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Celiac disease--a worldwide problem.

K Horvath1, D I Mehta

  • 1Division of Pediatric Gastroenterology and Nutrition, University of Maryland School of Medicine, Baltimore, USA. khorvath@pol.net

Indian Journal of Pediatrics
|December 6, 2000
PubMed
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Celiac disease and dermatitis herpetiformis stem from gluten in wheat, barley, and rye. Research highlights evolving symptoms, increased autoimmune links, and the role of tissue transglutaminase (tTG) in immune responses.

Area of Science:

  • Immunology
  • Gastroenterology
  • Genetics

Background:

  • Celiac disease (CD) and dermatitis herpetiformis (DH) are triggered by alcohol-soluble fractions of gluten-containing grains.
  • Epidemiological studies indicate CD prevalence ranges from 1:100 to 1:300 globally.
  • Clinical presentations of CD have shifted, with atypical symptoms like anemia or osteoporosis becoming more common.

Purpose of the Study:

  • To review current understanding of celiac disease and dermatitis herpetiformis pathogenesis.
  • To discuss diagnostic advancements and epidemiological trends.
  • To explore the role of genetics and tissue transglutaminase (tTG) in disease mechanisms.

Main Methods:

  • Literature review of epidemiological, clinical, and genetic studies on celiac disease and dermatitis herpetiformis.

Related Experiment Videos

  • Analysis of serological testing advancements and their application.
  • Examination of recent research on tissue transglutaminase (tTG) and its role in autoimmunity.

    • Main Results:

    • Serological tests for CD and DH are reliable for screening.
    • Atypical presentations of CD are increasingly recognized, often mimicking other conditions.
    • Increased prevalence of CD is observed in individuals with autoimmune diseases, potentially linked to gluten consumption duration.
    • Specific HLA antigens are common in celiac patients, but non-HLA genes may also contribute.
    • Tissue transglutaminase (tTG) is implicated as an autoantigen, with antibodies to tTG correlating with antiendomysium antibodies.

    Conclusions:

    • Celiac disease and DH pathogenesis involves gluten, with evolving clinical and epidemiological landscapes.
    • Atypical presentations necessitate broader diagnostic considerations.
    • Tissue transglutaminase (tTG) is a key player in the autoimmune response, though its precise role in initiating or exacerbating the reaction requires further study.