Special Issue "Celiac Disease"

A special issue of Diseases (ISSN 2079-9721). This special issue belongs to the section "Gastroenterology".

Deadline for manuscript submissions: closed (30 April 2015).

Special Issue Editors

Prof. Dr. Stefano Guandalini
Website
Guest Editor
Department of Pediatrics, University of Chicago Medicine, Chicago, IL, USA
Interests: Celiac Disease, Probiotics
Special Issues and Collections in MDPI journals
Dr. Sonia Kupfer
Website
Guest Editor
Department of Medicine, University of Chicago, 900 East 57th Street, MB#9, Chicago, IL 60637, USA
Interests: gastroenterology; colon cancer; rectal cancer; cancer genetics; gastrointestinal cancer risk and prevention; celiac disease; internal medicine

Special Issue Information

Dear Colleagues,

Celiac Disease (CD) has been known since ancient times, but it was only 70 years ago when the role of gluten was discovered. This systemic disorder, which has an autoimmune component, originates in genetically susceptible individuals and is increasing in prevalence in many parts of the world (now around 1% of the general population). If left undiagnosed and untreated, CD can lead to serious complications, ranging from severe malnutrition and impaired growth to malignancy. Originally believed to be only restricted to infancy and early childhood, and manifesting with gastrointestinal symptoms, CD is now well-known as a disease that affects all ages. Moreover, CD is known to present a variety of intestinal and extra-intestinal manifestations; it is also not uncommon for CD to be completely asymptomatic. Hence, diagnosing CD requires a high degree of suspicion by the physician, who must be aware of who can and how to screen for CD. Subjects with positive screens must then undergo a final diagnostic confirmation; this process for children has recently been revised by the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN). In selected cases, these new guidelines allow for the avoidance of endoscopic biopsies (of the duodenal mucosa). After diagnosis, the only therapeutic option currently available is a life-long gluten-free diet; this is typically very effective if strictly adhered to. In recent years however, it has become clear that many patients do not fully respond to the therapy (especially in the adult age). Consequently, there is very active research concerning alternative forms of treatment, some of which appear to be very promising, including the possibility of developing, for the first time, a real cure. This Special Issue will deal with this exciting and evolving field, covering new information concerning genetics and pathogenesis, evolving clinical presentations, diagnostic approaches, and new treatments appearing on the horizon. A separate section will be devoted to presenting the state of the art understanding of a growing and highly controversial area: that of non-celiac gluten sensitivity, better referred to as wheat intolerance syndrome.

Prof. Dr. Stefano Guandalini
Dr. Sonia Kupfer
Guest Editor

Manuscript Submission Information

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Keywords

  • celiac Disease
  • gluten-free
  • non-celiac gluten sensitivity
  • autoimmunity
  • malabsorption

Published Papers (5 papers)

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Review

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Open AccessReview
The Role of Environmental Factors in the Development of Celiac Disease: What Is New?
Diseases 2015, 3(4), 282-293; https://doi.org/10.3390/diseases3040282 - 27 Oct 2015
Cited by 8
Abstract
Celiac disease (CD) is a systemic immune-mediated disorder caused by the ingestion of gluten-containing grains in genetically susceptible persons. It is one of the most common lifelong disorders, affecting approximately 1% of the general population. The prevalence of CD has increased in developed [...] Read more.
Celiac disease (CD) is a systemic immune-mediated disorder caused by the ingestion of gluten-containing grains in genetically susceptible persons. It is one of the most common lifelong disorders, affecting approximately 1% of the general population. The prevalence of CD has increased in developed countries over recent decades, pointing to the role of additional environmental triggers other than gluten. It has been hypothesized that intestinal infections, the amount and quality of gluten, the intestinal microbiota, and early nutrition are all possible triggers of the switch from tolerance to an immune response to gluten. Two recent randomized controlled trials have been performed to clarify the relationship between the age at which gluten is introduced to a child’s diet and the risk of CD, showing that timing of gluten introduction does not modify the risk of CD. Both trials also showed that breastfeeding compared with no breastfeeding or breastfeeding duration or breastfeeding during gluten introduction have no effect on the risk of CD. The two trials, although not designed to address this issue, have shown that intestinal infections seem not to influence the risk of CD. Further studies are still needed to explore the missing environmental factors of CD for future prevention. Full article
(This article belongs to the Special Issue Celiac Disease)
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Open AccessReview
The Gluten-Free Diet in the 3rd Millennium: Rules, Risks and Opportunities
Diseases 2015, 3(3), 136-149; https://doi.org/10.3390/diseases3030136 - 13 Jul 2015
Cited by 9
Abstract
The gluten-free diet has long been considered the standard treatment for celiac disease. However, a significant number of patients continue to experience persistent symptoms despite following a gluten-free diet. Inadvertent gluten ingestion, fermentable carbohydrates, cross-contamination, and social or financial burdens present obstacles to [...] Read more.
The gluten-free diet has long been considered the standard treatment for celiac disease. However, a significant number of patients continue to experience persistent symptoms despite following a gluten-free diet. Inadvertent gluten ingestion, fermentable carbohydrates, cross-contamination, and social or financial burdens present obstacles to maintaining a gluten-free diet. Proper diet education and follow-up by an expert Registered Dietitian (RD) is essential to ensure adequate nutrition on the gluten-free diet. Patients may experience unintended weight gain or elevated cholesterol levels after initiating the gluten-free diet due to adequate absorption and healing of the intestines. This review deals with the evolving gluten-free diet, optimal recommendations while considering the overall health of patients, and multi-factorial aspects of the permanent lifestyle change. Full article
(This article belongs to the Special Issue Celiac Disease)
Open AccessReview
Auxo-Endocrinological Approach to Celiac Children
Diseases 2015, 3(2), 111-121; https://doi.org/10.3390/diseases3020111 - 19 Jun 2015
Cited by 2
Abstract
Celiac disease is a permanent genetically determined intolerance to gluten that generally presents with gastrointestinal symptoms in young children and extraintestinal manifestations (endocrinological, dermatological, neurological, etc.) later. Furthermore, many studies demonstrate the close association between celiac and endocrine diseases, including growth and [...] Read more.
Celiac disease is a permanent genetically determined intolerance to gluten that generally presents with gastrointestinal symptoms in young children and extraintestinal manifestations (endocrinological, dermatological, neurological, etc.) later. Furthermore, many studies demonstrate the close association between celiac and endocrine diseases, including growth and pubertal disorders, type I diabetes mellitus and autoimmune thyroid diseases, probably due to the presence of a common genetic predisposition. Follow-up for celiac children after the start of gluten-free diet is mandatory to avoid complications such as growth hormone deficiency. The present review deals with the problem of the diagnosis of endocrine-associated diseases in celiac children and gives suggestions for correct management and follow-up of these patients. Full article
(This article belongs to the Special Issue Celiac Disease)
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Open AccessReview
Celiac Disease: Diagnostic Standards and Dilemmas
Diseases 2015, 3(2), 86-101; https://doi.org/10.3390/diseases3020086 - 16 Jun 2015
Cited by 5
Abstract
Celiac Disease (CD) affects at least 1% of the population and evidence suggests that prevalence is increasing. The diagnosis of CD depends on providers being alert to both typical and atypical presentations and those situations in which patients are at high risk for [...] Read more.
Celiac Disease (CD) affects at least 1% of the population and evidence suggests that prevalence is increasing. The diagnosis of CD depends on providers being alert to both typical and atypical presentations and those situations in which patients are at high risk for the disease. Because of variable presentation, physicians need to have a low threshold for celiac testing. Robust knowledge of the pathogenesis of this autoimmune disease has served as a catalyst for the development of novel diagnostic tools. Highly sensitive and specific serological assays including Endomysial Antibody (EMA), tissue transglutaminase (tTG), and Deamidated Gliadin Peptide (DGP) have greatly simplified testing for CD and serve as the foundation for celiac diagnosis. In addition, genetic testing for HLA DQ2 and DQ8 has become more widely available and there has been refinement of the gluten challenge for use in diagnostic algorithms. While diagnosis is usually straightforward, in special conditions including IgA deficiency, very young children, discrepant histology and serology, and adoption of a gluten free diet prior to testing, CD can be difficult to diagnose. In this review, we provide an overview of the history and current state of celiac disease diagnosis and provide guidance for evaluation of CD in difficult diagnostic circumstances. Full article
(This article belongs to the Special Issue Celiac Disease)
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Open AccessOpinion
The Perceived Social Burden in Celiac Disease
Diseases 2015, 3(2), 102-110; https://doi.org/10.3390/diseases3020102 - 19 Jun 2015
Cited by 12
Abstract
In the present paper, we discuss the change in celiac disease (CD) awareness and perception through patients’ concerns and the most recent literature. Nowadays CD has moved in the public awareness (both doctors and population) from a rare disease to a common one [...] Read more.
In the present paper, we discuss the change in celiac disease (CD) awareness and perception through patients’ concerns and the most recent literature. Nowadays CD has moved in the public awareness (both doctors and population) from a rare disease to a common one and the gluten free diet (GFD) is no longer the exclusive therapy for CD patients but is becoming a popular health choice for everybody. Gluten-free food, once hard to find and requiring home preparation, is now available at restaurants and grocery stores. However, the quality of life of those affected by CD seems to be still compromised and this is particularly true for those who find it difficult to adhere to a GFD and those who were asymptomatic at the time of diagnosis. Intervention at diagnosis and follow-up to improve the patients’ adaptation to the condition and its limitations should be implemented. Full article
(This article belongs to the Special Issue Celiac Disease)
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