Department of Medicine and the Celiac Disease Center, Columbia University Medical Center, New York, NY.
Department of Medicine and the Celiac Disease Center, Columbia University Medical Center, New York, NY.
J Allergy Clin Immunol. 2015 May;135(5):1099-106; quiz 1107. doi: 10.1016/j.jaci.2015.01.044.
This review will focus on the pathogenesis, clinical manifestations, diagnosis, and management of celiac disease (CD). Given an increasing awareness of gluten-related disorders, medical professionals of all varieties are encountering patients with a diagnosis of CD or who are thought to have food intolerance to gluten. The prevalence of CD among the general population is estimated to be 1% in Western nations, and there is growing evidence for underdiagnosis of the disease, especially in non-Western nations that were traditionally believed to be unaffected. The development of serologic markers specific to CD has revolutionized the ability both to diagnose and monitor patients with the disease. Additionally, understanding of the clinical presentations of CD has undergone a major shift over the past half century. Although it is well understood that CD develops in genetically predisposed subjects exposed to gluten, the extent of other environmental factors in the pathogenesis of the disease is an area of continued research. Currently, the main therapeutic intervention for CD is a gluten-free diet; however, novel nondietary agents are under active investigation. Future areas of research should also help us understand the relationship of CD to other gluten-related disorders.
这篇综述将重点介绍乳糜泻（CD）的发病机制、临床表现、诊断和治疗。鉴于人们对与麸质相关疾病的认识不断提高，各种医学专业人员都在遇到 CD 诊断患者或疑似对麸质不耐受的患者。在西方国家，一般人群中 CD 的患病率估计为 1%，而且越来越多的证据表明该病存在漏诊，尤其是在传统上认为不受影响的非西方国家。针对 CD 的特异性血清标志物的发展彻底改变了诊断和监测该病患者的能力。此外，过去半个世纪以来，CD 的临床表现也发生了重大变化。尽管人们已经充分了解到 CD 是在易患遗传的个体接触麸质后发展起来的，但在疾病发病机制中其他环境因素的程度仍是一个持续研究的领域。目前，CD 的主要治疗干预措施是无麸质饮食；然而，新型非饮食药物正在积极研究中。未来的研究领域也应有助于我们了解 CD 与其他与麸质相关疾病的关系。
