Pediatric and Adult Celiac Disease

A Clinically Oriented Perspective

1st Edition - February 27, 2024
Editors: Gino Roberto Corazza, Riccardo Troncone, Marco Vincenzo Lenti, Marco Silano
Language: English
Paperback ISBN:
9 7 8 - 0 - 4 4 3 - 1 3 3 5 9 - 6
eBook ISBN:
9 7 8 - 0 - 4 4 3 - 1 3 3 5 8 - 9

Pediatric and Adult Coeliac Disease: A Clinically Oriented Perspective provides an up-to-date, comprehensive, and critical overview of coeliac disease, its complications, and relat… Read more

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Pediatric and Adult Coeliac Disease: A Clinically Oriented Perspective provides an up-to-date, comprehensive, and critical overview of coeliac disease, its complications, and related disorders. The book covers epidemiological, pathogenetic, diagnostic, and treatment issues, including pediatric and adult cases, with a broad and international view. This is the perfect reference for researchers dedicated to advancing the field of translational coeliac disease research as well as clinicians who are diagnosing and managing coeliac disease throughout all of its various stages.

Cover image
Title page
Table of Contents
Copyright
Dedication
List of contributors
Preface
Chapter 1. The dynamic epidemiology of celiac disease
Abstract
1.1 Introduction
1.2 Incidence of celiac disease
1.3 Prevalence of celiac disease in the world
1.4 Factors influencing the prevalence of celiac disease
1.5 Pediatric screening for celiac disease: lessons from the Italian studies
1.6 Is the prevalence of celiac disease changing over time?
1.7 How to improve the celiac disease detection rate (unraveling the celiac iceberg)
1.8 Conclusions
References
Chapter 2. Wheat gluten proteins: from taxonomy to toxic epitopes
Abstract
2.1 Introduction
2.2 Wheat species: ancient heritage and modern cultivars
2.3 Protein wheat chemistry: albumin/globulin, gliadins, and glutenins
2.4 Technological aspects: why gluten proteins are the dough treasure?
2.5 Large utilization of vital gluten in the food industry, as additive
2.6 Resistance of gluten proteins to gastrointestinal proteases: in vitro digestion model
2.7 Immunogenicity of gluten proteins: pathogenic implication for celiac disease
2.8 QXP aminoacidic consensus for deamidation by tissue transglutaminase
2.9 In vitro tools for the identification of T-cell immunogenic peptides in gluten proteins
2.10 Wheat breeding and gene editing procedures for wheat detoxification to obtain “safe” gluten
2.11 Conclusion
References
Chapter 3. Genetic predisposition
Abstracts
3.1 Why genetics?
3.2 The human leukocyte antigen complex
3.3 Non-HLA gene
3.4 Positive selection of CD-associated gene
3.5 Shared loci and pathways with other autoimmune and inflammatory disease
3.6 Transcriptomics
3.7 Gene regulation
3.8 Conclusions
References
Chapter 4. Relevance of environmental cofactors
Abstract
4.1 Introduction
4.2 Pregnancy and birth
4.3 Geographic region (latitude)
4.4 Diet
4.5 Intestinal infections and CD
4.6 Drug exposure and CD risk
4.7 Pesticide’s and persistent organic pollutant
4.8 CD triggers in adulthood
4.9 Conclusion
References
Chapter 5. Immunological mechanisms of lesions in celiac disease
Abstract
5.1 Mechanisms controlling the immune homeostasis in the gut
5.2 HLA and tissue transglutaminase 2 in the initiation of CD-associated immune response
5.3 Role of gluten-reactive T cells
5.4 Innate immune pathways in celiac disease
5.5 Crosstalk between immune cells and stromal cells
5.6 Conclusions and future perspectives
References
Chapter 6. Celiac disease in pediatric patients
Abstract
6.1 Introduction
6.2 Epidemiology
6.3 Clinical manifestations
6.4 Potential and seronegative celiac children
6.5 Associated conditions
6.6 Complications
6.7 Diagnosing a pediatric patient
6.8 Follow-up
References
Chapter 7. Celiac disease in adult patients
Abstract
7.1 Introduction
7.2 Clinical disease presentation in adults
7.3 Gender and clinical presentation
7.4 Clinical presentation in the elderly
7.5 Celiac disease in type 1 diabetes mellitus
7.6 The optimal strategy for identifying adults with celiac disease
7.7 Follow-up of adult celiac disease patients
7.8 Mortality in celiac disease
7.9 Celiac disease during the Covid-19 pandemic
References
Chapter 8. Serology and screening in celiac disease
Abstract
8.1 Introduction
8.2 Sensitivity and specificity of serological markers: review of the literature
8.3 Different protocols in various clinical settings
8.4 High antibody titers: a different diagnostic strategy in children and adults
8.5 Case finding or mass screening: which strategy should be adopted?
8.6 Antibodies in assessing adherence and response to gluten free diet: strengths and weaknesses of serology
References
Chapter 9. Role of intestinal biopsy in childhood and adult celiac disease
Abstract
9.1 Indications to intestinal biopsy for celiac disease diagnosis
9.2 Sampling and handling of small intestinal biopsies
9.3 Histological lesions associated with celiac disease
9.4 Assessing severity of celiac disease mucosal lesions
9.5 Conclusions
References
Chapter 10. Potential celiac disease
Abstract
10.1 Introduction
10.2 Pathogenesis
10.3 Clinical aspects
10.4 Conclusions
References
Chapter 11. Chronic enteropathies with negative celiac serology in adults
Abstract
11.1 Introduction
11.2 Epidemiology of seronegative enteropathies
11.3 Pathogenesis
11.4 Long-term outcomes and mortality
11.5 Clinical features of patients with seronegative enteropathies
11.6 Methodological approach to the differential diagnosis of seronegative enteropathies
11.7 Clinical management and follow-up of seronegative enteropathies
11.8 Conclusions
References
Chapter 12. Gluten free diet, assessment of its adherence, and quality of life
Abstract
12.1 Introduction
12.2 Allowed cereals and naturally gluten-free food
12.3 Definition of safe gluten threshold
12.4 The role of gluten contamination
12.5 How to monitor gluten-free diet adherence
12.6 Living with CD
12.7 Conclusion
References
Chapter 13. Medical treatments and follow-up for clinical conditions associated to celiac disease
Abstract
13.1 Introduction
13.2 Anemia
13.3 Osteopenia and osteoporosis
13.4 Metabolic disorders
13.5 Skin disorders
13.6 Reproductive disorders
13.7 Autoimmune diseases associated to CD
13.8 Neurological and psychiatric disorders
References
Chapter 14. Refractory celiac disease and lymphomagenesis
Abstract
14.1 Introduction
14.2 Nonresponsive celiac disease
14.3 Refractory celiac disease
14.4 Enteropathy-associated T-cell lymphoma
14.5 Monomorphic epitheliotropic intestinal T-cell lymphoma and other small bowel lymphomas in celiac disease
References
Chapter 15. Infectious and other oncological complications
Abstract
15.1 Introduction
15.2 Major infections in celiac disease
15.3 Other oncological diseases
References
Chapter 16. Dermatitis herpetiformis
Abstract
16.1 Introduction
16.2 Epidemiology
16.3 Pathogenesis
16.4 Clinical manifestations
16.5 Diagnosis
16.6 Differential diagnosis
16.7 Treatment
References
Chapter 17. Nonceliac gluten-related disorders
Abstract
17.1 Introduction
17.2 Definition
17.3 Epidemiology
17.4 Etiology and pathogenesis
17.5 Clinical manifestations
17.6 Natural history and complications
17.7 Associated diseases
17.8 Diagnosis
17.9 Treatment
17.10 Different points of view
17.11 Future perspectives
17.12 Gluten/wheat-dependent neurological manifestations
References
Chapter 18. Normative framework and public health interventions for the protection of celiac disease patients
Abstract
18.1 Introduction
18.2 Why the limit of 20 ppm of gluten in gluten-free food?
18.3 The national Italian regulations
18.4 The harmonization at the European level of the normative body for gluten-free foods
18.5 The declaration of gluten presence in the foods as allergen
18.6 The regulation in countries outside Europe
18.7 Official control of gluten-free products
18.8 The subsidies from the national health systems to patients with celiac disease
18.9 Interventions to ensure an early diagnosis and the prevention of complications
18.10 Law on secreening on celiac disease and diabetes mellitus type 1
References
Chapter 19. The Role of Patients’ Associations: the Italian Celiac Association as a case of best practice
Abstract
19.1 The Italian Celiac Association: building a link between patients and institutions
19.2 AIC with respect to lifestyle, health and therapy needs of celiacs: goals and present activities
19.3 Networking European Associations: the activities of AOECS in Europe and worldwide
19.4 Focus on scientific research: AIC funding activities of the research projects
19.5 The peer review methodology
19.6 Research projects funded by AIC
References
Chapter 20. Putative therapeutic targets in celiac disease
Abstract
20.1 Introduction
20.2 Endogenous therapeutic targets
20.3 Gluten as a therapeutic target
20.4 Perspectives
References
Chapter 21. Future directions
Abstract
21.1 Introduction
21.2 What triggers chronic inflammation?
21.3 Intestinal barrier function
21.4 The first 1000 days of life to program the immune system
21.5 The microbiome and its possible epigenetic role in chronic inflammatory disease pathogenesis
21.6 Developing therapeutic targets
21.7 Artificial intelligence to implement personalized medicine and primary prevention
21.8 Novel therapeutic approaches for celiac disease personalized interventions
21.9 Celiac disease primary prevention
21.10 Conclusions
References
Index

Gino Roberto Corazza

Dr. Corazza is Emeritus Professor of Internal Medicine at the University of Pavia, Italy. He got a specialization in Internal Medicine and Gastroenterology, and he spent a training period at the University of Leeds, focusing on intestinal diseases and malabsorption, under the direction of Professor Monty S. Losowsky (1978-1980). His research activity has mainly focused on celiac disease, other food intolerances, and inflammatory bowel disease. He has won multiple scientific awards, and he has been Editor of several Internal Medicine and Medical Therapeutics volumes and textbooks. He has served in the Scientific Board of the Italian Society of Gastroenterology, and, at present, he is an honorary member of the same Society. He has also served in the Executive Council of the Italian Society of Internal Medicine, and he has been elected as President in the years 2013-2015. Currently, he is Honorary President of the same Society. Moreover, he has been President of the Scientific Board of the Italian Celiac Association (AIC), and he is still a member of the Scientific Board. He was named a member of the Select Committee of Selection of Scientific Programs of the Ministry of University and the Group of Experts of Rating Research Products - Medical Sciences Area (GEV06).

Affiliations and expertise

Emeritus Professor of Internal Medicine, Department of Internal Medicine, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

Riccardo Troncone

Dr. Troncone is Full Professor and Head of the Department of Pediatrics at the University Federico II in Naples, Italy. His specialty is Pediatrics, but he has also been trained in mucosal immunology (1985-1987) at the University of Edinburgh under the direction of Professor Anne Ferguson. Celiac disease (CD) represents his main research field and most of his scientific production is focused on this area. He contributed, among others, to research areas such as mucosal cytokines, tissue transglutaminase (tTG) antibodies and the relationship of CD with autoimmune diseases. In the 5th framework he has been coordinator of the subproject Pathogenesis within the EU-Cluster on Celiac Disease (Coeliac-EU/cluster N°QLRT-1999-00037).

Affiliations and expertise

Full Professor and Head, Department of Pediatrics, University of Naples, Naples, Italy

Marco Vincenzo Lenti

Dr. Marco Vincenzo Lenti is Associate Professor of Internal Medicine at the University of Pavia and Gastroenterology Consultant at the Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. He has spent part of his training as a research fellow at the Gastroenterology Clinic of St. James’s Hospital, University of Leeds, UK. He has always been interested in clinical and translational research in the field of internal medicine and gastroenterology. He has led, coordinated, and taken part to several national and international mono- or multicenter studies regarding celiac disease, autoimmune gastritis, inflammatory bowel disease, and clinical complexity, which are the main fields of his research activity. He is currently a member of the Scientific Board of the Italian Society of Gastroenterology. He has won, as principal investigator, several competitive national and international grants, including one supported by the United European Gastroenterology for the writing of international guidelines on malabsorption.

Affiliations and expertise

Associate Professor of Internal Medicine, Department of Internal Medicine, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

Marco Silano

Dr. Marco Silano is currently Research Director, Director of the Department of Cardiovascular and Endocrine-metabolic Diseases and Aging, and Acting Director of the National center of Rare Diseases, Istituto Superiore di Sanità, Rome, Italy. He graduated from the Catholic University of the Sacred Heart in Rome and specialized in Pediatrics at the University of Milan. He has been serving as Coordinator of the Scientific Board of the Italian Celiac Patients Association (AIC). He is Member of the National Committee for Food Safety and Nutrition and of the Working Group for Food Security at the Italian Ministry of Health.

Affiliations and expertise

Research Director, Head of the Department of Cardiovascular and Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy