MEDIX, God. 28 Br. 153/154  •  Pregledni članak  •  Gastroenterologija HR ENG

Celijakija: novosti u etiopatogenezi, dijagnostici i terapijiCeliac disease: novelties in etiopathogenesis, diagnosis and therapy

Boris Brozović, Andrea Kresović, Irena Krznarić Zrnić, Brankica Mijandrušić Sinčić

Celijakija je tipična autoimunosna bolest u čijoj patogenezi sudjeluje gluten kao glavni čimbenik okoliša. Oboljeli imaju gensku predispoziciju obilježenu HLA-om DQ2 i DQ8 heterodimerima, a aktivirani urođeni i stečeni imunosni odgovor dovodi do oštećenja sluznice tankoga crijeva i produkciju autoantitijela. Dijagnoza celijakije zasniva se na kliničkoj slici, serološkim testovima i patohistološkom nalazu biopsije sluznice tankoga crijeva, pri čemu bi bolesnik trebao biti izložen glutenu. Za potvrdu bolesti potrebna su pozitivna specifična protutijela uz patohistološki dokaz atrofije crijevne sluznice. U slučaju diskordantnoga nalaza serologije i patohistološkoga nalaza potrebno je učiniti genetičko testiranje. Za sada je stroga, doživotna bezglutenska dijeta jedina terapija celijakije, a brojne molekule koje sudjeluju u raznim fazama patogeneze bolesti u fazi su kliničkoga ispitivanja

Ključne riječi:
celijakija; dijagnostički postupak; patogeneza; terapija

Članak u cijelosti pročitajte u tiskanom izdanju MEDIX, God. 28 Br. 153/154
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Celiac disease is a typical autoimmune disease in the pathogenesis of which a gluten participates as the main environmental factor. Patients have a genetic predisposition characterized by HLA DQ2 and DQ8 heterodimers, and the activated innate and acquired immune response leads to damage to the mucosa of the small intestine and the production of auto-antibodies. The diagnosis of celiac disease is based on the clinical presentation, serological tests and the pathohistological findings of a biopsy of the mucosa of the small intestine, whereby the patient should be exposed to gluten. To confirm the disease, positive specific antibodies are required along with pathohistological evidence of atrophy of the intestinal mucosa. In case of discordant serology findings and pathohistological findings, it is necessary to perform genetic testing. For now, a strict, lifelong gluten-free diet is the only treatment for celiac disease, and numerous molecules that participate in various stages of the diseas’s pathogenesis are being clinically tested.

Key words:
celiac disease; diagnostic procedure; pathogenesis; therapy