Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 21, 2021; 27(19): 2251-2256
Published online May 21, 2021. doi: 10.3748/wjg.v27.i19.2251
Celiac Disease in Asia beyond the Middle East and Indian subcontinent: Epidemiological burden and diagnostic barriers
Dimitri Poddighe, Diyora Abdukhakimova
Dimitri Poddighe, Diyora Abdukhakimova, Department of Medicine, School of Medicine, Nazarbayev University, Nur-Sultan 010000, Kazakhstan
Dimitri Poddighe, Clinical Academic Department of Pediatrics, Research Center for Maternal and Child Health, University Medical Center, Nur-Sultan 010000, Kazakhstan
Author contributions: Poddighe D conceived and wrote the manuscript; Abdukhakimova D provided intellectual contribution and contributed to the literature research.
Supported by Nazarbayev University Faculty Development Competitive Research Grant 2020-2022, No. 240919FD3912.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dimitri Poddighe, MD, MSc, PhD-Eq, Associate Professor, Director, Doctor, Department of Medicine, School of Medicine, Nazarbayev University, Kerei-Zhanibek Str. 5/1, Nur-Sultan 010000, Kazakhstan. dimitri.poddighe@nu.edu.kz
Received: January 17, 2021
Peer-review started: January 17, 2021
First decision: February 23, 2021
Revised: February 25, 2021
Accepted: April 13, 2021
Article in press: April 13, 2021
Published online: May 21, 2021

Celiac Disease (CD) had been considered uncommon in Asia for a long time. However, several studies suggested that, in the Indian subcontinent and Middle East countries, CD is present and as prevalent as in Western countries. Outside these Asian regions, the information about the epidemiology of CD is still lacking or largely incomplete for different and variable reasons. Here, we discuss the epidemiological aspects and the diagnostic barriers in several Asian regions including China, Japan, Southeast Asia and Russia/Central Asia. In some of those regions, especially Russia and Central Asia, the prevalence of CD is very likely to be underestimated. Several factors may, to a different extent, contribute to CD underdiagnosis (and, thus, underestimation of its epidemiological burden), including the poor disease awareness among physicians and/or patients, limited access to diagnostic resources, inappropriate use or interpretation of the serological tests, absence of standardized diagnostic and endoscopic protocols, and insufficient expertise in histopathological interpretation.

Keywords: Celiac disease, Epidemiology, Prevalence, Asia, China, Japan, Russia, Central Asia, HLA-DQB1, Diagnostic barriers

Core Tip: This editorial discusses the main epidemiological characteristics of Celiac Disease in Asia outside the Indian subcontinent and Middle East countries. Indeed, information about the epidemiology of Celiac Disease is still lacking or largely incomplete in those Asian regions (China, Japan, South-East Asia, and Russia/Centra Asia), where the disease prevalence is likely be underestimated. Factors contributing to diagnostic difficulties in these Asian regions are discussed.