title: Immunopathogenesis and therapeutic approaches in pediatric celiac disease.
abstract: Celiac Disease is an autoimmune enteropathy with increasing incidence worldwide in both adults and children. It occurs as an inflammatory condition with destruction of the normal architecture of villi on consumption of gluten and related protein products found in wheat, barley and rye. However, the exact pathogenesis is not yet fully understood. A gluten-free diet remains the main modality of therapy to date. While some patients continue to have symptoms even on a gluten-free diet, adherence to this diet is also difficult, especially for the children. Hence, there is continued interest in novel methods of therapy and the current research focus is on the promising novel non-dietary modalities of treatment. Here, we critically reviewed the existing literature regarding the pathogenesis of celiac disease in children including the role of in-utero exposure leading to neonatal and infant sensitization and its application for the development of new therapeutic approaches for these patients.
authors.affiliation: a Department of Clinical & Translational Science , Creighton University School of Medicine , Omaha , NE , USA.
authors.forename: Shreya
authors.initials: S
authors.lastname: Agarwal
authors.affiliation: b Department of Obstetrics and Gynecology , Creighton University School of Medicine , Omaha , NE , USA.
authors.forename: Oormila
authors.initials: O
authors.lastname: Kovilam
authors.affiliation: c Department of Pediatrics , Creighton University School of Medicine , Omaha , NE , USA.
authors.forename: Terence L
authors.initials: TL
authors.lastname: Zach
authors.affiliation: a Department of Clinical & Translational Science , Creighton University School of Medicine , Omaha , NE , USA.
authors.forename: Devendra K
authors.initials: DK
authors.lastname: Agrawal
mesh_terms: D000328:Adult; D000465:Algorithms; D015551:Autoimmunity; D002446:Celiac Disease / Q000175:diagnosis / Q000276:immunology* / Q000628:therapy; D002648:Child; D002824:Chorionic Villi / Q000276:immunology*; D004035:Diet Therapy; D020022:Genetic Predisposition to Disease; D005983:Glutens / Q000276:immunology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007413:Intestinal Mucosa / Q000276:immunology*
chemical_list: D005983:Glutens
keywords: Celiac disease; IL-15; autoimmunity; gluten sensitivity; villous atrophy