Advances in celiac disease

Celiac disease (CD) is a T-lymphocyte mediated small intestinal enteropathy induced by gluten. In genetically predisposed individuals, certain epitopes on the gluten protein, after processing by tissue transglutaminase, activate the immune response. The disease is much more common than previously appreciated with a prevalence of 0.5% to 1% of the population. Intestinal manifestations of CD may be entirely absent or overshadowed by extra intestinal manifestations. Serological markers are used to select patients in need for intestinal biopsy, which remains mandatory for establishing the diagnosis. With new insights into the pathogenesis of CD, the medical community enters an era where new treatment modalities, in addition to gluten-free diet, may turn into reality.