» Articles » PMID: 34693776

The Progression of Celiac Disease, Diagnostic Modalities, and Treatment Options

Overview
Specialty General Medicine
Date 2021 Oct 25
PMID 34693776
Citations 7
Authors
Affiliations
Soon will be listed here.
Abstract

Celiac disease (CD) is an autoimmune disorder that affects genetically predisposed individuals who are sensitive to gluten and related proteins. It affects children and adults with increasing prevalence in the older age groups. Both adaptive and innate immune responses play role in CD pathogenesis which results in damage of lamina propria and deposition of intraepithelial lymphocytes. There are other proposed mechanisms of CD pathogenesis like gastrointestinal infections, intestinal microbiota, and early introduction of gluten. The diagnosis of CD is based on clinical symptoms and serological testing, though a majority of cases are asymptomatic, and small intestinal biopsies are required to confirm the diagnosis. Celiac disease is generally associated with other autoimmune diseases, and it is advisable to test these patients for diseases like type 1 diabetes mellitus, Addison's disease, thyroid diseases, inflammatory bowel disease, and autoimmune hepatitis. The patient with a new diagnosis of CD requires close follow-up after starting treatment to see symptom improvement and check dietary compliance. A newly diagnosed patient is advised to follow with a dietitian to better understand the dietary restrictions as about 20% of patients stay symptomatic even after starting treatment due to noncompliance or poor understanding of diet restrictions. The most effective treatment for CD is a gluten-free diet, but work on non-dietary therapy is in process and few medications are in the clinical trial phase.

Citing Articles

Assessment of Gluten-Free Products' Availability and Satisfaction in a Polish Population of Coeliac Disease Patients and Their Caregivers.

Glabska D, Guzek D, Skolmowska D, Vriesekoop F Nutrients. 2024; 16(20).

PMID: 39458456 PMC: 11510341. DOI: 10.3390/nu16203460.


Limited support for a direct connection between prebiotics and intestinal permeability - a systematic review.

Acharya B, Tofthagen M, Maciej-Hulme M, Suissa M, Karlsson N Glycoconj J. 2024; 41(4-5):323-342.

PMID: 39287885 PMC: 11522178. DOI: 10.1007/s10719-024-10165-8.


Celiac Disease, Gluten-Free Diet and Metabolic Dysfunction-Associated Steatotic Liver Disease.

Cazac G, Mihai B, Stefanescu G, Gilca-Blanariu G, Mihai C, Grigorescu E Nutrients. 2024; 16(13).

PMID: 38999756 PMC: 11243569. DOI: 10.3390/nu16132008.


Gut Microbiota Alteration and Its Modulation with Probiotics in Celiac Disease.

Saviano A, Petruzziello C, Brigida M, Morabito Loprete M, Savioli G, Migneco A Biomedicines. 2023; 11(10).

PMID: 37893012 PMC: 10603901. DOI: 10.3390/biomedicines11102638.


Developing neural network diagnostic models and potential drugs based on novel identified immune-related biomarkers for celiac disease.

Shen T, Wang H, Hu R, Lv Y Hum Genomics. 2023; 17(1):76.

PMID: 37587523 PMC: 10433645. DOI: 10.1186/s40246-023-00526-z.


References
1.
Marsh M . Gluten, major histocompatibility complex, and the small intestine. A molecular and immunobiologic approach to the spectrum of gluten sensitivity ('celiac sprue'). Gastroenterology. 1992; 102(1):330-54. View

2.
Nistal E, Caminero A, Herran A, Perez-Andres J, Vivas S, Ruiz de Morales J . Study of duodenal bacterial communities by 16S rRNA gene analysis in adults with active celiac disease vs non-celiac disease controls. J Appl Microbiol. 2016; 120(6):1691-700. DOI: 10.1111/jam.13111. View

3.
Duerksen D, Pinto-Sanchez M, Anca A, Schnetzler J, Case S, Zelin J . Management of bone health in patients with celiac disease: Practical guide for clinicians. Can Fam Physician. 2018; 64(6):433-438. PMC: 5999247. View

4.
Zanchetta M, Longobardi V, Bai J . Bone and Celiac Disease. Curr Osteoporos Rep. 2016; 14(2):43-8. DOI: 10.1007/s11914-016-0304-5. View

5.
Kamycheva E, Goto T, Camargo Jr C . Celiac disease is associated with reduced bone mineral density and increased FRAX scores in the US National Health and Nutrition Examination Survey. Osteoporos Int. 2016; 28(3):781-790. DOI: 10.1007/s00198-016-3791-4. View