Recent advances in the understanding of celiac disease: therapeutic implications for the management of pediatric patients

Celiac disease (CD) is an autoimmune condition occurring in genetically susceptible individuals characterized by inflammatory injury to the mucosa of the small intestine after the ingestion of wheat glutens or related barley and rye products. Originally thought to be highly prevalent only in Norther...

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Bibliographic Details
Published in:Paediatric drugs 2006, Vol.8 (6), p.375-388
Main Authors: Kwon, John H, Farrell, Richard J
Format: Article
Language:English
Subjects:
Adolescent
Age Distribution
Celiac Disease - diagnosis
Celiac Disease - epidemiology
Celiac Disease - therapy
Child
Child, Preschool
Food Handling
Glutens - adverse effects
Humans
Incidence
Plant Proteins - adverse effects
Triticum
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Summary:Celiac disease (CD) is an autoimmune condition occurring in genetically susceptible individuals characterized by inflammatory injury to the mucosa of the small intestine after the ingestion of wheat glutens or related barley and rye products. Originally thought to be highly prevalent only in Northern European populations, growing evidence indicates a much higher prevalence in many other regions, including the US as well as South America, North Africa, and Asia. The growing awareness that pediatric patients may present with quite diverse and protean manifestations and the significant impact of CD on childhood development has prompted efforts to increase CD awareness for the early diagnosis and treatment of this disease. The current diagnostic criteria for CD requires characteristic histologic findings in small bowel biopsies and clinical remission when placed on a gluten-free diet. Serologic testing for CD can provide additional support for the diagnosis of CD or a means to assess efficacy and adherence to a gluten-free diet. The mainstay of treatment remains the institution of a gluten-free diet. However, patients with refractory CD may require treatment with immunosuppressant medications. With the increased identification of specific gluten epitopes and understanding of the pathogenesis of CD, future therapies may rely on genetically altering gluten proteins, immunization techniques, or therapies focused on either the development of specific immune tolerance or regulation of mucosal inflammation.
ISSN:1174-5878
DOI:10.2165/00148581-200608060-00005