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Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
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[Coeliac disease from pathogenesis to clinical practice: current concepts.]

Stefano Bibbò1, Giovanni Mario Pes1, Maria Pina Dore1

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Coeliac disease is an autoimmune disorder triggered by gluten in genetically susceptible individuals. Research highlights the roles of genetics, environment, gut barrier, and microbiota in its development and management.

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Area of Science:

  • Immunology
  • Gastroenterology
  • Genetics

Background:

  • Coeliac disease is an autoimmune small intestinal disorder in genetically predisposed individuals triggered by gluten ingestion.
  • Pathogenesis involves complex interactions between genetic, environmental, and immunological factors, with increasing focus on the intestinal barrier and microbiota.
  • Clinical presentations range from malabsorption symptoms to subtle or atypical manifestations.

Purpose of the Study:

  • To review current evidence on the pathogenesis of coeliac disease.
  • To outline current clinical practice guidelines for diagnosis and management.
  • To emphasize the interplay of factors contributing to coeliac disease.

Main Methods:

  • Literature review of current evidence on coeliac disease pathogenesis.
  • Summary of diagnostic criteria including serological markers and endoscopic/histological findings.
  • Overview of current management strategies, focusing on dietary gluten elimination and monitoring.

Main Results:

  • Understanding of coeliac disease pathogenesis has advanced, highlighting genetic, environmental, and immunological interactions.
  • The intestinal barrier and microbiota alterations are recognized as significant factors.
  • Diagnosis relies on serology, endoscopy, and histology, while management mandates strict gluten-free diet.

Conclusions:

  • Coeliac disease pathogenesis is multifactorial, involving genetic predisposition and environmental triggers like gluten.
  • Intestinal barrier dysfunction and dysbiosis are crucial in disease development.
  • Effective management requires lifelong gluten avoidance and regular patient monitoring for nutritional status and complications.