Celiac Disease: Waiting to Explode in Asia

Celiac disease (CeD) is an acquired immune enteropathy for which the presence of two factors, i.e., predisposing HLA genes (HLA DQ2/DQ8) and gluten in diet are essential for induction of the pathogenic immune response. Acute symptoms/gut injury specifically depend on the amount of gluten ingested. The incidence and prevalence of medically diagnosed CeD is expected to rise in the coming decades, and most of these people are expected to be from Asia. Through publicly available datasets, we mapped the estimated proportion of population harboring HLA DQ2/DQ8 in different regions of Asia and the per-capita gluten consumption for each country. We estimated each Asian's country's celiac risk based on these two factors and compared it with the published literature on population-based serological studies from these countries. The expected trajectory of CeD and the challenges in making different countries in Asia "celiac ready" is discussed.