Chapters authored
Probiotics in Childhood Celiac Disease
Celiac disease (CD) is an autoimmune enteropathy induced by gluten ingestion in genetically susceptible individuals. Genetic predisposition plays an important role in the development of CD, but it is not sufficient by itself for the disease development. Although gluten proteins are the main environmental factor involved in CD pathogenesis and ingestion of gluten is necessary to manifest the disease, recent studies have suggested that alteration of the microbiota could be involved and, in particular, the interplay between gut microbiota and the mucosal immune system. Dysbiosis, the alteration of the microbiota, has been associated with a variety of intestinal pathologies including Crohn disease and CD. Most observational studies in children and adults with CD have shown alterations in the intestinal microbiota composition compared to control subjects, which is only partially recovered after treatment with a gluten‐free diet (GFD). At this time, the only treatment for CD is lifelong adherence to a GFD, which involves the elimination of grains containing gluten, wheat, rye, and barley. However, it is difficult for many patients to follow a GFD. Abnormalities in the gut microbiome in CD patients have led to the use of probiotics as a promising alternative as a therapeutic or preventative approach.
Part of the book: Probiotics and Prebiotics in Human Nutrition and Health
Celiac Disease and HBV Vaccination
Celiac disease (CD) is an immune-mediated systemic disorder elicited by gluten and related prolamins in genetically susceptible individuals, characterized by the presence of a variable combination of gluten-dependent clinical manifestations, CD-specific antibodies, HLA-DQ2 and HLA-DQ8 haplotypes, and enteropathy. Hepatitis B virus (HBV) infection is an important global public health problem that can cause chronic liver disease, and it is associated to a high risk of death from cirrhosis and hepatocellular carcinoma. Since 1982, a safe and effective HBV vaccine has been available, and recommendation for HBV vaccination has been extended to all infants to achieve protection against HBV infection. HBV vaccination is highly effective in eliciting a sustained immune response in immune-competent individuals. However, research papers have suggested that celiac patients may have low rate of protective antibodies after HBV vaccination. The failure of CD subjects to respond to HBV vaccination has great importance for public health policies as the nonresponders could be regarded as a reservoir for HBV. The aim of our work is to revise and to discuss the scarce literature on this field in order to provide clinical practice guidelines to establish the best surveillance program of response to HBV vaccine in CD pediatric patient.
Part of the book: Celiac Disease and Non-Celiac Gluten Sensitivity