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Saving lives with spleen research

Understanding hyposplenism in Australians with coeliac disease: an important unmet need

Investigators: Assoc Prof Jason A. Tye-Din (WEHI), Dr Vanessa Bryant (WEHI) and Assoc Prof Paul Licciardi (MCRI)

Coeliac disease (CD) is an illness caused by dietary gluten, a protein from wheat, rye, barley and oats. It causes a range of medical problems. One of these serious problems involves the spleen, an important organ that helps a person’s body fight off infections. When a person’s spleen doesn’t work properly, they are considered to have a serious condition called “hyposplenism”. Hyposplenism makes people more susceptible to suffering life-threatening infections (“sepsis”), such as pneumonia caused by a bacteria called “pneumococcus”. Sepsis and pneumococcal disease are the leading causes of death in people with CD. 

An important research priority of Coeliac Australia is to improve the medical care of people with CD to optimise their health and quality of life. Unfortunately, studies on hyposplenism in CD have been small and insufficient to inform the development of guidelines on when and how doctors should screen for hyposplenism and what to do when it is present. In this project we aim to address this important unmet need.

This project will study people with newly diagnosed and treated CD to measure spleen function and assess the accuracy of a variety of screening approaches. Detailed immune studies will examine the impact of hyposplenism on the person’s ability to develop antibodies that help fight off infection. We will study people who have had their spleen removed, for example, due to trauma, to compare our results to. Some people with CD will also receive one of two types of pneumococcal vaccine to determine which one provides the best protective responses against pneumococcus.

The results of this study will tell us how frequently hyposplenism occurs in Australians with CD, establish an optimal screening approach, understand the patient factors that hyposplenism is associated with (for example, age, the presence of other medical issues, the impact of a gluten-free diet) and determine optimal vaccination strategies to reduce the risk of sepsis. The results will be developed into a clinical practice guideline to help inform doctors on best-practice when managing their CD patients.