Bibbò Stefano, Pes Giovanni Mario, Dore Maria Pina
Dipartimento di Scienze Mediche, Chirurgiche e Sperimentali, Università di Sassari.
Recenti Prog Med. 2020 Feb;111(2):91-101. doi: 10.1701/3309.32799.
Coeliac disease is an autoimmune disease affecting the small intestine in genetically predisposed subjects following the ingestion of gluten. Many advances have been made towards understanding the pathogenic mechanisms that underlie the development of coeliac disease. The interaction between genetic, environmental and immunological factors is the main pathophysiological aspect, but over the last few years growing importance has been given to the role of the intestinal barrier and in particular to the alteration of intestinal microbiota. Clinical manifestations mainly include signs and symptoms typical of malabsorption, but atypical or subtle clinical manifestations are not rare. The diagnosis must always be made in accordance with current guidelines, based on the finding of serological markers and typical intestinal mucosal alterations detected by upper endoscopic procedure and confirmed with histological examination. Clinical management is based on the strict elimination of gluten from the diet, and a regular monitoring of the nutritional status and the possible occurrence of complications and or associated clinical conditions. In this review we have been described the current evidences on pathogenesis and clinical practice of coeliac disease.
乳糜泻是一种自身免疫性疾病，在遗传易感性个体摄入麸质后影响小肠。在理解乳糜泻发病机制方面已经取得了许多进展。遗传、环境和免疫因素之间的相互作用是主要的病理生理方面，但在过去几年中，肠道屏障的作用，尤其是肠道微生物群的改变越来越受到重视。临床表现主要包括吸收不良的典型体征和症状，但非典型或细微的临床表现并不罕见。诊断必须始终按照现行指南进行，基于血清学标志物的发现以及通过上消化道内镜检查检测到的典型肠道黏膜改变，并经组织学检查证实。临床管理基于严格从饮食中消除麸质，并定期监测营养状况以及并发症和/或相关临床病症的可能发生情况。在这篇综述中，我们描述了关于乳糜泻发病机制和临床实践的当前证据。
