Pediatric Celiac Disease in Central and East Asia: Current Knowledge and Prevalence

Abstract

The current prevalence of pediatric Celiac Disease (CD) is estimated to be around 1% in the general population, worldwide. However, according to the geographic area, a great variability of CD prevalence has been described. Whereas a number of studies are available from Europe, North and South America, Australia, South-West Asia, and North Africa, the knowledge and awareness of CD in large parts of the remaining world areas is definitively poor. In several countries of Central and East Asia, the consumption of wheat is consistent and/or has significantly increased in recent decades, and CD is supposed to be underdiagnosed in children. In this mini-review, we aimed to summarize the current knowledge about the prevalence of pediatric CD in Central and East Asia, paying attention to the HLA-DQ immunogenetic background as well. Indeed, CD is likely not to be as uncommon as previously or currently thought in countries like Russia, Kazakhstan, and China, in addition to India, where pediatric CD has been clearly showed to be quite prevalent. Therefore, there is an urgent need for population-based studies on the prevalence of CD in those countries, especially in children, in order to increase the awareness of this disease and to improve the diagnostic strategy in these areas.

HLA‐DQB1*02 allele in children with celiac disease: Potential usefulness for screening strategies

“…The presence of this predisposing genetic background resulted to be not negligible even in geographical areas where CD has not been investigated so far (Poddighe, Rakhimzhanova, Marchenko, & Catassi, ; Singh et al, ).…”

Prevalence of coeliac disease in Northwest China: heterogeneity across Northern Silk road ethnic populations

“…The disease affects ~1% of the Caucasian population 1 . In the Middle East where the western part of the Silk Roads runs through, the prevalence of coeliac disease has been documented 2,3 . In Turkey (1%‐1.74%), 4,5 Syria (1.67%) 6 and Iran (0.6%‐3%) 7,8 figures comparable to those reported in Europe and the United States were found.…”

Genetic predisposition to celiac disease in Kazakhstan: Potential impact on the clinical practice in Central Asia

“…Indeed, other public health issues (related to some communicable diseases) have attracted a lot of resources and attention in Kazakhstan in last few years; moreover, as regards CD specifically, it has been-and it is still-considered a negligible disease in this country and, thus, such a diagnosis is usually sought only in presence of severe gastrointestinal manifestations without any other explanation, according to our personal clinical observation so far. [6][7] However, the dietary style in this country includes wheat as staple food: indeed, the average consumption per person per year of wheat foods in Kazakhstan, has been estimated to be 100-150 kg. [6,11] Therefore, the exposure to this necessary environmental trigger for CD in Central Asia is comparable to Western countries, where the disease prevalence in the general population is known to be around 1% and the portion of HLA-DQ CD-predisposed individuals is comprised between 30-40%.…”

“…Here, a poor awareness about CD and its clinical expression (which may be subtle and dominated by extra-gastrointestinal manifestations) and the baseless belief that CD is not prevalent in these populations, have hampered the clinical approach and research regarding this specific non-communicable disease so far. [3,[6][7] Very recently, we reviewed those few scientific sources available from the Central Asia about pediatric CD and, actually, we obtained cues that CD could not be as negligible as thought so far. However, we could not find any specific study providing data on the genetic predisposition to CD development in Central Asian populations.…”

“…However, we could not find any specific study providing data on the genetic predisposition to CD development in Central Asian populations. [7] Here, we describe the allelic frequencies at the HLA-DQB1 locus in healthy bone marrow donors from Kazakhstan, in order to first demonstrate that the HLA genetic predisposition in the general population of this geographical area is comparable to that in Europe and North America.…”