LEWIS PHENOTYPE, SECRETOR STATUS, AND CELIAC-DISEASE

Patients who cannot secrete ABO and Lewis blood group antigens into bo dy fluids, an ability controlled by a single gene on chromosome 19, ar e known to be at increased risk of certain autoimmune diseases associa ted with human leucocyte antigen (HLA) markers. This study investigate d the possibility of an association with coeliac disease using red cel l Lewis (Le) blood group phenotype to infer secretor status. Among 73 patients with coeliac disease who had Le a or b antigen, 48% were nons ecretors (Le a+ b-) compared with 27% of 137 blood donors (p = 0.004: odds ratio 2.49, 95% confidence intervals 1.37 to 4.51) and 26% of 62 medical and nursing staff controls (p = 0.014: odds ratio 2.65, 95% co nfidence intervals 1.27 to 5.50). Clinical characteristics did not dif fer between secretors and nonsecretors with coeliac disease. Thus, the nonsecretor state is significantly associated with coeliac disease, s uggesting that genes on chromosome 19 may directly or indirectly parti cipate in conferring susceptibility.