Metabolomic Profiling in Children with Celiac Disease: Beyond the Gluten-Free Diet

Abstract

Celiac disease (CD) is included in the group of complex or multifactorial diseases, i.e., those caused by the interaction of genetic and environmental factors. Despite a growing understanding of the pathophysiological mechanisms of the disease, diagnosis is still often delayed and there are no effective biomarkers for early diagnosis. The only current treatment, a gluten-free diet (GFD), can alleviate symptoms and restore intestinal villi, but its cellular effects remain poorly understood. To gain a comprehensive understanding of CD’s progression, it is crucial to advance knowledge across various scientific disciplines and explore what transpires after disease onset. Metabolomics studies hold particular significance in unravelling the complexities of multifactorial and multisystemic disorders, where environmental factors play a significant role in disease manifestation and progression. By analyzing metabolites, we can gain insights into the reasons behind CD’s occurrence, as well as better comprehend the impact of treatment initiation on patients. In this review, we present a collection of articles that showcase the latest breakthroughs in the field of metabolomics in pediatric CD, with the aim of trying to identify CD biomarkers for both early diagnosis and treatment monitoring. These advancements shed light on the potential of metabolomic analysis in enhancing our understanding of the disease and improving diagnostic and therapeutic strategies. More studies need to be designed to cover metabolic profiles in subjects at risk of developing the disease, as well as those analyzing biomarkers for follow-up treatment with a GFD.

Nutritional Status and Metabolism in Celiac Disease: Narrative Review

“…These studies suggest that a dysregulation of lipid metabolism may be associated with the development of CD and that it occurs in the first months of life, before exposure to gluten in a diet. These findings prove the importance of metabolomic analysis in increasing the understanding of celiac disease and improving diagnostic and therapeutic strategies [85]. By analyzing metabolites, it is possible to gain insight into the pathophysiology of CD and better understand the impact of treatment on patients.…”