Celiac disease.
There continues to be much research interest in celiac disease, with well over 200 papers published in the year under review, covering a multitude of areas from population screening to the molecular immunology of disease pathogenesis. The high prevalence of "silent" disease again has been demonstrated, and there is continued emphasis on the increasingly wide recognized range of associated conditions and extraintestinal manifestations. The case for the safety of oats is further strengthened by a study involving patients with dermatitis hepetiformis. One of the most significant scientific advances has been the discovery of a potential role for tissue transglutaminase, recently found to be the autoantigen of antiendomysial antibodies, in disease pathogenesis, by enhancing gliadin peptide class II binding and consequent T-cell activation. However, the very central role of T cells has been thrown into doubt with an elegant study that assessed the effect of blocking costimulation in T-cell activation.
Parnell
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Gastroenterology Unit, UMDS, St. Thomas' Hospital, Lambeth Palace Road, London SE1 7EH, UK.
Ciclitira
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PJ