Celiac Disease in Asia beyond the Middle East and Indian subcontinent: Epidemiological burden and diagnostic barriers

Poddighe, Dimitri; Abdukhakimova, Diyora

doi:10.3748/wjg.v27.i19.2251

Cited by 19 publications

(21 citation statements)

References 30 publications

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“…CD seems to have a non-negligible prevalence in Asia and sub-Saharan Africa[ 77 , 78 ]. Especially in Russia and Central Asia, the prevalence of CD is very likely to be underestimated due to poor disease awareness among physicians and/or patients, limited access to diagnostic resources, inappropriate use or interpretation of the serological tests, absence of standardised diagnostic and endoscopic protocols, and insufficient expertise in histopathological interpretation[ 3 ]. Specific guidelines are lacking in these geographical areas[ 79 ].…”

Section: Discussionmentioning

confidence: 99%

“…Celiac disease (CD) is an immune-mediated reaction to gluten characterised by an inflammatory injury to the small bowel in genetically predisposed subjects as a result of an inappropriate T cell-mediated immune response[ 1 ].The epidemiology of CD is well known, with an estimated worldwide prevalence of 0.6%-1% of the general population[ 2 ]. However, CD remains largely underdiagnosed in developing countries and has a higher impact on children[ 3 , 4 ]. Simultaneously, the misdiagnosis of CD is becoming an emergent problem worldwide[ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Current guidelines for the management of celiac disease: A systematic review with comparative analysis

Raiteri¹,

Granito²,

Giamperoli³

et al. 2022

WJG

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BACKGROUND Wheat and other gluten-containing grains are widely consumed, providing approximately 50% of the caloric intake in both industrialised and developing countries. The widespread diffusion of gluten-containing diets has rapidly led to a sharp increase in celiac disease prevalence. This condition was thought to be very rare outside Europe and relatively ignored by health professionals and the global media. However, in recent years, the discovery of important diagnostic and pathogenic milestones has led to the emergence of celiac disease (CD) from obscurity to global prominence. These modifications have prompted experts worldwide to identify effective strategies for the diagnosis and follow-up of CD. Different scientific societies, mainly from Europe and America, have proposed guidelines based on CD's most recent evidence. AIM To identify the most recent scientific guidelines on CD, aiming to find and critically analyse the main differences. METHODS We performed a database search on PubMed selecting papers published between January 2010 and January 2021 in the English language. PubMed was lastly accessed on 1 March 2021. RESULTS We distinguished guidelines from 7 different scientific societies whose reputation is worldwide recognized and representative of the clinical practice in different geographical regions. Differences were noted in the possibility of a no-biopsy diagnosis, HLA testing, follow-up protocols, and procedures. CONCLUSION We found a relatively high concordance between the guidelines for CD. Important modifications have occurred in the last years, especially about the possibility of a no-biopsy diagnosis in children. Other modifications are expected in the next future and will probably involve the extension of the non-invasive diagnosis to the adult population and the follow-up modalities.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Current guidelines for the management of celiac disease: A systematic review with comparative analysis

Raiteri¹,

Granito²,

Giamperoli³

et al. 2022

WJG

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“…Studies by Poddighe et al show that barriers to diagnosis in Central Asia include low awareness of the disease among physicians and/or patients, limited access to diagnostic resources (due to economic and/or organizational and/or geographic reasons), misuse or misinterpretation of available serologic tests, lack of standardized diagnostic and endoscopic protocols, and insufficient experience with histopathologic interpretation ( 57 ).…”

Section: Discussionmentioning

confidence: 99%

The Activity of Antimicrobial Peptides in Pediatric Celiac Disease

Kamilova¹,

Azizova²,

Umarnazarova³

et al. 2022

Front. Pediatr.

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BackgroundCeliac disease (CD) is an immune-mediated disorder of the gut in which innate and adaptive responses are involved. Antimicrobial peptides (AMPs) constitute an arsenal of innate immunity regulators of paramount importance in the gut. However, the role of AMPs in CD is unclear.AimsTo evaluate the levels of fecal β-defensin-2, fecal calprotectin (FC), and antibodies against bactericidal/permeability-increasing protein (BPI) in the serum of children with active CD and to compare them with those of healthy controls (HCs).MethodsWe examined 76 children with recently diagnosed CD between the age of 2–10 years (average age: 6.1 ± 1.2 years) and 32 HC (average age: 6.2 ± 3.8 years) in this study. We evaluated the level of fecal β-defensin-2 and FC levels in coprofiltrates, and the level of anti-BPI antibodies in blood serum. Correlation relationships between the parameters were assessed according to Pearson correlation coefficient.ResultsFecal β-defensin-2 concentration was greater in the CD group than in HC group, amounting to 99.6 ± 15.5 ng/mL and 64.0 ± 2.4 ng/mL, respectively (p < 0.02). The level of FC in the CD children was 35.4 ± 8.1 μg/g, while that in the control group was 19.1 ± 1.1 μg/g, (p < 0.05), representing a slightly increase. The concentration of anti-BPI antibodies in the CD and HC groups was 35.9 ± 10.1 U/mL and 5.2 ± 3.2 U/mL, respectively (p < 0.002). There was a strong and direct correlation between fecal β-defensin-2 and FC (r = 0.69), as well as a direct but weak relationship between fecal β-defensin-2 and anti-BPI antibodies (r = 0.35).ConclusionsOur data reinforce that fecal β-defensin-2 and anti-BPI antibodies are greatly increased in patients with active CD. These biomarkers may be components of epithelial innate immunity in the intestine, with each having a distinct functional role in intestinal6 mucosal defense.

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“…In terms of the health care system, significant improvements have been made in Kazakhstan in the last few years and the implementation of official national diagnostictherapeutic protocols for the most prevalent and challenging (acute or chronic) diseases is an important aspect of this process. However, several diagnostic challenges and barriers are still present, as we have evidenced for several other chronic and/or immune-mediated disorders in Kazakhstan and, presumably, in Central Asia [13][14][15][16].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Barriers in Children with Immunodeficiencies in Central Asia: A Case-Based Discussion

Dauyey

Poddighe

2021

Pediatric Reports

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Common variable immunodeficiency (CVID) is a primary immune deficit (PID) mainly characterized by hypogammaglobulinemia. In addition to increased susceptibility to infections and several immune-mediated manifestations, patients with CVID frequently develop bronchiectasis because of recurrent respiratory infections. This occurrence could be more likely if the diagnosis of CVID is delayed, as it often happens in less resourced clinical settings. A 15-year-old female patient was admitted to a tertiary hospital in Kazakhstan for consultation regarding a previous and established diagnosis of bronchiectasis. The clinical history was characterized by recurrent respiratory infections for several years, in addition to the development of a mixed restrictive-obstructive respiratory syndrome. Therefore, she underwent chest computerized tomography, which confirmed the presence of multiple and bilateral bronchiectasis. The clinical discussion on this patient highlighted that serum immunoglobulins were never measured previously and, thus, their assessment was strongly recommended. Based on that, a diagnosis of CVID was finally achieved, and the patient started the appropriate immunoglobulin replacement therapy. To our knowledge, this report is the first English-language publication on CVID and bronchiectasis from Central Asia. Bronchiectasis is currently an important medical problem in developing countries and populations with low socioeconomic status, where the diagnosis of the underlying cystic fibrosis and non-cystic fibrosis comorbidities can be delayed and more difficult than in countries with more accessible health care systems and facilities. This case report emphasized this important clinical issue in Central Asia and should raise the medical attention and awareness of this health problem, in order to improve the diagnostic timing and rate.

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Celiac Disease in Asia beyond the Middle East and Indian subcontinent: Epidemiological burden and diagnostic barriers

Cited by 19 publications

References 30 publications

Current guidelines for the management of celiac disease: A systematic review with comparative analysis

Current guidelines for the management of celiac disease: A systematic review with comparative analysis

The Activity of Antimicrobial Peptides in Pediatric Celiac Disease

Diagnostic Barriers in Children with Immunodeficiencies in Central Asia: A Case-Based Discussion

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