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Celiac disease： Prevalence, diagnosis, pathogenesis and treatment

World journal of gastroenterology : WJG, 2012-11, Vol.18 (42), p.6036-6059

2012 Baishideng Publishing Group Co., Limited. All rights reserved. 2012 ;ISSN: 1007-9327 ;EISSN: 2219-2840 ;DOI: 10.3748/wjg.v18.i42.6036 ;PMID: 23155333

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  • Title:
    Celiac disease： Prevalence, diagnosis, pathogenesis and treatment
  • Author: Gujral, Naiyana ; Freeman, Hugh J ; Thomson, Alan B R
  • Subjects: Animals ; Autoimmunity ; Celiac Disease - diagnosis ; Celiac Disease - ethnology ; Celiac Disease - genetics ; Celiac Disease - immunology ; Celiac Disease - therapy ; Diet, Gluten-Free ; Gene-Environment Interaction ; Genetic Predisposition to Disease ; Gliadin - immunology ; HLA基因 ; Humans ; Intestine, Small - immunology ; Prevalence ; Review ; Risk Factors ; Treatment Outcome ; 发病机理 ; 发病率 ; 治疗 ; 诊断 ; 转谷氨酰胺酶 ; 过敏症 ; 麸质
  • Is Part Of: World journal of gastroenterology : WJG, 2012-11, Vol.18 (42), p.6036-6059
  • Description: Celiac disease （CD） is one of the most common diseas- es, resulting from both environmental （gluten） and ge- netic factors [human leukocyte antigen （HLA） and non- HLA genes]. The prevalence of CD has been estimated to approximate 0.5%-1% in different parts of the world. However, the population with diabetes, autoim- mune disorder or relatives of CD individuals have even higher risk for the development of CD, at least in part, because of shared HLA typing. Gliadin gains access to the basal surface of the epithelium, and interact directly with the immune system, via both trans- and para-cellular routes. From a diagnostic perspective, symptoms may be viewed as either ＂typical＂ or ＂atypi- cal＂. In both positive serological screening results sug- gestive of CD, should lead to small bowel biopsy fol- lowed by a favourable clinical and serological response to the gluten-free diet （GFD） to confirm the diagnosis. Positive anti-tissue transglutaminase antibody or anti- endomysial antibody during the clinical course helps to confirm the diagnosis of CD because of their over 99% specificities when small bowel villous atrophy is pres- ent on biopsy. Currently, the only treatment available for CD individuals is a strict life-long GFD. A greater understanding of the pathogenesis of CD allows alter- native future CD treatments to hydrolyse toxic gliadin peptide, prevent toxic gliadin peptide absorption, blockage of selective deamidation of specific glutamine residues by tissue, restore immune tolerance towards gluten, modulation of immune response to dietary glia- din, and restoration of intestinal architecture.
  • Publisher: United States: Baishideng Publishing Group Co., Limited
  • Language: English
  • Identifier: ISSN: 1007-9327
    EISSN: 2219-2840
    DOI: 10.3748/wjg.v18.i42.6036
    PMID: 23155333
  • Source: Geneva Foundation Free Medical Journals at publisher websites
    MEDLINE
    PubMed Central
    Alma/SFX Local Collection
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