Dear Colleagues,

Celiac Disease (CD) has been known since ancient times, but it was only 70 years ago when the role of gluten was discovered. This systemic disorder, which has an autoimmune component, originates in genetically susceptible individuals and is increasing in prevalence in many parts of the world (now around 1% of the general population). If left undiagnosed and untreated, CD can lead to serious complications, ranging from severe malnutrition and impaired growth to malignancy. Originally believed to be only restricted to infancy and early childhood, and manifesting with gastrointestinal symptoms, CD is now well-known as a disease that affects all ages. Moreover, CD is known to present a variety of intestinal and extra-intestinal manifestations; it is also not uncommon for CD to be completely asymptomatic. Hence, diagnosing CD requires a high degree of suspicion by the physician, who must be aware of who can and how to screen for CD. Subjects with positive screens must then undergo a final diagnostic confirmation; this process for children has recently been revised by the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN). In selected cases, these new guidelines allow for the avoidance of endoscopic biopsies (of the duodenal mucosa). After diagnosis, the only therapeutic option currently available is a life-long gluten-free diet; this is typically very effective if strictly adhered to. In recent years however, it has become clear that many patients do not fully respond to the therapy (especially in the adult age). Consequently, there is very active research concerning alternative forms of treatment, some of which appear to be very promising, including the possibility of developing, for the first time, a real cure. This Special Issue will deal with this exciting and evolving field, covering new information concerning genetics and pathogenesis, evolving clinical presentations, diagnostic approaches, and new treatments appearing on the horizon. A separate section will be devoted to presenting the state of the art understanding of a growing and highly controversial area: that of non-celiac gluten sensitivity, better referred to as wheat intolerance syndrome.

Prof. Dr. Stefano Guandalini
Dr. Sonia Kupfer
Guest Editor

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• celiac Disease
• gluten-free
• non-celiac gluten sensitivity
• autoimmunity
• malabsorption