1 2 Lebwohl B, Ludvigsson JF, Green PH (tháng 10 năm 2015). “Celiac disease and non-celiac gluten sensitivity”. BMJ (Review). 351: h4347. doi:10.1136/bmj.h4347. PMC4596973. PMID26438584. Celiac disease occurs in about 1% of the population worldwide, although most people with the condition are undiagnosed. It can cause a wide variety of symptoms, both intestinal and extra-intestinal because it is a systemic autoimmune disease that is triggered by dietary gluten. Patients with coeliac disease are at increased risk of cancer, including a twofold to fourfold increased risk of non-Hodgkin’s lymphoma and a more than 30-fold increased risk of small intestinal adenocarcinoma, and they have a 1.4-fold increased risk of death.
1 2 3 Lundin KE, Wijmenga C (tháng 9 năm 2015). “Coeliac disease and autoimmune disease-genetic overlap and screening”. Nature Reviews. Gastroenterology & Hepatology (Review). 12 (9): 507–15. doi:10.1038/nrgastro.2015.136. PMID26303674. The abnormal immunological response elicited by gluten-derived proteins can lead to the production of several different autoantibodies, which affect different systems.
1 2 3 4 Ciccocioppo R, Kruzliak P, Cangemi GC, Pohanka M, Betti E, Lauret E, Rodrigo L (ngày 22 tháng 10 năm 2015). “The Spectrum of Differences between Childhood and Adulthood Celiac Disease”. Nutrients (Review). 7 (10): 8733–51. doi:10.3390/nu7105426. PMC4632446. PMID26506381. Several additional studies in extensive series of coeliac patients have clearly shown that TG2A sensitivity varies depending on the severity of duodenal damage, and reaches almost 100% in the presence of complete villous atrophy (more common in children under three years), 70% for subtotal atrophy, and up to 30% when only an increase in IELs is present. (IELs: intraepithelial lymphocytes)
↑ Lionetti E, Francavilla R, Pavone P, Pavone L, Francavilla T, Pulvirenti A, Giugno R, Ruggieri M (tháng 8 năm 2010). “The neurology of coeliac disease in childhood: what is the evidence? A systematic review and meta-analysis”. Developmental Medicine and Child Neurology. 52 (8): 700–7. doi:10.1111/j.1469-8749.2010.03647.x. PMID20345955.
1 2 3 4 Husby S, Koletzko S, Korponay-Szabó IR, Mearin ML, Phillips A, Shamir R, Troncone R, Giersiepen K, Branski D, Catassi C, Lelgeman M, Mäki M, Ribes-Koninckx C, Ventura A, Zimmer KP, ESPGHAN Working Group on Coeliac Disease Diagnosis; ESPGHAN Gastroenterology Committee; European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (tháng 1 năm 2012). “European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease” (PDF). J Pediatr Gastroenterol Nutr (Practice Guideline). 54 (1): 136–60. doi:10.1097/MPG.0b013e31821a23d0. PMID22197856. Lưu trữ (PDF) bản gốc ngày 3 tháng 4 năm 2016. Since 1990, the understanding of the pathological processes of CD has increased enormously, leading to a change in the clinical paradigm of CD from a chronic, gluten-dependent enteropathy of childhood to a systemic disease with chronic immune features affecting different organ systems. (...) atypical symptoms may be considerably more common than classic symptoms
1 2 Vivas S, Vaquero L, Rodríguez-Martín L, Caminero A (tháng 11 năm 2015). “Age-related differences in celiac disease: Specific characteristics of adult presentation”. World Journal of Gastrointestinal Pharmacology and Therapeutics (Review). 6 (4): 207–12. doi:10.4292/wjgpt.v6.i4.207. PMC4635160. PMID26558154. In addition, the presence of intraepithelial lymphocytosis and/or villous atrophy and crypt hyperplasia of small-bowel mucosa, and clinical remission after withdrawal of gluten from the diet, are also used for diagnosis antitransglutaminase antibody (tTGA) titers and the degree of histological lesions inversely correlate with age. Thus, as the age of diagnosis increases antibody titers decrease and histological damage is less marked. It is common to find adults without villous atrophy showing only an inflammatory pattern in duodenal mucosa biopsies: Lymphocytic enteritis (Marsh I) or added crypt hyperplasia (Marsh II)
↑ Ferri, Fred F. (2010). Ferri's differential diagnosis: a practical guide to the differential diagnosis of symptoms, signs, and clinical disorders (ấn bản 2). Philadelphia, PA: Elsevier/Mosby. tr. Chapter C. ISBN0323076998.
1 2 See JA, Kaukinen K, Makharia GK, Gibson PR, Murray JA (tháng 10 năm 2015). “Practical insights into gluten-free diets”. Nature Reviews. Gastroenterology & Hepatology (Review). 12 (10): 580–91. doi:10.1038/nrgastro.2015.156. PMID26392070. A lack of symptoms and/or negative serological markers are not reliable indicators of mucosal response to the diet. Furthermore, up to 30% of patients continue to have gastrointestinal symptoms despite a strict GFD.122,124 If adherence is questioned, a structured interview by a qualified dietitian can help to identify both intentional and inadvertent sources of gluten.
1 2 Fasano A, Catassi C (tháng 12 năm 2012). “Clinical practice. Celiac disease”. The New England Journal of Medicine (Review). 367 (25): 2419–26. doi:10.1056/NEJMcp1113994. PMID23252527.
↑ Newnham, Evan D (2017). “Coeliac disease in the 21st century: Paradigm shifts in the modern age”. Journal of Gastroenterology and Hepatology. 32: 82–85. doi:10.1111/jgh.13704. PMID28244672. Presentation of CD with malabsorptive symptoms or malnutrition is now the exception rather than the rule.
↑ Tonutti E, Bizzaro N (2014). “Diagnosis and classification of celiac disease and gluten sensitivity”. Autoimmun Rev (Review). 13 (4–5): 472–6. doi:10.1016/j.autrev.2014.01.043. PMID24440147.
↑ Pinto-Sánchez MI, Causada-Calo N, Bercik P, Ford AC, Murray JA, Armstrong D, Semrad C, Kupfer SS, Alaedini A, Moayyedi P, Leffler DA, Verdú EF, Green P (tháng 8 năm 2017). “Safety of Adding Oats to a Gluten-Free Diet for Patients With Celiac Disease: Systematic Review and Meta-analysis of Clinical and Observational Studies”. Gastroenterology. 153 (2): 395–409.e3. doi:10.1053/j.gastro.2017.04.009. PMID28431885.
1 2 3 4 Comino I, Moreno M, Sousa C (tháng 11 năm 2015). “Role of oats in celiac disease”. World Journal of Gastroenterology. 21 (41): 11825–31. doi:10.3748/wjg.v21.i41.11825. PMC4631980. PMID26557006. It is necessary to consider that oats include many varieties, containing various amino acid sequences and showing different immunoreactivities associated with toxic prolamins. As a result, several studies have shown that the immunogenicity of oats varies depending on the cultivar consumed. Thus, it is essential to thoroughly study the variety of oats used in a food ingredient before including it in a gluten-free diet.
↑ Matthias T, Pfeiffer S, Selmi C, Eric Gershwin M (tháng 4 năm 2010). “Diagnostic challenges in celiac disease and the role of the tissue transglutaminase-neo-epitope”. Clin Rev Allergy Immunol (Review). 38 (2–3): 298–301. doi:10.1007/s12016-009-8160-z. PMID19629760.
↑ Lewis NR, Scott BB (tháng 7 năm 2006). “Systematic review: the use of serology to exclude or diagnose coeliac disease (a comparison of the endomysial and tissue transglutaminase antibody tests)”. Alimentary Pharmacology & Therapeutics. 24 (1): 47–54. doi:10.1111/j.1365-2036.2006.02967.x. PMID16803602.
↑ Molina-Infante J, Santolaria S, Sanders DS, Fernández-Bañares F (tháng 5 năm 2015). “Systematic review: noncoeliac gluten sensitivity”. Alimentary Pharmacology & Therapeutics (Review). 41 (9): 807–20. doi:10.1111/apt.13155. PMID25753138. Furthermore, seronegativity is more common in coeliac disease patients without villous atrophy (Marsh 1-2 lesions), but these ‘minor’ forms of coeliac disease may have similar clinical manifestations to those with villous atrophy and may show similar clinical–histological remission with reversal of haematological or biochemical disturbances on a gluten-free diet (GFD).
↑ Bibbins-Domingo K, Grossman DC, Curry SJ, Barry MJ, Davidson KW, Doubeni CA, Ebell M, Epling JW, Herzstein J, Kemper AR, Krist AH, Kurth AE, Landefeld CS, Mangione CM, Phipps MG, Silverstein M, Simon MA, Tseng CW (tháng 3 năm 2017). “Screening for Celiac Disease: US Preventive Services Task Force Recommendation Statement”. JAMA. 317 (12): 1252–1257. doi:10.1001/jama.2017.1462. PMID28350936.
1 2 Lionetti E, Gatti S, Pulvirenti A, Catassi C (tháng 6 năm 2015). “Celiac disease from a global perspective”. Best Practice & Research. Clinical Gastroenterology (Review). 29 (3): 365–79. doi:10.1016/j.bpg.2015.05.004. PMID26060103.
↑ Hischenhuber C, Crevel R, Jarry B, Mäki M, Moneret-Vautrin DA, Romano A, Troncone R, Ward R (tháng 3 năm 2006). “Review article: safe amounts of gluten for patients with wheat allergy or coeliac disease”. Alimentary Pharmacology & Therapeutics. 23 (5): 559–75. doi:10.1111/j.1365-2036.2006.02768.x. PMID16480395.
↑ “American Gastroenterological Association medical position statement: Celiac Sprue”. Gastroenterology. 120 (6): 1522–5. 2001. doi:10.1053/gast.2001.24055. PMID11313323.
↑ Presutti RJ, Cangemi JR, Cassidy HD, Hill DA (2007). “Celiac disease”. Am Fam Physician. 76 (12): 1795–802. PMID18217518.
1 2 Pietzak MM (2014). “Dietary supplements in celiac disease”. Trong Rampertab SD, Mullin GE (biên tập). Celiac disease. tr. 137–59. ISBN978-1-4614-8559-9.
↑ Tersigni C, Castellani R, de Waure C, Fattorossi A, De Spirito M, Gasbarrini A, Scambia G, Di Simone N (2014). “Celiac disease and reproductive disorders: meta-analysis of epidemiologic associations and potential pathogenic mechanisms”. Human Reproduction Update. 20 (4): 582–93. doi:10.1093/humupd/dmu007. PMID24619876.
1 2 Biesiekierski, Jessica R (2017). “What is gluten?”. Journal of Gastroenterology and Hepatology. 32: 78–81. doi:10.1111/jgh.13703. PMID28244676. Similar proteins to the gliadin found in wheat exist as secalin in rye, hordein in barley, and avenins in oats and are collectively referred to as "gluten." Derivatives of these grains such as triticale and malt and other ancient wheat varieties such as spelt and kamut also contain gluten. The gluten found in all of these grains has been identified as the component capable of triggering the immune-mediated disorder, coeliac disease.
↑ Pinto-Sánchez MI, Verdu EF, Liu E, Bercik P, Green PH, Murray JA, Guandalini S, Moayyedi P (tháng 1 năm 2016). “Gluten Introduction to Infant Feeding and Risk of Celiac Disease: Systematic Review and Meta-Analysis”. The Journal of Pediatrics. 168: 132–43.e3. doi:10.1016/j.jpeds.2015.09.032. PMID26500108.
↑ Ierodiakonou D, Garcia-Larsen V, Logan A, Groome A, Cunha S, Chivinge J, Robinson Z, Geoghegan N, Jarrold K, Reeves T, Tagiyeva-Milne N, Nurmatov U, Trivella M, Leonardi-Bee J, Boyle RJ (tháng 9 năm 2016). “Timing of Allergenic Food Introduction to the Infant Diet and Risk of Allergic or Autoimmune Disease: A Systematic Review and Meta-analysis”. JAMA. 316 (11): 1181–1192. doi:10.1001/jama.2016.12623. PMID27654604.
↑ Lionetti E, Castellaneta S, Francavilla R, Pulvirenti A, Tonutti E, Amarri S, Barbato M, Barbera C, Barera G, Bellantoni A, Castellano E, Guariso G, Limongelli MG, Pellegrino S, Polloni C, Ughi C, Zuin G, Fasano A, Catassi C (tháng 10 năm 2014). “Introduction of gluten, HLA status, and the risk of celiac disease in children”. The New England Journal of Medicine (comparative study). 371 (14): 1295–303. doi:10.1056/NEJMoa1400697. PMID25271602.
