12,10]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31796-8"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2017.06.037"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2018-205209"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/21688370.2017.1373208"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40779-017-0122-9"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijfoodmicro.2016.07.025"},{"key":"e_1_2_6_8_1","first-page":"551","article-title":"Increased prevalence of pathogenic bacteria in the gut microbiota of infants at risk of developing celiac disease: the PROFICEL study","volume":"9","author":"Olivares M","year":"2018","journal-title":"Gut Microbes."},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40168-018-0415-6"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2014.246"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2017.2905"},{"key":"e_1_2_6_12_1","article-title":"Association between antibiotics in the first year of life and celiac disease","author":"Sander SD","year":"2019","journal-title":"Gastroenterology"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwu101"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2431-12-194"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwx190"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2002.tb01635.x"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2016.05.013"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-4102"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.13150"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.15.2008"},{"key":"e_1_2_6_21_1","unstructured":"Higgins.Cochrane handbook for systematic reviews of interventions version 5.1.0. 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