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World J Gastrointest Pathophysiol. May 15, 2017; 8(2): 27-38
Published online May 15, 2017. doi: 10.4291/wjgp.v8.i2.27
Celiac disease: From pathophysiology to treatment
Ilaria Parzanese, Luca Elli, Gastroenterology and Endoscopy Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Department of Pathophysiology and Transplantation, University of Milan, 20122 Milano, Italy
Dorina Qehajaj, Federica Patrinicola, Fabio Grizzi, Department of Immunology and Inflammation, Humanitas Clinical and Research Center, 20089 Rozzano, Milan, Italy
Merica Aralica, Department of Laboratory Medicine, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
Maurizio Chiriva-Internati, Division of Hematology and Oncology, Texas Tech University Health Sciences Center, Lubbock, TX 79430, United States
Sanja Stifter, Department of Pathology, School of Medicine, University of Rijeka, 51000 Rijeka, Croatia
Author contributions: Parzanese I, Qehajaj D, Patrinicola F, Aralica M, Chiriva-Internati M, Stifter S, Elli L and Grizzi F draft, discuss the manuscript and approved the final version.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
Correspondence to: Dr. Fabio Grizzi, Department of Immunology and Inflammation, Humanitas Clinical and Research Center, Via Manzoni 56, 20089 Rozzano, Milan, Italy. firstname.lastname@example.org
Telephone: +39-02-82245262 Fax: +39-02-82244590
Received: April 24, 2016
Peer-review started: April 25, 2016
First decision: June 6, 2016
Revised: March 8, 2017
Accepted: March 23, 2017
Article in press: March 24, 2017
Published online: May 15, 2017
Celiac disease, also known as “celiac sprue”, is a chronic inflammatory disorder of the small intestine, produced by the ingestion of dietary gluten products in susceptible people. It is a multifactorial disease, including genetic and environmental factors. Environmental trigger is represented by gluten while the genetic predisposition has been identified in the major histocompatibility complex region. Celiac disease is not a rare disorder like previously thought, with a global prevalence around 1%. The reason of its under-recognition is mainly referable to the fact that about half of affected people do not have the classic gastrointestinal symptoms, but they present nonspecific manifestations of nutritional deficiency or have no symptoms at all. Here we review the most recent data concerning epidemiology, pathogenesis, clinical presentation, available diagnostic tests and therapeutic management of celiac disease.
Core tip: Celiac disease is a chronic inflammatory disorder of the small intestine, produced by the ingestion of dietary gluten products in susceptible people. It is a multifactorial disease, including genetic and environmental factors. Thanks to advanced understanding of its pathogenesis, numerous therapeutic strategies have been devised for the treatment of celiac disease. But there is need of further basic research studies and randomized clinical trials to introduce them into usual management of this disease.