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Dtsch Med Wochenschr 2022; 147(08): 460-469
DOI: 10.1055/a-1520-4184
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Neues zur Zöliakie

Update on celiac disease
Lukas Poralla
,
Michael Schumann
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Die Zöliakie ist eine T-Zell-vermittelte Autoimmunerkrankung. Da Gluten wie ein Trigger dieser Autoimmunreaktion fungiert, entstehen bei der Zöliakie Einblicke in die immunpathologischen Zusammenhänge, die die Entwicklung neuer Therapeutika ermöglichen. Dies und Zusammenfassungen relevanter Empfehlungen der in diesem Jahr erscheinenden, aktualisierten Zöliakie-Leitlinie sind Thema des folgenden Artikels.

Abstract

Celiac disease is a T-cell-mediated autoimmune disorder. It is relevant to us for two very different reasons. Firstly, it has a prevalence of 1 % in the European population. Thus, a huge number of celiac patients remains undiagnosed. Secondly, the celiac trigger, gluten, functions as a “switch”, that has the potential to selectively activate celiac immune pathology, thereby allowing us to uncover previously unknown immune conditions. This again contributes to new celiac treatment modalities that will presumably alleviate the future fate of celiac disease patients. In 2022, the German guidelines for celiac disease are published by the Deutsche Gesellschaft für Verdauungs- und Stoffwechselkrankheiten (DGVS). We have summarized some of the recommendations published therein.

Schlüsselwörter

Zöliakie - Gluten - Malabsorption - Enteropathie - refraktäre Zöliakie

Key words

celiac disease - gluten - malabsorption - enteropathy - refractory celiac disease


Publication History

Article published online:
11 April 2022

© 2022. Thieme. All rights reserved.

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  • Literatur

  • 1 Felber J, Aust D, Baas S. et al. [Results of a S2k-Consensus Conference of the German Society of Gastroenterolgy, Digestive- and Metabolic Diseases (DGVS) in conjunction with the German Coeliac Society (DZG) regarding coeliac disease, wheat allergy and wheat sensitivity]. Z Gastroenterol 2014; 52: 711-743
    Thieme ConnectPubMedSearch in Google Scholar
  • 2 Laass MW, Schmitz R, Uhlig HH. et al. The prevalence of celiac disease in children and adolescents in Germany. Dtsch Ärztebl Int 2015; 112: 553-560
    PubMedSearch in Google Scholar
  • 3 Shan L, Molberg O, Parrot I. et al. Structural basis for gluten intolerance in celiac sprue. Science 2002; 297: 2275-2279
    CrossrefPubMedSearch in Google Scholar
  • 4 Schumann M, Siegmund B, Schulzke JD. et al. Celiac Disease: Role of the Epithelial Barrier. Cell Mol Gastroenterol Hepatol 2017; 3: 150-162
    CrossrefPubMedSearch in Google Scholar
  • 5 du Pre MF, Sollid LM. T-cell and B-cell immunity in celiac disease. Best Pract Res Clin Gastroenterol 2015; 29: 413-423
    CrossrefPubMedSearch in Google Scholar
  • 6 Ivarsson A. The Swedish epidemic of coeliac disease explored using an epidemiological approach – some lessons to be learnt. Best Pract Res Clin Gastroenterol 2005; 19: 425-440
    CrossrefPubMedSearch in Google Scholar
  • 7 Lionetti E, Castellaneta S, Francavilla R. et al. Introduction of gluten, HLA status, and the risk of celiac disease in children. N Engl J Med 2014; 371: 1295-1303
    CrossrefPubMedSearch in Google Scholar
  • 8 Vriezinga SL, Auricchio R, Bravi E. et al. Randomized feeding intervention in infants at high risk for celiac disease. N Engl J Med 2014; 371: 1304-1315
    CrossrefPubMedSearch in Google Scholar
  • 9 Andren Aronsson C, Lee HS, Koletzko S. et al. Effects of Gluten Intake on Risk of Celiac Disease: A Case-Control Study on a Swedish Birth Cohort. Clin Gastroenterol Hepatol 2016; 14: 403-409.e3
    CrossrefPubMedSearch in Google Scholar
  • 10 Kagnoff MF, Paterson YJ, Kumar PJ. et al. Evidence for the role of a human intestinal adenovirus in the pathogenesis of coeliac disease. Gut 1987; 28: 995-1001
    CrossrefPubMedSearch in Google Scholar
  • 11 Stene LC, Honeyman MC, Hoffenberg EJ. et al. Rotavirus infection frequency and risk of celiac disease autoimmunity in early childhood: a longitudinal study. Am J Gastroenterol 2006; 101: 2333-2340
    CrossrefPubMedSearch in Google Scholar
  • 12 Bouziat R, Hinterleitner R, Brown JJ. et al. Reovirus infection triggers inflammatory responses to dietary antigens and development of celiac disease. Science 2017; 356: 44-50
    CrossrefPubMedSearch in Google Scholar
  • 13 Leffler D, Schuppan D, Pallav K. et al. Kinetics of the histological, serological and symptomatic responses to gluten challenge in adults with coeliac disease. Gut 2013; 62: 996-1004
    CrossrefPubMedSearch in Google Scholar
  • 14 Weber M, Wolf N, Branchi F. et al. Results from the German registry for refractory celiac disease. Z Gastroenterol 2021; 59: 944-953
    Thieme ConnectPubMedSearch in Google Scholar
  • 15 Lebwohl B, Kapel RC, Neugut AI. et al. Adherence to biopsy guidelines increases celiac disease diagnosis. Gastrointest Endosc 2011; 74: 103-109
    CrossrefPubMedSearch in Google Scholar
  • 16 Werkstetter KJ, Korponay-Szabo IR, Popp A. et al. Accuracy in Diagnosis of Celiac Disease Without Biopsies in Clinical Practice. Gastroenterology 2017; 153: 924-935
    CrossrefPubMedSearch in Google Scholar
  • 17 Husby S, Koletzko S, Korponay-Szabo I. et al. European Society Paediatric Gastroenterology, Hepatology and Nutrition Guidelines for Diagnosing Coeliac Disease 2020. J Pediatr Gastroenterol Nutr 2020; 70: 141-156
    CrossrefPubMedSearch in Google Scholar
  • 18 Ruiz-Carnicer A, Garzon-Benavides M, Fombuena B. et al. Negative predictive value of the repeated absence of gluten immunogenic peptides in the urine of treated celiac patients in predicting mucosal healing: new proposals for follow-up in celiac disease. Am J Clin Nutr 2020; 112: 1240-1251
    CrossrefPubMedSearch in Google Scholar
  • 19 Tangermann P, Branchi F, Itzlinger A. et al. Low Sensitivity of Simtomax Point of Care Test in Detection of Celiac Disease in a Prospective Multicenter Study. Clin Gastroenterol Hepatol 2019; 17: 1780-1787.e5
    CrossrefPubMedSearch in Google Scholar
  • 20 Biagi F, Trotta L, Alfano C. et al. Prevalence and natural history of potential celiac disease in adult patients. Scand J Gastroenterol 2013; 48: 537-542
    CrossrefPubMedSearch in Google Scholar
  • 21 Alhassan E, Yadav A, Kelly CP. et al. Novel Nondietary Therapies for Celiac Disease. Cell Mol Gastroenterol Hepatol 2019; 8: 335-345
    CrossrefPubMedSearch in Google Scholar
  • 22 Lahdeaho ML, Kaukinen K, Laurila K. et al. Glutenase ALV003 attenuates gluten-induced mucosal injury in patients with celiac disease. Gastroenterology 2014; 146: 1649-1658
    CrossrefPubMedSearch in Google Scholar
  • 23 Schuppan D, Maki M, Lundin KEA. et al. A Randomized Trial of a Transglutaminase 2 Inhibitor for Celiac Disease. N Engl J Med 2021; 385: 35-45
    CrossrefPubMedSearch in Google Scholar
  • 24 Kelly CP, Murray JA, Leffler DA. et al. TAK-101 Nanoparticles Induce Gluten-Specific Tolerance in Celiac Disease: A Randomized, Double-Blind, Placebo-Controlled Study. Gastroenterology 2021; 161: 66-80.e8
    CrossrefPubMedSearch in Google Scholar
  • 25 Malamut G, Cording S, Cerf-Bensussan N. Recent advances in celiac disease and refractory celiac disease. F1000Res 2019; 8: F1000 Faculty Rev-969
    PubMed
  • 26 Daum S, Ipczynski R, Schumann M. et al. High rates of complications and substantial mortality in both types of refractory sprue. Eur J Gastroenterol Hepatol 2009; 21: 66-70
    CrossrefPubMedSearch in Google Scholar
  • 27 Daum S, Ipczynski R, Heine B. et al. Therapy with budesonide in patients with refractory sprue. Digestion 2006; 73: 60-68
    CrossrefPubMedSearch in Google Scholar
  • 28 Schumann M, Kamel S, Jöhrens K. et al. Zöliakie – Eine Übersicht zur Leitlinie der DGVS. Gastroenterologie up2date 2014; 10 (04) 235-245
    Thieme ConnectPubMedSearch in Google Scholar