Celiac Disease

Division of Gastroenterology and Hepatology, Departments of Medicine and Immunology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Current opinion in gastroenterology (Impact Factor: 4.29). 03/2010; 26(2):116-22. DOI: 10.1097/MOG.0b013e3283365263
Source: PubMed


To summarize recent advances in celiac disease published between August 2008 and July 2009.
Celiac disease affects nearly 1% of most populations but remains largely unrecognized. In the last year, work has shown that the prevalence of celiac disease has increased dramatically, not simply due to increased detection. Also, undiagnosed celiac disease may be associated with increased mortality. Significant progress has been made in understanding how gliadin peptides can cross the intestinal border and access the immune system. New genetic loci and candidate genes that may contribute to the risk of celiac disease and its overlap with type 1 diabetes mellitus have been identified. Novel deamidated gliadin peptides antibodies have better diagnostic accuracy over native gliadin-based tests. The inclusion of duodenal bulb biopsy specimens may increase the rate of celiac disease detection. The spectrum of celiac disease likely includes a minority of patients with mild enteropathy. A practical seven-item instrument may facilitate standardized evaluation of gluten-free diet adherence. Finally, refractory celiac disease, although rare, is associated with a poor prognosis.
Celiac disease is a global health problem that requires a multidisciplinary and increasingly cooperative multinational research effort.

Full-text preview

Available from:
  • Source
    • "The diagnosis of CD was made according to currently accepted criteria [36] and was based on both serology and histology. Anti-endomysial antibodies were sought using direct immunofluorescence on monkey esophagus (Bio-Rad, Milan, Italy); positive staining around the smooth muscle was considered positive. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background and Aims. Hepatic hemangioma (HH) has a widely ranging prevalence. The etiology is unclear; however, associations with autoimmune disorders have been described. We aimed at evaluating the prevalence of HH in celiac disease. Methods. Ninety-seven consecutive patients with celiac disease (18 M, 79 F, median age 41, and range 17-84 years) underwent liver ultrasound between January 2011 and 2012. The findings were compared with those of 1352 nonceliac patients (581 M, 771 F, median age 50, and range 16-94 years), without liver disease or previously detected HH, who underwent US in the same period. Results. Ultrasonographic findings consistent with HH were observed in 14 celiac patients (14.4%), a prevalence significantly higher than in controls (69 cases, 5.1%) (P = 0.0006). Subgroup analysis showed that, among women, the prevalence of HH was 16.4% in the celiac disease group (13/79) compared with 5.9% in controls (46/771) (P = 0.002). In celiac setting, HH had a median diameter of 1.3 cm and presented as a single lesion in 12 cases (86%). Conclusions. Our findings are consistent with a significantly higher prevalence of HH in celiac patients. Although mechanisms underlying this association remain unclear, autoimmune and metabolic processes, as well as alterations of gut-liver axis equilibrium, could play a role.
    Full-text · Article · Jan 2015 · Gastroenterology Research and Practice
  • Source
    • "Currently, the only available therapy for CD is a life-long glutenfree diet, which has been proven to clear the symptoms and prevent the CD potential complications [11] [12]. However, the costly and restrictive aspect of complying with a life-long gluten-free regimen may have a significant adverse impact upon the quality of life of the patients [13] [14]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Celiac disease (CD) is a small intestinal enteropathy, triggered in susceptible individuals by the ingestion of dietary gluten. Dendritic cells (DC) are instrumental in the generation and regulation of immune responses and oversee intestinal immune homeostasis promoting and maintaining oral tolerance to food antigens. The aim of this study was to monitor the effect of peptic-tryptic digest of gliadin (PT-gliadin) on the maturation of human monocyte-derived DC and the impact of pDAV and pRPQ decapeptides in the modulation of PT-gliadin-induced phenotypic and functional DC maturation. Immature DC (iDC) were challenged in vitro with PT-gliadin. In some experiments iDC were pre-treated with pDAV or pRPQ and after 2h PT-gliadin was added to the cultures. We found that PT-gliadin up-regulates the expression of the maturation markers HLA-DR, CD83, CD80 and CD86. The functional consequence of PT-gliadin treatment of iDC is a significant increase in IL-12, TNF-alpha production as well as in their T cell stimulatory capacity. On the contrary, the digest of zein had no effect on DC maturation. Interestingly, we found that pre-treatment of iDC with pDAV or pRPQ decapeptides significantly prevents the functional maturation of DC induced by PT-gliadin. On the other hand, pDAV and pRPQ did not revert the PT-gliadin-induced phenotypic maturation of DC. Here we report, for the first time, that naturally occurring peptides are able to prevent the gliadin-dependent DC maturation. This finding could have implication for CD, raising the perspective of a potential therapeutic strategy alternative to a gluten free diet.
    Full-text · Article · Nov 2013 · Experimental Cell Research
  • Source
    • "Genetic loci and candidate genes that may contribute to celiac risk and its association with diabetes mellitus have been identified [20]. The haplotype AH8.1 contains the celiac-associated HLA alleles and appears to be involved in immunological disorders , possibly predisposing individuals to both diabetes mellitus and celiac disease [10]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Hirschsprung disease is a disorder of neural crest migration characterized by intestinal aganglionosis along a variable segment of the gastrointestinal tract. It is a complex disorder associated with several syndromes. Celiac disease is an autoimmune enteropathy characterized by dietary intolerance to gluten proteins and can be associated with autoimmune conditions such as diabetes mellitus. Celiac disease can mimic Hirschsprung disease when presenting with constipation and abdominal distention. We present the case of celiac disease diagnosed in a patient with Hirschsprung disease who subsequently developed type one diabetes mellitus.
    Full-text · Article · Apr 2013 · Fetal and pediatric pathology
Show more