Celiac Disease

Peter H.R. Green, MD, Guest Editor

Many aspects of the world of celiac disease (CD) are on the rise. The prevalence of CD in the United States has increased 4-fold over the course of the past half-century. Rates of new diagnoses are increasing, including among groups that were previously not thought to be at risk, such as older adults. In parallel with this growth in prevalence and diagnoses, our understanding of CD pathophysiology has increased, and CD is now held up as a unique opportunity in the study of autoimmune diseases, as the triggering antigen (dietary gluten) is known. Also on the rise is awareness of CD, both among patients as well as among physicians and researchers, as evidenced by the growth in research publication output on the subject of CD in the past decade. The popularity and availability of gluten-free food are also on the rise, and gluten sensitivity has hit the mainstream, with the medical community racing to catch up with our patients in terms of understanding the biologic basis for this phenomenon.

The goal of this issue is to summarize and synthesize the latest advances in understanding, diagnosing, and treating CD. The first part of this volume concerns the protean clinical manifestations and pathophysiology of CD, as well as the progress in the diagnosis of CD, which for the majority of patients remains dependent on small intestinal histology. The second section focuses on the monitoring and consequences of CD, as well as an update on our emerging understanding of gluten sensitivity, and the state of CD in the developing world. The third section presents a pair of articles concerning therapy for CD, which at this time is limited to the gluten-free diet, but may soon expand to nondietary therapies based on a variety of promising pharmacologic approaches.

We would like to thank Dr Charles Lightdale, Consulting Editor, for the invitation to develop this volume. We also thank Kerry Holland for her editorial guidance, and the article authors for contributing their expertise to this volume. Last, we thank our patients for inspiring us, for encouraging and assisting us in our research efforts, and for raising awareness of this important disease.

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