Does gluten intake influence the development of celiac disease-associated complications?

Luca Elli, Valentina Discepolo, Maria T. Bardella, Stefano Guandalini

Research output: Contribution to journalArticle

Abstract

Celiac disease (CD) is regarded as the most common autoimmune enteropathy in western countries. Epidemiological studies indicate that approximately 1:100 individuals may present with histologically proven CD. CD develops in genetically predisposed subjects after gluten ingestion. It usually subsides after gluten is withdrawn from their diet. Gluten is the only known environmental factor that affects the progression/regression of the intestinal villous atrophy, which is the hallmark of this disease. CD generally follows a benign course after gluten elimination. However, it is also associated with the development of other autoimmune disorders or of intestinal malignancies. The issue of whether such complications, sometimes of significant clinical and prognostic impact, are or are not the result of ongoing gluten ingestion, is an important one that has been investigated over the recent years with conflicting results. In terms of practical implications, the presence of a positive correlation between gluten intake and the development of severe complications would lead to the need for early diagnosis and mass screening. The lack of such correlation would instead suggest a less aggressive diagnostic strategy. This review aims at critically summarizing the evidence supporting either hypothesis.

Original languageEnglish
Pages (from-to)13-20
Number of pages8
JournalJournal of Clinical Gastroenterology
Volume48
Issue number1
DOIs
Publication statusPublished - Jan 2014

Keywords

  • autoimmune disease
  • celiac disease
  • gluten
  • gluten-free diet
  • lymphoma
  • malignancy

ASJC Scopus subject areas

  • Gastroenterology

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