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Hello. My name is
Dr. Maureen Leonard.
I'm the Clinical Director at
the Center for Celiac
Research and Treatment at
Mass General Hospital
for Children and
an Assistant Professor of
pediatrics at Harvard
Medical School.
Today, I'm going to talk about
gluten-related disorders.
0:19
The objectives of this talk
are to provide an overview of
gluten-related
disorders including
celiac disease and non-celiac
gluten sensitivity,
describe the treatment of
gluten-related disorders,
and review what is still
unknown about
gluten-related disorders.
0:35
I'd like to start
with an overview of
gluten-related disorders
which encompass
celiac disease and
autoimmune conditions
triggered by gluten ingestion in
genetically compatible
individuals,
wheat allergy, an IgE-mediated
response to wheat in
which a patient may
develop lip and throat
swelling, difficulty breathing,
and ultimately anaphylaxis which
is diagnosed by a
combination of blood test,
skin prick testing,
and oral challenge,
and finally non-celiac
gluten sensitivity,
which is an entity with
an unknown
pathophysiology for which
a diagnosis is made
in patients who
have symptoms when
ingesting gluten,
but for whom celiac disease
and what allergy
have been ruled out.
In this lecture, we'll focus on
celiac disease and non-celiac
gluten sensitivity.
1:24
Before discussing
these disorders,
it's important to review
exactly what gluten is.
Gluten is a protein
found in the grains,
wheat, rye, and barley.
It's a composite protein made
up of gliadin and glutenin.
When we talk about
celiac disease,
we focus on gliadin because it's
the known trigger of
inflammation in celiac disease.
No one can completely
digest gluten.
Therefore, these
molecules are left to
interact with the small
intestinal epithelium.
Research has shown
that peptides within
gliadin elicit and contribute
to an immune response.
For example,
some areas within the protein
are known to be cytotoxic,
others are known
to contribute to
increased intestinal
permeability,
and still, others have
been shown to stimulate
the release of
pro-inflammatory cytokines.
Before discussing non-celiac
gluten sensitivity,
