title: Celiac disease.
abstract: OBJECTIVE
  To summarize recent advances in celiac disease published between August 2008 and July 2009.
  
  
  RESULTS
  Celiac disease affects nearly 1% of most populations but remains largely unrecognized. In the last year, work has shown that the prevalence of celiac disease has increased dramatically, not simply due to increased detection. Also, undiagnosed celiac disease may be associated with increased mortality. Significant progress has been made in understanding how gliadin peptides can cross the intestinal border and access the immune system. New genetic loci and candidate genes that may contribute to the risk of celiac disease and its overlap with type 1 diabetes mellitus have been identified. Novel deamidated gliadin peptides antibodies have better diagnostic accuracy over native gliadin-based tests. The inclusion of duodenal bulb biopsy specimens may increase the rate of celiac disease detection. The spectrum of celiac disease likely includes a minority of patients with mild enteropathy. A practical seven-item instrument may facilitate standardized evaluation of gluten-free diet adherence. Finally, refractory celiac disease, although rare, is associated with a poor prognosis.
  
  
  CONCLUSIONS
  Celiac disease is a global health problem that requires a multidisciplinary and increasingly cooperative multinational research effort.
authors.affiliation: Division of Gastroenterology and Hepatology, Departments of Medicine and Immunology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
authors.forename: Alberto
authors.initials: A
authors.lastname: Rubio-Tapia
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Murray
mesh_terms: D000818:Animals; D001323:Autoantibodies / Q000276:immunology; D001327:Autoimmune Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D001707:Biopsy, Needle; D002446:Celiac Disease / Q000453:epidemiology / Q000235:genetics / Q000276:immunology* / Q000628:therapy*; D055050:Diet, Gluten-Free / Q000379:methods*; D004195:Disease Models, Animal; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005983:Glutens / Q000276:immunology* / Q000378:metabolism; D006801:Humans; D007413:Intestinal Mucosa / Q000276:immunology / Q000473:pathology; D007421:Intestine, Small / Q000276:immunology / Q000473:pathology; D008297:Male; D051379:Mice; D015995:Prevalence; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D001323:Autoantibodies; D005983:Glutens