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1.
Pediatr Clin North Am ; 64(3): 563-576, 2017 06.
Article in English | MEDLINE | ID: mdl-28502438

ABSTRACT

Gluten-related disorders include celiac disease (CD), wheat allergy, and nonceliac gluten sensitivity. CD is an autoimmune enteropathy caused by damage to small intestinal mucosa when gluten is ingested in genetically susceptible individuals. Currently, the only available treatment of CD is gluten-free diet. Several potential treatments are being researched. Wheat allergy is a hypersensitivity reaction caused by IgE-mediated and/or non-IgE-mediated immune response, and can involve the gastrointestinal tract, skin, or respiratory tract. Nonceliac gluten sensitivity is one of a variety of immunologic, morphologic, or symptomatic manifestations precipitated by ingestion of gluten in individuals in whom CD and wheat allergy are excluded.


Subject(s)
Celiac Disease/diagnosis , Diet, Gluten-Free/methods , Polyendocrinopathies, Autoimmune/diagnosis , Wheat Hypersensitivity/diagnosis , Celiac Disease/therapy , Female , Glutens , Humans , Male , Polyendocrinopathies, Autoimmune/therapy , Wheat Hypersensitivity/therapy
2.
Gut Microbes ; 4(6): 568-76, 2013.
Article in English | MEDLINE | ID: mdl-24253617

ABSTRACT

Helicobacter pylori infects more than half the world's population and in developing nations the incidence can be over 90%. The morbidity and mortality associated with H. pylori-associated diseases including ulcers and gastric cancer therefore, disproportionately impact the developing world. Mice have been used extensively to demonstrate the feasibility of developing a vaccine for H. pylori infection, and for testing antigens, routes of immunization, dose, and adjuvants. These successes however, have not translated well in clinical trials. Although there are examples where immune responses have been activated, there are few instances of achieving a reduced bacterial load. In vivo and in vitro analyses in both mice and humans demonstrates that the host responds to H. pylori infection through the activation of immunoregulatory mechanisms designed to suppress the anti-H. pylori response. Improved vaccine efficacy therefore, will require the inclusion of factors that over-ride or re-program these immunoregulatory rersponse mechanisms.


Subject(s)
Adjuvants, Immunologic , Bacterial Vaccines/therapeutic use , Helicobacter Infections/prevention & control , Helicobacter pylori/immunology , Animals , Clinical Trials as Topic , Disease Models, Animal , Helicobacter Infections/complications , Helicobacter Infections/immunology , Humans , Stomach Neoplasms/complications , Stomach Neoplasms/microbiology , Stomach Neoplasms/prevention & control
3.
Curr Opin Pediatr ; 21(5): 655-60, 2009 Oct.
Article in English | MEDLINE | ID: mdl-19606042

ABSTRACT

PURPOSE OF REVIEW: Celiac disease is an extremely common, although underdiagnosed, disorder. Knowledge about the varied clinical manifestations and the proper approach to screening and diagnosing celiac disease will lead to appropriate early intervention in affected children RECENT FINDINGS: New age-dependent algorithms are emerging to properly screen for celiac disease. There is new evidence on the patchy nature of celiac disease supporting the practice of multiple duodenal biopsies including the bulb of the duodenum. Therapeutic dietary compliance, particularly in asymptomatic children, can be poor, and therefore, the involvement of a dietician trained in celiac disease is instrumental in keeping patients up to date with dietary guidelines and to improve their compliance to the diet. Expanding knowledge about the pathogenesis of celiac disease has led to the development of investigational therapeutic alternatives to the gluten-free diet. Ongoing clinical trials are evaluating methods of celiac disease prevention in at-risk infants. SUMMARY: This review aims at outlining the different manifestations of celiac disease in children as well as a step-wise approach to screen and diagnose the disease. A better understanding of the pathogenic mechanisms of celiac disease is paving the way to innovative diagnostic tools, preventive strategies, and therapeutic interventions alternative to a gluten-free diet.


Subject(s)
Celiac Disease/diagnosis , Celiac Disease/etiology , Adolescent , Age Factors , Celiac Disease/therapy , Child , Diet, Gluten-Free , Endoscopy , Humans , Patient Compliance
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