Department of Gastroenterology, Children's Hospital Oxford, Oxford University Hospitals NHS Trust, Oxford OX3 9DU, UK.
Department of Gastroenterology, Perth Children's Hospital, Perth, WA 6009, Australia.
Medicina (Kaunas). 2024 Oct 9;60(10):1650. doi: 10.3390/medicina60101650.
Coeliac disease (CD) affects almost of 1% of the population, yet remains undiagnosed in the majority. Though the demonstration of enteropathy in duodenal biopsy was traditionally the essential criterion for the diagnosis of coeliac disease, the guidelines published by the European Society of Paediatric Gastroenterology and Nutrition (ESPGHAN) in 2012, and revised in 2020, paved the way to a no-biopsy approach to diagnosis. In a select group of children meeting certain criteria, a definitive diagnosis of CD can now be made without the need for duodenal biopsies. This is being increasingly applied in clinical practice. It is well established that untreated coeliac disease is associated with several chronic adverse health conditions. At present, a strict gluten-free diet remains the only effective treatment for CD. The advances in our understanding of the pathogenesis of CD have led to a search for alternative treatment agents. Several investigational agents are in various phases of clinical trials at present. In this review, we outline the clinical aspects of coeliac disease and summarise various investigational treatment agents.
乳糜泻（CD）影响近 1%的人口，但大多数人仍未被诊断出来。尽管十二指肠活检中肠病的表现传统上是乳糜泻诊断的必要标准，但欧洲儿科胃肠病学和营养学会（ESPGHAN）于 2012 年发布并于 2020 年修订的指南为无活检诊断方法铺平了道路。在符合某些标准的特定儿童组中，现在无需进行十二指肠活检即可明确诊断 CD。这在临床实践中得到了越来越多的应用。未经治疗的乳糜泻与多种慢性不良健康状况有关，这一点已得到充分证实。目前，严格的无麸质饮食仍然是 CD 的唯一有效治疗方法。我们对 CD 发病机制的理解的进步导致了对替代治疗药物的探索。目前，有几种研究药物处于不同的临床试验阶段。在这篇综述中，我们概述了乳糜泻的临床方面，并总结了各种研究性治疗药物。
