Celiac disease from a global perspective

Lionetti, Elena; Gatti, Simona; Pulvirenti, Alfredo; Catassi, Carlo

doi:10.1016/j.bpg.2015.05.004

Cited by 149 publications

(124 citation statements)

References 77 publications

Supporting

Mentioning

113

Contrasting

Unclassified

Order By: Relevance

“…In the US and UK, more than 10% of adults currently start treatment with the GFD for different reasons and duration of time; however, many of these cases are self-diagnoses not verified by a doctor [7] . Indirect evidence suggests that 'true' NCGS is slightly more common than CD [8] , the latter affecting around 1% of the general population [9] . NCGS has been mostly described in adults, particularly in females in the age group of 30-50 years; however, pediatric case series have also been reported [10][11] .…”

Section: Introductionmentioning

confidence: 99%

Gluten Sensitivity

Catassi¹

2015

Ann Nutr Metab

Self Cite

View full text Add to dashboard Cite

Non-celiac gluten sensitivity (NCGS) is a syndrome characterized by intestinal and extraintestinal symptoms related to the ingestion of gluten-containing food in subjects who are not affected by either celiac disease (CD) or wheat allergy (WA). The prevalence of NCGS is not clearly defined yet. Indirect evidence suggests that NCGS is slightly more common than CD, the latter affecting around 1% of the general population. NCGS has been mostly described in adults, particularly in females in the age group of 30-50 years; however, pediatric case series have also been reported. Since NCGS may be transient, gluten tolerance needs to be reassessed over time in patients with NCGS. NCGS is characterized by symptoms that usually occur soon after gluten ingestion, disappear with gluten withdrawal, and relapse following gluten challenge within hours/days. The ‘classical' presentation of NCGS is a combination of irritable bowel syndrome-like symptoms, including abdominal pain, bloating, bowel habit abnormalities (either diarrhea or constipation), and systemic manifestations such as ‘foggy mind', headache, fatigue, joint and muscle pain, leg or arm numbness, dermatitis (eczema or skin rash), depression, and anemia. In recent years, several studies explored the relationship between the ingestion of gluten-containing food and the appearance of neurological and psychiatric disorders/symptoms like ataxia, peripheral neuropathy, schizophrenia, autism, depression, anxiety, and hallucinations (so-called gluten psychosis). The diagnosis of NCGS should be considered in patients with persistent intestinal and/or extraintestinal complaints showing a normal result of the CD and WA serological markers on a gluten-containing diet, usually reporting worsening of symptoms after eating gluten-rich food. NCGS should not be an exclusion diagnosis only. Unfortunately, no biomarker is sensitive and specific enough for diagnostic purposes; therefore, the diagnosis of NCGS is currently based on establishing a clear-cut cause-effect relationship between the ingestion of gluten and the appearance of symptoms by a standardized double-blind, placebo-controlled gluten challenge.

show abstract

Section: Introductionmentioning

confidence: 99%

Gluten Sensitivity

Catassi¹

2015

Ann Nutr Metab

Self Cite

View full text Add to dashboard Cite

show abstract

“…The highest incidence of celiac disease worldwide (5.6 %) occurs in Sarahawi children of Arab-Berber origin living as refugees in Algeria [14]. In parts of India, particularly the north, celiac disease may be as common as in Europe [15]. A screening study in north India identified positive tTG-2 antibodies in 1.4 % and confirmed celiac disease in 1 % -this suggests that between 5 and 8 million people in India may have undiagnosed celiac disease [16].…”

Section: Incidence and Presentation Of Celiac Diseasementioning

confidence: 99%

Recent Advances in Celiac Disease

Murch

2016

Indian J Pediatr

View full text Add to dashboard Cite

Recent diagnostic advances have demonstrated that celiac disease is relatively common although most patients have less florid symptoms than previously recognised. The mucosal lesion of this autoimmune disorder depends on both adaptive and innate immune responses. The characteristic antibodies to tissue transglutaminase-2 (tTG-2) and deamidated gliadin peptides may be produced in persons possessing the relevant HLA-DQ genotypes if intact gliadin peptides can penetrate the epithelial barrier to reach antigen presenting cells. Progression from celiac autoimmunity to overt disease may depend on innate immune mechanisms, not HLA-restricted, where IL-15 is generated within the epithelial compartment. A specific innate immune response previously thought restricted to invertebrates, the encapsulation reaction, may contribute to mucosal volume expansion through recruitment of syndecan-expressing leukocytes and stimulated matrix production. It is notable that tissue transglutaminase is critical in this reaction in insects, and that the very few insects that can predate wheat, possess specific salivary or intestinal enzymes that degrade gluten. Animal models in HLA-DQ transgenic mice suggest that the microbial flora of the intestine may play a role in host responses and modulate the evolution of the disease. This suggests that therapeutic modulation of the microbiome may contribute to management of celiac disease. In developing world countries, there is a potential difficulty in histological diagnosis because of the widespread incidence of environmental enteropathy amongst apparently healthy children. Thus, recognition of local patterns of enteropathy will be important for histopathologists, and high titre tTG-2 autoantibody titres may hold considerable diagnostic significance.

show abstract

“…prevalence of approximately 1%, is one of the most common lifelong disorders in Europe [1], and the most common food intolerance in the general Western population [2]. Healthcare assumes that people suffering from CD who keep strictly to a GFD are considered to experience a significant symptomatic improvement in a short period of time [3].…”

Section: Camentioning

confidence: 99%

“…shows a worldwide distribution [1], and as is the case also for many other diseases with autoimmune background, the true incidence seems to have increased [1,66] both in children and adults of various ethnic origins [59]. In Japan, Korea, Indonesia and the Philippines, CD is rare, probably as a result of low consumption of wheat, but also a low frequency of HLA-DQ2 [58] .…”

Section: Sex and Gender Differences In Healthmentioning

confidence: 99%

Perspectives on living with coeliac disease in remission : Daily life experiences, symptoms and well-being

Jacobsson¹

2015

View full text Add to dashboard Cite

Celiac disease from a global perspective

Cited by 149 publications

References 77 publications

Gluten Sensitivity

Gluten Sensitivity

Recent Advances in Celiac Disease

Perspectives on living with coeliac disease in remission : Daily life experiences, symptoms and well-being

Contact Info

Product

Resources

About