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Printable Handouts
Navigable Slide Index
- Introduction
- Gluten
- Celiac disease (CD)
- Gluten structure
- CD - damaged small intestine lining
- The four degrees of intestinal atrophy in CD
- Genetic basis of CD
- Prevalence of celiac disease
- Reasons for the increased incidence of CD
- Clinical presentations
- Multiple clinical presentations of celiac disease
- Historical photo of celiac child
- The celiac iceberg
- Pathogenesis
- Adverse effects of gluten
- CD pathogenesis
- Food additive breach intestinal permeability
- The HLA-DQ 2/8 grove
- Proinflammatory trigger
- Anti endomysial antibody: marker of CD
- Other serological markers of CD
- Decision flowchart: diagnostic evaluation of CD
- Summary – antibodies in CD
- Sera immunoreactivity of neo-epitopes
- Antibodies’ activity and intestinal damage
- Sensitivity and specificity of CD biomarkers
- High risk groups who should be screened
- The importance of early diagnosis
- Cumulative risk of other autoimmune disease
- The difficulties to follow gluten-free diet
- New therapeutic strategies for CD
- Gluten dependent conditions
- Gluten dependent disease compared to IBS
- The debate continues…
- Cross linking capacities of the mTg
- Pathophysiological summary - tTg
- Pathophysiological summary - mTg
- CD take home messages
- Acknowledgements
Topics Covered
- Celiac disease as a multi-faced, gluten dependent, autoimmune disease
- Substantial change in epidemiology and clinical presentations in the last decades
- The growing list of environmental factors
- Microbial transglutaminase (mTg)
- Diagnostic biomarkers (EMA, tTg, DGP, neo-tTg, neo-mTg)
- Expansion of gluten dependent conditions
- The problem of gluten free diet compliance
- Impacting the environmental factors
Links
Series:
Categories:
Therapeutic Areas:
Talk Citation
Lerner, A. (2018, May 1). An update on the multiple faces of celiac disease [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved December 3, 2024, from https://doi.org/10.69645/KGTI1661.Export Citation (RIS)
Publication History
Financial Disclosures
- Prof. Aaron Lerner has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
An update on the multiple faces of celiac disease
Other Talks in the Series: Periodic Reports: Advances in Clinical Interventions and Research Platforms
Transcript
Please wait while the transcript is being prepared...
0:00
My name is Professor Aaron Lerner.
I am a pediatrician,
specializes in Pediatric Gastroenterology and Nutrition,
and the Adult Gastroenterology.
Originally, I am from Israel,
from the Technion - Israel Institute of Technology.
But now, I am doing my research in the Aesku.Kipp Institute in Germany.
We are going to talk about some updates on the multiple faces of Celiac disease.
0:27
In fact, we are talking about a lot of products that contains
gluten and gluten is the main environmental inducer of Celiac disease.
But before starting, let's have a definition.
What is Celiac disease?
0:44
Celiac disease is an autoimmune disorder elicited on
genetically predisposed individuals that are consuming gluten-containing grains.
The gluten is the offending agent but
there are some other prolamins that the patients are not allowed to ingest.
I'm talking about wheat,
barley, rye, and oats.
Epidemiologically speaking, the incidence is one to two percent in the population.
However, there are some Nordic countries like Sweden, Norway,
Ireland, most of the Germany, Finland,
etc, where the incidence is above two percent.
In the last couple of years,
there were some observations that in the Sahara desert,
some tribes, they have
an increased incidence of Celiac disease amounting to six to seven percent.
This is most probably because of genetic inbreeding.
Their disease has some geographical ingredient.
It is much more in the Northern,
in the Western countries.
We are talking about life-long and gluten-dependent autoimmune condition.
Being auto-immune, there is always some genetic aspect to it.
But always, there are environmental factors and more and more,
we are discovering much more environmental factors.
Up 'til now, gluten is the causative.
However, many others associated environmental factors were suggested like infection,
be it viral or bacterial;
the age of the infant; the infant nutrition;
the amount and the type of gluten ingested during the first year of life;
early antibiotics in the first year of life;
microbiota or dysbiota ratio is most probably contributing to a lot of the disease;
and lately, the couple of publication about
industrial processed food additives that they may affect Celiac disease.
Of course nowadays, some modern
lifestyle can affect the disease like the amount of stress, etc.
Clinically speaking, there is epidemiological shift in the disease phenotype.
The disease is much more prevalent in the last three or four decades in advanced age,
and the clinical presentation is much more subtle.
We see more and more latent hypo-symptomatic or asymptomatic presentation.
We know also the evolutionary aspect of wheat might be important because during evolution,
I'm talking about the last 10,000 years,
the gluten content toxicity and immunogenicity is increasing in the wheat.