Celiac Disease Genetics, Pathogenesis, and Standard Therapy for Japanese Patients

Abstract

Celiac disease is an autoimmune disease primarily affecting the small intestine that is caused by the ingestion of gluten in genetically susceptible individuals. The development of celiac disease is based on a complex immune response to gluten proteins. The global average prevalence in the general population is about 1%. In recent years, it has become clear that celiac disease is not less common in Asian countries than in Western countries but often remains undiagnosed. Although the number of patients with celiac disease in Asia is expected to increase with improving disease recognition and advances in diagnostic techniques, there remain few reports of celiac disease in the Far East region of Asia, especially in Japan. In this paper, we outline the epidemiology, diagnosis, and treatment of celiac disease. In addition, we summarize the reported Japanese cases of celiac disease with an overview in Japan.

Clinical Presentation Is Dependent on Age and Calendar Year of Diagnosis in Celiac Disease: A Hungarian Cross-Sectional Study

“…The prevalence of CeD varies across continents and was reported to be high in Europe and some countries of Asia [ 2 , 3 , 4 ]. The variance in prevalence, e.g., the unexpectedly low prevalence in the far East such as in Japan and Korea, might be explained by the distribution of HLA-DQ2 and by the difference in the consumption of wheat products [ 5 ]. Parallel to the increasing wheat consumption in Japan, the prevalence of CeD is expected to rise, as well [ 6 ].…”

Celiac disease - a pluripathological model in pediatric practice

“…et al. discuss the involvement of the IL-6 polymorphism (-572G/C) in dictating the susceptibility to the development of CD ( 2 , 3 , 7 , 20 , 24 , 25 ). In addition to this mechanism, other factors that modulate the predisposition to CD include the premature cessation of breastfeeding and the gender of the patient, although the risk ratio for sexes in children is 1:1.…”

“…The two exert their negative effect by decreasing the body’s defense capabilities against exogenous infections, as well as by promoting a hormone-dependent pro-autoimmune status ( 3 ). Finally, we can also add the impact played by low birth weight, lack of H. pylori colonization, SARS-CoV-2 infection or smoking status ( 24 ). Focusing on H. pylori infection among patients with celiac disease, we notice that this is an intensely debated topic in the literature.…”

“…Subsequently, these progress towards growth retardation, severe malnutrition, nutritional deficiencies, anemia or delay in the onset of puberty. It is noted that with advancing age, the clinical picture may become non-specific/atypical ( 2 , 9 , 24 , 43 ). In this situation, the intestinal histology damage is more pronounced than in the classic/asymptomatic forms of the disease ( 44 ).…”

“…For the purpose of appropriate interpretation, the investigations must be completed by the evaluation of the serum IgA titer, to avoid cases of superimposition of normal values of anti-tTG over a selective immune deficiency. In order to obtain a reliable diagnosis in the case of a selective immune deficiency of IgA, the values of IgG antibodies are measured ( 9 , 24 , 46 ). However, it is necessary to clearly distinguish the selective IgA deficiency from the partial one.…”