Celiac Disease

Celiac disease, with a prevalence of about 1% in many countries, is a chronic immune-mediated enteropathy triggered by exposure to dietary gluten (storage proteins of wheat, rye, barley, and oats) in genetically susceptible individuals. Small-intestinal villous atrophy is the characteristic feature, and symptoms include diarrhea or steatorrhea and extraintestinal manifestations. A strict, lifelong gluten-free diet is the current essential therapy. The complex pathomechanism consists of incomplete gluten digestion, para- and transcellular passage of gluten peptides through the epithelium, and adaptive and innate immune responses in the lamina propria.