Maria Ulnes: From risk factors to follow-up in children with celiac disease
Maria Ulnes has studied celiac disease both before and after diagnosis. Her research raises questions about the association between antibiotics and celiac disease and whether follow-up for children with the condition could be more closely tailored to individual needs.
MARIA ULNES
Dissertation defense: 6 November 2026 (click for details)
Doctoral thesis: Risk factors and clinical follow-up of celiac disease
Research area: Pediatrics
Sahlgrenska Academy, The Institute of Clinical Sciences
Celiac disease is a chronic condition in which the immune system reacts to gluten, causing inflammation in the small intestine. Around two percent of people in Sweden are affected, and treatment consists of a strict gluten-free diet.
“About 40 percent of the population has a genetic risk of celiac disease, but we still do not know why only some of them develop the condition,” says Maria Ulnes, specialist in pediatrics at the Department of Pediatric Gastroenterology, Queen Silvia Children’s Hospital, and doctoral student at the Institute of Clinical Sciences.
The link with antibiotics is complex
A link between antibiotic use and celiac disease has been observed in several previous studies, including registry studies. In a large registry study included in this thesis, antibiotic use was associated with the disease, and the association remained when people with celiac disease were compared with their siblings.
The researchers also conducted a similar analysis of people who had undergone gastroscopy but had a normal intestinal lining. Here, too, they found a clear association with antibiotic use.
“This suggests that the association between antibiotics and celiac disease is also influenced by other factors.”
Follow-up after diagnosis
Other studies in the thesis examine how children and adolescents with celiac disease are doing several years after diagnosis and what follow-up they receive. Among children and adolescents in Gothenburg, one in seven had received no follow-up for their celiac disease in the previous two years.
“At the group level, we found no differences between those who had received follow-up and those who had not. The comparison included symptoms, quality of life, adherence to a gluten-free diet, growth, and blood test results. The findings raise questions about whether everyone really needs the same follow-up and how it can best be tailored to individual needs.”
“Almost unreasonably privileged”
What have been the most enjoyable and the most challenging parts of your doctoral project?
“The most enjoyable part has been learning so much and trying very different approaches to research, from laboratory and registry studies to patient recruitment and questionnaire studies. Having the opportunity to do all this with such talented and generous people has made me feel almost unreasonably privileged,” says Maria Ulnes and continues:
“During my doctoral studies, I have also gone from being a resident physician to a specialist and from having one baby to two young children. The greatest challenge has probably been that, at times, I would have needed to clone myself to find the time to learn everything I wanted to about such a broad field in four years.”
Text: Jakob Lundberg