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Update on celiac disease – etiology, differential diagnosis, drug targets, and management advances

Authors Scanlon SA, Murray J

Published 19 December 2011 Volume 2011:4 Pages 297—311

DOI https://doi.org/10.2147/CEG.S8315

Review by Single-blind

Peer reviewer comments 2

Samantha A Scanlon1, Joseph A Murray1,2
1Department of Internal Medicine, 2Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA

Abstract: Celiac disease (CD) is an immune-mediated enteropathy triggered by exposure to wheat gluten and similar proteins found in rye and barley that affects genetically susceptible persons. This immune-mediated enteropathy is characterized by villous atrophy, intraepithelial lymphocytosis, and crypt hyperplasia. Once thought a disease that largely presented with malnourished children, the wide spectrum of disease activity is now better recognized and this has resulted in a shift in the presenting symptoms of most patients with CD. New advances in testing, both serologic and endoscopic, have dramatically increased the detection and diagnosis of CD. While the gluten-free diet is still the only treatment for CD, recent investigations have explored alternative approaches, including the use of altered nonimmunogenic wheat variants, enzymatic degradation of gluten, tissue transglutaminase inhibitors, induction of tolerance, and peptides to restore integrity to intestinal tight junctions.

Keywords: immune-mediated enteropathy, gliadin, gluten, epidemiology, CD diagnosis, therapy

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