COELIAC DISEASE: A COMPREHENSIVE LITERATURE REVIEW

Szymon Targosz; Karol Józef Szkarłat; Maksymilian Szklarski; Jędrzej Sztajura; Ewa Maraszewska; Michał Stachel; Weronika Szymacha; Aleksandra Płecka; Karol Zimnicki; Alicja Stępień

doi:10.31435/ijitss.2(50).2026.5475

Authors

Szymon Targosz Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland https://orcid.org/0009-0005-2251-5229
Karol Józef Szkarłat Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland https://orcid.org/0009-0004-2889-8382
Maksymilian Szklarski Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland https://orcid.org/0009-0001-6977-0666
Jędrzej Sztajura Students’ Scientific Club, Department of Neurosurgery, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland https://orcid.org/0009-0009-8975-731X
Ewa Maraszewska Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland https://orcid.org/0009-0003-0992-7144
Michał Stachel Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland https://orcid.org/0009-0008-3264-4747
Weronika Szymacha Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Poland https://orcid.org/0009-0000-1592-5602
Aleksandra Płecka Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland https://orcid.org/0009-0007-0075-5234
Karol Zimnicki Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland https://orcid.org/0009-0001-9687-2641
Alicja Stępień Voivodship Dental Clinic, Consulting Dental Prosthetics Department, Cracow, Poland https://orcid.org/0009-0003-2717-6030

DOI:

https://doi.org/10.31435/ijitss.2(50).2026.5475

Keywords:

Gluten, Transglutaminase, Dermatitis Herpetiformis, Endomysium, T-cell Lymphoma

Abstract

Introduction and purpose: Celiac disease is a chronic, autoimmune, and gluten-dependent disorder that, in genetically predisposed individuals, leads to inflammation of the intestinal mucosa and villous atrophy. This results in the malabsorption of micro- and macroelements, subsequently leading to various complications. It is estimated to affect approximately 1% of the population. Due to oligosymptomatic presentations, many cases remain undiagnosed; however, untreated disease can lead to serious complications ranging from anemia to gastrointestinal malignancies. This review paper summarizes the epidemiology, diagnostics, clinical presentation, and treatment of the disease, while also discussing potential new methods for treatment and monitoring.

Description of the State of Knowledge: Gluten molecules entering the gastrointestinal tract are rich in glutamine, which is converted by tissue transglutaminase (tTG) into glutamic acid. This acid has a high affinity for HLA-DQ2/DQ8 antigens on antigen-presenting cells. These cells stimulate CD4+ T lymphocytes, which produce pro-inflammatory cytokines and activate B lymphocytes to produce specific antibodies: anti-endomysial (EMA), anti-deamidated gliadin peptides (DGP), and anti-tissue transglutaminase (tTG). Under the influence of IL-15, intraepithelial CD8+ lymphocytes destroy the intestinal villi. These mechanisms lead to gastrointestinal symptoms such as abdominal pain, diarrhea, and bloating, as well as extraintestinal manifestations including anemia, skin lesions, and neurological, psychiatric, or gynecological disorders. Currently, the primary treatment is a strict gluten-free diet. As many cases remain undiagnosed or are detected late, new diagnostic and therapeutic methods are actively being researched.

Conclusion: Our understanding of celiac disease is constantly expanding, and new diagnostic tools are being developed. While a restrictive diet is effective in many cases, it remains burdensome and can decrease the patient's quality of life. Further research into novel therapeutic and diagnostic approaches is essential to improve the detection rate, particularly in cases with an atypical clinical course.

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