Genetic predisposition to gluten intolerance

Gluten intolerance and heredity 

Genetic predisposition is a significant factor in the development of gluten intolerance. The HLA-DQ gene has the biggest influence. Due to genetic variations in our DNA, there are different variants of the HLA gene. The HLA variants DQ2.5, DQ2.2 and DQ8 are the strongest genetic risk factors for coeliac disease. Almost 95% of coeliac disease patients are positive for HLA-DQ2; virtually all other patients are positive for HLA-DQ8.

Please note: not everyone who has a (significantly) increased genetic predisposition to coeliac disease will actually develop it. Around 40% of the population carry one or two high-risk HLA genes, but only a small proportion of them will ultimately develop gluten intolerance (approximately 1% in total). Conversely, coeliac disease can be ruled out if no high-risk HLA variant is identified.

It is therefore possible to determine your personal predisposition to gluten intolerance on the basis of your DNA. 

Intolerant of or hypersensitive to gluten?

Although coeliac disease (gluten intolerance) is diagnosed in just 1% of people, many more people appear to be sensitive to gluten. Non-coeliac gluten sensitivity (NCGS), or gluten sensitivity, has been a recognised condition for a number of years. However, the typical signs of coeliac disease, such as antibodies and intestinal damage, are not seen in people with gluten sensitivity.

Common symptoms of gluten sensitivity are nevertheless the same as those associated with coeliac disease, namely intestinal complaints such as stomach pain, flatulence, diarrhoea and constipation. As in the case of coeliac disease, these symptoms disappear if the patient follows a gluten-free diet. People who have NCGS can also suffer from headaches and chronic fatigue. It is not yet clear what causes these symptoms. We also do not yet know of any clear genetic link in the case of gluten sensitivity.