Spanish national registry of celiac disease: incidence and clinical presentation.

Objectives: The aim of this study was to assess the incidence and clinical pattern of celiac disease (CD) presently diagnosed in Spanish children.

Methods: A prospective, multicenter, nationwide registry of new cases of CD in children <15 years was conducted from June 1, 2006 to May 31, 2007. The parameters studied were age at diagnosis, sex, clinical symptoms, associated diseases, nutritional status, CD serology, histological lesions, and HLA-DQ2/-DQ8.

Combined functional and positional gene information for the identification of susceptibility variants in celiac disease.

Background & Aims: Celiac disease is a complex, immune-mediated disorder of the intestinal mucosa with a strong genetic component. HLA-DQ2 is the major determinant of risk, but other minor genes, still to be identified, also are involved.

Methods: We designed a strategy that combines gene expression profiling of intestinal biopsy specimens, linkage region information, and different bioinformatics tools for the selection of potentially regulatory single-nucleotide polymorphisms (SNPs) involved in the disease.

MICA response to gliadin in intestinal mucosa from celiac patients.

MHC class I chain-related gene A (MICA), a putative independent susceptibility gene in autoimmune diseases, encodes a surface protein present in epithelial cells that binds to NKG2D, an activating receptor of NK, alphabeta and gammadelta T cells, and could function as a stress-inducible activator of the innate immune response. There is no evidence of a long-term implication of MICA in the celiac autoimmune process. However, it could be that gliadin activation of MICA occurs only during the initial stages of the disease.

Immunoglobulin G autoantibodies against tissue-transglutaminase. A sensitive, cost-effective assay for the screening of celiac disease.

The characterization of target antigens in several autoimmune disorders has made it possible to develop antigen-specific immunoassays that are superior in terms of sensitivity, specificity, reproducibility and ease of standardization, compared to immunohistological methods that are highly subjective, rely on skilled technicians and are not applicable to large-scale studies. In the case of celiac disease (CD), tissue transglutaminase (tTGase) has been identified as a major autoantigen, and antibodies against this molecule are present in most CD patients before gluten is removed from diet. In general, anti-tTGase detection assays detect the presence of IgA class antibodies, but these immunoglobulins are absent among patients with IgA deficiency, a frequent condition in which CD is very prevalent.