Scherf Katharina A, Catassi Carlo, Chirdo Fernando, Ciclitira Paul J, Feighery Conleth, Gianfrani Carmen, Koning Frits, Lundin Knut E A, Schuppan Detlef, Smulders Marinus J M, Tranquet Olivier, Troncone Riccardo, Koehler Peter
Department of Bioactive and Functional Food Chemistry, Institute of Applied Biosciences, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany.
Department of Pediatrics, Polytechnic University of Marche, Ancona, Italy.
Front Nutr. 2020 Mar 17;7:29. doi: 10.3389/fnut.2020.00029. eCollection 2020.
Celiac disease (CD) affects a growing number of individuals worldwide. To elucidate the causes for this increase, future multidisciplinary collaboration is key to understanding the interactions between immunoreactive components in gluten-containing cereals and the human gastrointestinal tract and immune system and to devise strategies for CD prevention and treatment beyond the gluten-free diet. During the last meetings, the Working Group on Prolamin Analysis and Toxicity (Prolamin Working Group, PWG) discussed recent progress in the field together with key stakeholders from celiac disease societies, academia, industry and regulatory bodies. Based on the current state of knowledge, this perspective from the PWG members provides recommendations regarding clinical, analytical and legal aspects of CD. The selected key topics that require future multidisciplinary collaborative efforts in the clinical field are to collect robust data on the increasing prevalence of CD, to evaluate what is special about gluten-specific T cells, to study their kinetics and transcriptomics and to put some attention to the identification of the environmental agents that facilitate the breaking of tolerance to gluten. In the field of gluten analysis, the key topics are the precise assessment of gluten immunoreactive components in wheat, rye and barley to understand how these are affected by genetic and environmental factors, the comparison of different methods for compliance monitoring of gluten-free products and the development of improved reference materials for gluten analysis.
乳糜泻（CD）在全球影响着越来越多的人。为了阐明这种增长的原因，未来的多学科合作对于理解含麸质谷物中的免疫反应成分与人类胃肠道和免疫系统之间的相互作用，以及制定除无麸质饮食之外的乳糜泻预防和治疗策略至关重要。在最近的会议上，醇溶蛋白分析与毒性工作组（醇溶蛋白工作组，PWG）与来自乳糜泻协会、学术界、行业和监管机构的关键利益相关者共同讨论了该领域的最新进展。基于当前的知识状况，PWG成员的这一观点就乳糜泻的临床、分析和法律方面提供了建议。在临床领域，需要未来多学科合作努力的选定关键主题包括收集关于乳糜泻患病率上升的可靠数据，评估麸质特异性T细胞的特殊之处，研究它们的动力学和转录组学，并关注识别促使对麸质耐受性破坏的环境因素。在麸质分析领域，关键主题包括精确评估小麦、黑麦和大麦中的麸质免疫反应成分，以了解这些成分如何受到遗传和环境因素的影响，比较无麸质产品合规监测的不同方法，以及开发用于麸质分析的改进参考物质。
