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Written by an all-star cast of celiac experts, including Dr. Green and Dr. Fassano. They are trying to make sense of the gluten intolerance spectrum.
I'm still reading so I won't opine yet...
Abstract
A decade ago celiac disease was considered extremely rare outside Europe and, therefore, was almost
completely ignored by health care professionals. In only 10 years, key milestones have moved celiac
disease from obscurity into the popular spotlight worldwide. Now we are observing another interesting
phenomenon that is generating great confusion among health care professionals. The number of
individuals embracing a gluten-free diet (GFD) appears much higher than the projected number of celiac
disease patients, fueling a global market of gluten-free products approaching $2.5 billion (US) in global
sales in 2010. This trend is supported by the notion that, along with celiac disease, other conditions
related to the ingestion of gluten have emerged as health care concerns. This review will summarize our
current knowledge about the three main forms of gluten reactions: allergic (wheat allergy), autoimmune
(celiac disease, dermatitis herpetiformis and gluten ataxia) and possibly immune-mediated (gluten
sensitivity), and also outline pathogenic, clinical and epidemiological differences and propose new
nomenclature and classifications.
I think this article means progress, sort of. It acknowledges the existence of glutebn sensitivity, but then oversimplifies it by postulating that there is NO immune reaction involved. We know here that the immune system plays a role, maybe just not with the particular antibodies they are looking for in peripheral blood, and without obvious small intestine damage. Oh well. One slow step at a time...
No, they are saying the reactions are immune mediated, just not a humoral response with antibody production. The fact that they are acknowledging extra-intestinal symptoms and gut permeability is huge progress for these guys. It was really only a few short years ago that Dr. Fasano didn't even agree that gluten sensitivity existed, so the recent studies that have been done are very important. In time the rest will come to light . . .at least I hope.
Mary Beth
"If you believe it will work out, you'll see opportunities. If you believe it won't you will see obstacles." - Dr. Wayne Dyer
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