Orally based diagnosis of celiac disease:current perspective

Domenico Compilato, Giuseppina Campisi, Luca Pastore, L. Lo Muzio

Risultato della ricerca: Article

23 Citazioni (Scopus)

Abstract

Celiac disease (CD) is a lifelong immune-mediated disorder caused by the ingestion of wheat gluten in genetically susceptible persons. Most cases of CD are atypical and remain undiagnosed, which exposes the individuals to the risk of life-threatening complications. Serologic endomysial and tissue transglutaminase antibody tests are used to screen at-risk individuals, although a firm diagnosis requires demonstration of characteristic histopathologic findings in the small-intestinal mucosa. A gluten challenge, with a repeat biopsy to demonstrate recurrence of histopathologic changes in the intestinal mucosa after the re-introduction of gluten, is considered for those persons in whom diagnosis remains in doubt. In this paper, we review studies that evaluated: (1) the possibility of using oral mucosa for the initial diagnosis of CD or for local gluten challenge; and (2) the possibility of using salivary CD-associated antibodies as screening tests. Our review shows that orally based diagnosis of CD is attractive and promising, although additional evaluations with standardized collection and analysis methods are needed. There is some evidence of a dissociation between systemic and oral mucosal immune responses in CD. The hypothesis that gluten could stimulate naive lymphocytes directly in the oral cavity would have important implications for the understanding, diagnosis, and management of CD.
Lingua originaleEnglish
pagine (da-a)1100-1107
Numero di pagine8
RivistaJournal of Dental Research
Volume87
Stato di pubblicazionePublished - 2008

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Celiac Disease
Glutens
Intestinal Mucosa
Mucosal Immunity
Antibodies
Immune System Diseases
Mouth Mucosa
Triticum
Mouth
Eating
Lymphocytes
Biopsy
Recurrence

All Science Journal Classification (ASJC) codes

  • Dentistry(all)

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Orally based diagnosis of celiac disease:current perspective. / Compilato, Domenico; Campisi, Giuseppina; Pastore, Luca; Muzio, L. Lo.

In: Journal of Dental Research, Vol. 87, 2008, pag. 1100-1107.

Risultato della ricerca: Article

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AB - Celiac disease (CD) is a lifelong immune-mediated disorder caused by the ingestion of wheat gluten in genetically susceptible persons. Most cases of CD are atypical and remain undiagnosed, which exposes the individuals to the risk of life-threatening complications. Serologic endomysial and tissue transglutaminase antibody tests are used to screen at-risk individuals, although a firm diagnosis requires demonstration of characteristic histopathologic findings in the small-intestinal mucosa. A gluten challenge, with a repeat biopsy to demonstrate recurrence of histopathologic changes in the intestinal mucosa after the re-introduction of gluten, is considered for those persons in whom diagnosis remains in doubt. In this paper, we review studies that evaluated: (1) the possibility of using oral mucosa for the initial diagnosis of CD or for local gluten challenge; and (2) the possibility of using salivary CD-associated antibodies as screening tests. Our review shows that orally based diagnosis of CD is attractive and promising, although additional evaluations with standardized collection and analysis methods are needed. There is some evidence of a dissociation between systemic and oral mucosal immune responses in CD. The hypothesis that gluten could stimulate naive lymphocytes directly in the oral cavity would have important implications for the understanding, diagnosis, and management of CD.

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