What is celiac disease?

What is celiac disease?

Celiac disease or celiac disease is a permanent intolerance to gluten , a complex of nitrogenous substances that forms during the mixing, with water, of the flour of some cereals , such as oats *, wheat , spelled , kamut , barley , rye , spelled and triticale .

Strictly speaking, celiac disease is not a disease, but a simple condition which, in order to manifest itself, requires the simultaneous presence of a genetic predisposition and the consumption of foods containing gluten .

In Italy it is recognized as a social disease, so much so that it is estimated that it affects approximately 400 / 600,000 Italians, that is, one person for every 100/150 inhabitants. Given that many people live with this condition for many years without experiencing particularly serious disorders, the number of diagnosed cases (about 160 thousand in 2012) is much lower than the real incidence of the disease.

To combat celiac disease the only therapy currently valid is dietary. The celiac is therefore forced to eliminate from their table all those foods that contain even small amounts of gluten (pasta, sweets, bread , beer , biscuits, etc.).

It is no coincidence that celiac disease mainly affects Caucasian subjects in which the consumption of cereals containing gluten is higher than in other populations such as African or Asian ones. Celiac disease is also more frequent in women, so much so that women are affected twice as much as men.

* According to some studies, if introduced pure, i.e. not contaminated by gluten during processing, oats would not be harmful to most (99.4%) of celiacs. Bibliography: Can oats be taken in a gluten-free diet? A systematic review. Scand. J. Gastroenterol. Vol. 42, No. 2, pages 171-178.

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Causes of origin

Celiac disease is a disease with a genetic predisposition. This term is used in the scientific field to indicate the genetic origin of a pathology that requires particular conditions to manifest itself. In other words, at the time of birth, an individual already carries with him the genes linked to celiac disease. However, this is a necessary but not sufficient condition, so being a carrier of the abnormal gene does not necessarily mean getting sick but only having a greater chance of doing so. On the other hand, the absence of these genes precludes the possibility of contracting celiac disease.

Another peculiarity of the disease is that it is autoimmune. According to this characteristic, the consumption of gluten causes an excessive immune response in a predisposed individual that affects the cells of the small intestine responsible for the absorption of nutrients . This section of the intestine, more or less 5 meters long, is in fact rich in finger-shaped protrusions ( intestinal villi ) which are used to absorb nutritional materials. When the cells of these important microstructures are attacked they lose their absorption capacity and this is where the first problems for the organism begin. This phenomenon in fact deprives organs such as the brain and liver of nutrientsessential for proper operation. Unfortunately, a late diagnosis determines the progressive deterioration of the intestinal villi, further aggravating the pathology and predisposing the subject to diseases of another nature. The phenomenon is particularly serious in children, who need abundant nutrients for development and growth processes.

A profound relationship between infection with a common virus called rotavirus and celiac disease was recently demonstrated in an Italian study . In particular, the researchers found that, unlike healthy individuals, celiacs have antibodies to a specific protein present in this virus. These antibodies capture its presence on intestinal villous cells and attack it to neutralize it. The attack on these structures causes the opening of small channels between one cell and the other, opening the doors for gluten to enter and for the consequent inflammation of the intestinal wall.

This discovery has opened new horizons in the prevention of celiac disease also thanks to the synthesis of a specific vaccine for the pediatric age currently in the experimental phase.