Edi o ial
Coeliac Disease
Ra aella Nenna,1S e ano Guandalini,2Alina Popp,3and Kalle Ku ppa4
1Depa men o Paedia ics, “Sapienza” Uni e si y o Rome, I aly
2Sec ion o Gas oen e ology, Depa men o Pedia ics, Uni e si y o Chicago, Chicago, IL, USA
3Uni e si y o Medicine and Pha macy “Ca ol Da ila”, Bucha es , Romania
4Tampe e Cen e o Child Heal h Resea ch, Uni e si y o Tampe e and Tampe e Uni e si y Hospi al, Finland
Co espondence should be add essed o Ra aella Nenna; a aella.nenna@uni oma1.i
Recei ed 13 May 2014; Accep ed 13 May 2014; Published 28 May 2014
Copy igh © 2014 Ra aella Nenna e al. This is an open access a icle dis ibu ed unde he C ea i e Commons A ibu ion License,
which pe mi s un es ic ed use, dis ibu ion, and ep oduc ion in any medium, p o ided he o iginal wo k is p ope ly ci ed.
Celiacdiseaseisanau oimmunediso de ,causedbya
pe manen in ole ance o glu en con ained in whea and o
simila p olamines p esen in ba ley and ye. I is a common
disease as i s p e alence, in Caucasian popula ions, is abou
1%. The e a e se e al pa e ns o clinical p esen a ion: ypical
(wi h gas oin es inal symp oms), a ypical (ex ain es inal
mani es a ions), and silen o ms, all cha ac e ized by ypical
his ological lesions in he small bowel mucosa. Nowadays
he glu en- ee die o li e is he only he apy a ailable o
CD. Conside able p og ess has been made due o ad ances in
molecula biology, which ha e allowed be e unde s anding
o he gene ic mechanisms in ol ed in CD and he iden i ica-
ion o new pa hogene ic pa hways ha ha e he po en ial o
be a ge ed by new d ugs. In his special issue, we ha e in i ed
au ho s o con ibu e o iginal pape s ha will s imula e
he con inuing e o s o unde s and he pa hogenesis and
he e ogeneous clinical p esen a ion o celiac disease.
Immunogenic pep ides, c ea ed by deamida ion o ood-
de i ed gliadin pep ides by small in es inal issue ansglu-
aminase, a e p esen ed by an igen-p esen ing cells, mos ly
dend i ic cells bea ing HLA-DQ2 and DQ8 molecules, o
p oin lamma o y CD4+ T cells, ac i a ing hem. E. Liu e al.
in es iga ed pe iphe al T cell esponses om young child en
wi h newly diagnosed CD p io o ea men wi h a glu en-
ee die , inding ha T cell eac i i y is he e ogeneous bu
a o s eac i i y wi h 𝛼-gliadin epi opes mo e han 𝛾-gliadin.
Me abolomics is a apidly eme ging new concep in
science ha appea s o ha e ele an applica ion also in he
ield o celiac disease. In hei me iculous e iew, A. Cal-
ab `
o e al. highligh he me abolomics pe spec i e on celiac
disease. Fu he mo e, he g owing ecogni ion o he impo -
an ole o gu mic obio a in he de elopmen o celiac
disease and o he ood- ela ed diso de s is add essed and
ho oughly e iewed.
Healing o he small bowel mucosa is di ec ly dependen
on he adhe ence o he glu en- ee die , and i s assessmen
by nonin asi e ools has been a long- ime objec i e o
esea ch in celiac disease, wi h he aim o es ablishing sui able
minimally in asi e me hods bo h o diagnosing and o
adequa e ollow-up o celiac disease and o he adequacy o
he glu en- ee die . In hei s udy, E. T igoni e al. concluded
ha an i-endomysium an ibodies had be e abili y, a leas in
adul indi iduals, han an i- issue ansglu aminase o p edic
celiac disease and o assess he glu en- ee die in he c i ical
pe iod o he i s semes e a e diagnosis and he beginning
o he die .
Among he a ypical clinical o ms o CD, o al signs a e
o enneglec edbu couldo e impo an diagnos icclues
in challenging diagnoses. Lesions in he o al mucosa o
de ec s in den al enamel can in ac be p esen in celiac
pa ien s. The pape o M. E iu e al., e alua ing o al signs and
di e en DQ2 haplo ypes, highligh s he undamen al ole
ha den is s can play in ea ly ecogni ion o CD.
I is well known ha un ea ed celiac disease pa ien s
de elop speci ic se um au oan ibodies agains ansglu am-
inase 2. Recen ly i has been disco e ed ha co esponding
ci cula ing an ibodies agains ansglu aminase 6 (TG6) may
play a ole in pa icula glu en- ela ed neu ological diso de s.
In hei s udy, R. S enbe g e al. demons a e ha he p esence
o an i-TG6 an ibodies is inc eased in subjec s wi h ea ly
Hindawi Publishing Co po a ion
Au oimmune Diseases
Volume 2014, A icle ID 623784, 2 pages
h p://dx.doi.o g/10.1155/2014/623784
2Au oimmune Diseases
neu ological inju y esul ing in ce eb al palsy, sugges ing
ha an ea ly b ain insul may lead o subsequen TG6 au o-
immuni y.
Due o hei common gene ic backg ound, celiac disease,
ype 1 diabe es melli us, and au oimmune hy oidi is a e
o en associa ed. M. an de Pals e al. con i med h ee
imes highe p e alence o hy oid au oimmuni y ma ke s
(au oan ibodies agains hy oid pe oxidase) in celiac disease
child en compa ed wi h 12-yea -old heal hy con ols bu
no di e ence in hy oid au oimmuni y be ween clinically
de ec ed and sc een-de ec ed celiac disease child en.
Ra aella Nenna
S e ano Guandalini
Alina Popp
Kalle Ku ppa