腹腔疾病（CD）是一种自身免疫消化条件，大约影响1 in 100people worldwide. Thesymptomsof celiac disease – including diarrhea, bloating and abdominal pain – occur as a result of the body’s immune system mistakenly attacking gluten proteins, causing damage to the surface of the small intestine. The symptoms of CD can bewell-controlledwith a gluten-free diet, and prompt诊断is essential for controlling the symptoms. CD is usually detected through a blood test for CD-associated antibodies followed by an intestinal biopsy.

Advances in detecting CD and comorbid autoimmune disease

Newresearchby Carlos López-Larrea and colleagues published inBMC Medicinehas revealed that antibodies against the proteinMHC I类多肽相关序列A（云母）存在于CD患者中，其存在与含麸质的饮食有关。这些发现表明，云母蛋白可能参与CD发病机理，测量针对这些蛋白质的抗体可以预测无麸质饮食的成功。

Importantly, the authors also showed that anti-MICA抗体与腹腔患者患上自身免疫性疾病的风险增加有关。来自荟萃分析by Juan-Manuel Anaya and colleagues suggests that autoimmune diseases tend to cluster in individuals and families, so it is important to elucidate predictive factors for further autoimmunity. The results of the study by López-Larrea等。suggest that anti-MICA antibodies could be used as a predictive marker for further autoimmune disease development in celiac patients, so that monitoring and treatment can be tailored towards the appropriate patients.

CD还是非胶体面筋敏感性？

尽管我们对CD发病机制的理解treatment has increased substantially in recent years, a number of controversies in the field remain, particularly regarding nomenclature and prevalence. Some people suffer gastrointestinal symptoms after eating gluten but the cause is unknown; these patients do not have CD or damage to the gut wall, but have symptoms similar to those experienced by celiac patients. In anOpinion article,Alessio Fasano和colleagues presented new nomenclature for gluten sensitivity disorders, broadly divided into “allergic”, “autoimmune” and “possibly immune-mediated”. Fasano and colleagues explain that:

“It is now becoming apparent that reactions to gluten are not limited to CD, rather we now appreciate the existence of a spectrum of gluten-related disorders”

虽然non-celiac gluten sensitivity（NCGS）在许多国家越来越多地认识到它，无法通过血液检查来识别它，并且仍然了解不足。为了解决这种情况围绕这种情况的争议，需要进一步的工作来阐明致病机制并了解谁受到NGC的风险。

Improving celiac prevalence estimates

由于改变了与麸质相关疾病的命名法，以及某些患者不愿进行活检以识别CD的结果，已经提出CD的患病率估计值inaccurate. In an attempt to address this disparity, Robert Anderson and colleagues applied a新型的血清发育方法to estimating CD prevalence in those with biopsy-confirmed CD. In this study, the authors showed that antibody testing alone leads to substantial underestimation of CD prevalence, whereas serological testing for the human leukocyte antigen (HLA)-DQ genotype improves detection. These findings suggest that serogenetic testing could be used in the clinic to reduce the number of invasive biopsies and improve the accuracy of CD testing.

Taken together, these studies reveal new and improved ways to detect celiac disease and its comorbidities through minimally invasive serological methods. Continued refinement of sensitive diagnostic tests, used alongside Fasano and colleagues’ criteria for the spectrum of gluten-related disorders, should improve the detection and management of CD and related conditions. We are keen to receive further submissions in this rapidly advancing area of medicine, and if you have any research you would like us to consider, please emailbmcmedicineeditorial@biomedcentral.com.