Celiac disease: novelties in etiopathogenesis, diagnosis and therapy
Celiac disease is a typical autoimmune disease in the pathogenesis of which a gluten participates as the main environmental factor. Patients have a genetic predisposition characterized by HLA DQ2 and DQ8 heterodimers, and the activated innate and acquired immune response leads to damage to the mucosa of the small intestine and the production of auto-antibodies. The diagnosis of celiac disease is based on the clinical presentation, serological tests and the pathohistological findings of a biopsy of the mucosa of the small intestine, whereby the patient should be exposed to gluten. To confirm the disease, positive specific antibodies are required along with pathohistological evidence of atrophy of the intestinal mucosa. In case of discordant serology findings and pathohistological findings, it is necessary to perform genetic testing. For now, a strict, lifelong gluten-free diet is the only treatment for celiac disease, and numerous molecules that participate in various stages of the diseas’s pathogenesis are being clinically tested.
Key words:
celiac disease; diagnostic procedure; pathogenesis; therapy
