Important studies published in 2020 highlight that coeliac disease is a systemic autoimmune-like disorder with the potential to result in serious long-term health consequences that might also occur outside the gastrointestinal tract. Ultimately, the results of these studies will enable the development of better strategies for the management of coeliac disease.
Key advances
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Patients with coeliac disease have cognitive defects, signs of worsened mental health and evidence of white matter damage in the brain compared with matched controls2.
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Despite improved diagnostics and treatment of coeliac disease, diagnosed coeliac disease is still associated with increased mortality risk compared with control population, and the increased risk persists beyond 10 years after diagnosis. The risk of death is especially related to cancer and cardiovascular and respiratory diseases4.
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Undiagnosed and therefore untreated coeliac disease can have serious long-term health consequences: individuals with untreated disease have been found to have an increased risk of cardiovascular diseases and cancers that can occur outside the gastrointestinal tract8.
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References
Hadjivassiliou, M. et al. Neurologic deficits in patients with newly diagnosed celiac disease are frequent and linked with autoimmunity to transglutaminase 6. Clin. Gastroenterol. Hepatol. 17, 2678–2686 (2019).
Croall, I. D. et al. Cognitive deficit and white matter changes in persons with celiac disease: A Population-based study. Gastroenterology 158, 2112–2122 (2020).
Tylee, D. S. et al. Genetic correlations among psychiatric and immune-related phenotypes based on genome-wide association data. Am. J. Med. Genet. B Neuropsychiatr. Genet. 177, 641–657 (2018).
Lebwohl, B., Green, P. H. R., Söderling, J., Roelstraete, B. & Ludvigsson, J. F. Association between celiac disease and mortality risk in a Swedish population. JAMA 323, 1277–1285 (2020).
Dotsenko, V. et al. Genome-wide transcriptomic analysis of intestinal mucosa in celiac disease patients on a gluten-free diet and post-gluten challenge. Cell. Mol. Gastroenterol. Hepatol. 11, 13–32 (2020).
Lebwohl, B. et al. Long term gluten consumption in adults without celiac disease and risk of coronary heart disease: prospective cohort study. BMJ 357, j1892 (2017).
Choung, R. S. et al. Prevalence and morbidity of undiagnosed celiac disease from a community-based study. Gastroenterology 152, 830–839 (2017).
Kårhus, L. L. e al. Long-term Consequences of undiagnosed celiac seropositivity. Am. J. Gastroenterol. 115, 1681–1688 (2020).
Sciatti, E. et al. Evaluation of systo–diastolic cardiac function and arterial stiffness in subjects with new diagnosis of coeliac disease without cardiovascular risk factors. Intern. Emerg. Med. 15, 981–988 (2020).
Valles-Colomer, M. et al. The neuroactive potential of the human gut. Nat. Microbiol. 4, 623–632 (2019).
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Kaukinen, K. Updates on systemic consequences of coeliac disease. Nat Rev Gastroenterol Hepatol 18, 87–88 (2021). https://doi.org/10.1038/s41575-020-00387-0
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DOI: https://doi.org/10.1038/s41575-020-00387-0
