Reviews
15 February 2005

Narrative Review: Celiac Disease: Understanding a Complex Autoimmune Disorder

Publication: Annals of Internal Medicine
Volume 142, Number 4

Abstract

Celiac disease is a common autoimmune disorder that has genetic, environmental, and immunologic components. It is characterized by an immune response to ingested wheat gluten and related proteins of rye and barley that leads to inflammation, villous atrophy, and crypt hyperplasia in the intestine. The disease is closely associated with genes that code for human leukocyte antigens DQ2 and DQ8. Transglutaminase 2 appears to be an important component of the disease, both as a deamidating enzyme that can enhance the immunostimulatory effect of gluten and as a target autoantigen in the immune response. Sensitive and specific serologic tests, including those for anti–transglutaminase antibody, are facilitating fast and noninvasive screening for celiac disease. Thus, they are contributing to a more accurate estimate of the prevalence of the disease and its association with other disorders. Celiac disease is associated with increased rates of anemia, osteoporosis, cancer, neurologic deficits, and additional autoimmune disorders. A gluten-free diet is the mainstay of safe and effective treatment of celiac disease, although its effect on some of the extraintestinal manifestations of the disease remains to be determined.

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Information & Authors

Information

Published In

cover image Annals of Internal Medicine
Annals of Internal Medicine
Volume 142Number 415 February 2005
Pages: 289 - 298

History

Published online: 15 February 2005
Published in issue: 15 February 2005

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Authors

Affiliations

Armin Alaedini, PhD
From Cornell University and Columbia University, New York, New York.
Peter H.R. Green, MD
From Cornell University and Columbia University, New York, New York.
Corresponding Author: Armin Alaedini, PhD, Department of Neurology and Neuroscience, LC-807, Cornell University, 1300 York Avenue, New York, NY 10021; e-mail, [email protected].
Disclosures: Consultancies and Honoraria: P.H.R. Green (Prometheus Laboratory).
Current Author Addresses: Dr. Alaedini: Department of Neurology and Neuroscience, LC-807, Cornell University, 1300 York Avenue, New York, NY 10021.
Dr. Green: Department of Medicine, Room 645, Columbia University, 161 Fort Washington Avenue, New York, NY 10032.

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Armin Alaedini, Peter H.R. Green. Narrative Review: Celiac Disease: Understanding a Complex Autoimmune Disorder. Ann Intern Med.2005;142:289-298. [Epub 15 February 2005]. doi:10.7326/0003-4819-142-4-200502150-00011

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