Study of celiac disease

Celiac disease has been a subject of constant research and study throughout the history of medicine.

Although great advances have been made in its understanding and treatment, there is still much to be learned about celiac disease and how it affects people who suffer from it. It is a medical condition that has been described since ancient times, although its cause and treatment were not fully understood.

The first record of celiac disease is from an ancient treatise by the Greek physician Aretaeus of Cappadocia. In this treatise he refers to koiliakos, as those who suffer from the intestine, and from this the term we know today was derived. Although this physician did not understand the cause, he did his best to treat it with methods such as fasting and natural remedies to combat its symptoms.

With this treatise as a reference, the next breakthrough really came at the end of the 19th century from the British Samuel Gee. He described the disease as a chronic eating disorder and therefore the diet of those affected had to be revised.

During the 20th century, efforts to understand this condition continued. At the beginning of the century, the first book on the subject was published, in which Dr. Christian A. Herter referred to the fact that infants suffering from the disease accepted fats better than carbohydrates.

Little by little they began to focus on bread as the cause of aggravating the disease and some diets appeared where its consumption was suppressed. The most popular was the banana diet, which at the time was supposed to affect celiacs. With studies like this one it was demonstrated that it was not the carbohydrates that were responsible for aggravating the condition.

It was during the 1940s and 1950s that physicians began to identify celiac disease as a condition related to gluten consumption.

Dr. Willem-Karel Dicke, a Dutch pediatrician, noted that, during World War II, when gluten-rich foods were scarce, children with celiac disease experienced a marked improvement in their symptoms. Dicke suggested that celiac disease was related to gluten in the diet, and his findings were confirmed by other researchers.

Another important breakthrough at this stage was for diagnosis, as Dr. JW Paulley noticed during an operation the type of damage to the small intestine that would later be associated with the disease. This led to the development of techniques for collecting and analyzing samples in the intestine.

In the 1960s, it was discovered that patients with celiac disease had antibodies against a protein called gliadin, which is found in gluten. Since then, celiac disease has been shown to be an autoimmune condition in which the body's immune system attacks the lining of the small intestine when gluten is consumed.

In recent decades, there have been significant advances in the understanding of celiac disease and in the diagnosis and treatment of the disease. Diagnosis of celiac disease used to be difficult, as symptoms can vary and may be similar to other gastrointestinal conditions. However, there are now antibody detection tests that can be useful in diagnosis. As well as genetic testing to confirm predisposition to the disease.

Endoscopy with biopsy is a standard in the diagnosis of celiac disease, as it allows the physician to examine the lining of the small intestine and take a tissue sample for laboratory examination. If the diagnosis of celiac disease is confirmed, treatment involves following a lifelong gluten-free diet.

Eliminating gluten from the diet can improve symptoms and reduce the risk of long-term complications, such as autoimmune diseases, neurological problems and cancer.

Current research

As more has been understood about celiac disease, broader dietary options have been developed and new lines of research have opened up:

• Identification of gluten-containing ingredients in processed foods has improved.

• The use of digestive enzymes to break down gluten and reduce its impact on the small intestine is being studied. These treatments may be useful for people who have difficulty following a strict gluten-free diet, and are expected to help improve the quality of life for people with celiac disease.

• Several genes have been identified that are associated with an increased risk of developing the disease. These genes are believed to play a role in how the body's immune system interacts with gluten.

• Environmental factors that may contribute to celiac disease are being studied.

• It has been suggested that early exposure to gluten or certain infections may trigger the disease in people who have a genetic predisposition.

Researchers are also studying the relationship between celiac disease and other autoimmune conditions, such as type 1 diabetes and Hashimoto's thyroiditis.

Another area of active research in celiac disease is the development of new dietary options. While eliminating gluten from the diet remains the standard treatment for celiac disease, work is underway to develop gluten-free food products that are healthier and more nutritious. Great strides have been made in this field in recent years, and there are now a wide variety of gluten-free food products available on the market.

One of the most promising approaches is the use of immunotherapy, which involves administering small amounts of gluten to help the body's immune system develop a tolerance to gluten. Several clinical trials have been conducted to evaluate the effectiveness of immunotherapy in people with celiac disease, and the results have been encouraging so far.

In addition, the relationship between celiac disease and the gut microbiota is being studied, and diets that may help restore the balance of the microbiota in people with the disease are being investigated.