title: Advances in coeliac disease.
abstract: OBJECTIVE
  This article critically summarizes the recent scientific and clinical advances in coeliac disease.
  
  
  RESULTS
  Epidemiological studies have shown that coeliac disease is as common in parts of Asia, Africa and Eastern Europe as in the western world. Genome-wide association studies continue to identify genetic susceptibilities that are both unique to coeliac disease and overlap with other autoimmune diseases. Human leukocyte antigen genotyping offers additional sensitivity in detecting coeliac disease in individuals who have self-prescribed gluten-free diets (GFD) or have atypical presentations. Immunological advances have highlighted the potential proinflammatory pitfalls of vitamin A supplementation in active coeliac disease and have enabled identification of oat and barley subsets that may be safely incorporated into coeliac diets. Large population-based studies have expanded our knowledge of the long-term risks of coeliac disease, in addition to excluding infertility as a cause for concern once a GFD has been established.
  
  
  CONCLUSIONS
  The long-term implications of active coeliac disease emphasize the need for early detection and strict adherence to GFD, which remains the cornerstone of management. Technological advances in food modulation and immuno-therapies offer promise, but remain in the translational phases of clinical trials at present.
authors: Centre for Liver Research & NIHR Biomedical Research Unit, University of Birmingham, Birmingham, UK. mattyarm@doctors.org.uk
authors: Matthew J
authors: MJ
authors: Armstrong
authors: Vinod S
authors: VS
authors: Hegade
authors: Gerry
authors: G
authors: Robins
mesh_terms: D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis* / Q000178:diet therapy* / Q000453:epidemiology / Q000235:genetics; D055050:Diet, Gluten-Free; D019587:Dietary Supplements / Q000009:adverse effects; D006801:Humans; D014801:Vitamin A / Q000009:adverse effects
chemical_list: D014801:Vitamin A