Pediatrics. Consilium MedicumPediatrics. Consilium MedicumПедиатрия. Consilium Medicum2658-66302658-6622Consilium Medicum60305510.26442/26586630.2023.3.202389ArticlesСтатьиReview ArticleGluten related disorders: a review of the literatureРасстройства, связанные с глютеном: обзор литературы. Часть 1https://orcid.org/0000-0003-1695-0978KamilovaAltinoy N.КамиловаАлтиной Турсуновна
Uzbekistan

D. Sci. (Med.), Prof., Republican Specialized Scientific-Practical Medical Center of Pediatrics

д-р мед. наук, проф., рук. отд. гастроэнтерологии Республиканского специализированного научно-практического медицинского центра педиатрии

okamilova@mail.ruhttps://orcid.org/0000-0002-2435-7093AzimovaNoiba D.АзимоваНоиба Джамалитдиновна
Uzbekistan

Res. Assist., Republican Specialized Scientific-Practical Medical Center of Pediatrics

мл. науч. сотр. отд. гастроэнтерологии Республиканского специализированного научно-практического медицинского центра педиатрии

okamilova@mail.ruhttps://orcid.org/0000-0003-4200-4598ZakharovaIrina N.ЗахароваИрина Николаевна
Russian Federation

D. Sci. (Med.), Prof., Russian Medical Academy of Continuous Professional Education

д-р мед. наук, проф., зав. каф. педиатрии им. акад. Г.Н. Сперанского ФГБОУ ДПО РМАНПО, засл. врач РФ

zakharova-rmapo@yandex.ruRepublican Specialized Scientific-Practical Medical Center of PediatricsРеспубликанский специализированный научно-практический медицинский центр педиатрии Минздрава Республики УзбекистанRussian Medical Academy of Continuous Professional EducationФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России0408202331731780410202304102023Copyright ©; 2023, Consilium MedicumCopyright ©; 2023, ООО "Консилиум Медикум"2023Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://pediatria.orscience.ru/2658-6630/article/view/603055

Gluten-related disorders have become an epidemiologically significant phenomenon, with an estimated prevalence of about 5% worldwide. The current classification of gluten-related disorders is based mainly on their pathophysiology, and the following categories can be distinguished: Immune-mediated disorders, which include celiac disease, allergic reactions, such as wheat allerg, and non-celiac gluten sensitivity, a condition characterized by both gastrointestinal and extraintestinal symptoms, which has recently gained popularity. Diagnostic errors in gluten-associated diseases are still a pressing clinical problem. Based on the literature, we propose a practical methodological approach to guide clinicians on how to recognize them and avoid errors. The first part of the review presents literature data on the history, causal factors in the development of gluten-related diseases, and autoimmune gluten intolerance – celiac disease.

Расстройства, связанные с глютеном, стали эпидемиологически значимым явлением, распространенность которого в мире оценивается около 5%. Современная классификация глютензависимых заболеваний (ГЗЗ) базируется, в основном, на их патофизиологии, и можно выделить следующие категории: иммуноопосредованные нарушения, которые включают целиакию, аллергические реакции, такие как аллергия на пшеницу, и нецелиакийная чувствительность к глютену – состояние, характеризующееся как желудочно-кишечными, так и внекишечными симптомами, что в последнее время выявляется все чаще. Ошибки в диагностике ГЗЗ все еще остаются актуальной клинической проблемой. Основываясь на литературных данных, мы предлагаем практический методологический подход, чтобы подсказать врачам, как их распознать и избежать ошибок. В первой части обзора представлены данные литературы по истории, о причинных факторах развития ГЗЗ, целиакии, аутоиммунной непереносимости глютена.

glutenwheatceliac diseasediagnosischildrenглютенпшеницацелиакиядиагностикадетиOECD and Food and Agriculture Organization of the United Nations. OECD-FAO Agricultural Outlook 2019–2028.Shewry PR, Hey SJ. The Contribution of Wheat to Human Diet and Health. Food Energy Secur. 2015;4:178-202.Al-Toma A, Volta U, Auricchio R, et al. European Society for the Study of Coeliac Disease (ESsCD) Guideline for Coeliac Disease and Other Gluten-Related Disorders. United Eur Gastroenterol J. 2019;7:583-613.Tovoli F, Masi C, Guidetti E, et al. Clinical and diagnostic aspects of gluten related disorders. World J Clin Cases. 2015;3(3):275-84. DOI:10.12998/wjcc.v3.i3.275Leonard MM, Vasagar B. US perspective on gluten-related diseases. Clin Exp Gastroenterol. 2014;7:25-37.Salvatori N, Reccardini F, Convento M, et al. Asthma induced by inhalation of flour in adults with food allergy to wheat. Clin Exp Allergy. 2008;38:1349-56.Taraghikhah N, Ashtari S, Asri N, et al. An updated overview of spectrum of gluten-related disorders: clinical and diagnostic aspects. BMC Gastroenterol. 2020;20(1):258. DOI:10.1186/s12876-020-01390-0Colombo F, Di Lorenzo C, Biella S, et al. Ancient and Modern Cereals as Ingredients of the Gluten-Free Diet: Are They Safe Enough for Celiac Consumers? Foods. 2021;10(4):906. DOI:10.3390/foods10040906Catassi C, Cobellis G. Coeliac disease epidemiology is alive and kicking, especially in the developing world. Dig Liver Dis. 2007;39:908-10.Камилова А.Т., Азизова Г.К., Геллер С.И. Современное состояние диагностики целиакии в Узбекистане: проблемы и решения. Вопросы детской диетологии. 2021;19(4):15-22 [Kamilova AT, Azizova GK, Geller SI. Current state of celiac disease diagnosis in Uzbekistan: problems and solutions. Vopr. det. dietol. (Pediatric Nutrition). 2021;19(4):15-22 (in Russian)]. DOI:10.20953/1727-5784-2021-4-15-22Ashtari S, Pourhoseingholi MA, Rostami K, et al. Prevalence of gluten-related disorders in Asia-Pacific region: a systematic review. J Gastrointestin Liver Dis. 2019;28(1):95-105. DOI:10.15403/jgld.2014.1121.281.sysEllis A, Linaker BD. Non-coeliac gluten sensitivity? Lancet. 1978;1:1358-9.Гурова М.М. Аллергия к белку пшеницы и непереносимость глютена (обзор литературы). Медицина: теория и практика. 2020;(1). Режим доступа: https://cyberleninka.ru/article/n/allergiya-k-belku-pshenitsy-i-neperenosimost-glyutena-obzor-literatury. Ссылка активна на 15.06.2022 [Gurova MM. Allergiia k belku pshenitsy i neperenosimost' gliutena (obzor literatury). Meditsina: teoriia i praktika. 2020;(1). Available at: https://cyberleninka.ru/article/n/allergiya-k-belku-pshenitsy-i-neperenosimost-glyutena-obzor-literatury. Accessed: 15.06.2022 (in Russian)].Alvey C, Anderson CM, Freeman M. Wheat Gluten and Coeliac Disease. Arch Dis Child. 1957;32:434-7.Cooper B, Holmes G, Ferguson R, et al. Gluten-Sensitive Diarrhea without Evidence of Celiac Disease. Gastroenterology. 1980;79:801-6.Carroccio A, Mansueto P, Iacono G, et al. Non-Celiac Wheat Sensitivity Diagn osed by Double-Blind Placebo-Controlled Challenge: Exploring a New Clinical Entity. Am J Gastroenterol. 2012;107:1898-906.Rubio-Tapia A, Murray JA. Celiac disease. Curr Opin Gastroenterol. 2010;26:116-22.Elli L, Branchi F, Tomba C, et al. Diagnosis of gluten related disorders: Celiac disease, wheat allergy and non-celiac gluten sensitivity. World J Gastroenterol. 2015;21(23):7110-9. DOI:10.3748/wjg.v21.i23.7110Wang D, Li F, Cao S, Zhang K. Genomic and functional genomics analyses of gluten proteins and prospect for simultaneous improvement of end-use and health-related traits in wheat. Theor Appl Genet. 2020;133(5):1521-39. DOI:10.1007/s00122-020-03557-5Asri N, Rostami-Nejad M, Anderson RP, Rostami K. The Gluten Gene: Unlocking the Understanding of Gluten Sensitivity and Intolerance. Appl Clin Genet. 2021;14:37-50. DOI:10.2147/TACG.S276596Янкина Г.Н., Кондратьева Е.И., Лошкова Е.В., Терентьева А.А. Особенности диагностики и лечения различных форм непереносимости белка пшеницы. Вопросы детской диетологии. 2017;15(1):13-24 [Iankina GN, Kondrat'eva EI, Loshkova EV, Terent'eva AA. Osobennosti diagnostiki i lecheniia razlichnykh form neperenosimosti belka pshenitsy. Voprosy detskoi dietologii. 2017;15(1):13-24 (in Russian)].Henderson KN, Tye-Din JA, Reid HH, et al. A structural and immunological basis for the role of human leukocyte antigen DQ8 in celiac disease. Immunity. 2007;27(1):23-34. DOI:10.1016/j.immuni.2007.05.015Shan L, Molberg Ø, Parrot I, et al. Structural basis for gluten intolerance in celiac sprue. Science. 2002;297(5590):2275-9. DOI:10.1126/science.1074129Singh P, Arora A, Strand TA, et al. Global Prevalence of Celiac Disease: Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol. 2018;16:823-36.e2. DOI:10.1016/j.cgh.2017.06.037Allardyce RA, Shearman DJ. Leukocyte reactivity to alpha-gliadin in dermatitis herpetiformis and adult coeliac disease. Int Arch Allergy Appl Immunol. 1975;48(3):395-400. DOI:10.1159/000231324Hofmann S, Fischer J, Eriksson C, et al. IgE detection to α/β/γ-gliadin and its clinical relevance in wheat-dependent exercise-induced anaphylaxis. Allergy. 2012;67:1457-60. DOI:10.1111/all.12020Morita E, Matsuo H, Mihara S, et al. Fast ω-gliadin is a major allergen in wheat-dependent exercise-induced anaphylaxis. J Dermatol Sci. 2003;33(2):99-104. DOI:10.1016/s0923-1811(03)00156-7Palosuo K, Alenius H, Varjonen E, et al. Rye γ-70 and γ-35 secalins and barley γ-3 hordein cross-react with ω-5 gliadin, a major allergen in wheat-dependent, exercise-induced anaphylaxis. Clin Exp Allergy. 2001;31(3):466-73. DOI:10.1046/j.1365-2222.2001.01023.xSandiford CP, Tatham AS, Fido R, et al. Identification of the major water/salt insoluble wheat proteins involved in cereal hypersensitivity. Clin Exp Allergy. 1997;27(10):1120-9.Wieser H. Chemistry of gluten proteins. Food Microbiol. 2007;24:115-9. DOI:10.1016/j.fm.2006.07.004Liu L, Ikeda TM, Branlard G, et al. Comparison of low molecular weight glutenin subunits identified by SDS-PAGE, 2-DE, MALDI-TOF-MS and PCR in common wheat. BMC Plant Biol. 2010;10:124. DOI:10.1186/1471-2229-10-124Day L, Augustin MA, Batey IL, Wrigley CW. Wheat-Gluten Uses and Industry Needs. Trends Food Sci Technol. 2006;17:82-90.Kagnoff MF. Celiac disease: pathogenesis of a model immunogenetic disease. J Clin Invest. 2007;117(1):41-9.Ludvigsson J, Green P. Clinical management of celiac disease. J Intern Med. 2011;269:560-71.Makharia GK, Catassi C. Celiac Disease in Asia. Gastroenterol Clin North Am. 2019;48(1):101-13. DOI:10.1016/j.gtc.2018.09.007Malekzadeh R, Sachdev A, Ali AF. Coeliac disease in developing countries: middle east, India and North Africa. Best Pract Res Clin Gastroenterol. 2005;19(3):351-8.Silano M, Agostoni C, Guandalini S. Effect of the timing of gluten introduction on the development of celiac disease. World J Gastroenterol. 2010;16(16):1939-42.Rostami Nejad M, Hogg-Kollars S, Ishaq S, Rostami K. Subclinical celiac disease and gluten sensitivity. Gastroenterol Hepatol Bed Bench. 2011;4(3):102-8.Sollid LM, Markussen G, Ek J, et al. Evidence for a primary association of celiac disease to a particular HLA-DQ alpha/beta heterodimer. J Exp Med. 1989;169:345-50.Husby S, Koletzko S, Korponay-Szabó I, et al. European Society Paediatric Gastroenterology, Hepatology and Nutrition Guidelines for Diagnosing Coeliac Disease 2020. J Pediatr Gastroenterol Nutr. 2020;70(1):141-56. DOI:10.1097/MPG.0000000000002497Gujral N, Freeman HJ, Thomson ABR. Celiac disease: prevalence, diagnosis, pathogenesis and treatment. World J Gastroenterol. 2012;18(42):6036-59.Nelson Textbook Of Pediatrics, 20th ed. 2016.Rubio-Tapia A, Murray JA. Classification and management of refractory coeliac disease. Gut. 2010;59(4):547-57. DOI:10.1136/gut.2009.195131Rubio-Tapia A, Kelly DG, Lahr BD, et al. Clinical staging and survival in refractory celiac disease: a single center experience. Gastroenterology. 2009;136:99-107. DOI:10.1053/j.gastro.2008.10.013Eigner W, Bashir K, Primas C, et al. Dynamics of occurrence of refractory coeliac disease and associated complications over 25 years. Alimen Pharmacol Ther. 2017;45:364-72. DOI:10.1111/apt.13867Volta U, Caio G, Boschetti E, et al. Seronegative celiac disease: Shedding light on an obscure clinical entity. Dig Liver Dis. 2016;48:1018-22.Krauthammer A, Guz-Mark A, Zevit N, et al. Two decades of pediatric celiac disease in a tertiary referral center: What has changed? Dig Liver Dis. 2020;52:457-61.Jericho H, Sansotta N, Guandalini S. Extraintestinal Manifestations of Celiac Disease: Effectiveness of the Gluten-Free Diet. J Pediatr Gastroenterol Nutr. 2017;65:75-9.Saari A, Harju S, Mäkitie O, et al. Systematic growth monitoring for the early detection of celiac disease in children. JAMA Pediatr. 2015;169:e1525.Abaci A, Esen I, Unuvar T, et al. Two cases presenting with pubertal delay and diagnosed as Celiac disease. Clin Pediatr (Phila). 2008;47:607-9.Traggiai C, Stanhope R. Disorders of pubertal development. Best Pract Res Clin Obstet Gynaecol. 2003;17:41-56.Baydoun A, Maakaron JE, Halawi H, et al. Hematological manifestations of celiac disease. Scand J Gastroenterol. 2012;47:1401-11.Pantaleoni S, Luchino M, Adriani A, et al. Bone mineral density at diagnosis of celiac disease and after 1 year of gluten-free diet. Scientific World Journal. 2014;2014:173082. DOI:10.1155/2014/173082Sahin Y. Celiac disease in children: A review of the literature. World J Clin Pediatr. 2021;10(4):53-71.Алиева Н.Р., Камилова А.Т., Арипов А.Н. Статус витамина D при заболеваниях тонкой кишки у детей в зоне повышенной солнечной инсоляции. Клиническая лабораторная диагностика. 2017;(3). Режим доступа: https://cyberleninka.ru/article/n/status-vitamina-d-pri-zabolevaniyah-tonkoy-kishki-u-detey-v-zone-povyshennoy-solnechnoy-insolyatsii. Ссылка активна на 15.06.2022 [Alieva NR, Kamilova AT, Aripov AN. Status vitamina D pri zabolevaniiakh tonkoi kishki u detei v zone povyshennoi solnechnoi insoliatsii. Klinicheskaia laboratornaia diagnostika. 2017;(3). Available at: https://cyberleninka.ru/article/n/status-vitamina-d-pri-zabolevaniyah-tonkoy-kishki-u-detey-v-zone-povyshennoy-solnechnoy-insolyatsii. Accessed: 15.06.2022 (in Russian)].Garg K, Agarwal P, Gupta RK, Sitaraman S. Joint Involvement in Children with Celiac Disease. Indian Pediatr. 2017;54:946-8.Jericho H, Guandalini S. Extra-Intestinal Manifestation of Celiac Disease in Children. Nutrients. 2018;10:755.Kaswala DH, Veeraraghavan G, Kelly CP, Leffler DA. Celiac disease: diagnostic standards and dilemmas. Diseases. 2015;3(2):86-101.Stanković B, Radlović N, Leković Z, et al. HLA genotyping in pediatric celiac disease patients. Bosn J Basic Med Sci. 2014;14(3):171-6.Al-Toma A, Volta U, Auricchio R, et al. European Society for the Study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten-related disorders. United European Gastroenterology Journal. 2019;7(5):583-613. DOI:10.1177/2050640619844125Hadithi M, von Blomberg BME, Crusius JBA, et al. Accuracy of serologic tests and HLA-DQ typing for diagnosing celiac disease. Ann Intern Med. 2007;147(5):294-302.Catassi C, Fasano A. Celiac disease diagnosis: simple rules are better than complicated algorithms. Am J Med. 2010;123(8):691-3.Ludvigsson JF, Bai JC, Biagi F, et al. Diagnosis and management of adult coeliac disease: guidelines from the British Society of Gastroenterology. Gut. 2014;63(8):1210-28.Catassi C, Bearzi I, Holmes GK. Association of celiac disease and intestinal lymphomas and other cancers. Gastroenterology. 2005;128:S79-86.