Ameloblasts are specialized epithelial cells in the jaw that have an indispensable role in tooth enamel formation-amelogenesis1. Amelogenesis depends on multiple ameloblast-derived proteins that function as a scaffold for hydroxyapatite crystals. The loss of function of ameloblast-derived proteins results in a group of rare congenital disorders called amelogenesis imperfecta2. Defects in enamel formation are also found in patients with autoimmune polyglandular syndrome type-1 (APS-1), caused by AIRE deficiency3,4, and in patients diagnosed with coeliac disease5-7. However, the underlying mechanisms remain unclear. Here we show that the vast majority of patients with APS-1 and coeliac disease develop autoantibodies (mostly of the IgA isotype) against ameloblast-specific proteins, the expression of which is induced by AIRE in the thymus. This in turn results in a breakdown of central tolerance, and subsequent generation of corresponding autoantibodies that interfere with enamel formation. However, in coeliac disease, the generation of such autoantibodies seems to be driven by a breakdown of peripheral tolerance to intestinal antigens that are also expressed in enamel tissue. Both conditions are examples of a previously unidentified type of IgA-dependent autoimmune disorder that we collectively name autoimmune amelogenesis imperfecta.
- MeSH
- ameloblasty metabolismus MeSH
- amelogenesis imperfecta * komplikace imunologie MeSH
- antigeny imunologie metabolismus MeSH
- autoimunitní polyglandulární syndromy * komplikace imunologie MeSH
- autoprotilátky * imunologie MeSH
- celiakie * komplikace imunologie MeSH
- imunoglobulin A imunologie MeSH
- lidé MeSH
- protein AIRE nedostatek MeSH
- proteiny imunologie metabolismus MeSH
- střeva imunologie metabolismus MeSH
- zubní sklovina imunologie metabolismus MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Celiac disease is an immune-mediated enteropathy triggered by gluten in genetically susceptible individuals. Diagnosis is based on evaluating specific autoantibodies and histopathologic findings of duodenal biopsy specimens. The only therapy for celiac disease is a gluten-free diet. Celiac disease can be complicated by malnutrition, other autoimmune diseases, refractoriness to treatment, and gastrointestinal tumors. This article presents seven cases of malignancies in patients with celiac disease. Its objective is to raise awareness of the malignant complications of celiac disease, leading to earlier diagnosis and improved outcomes. CASE PRESENTATION: Seven cases of malignant complications of celiac disease occurred among 190 patients followed at the Department of Internal Medicine and Gastroenterology, University Hospital Brno from 2014 to 2021. We describe these cases and the presentation, diagnostic process, course, management, and outcomes for each, along with proposed potential risk factors of malignant complications. There was one Caucasian man who was 70 years old and six Caucasian women who were 36, 46, 48, 55, 73, and 82 years old in our cohort. Of the seven cases of malignancies in our cohort, four patients were diagnosed with small bowel adenocarcinoma, one with diffuse large B-cell lymphoma, one with carcinoma of the tongue, and one with colorectal carcinoma. CONCLUSIONS: Malignancies occurred in 3.7% of patients followed up for celiac disease. Awareness of the malignant complications of celiac disease, risk factors, presentation, and disease course could lead to earlier diagnosis and improved outcomes.
Gastrointestináiní trakt hraje klíčovou roli v metabolismu vápníku a vitaminu D a významně se tak podílí na zdraví skeletu. Onemocnění gastrointestinálního traktu, zejména tenkého střeva, pankreatu a jater, jsou spojena nejen s poruchami metabolismu vápníku a vitaminu D, ale i s vyšším výskytem osteoporózy a nízkotraumatických fraktur. Rovněž v gastroenterologii běžně užívaná farmaka interagují se vstřebáváním vápníku v tenkém střevě, a tím se nepřímo podílejí na zvýšeném riziku osteoporózy.
Gastrointestinal tract plays a key role in calcium and vitamin D metabolism, thus significantly participates in bone health. Diseases of the gastrointestinal tract, especially small intestine, pancreas and liver, are interwoven not only with disorders of the calcium and vitamin D metabolism, but also with higher incidence of osteoporosis and low-trauma fractures. Common gastrointestinal medication can also interact with calcium absorption in the small intestine, and so increase the risk of osteoporosis.
- MeSH
- celiakie komplikace MeSH
- gastrointestinální nemoci * komplikace metabolismus MeSH
- kosti a kostní tkáň patologie MeSH
- kostní denzita účinky léků MeSH
- lidé MeSH
- metabolické nemoci kostí chemicky indukované epidemiologie MeSH
- nežádoucí účinky léčiv epidemiologie etiologie MeSH
- osteoporóza * chemicky indukované epidemiologie MeSH
- vápník metabolismus MeSH
- vitamin D metabolismus MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Celiakia je celoživotná intolerancia lepku, ktorý sa nachádza v základných obilninách a tým aj v množstve bežne konzumovaných potravín. Celiakia je ochorenie, ktoré sa čoraz častejšie manifestuje v subklinickej alebo oligosymptomatickej forme alebo atypickými prejavmi. Problémy zubnej skloviny, pri ochorení celiakiou, sú pomerne časté a postihujú hlavne permanentný chrup. Často sú vo forme zmeny farby - sivobiele, žlté alebo s hnedými škvrnami na zuboch, s chybnou tvorbou skloviny, s drobnými priehlbinkami či kaskádovitým vzhľadom. Tieto poruchy sú symetrické s najčastejším výskytom na rezákoch a molároch.
Celiac disease is a lifelong intolerance to gluten which is found in basic cereals as well as in a number of commonly consumed foods. Celiac disease is a condition which is increasingly manifested in a subclinical or oligosymptomatic form or by atypical symptoms. In patients with celiac disease, tooth enamel problems are relatively common, particularly affecting the permanent dentition. They often present with discoloration - off-white, yellow, or with brown spots on the teeth, defective enamel formation, small depressions, or cascading appearance. These defects are symmetrical and most commonly occur in the incisors and molars. Material and method: The paper presents an analysis of a group of 48 patients investigated during a 10-year period (2011-2020), aged 7-20 years, of whom 17 were men (35.4%) and 31 women (64.6%). Patients with celiac disease were most often diagnosed with dental malocclusion, delayed tooth eruption, enamel defects, unequal tooth size as well as recurrent aphthous stomatitis or fissured tongue. Discussion: Manifestations in the oral cavity are caused, in particular, by insufficient nutrition, primarily lacking the protein component as well as vitamins and trace elements. The changes in teeth are often permanent and cannot be improved without the patient following a gluten-free diet, the only causal treatment for celiac disease. Conclusion: Patients with celiac disease require a multidisciplinary approach, and good patient cooperation is necessary not only with a gastroenterologist, but also with a dentist. The quality of oral health, including teeth and oral mucosa, often significantly limits the overall health of not only those with celiac disease.
- MeSH
- bezlepková dieta MeSH
- celiakie * diagnóza dietoterapie imunologie klasifikace komplikace patofyziologie patologie MeSH
- diferenciální diagnóza MeSH
- dítě MeSH
- lidé MeSH
- terciární prevence MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- anemie z nedostatku železa * diagnóza etiologie terapie MeSH
- aplikace orální MeSH
- bezlepková dieta MeSH
- celiakie * komplikace krev patofyziologie MeSH
- intravenózní podání MeSH
- lidé MeSH
- železité sloučeniny aplikace a dávkování terapeutické užití MeSH
- železo aplikace a dávkování terapeutické užití MeSH
- Check Tag
- lidé MeSH
- MeSH
- autoimunita MeSH
- celiakie * komplikace patofyziologie patologie MeSH
- duodenum patologie MeSH
- histologické techniky MeSH
- komplikace těhotenství imunologie patofyziologie patologie MeSH
- lidé MeSH
- protilátky imunologie MeSH
- T-lymfocyty MeSH
- těhotenství MeSH
- transglutaminasy antagonisté a inhibitory imunologie MeSH
- ženská infertilita * etiologie MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- přehledy MeSH
Celiac disease has been recognized as a multisystem immunological disorder commonly manifested in children and adults. Celiac disease is a common syndrome which is usually efficiently treated with a gluten-free diet as well as an optimal prognosis. Some major symptoms of celiac disease include malabsorption syndrome which could manifest in the form of chronic diarrhea, weight loss, and abdominal distention. COVID-19 have been observed to impact and worsen several disorders and lifestyle habits but have been found to not affect patients with autoimmune diseases such as celiac disease. This article would serve as a foundation for further research on the impact of COVID-19 on celiac disease.
- MeSH
- celiakie * komplikace prevence a kontrola MeSH
- COVID-19 MeSH
- kongresy jako téma MeSH
- lidé MeSH
- rizikové faktory MeSH
- vakcíny proti COVID-19 normy škodlivé účinky terapeutické užití MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- zprávy MeSH
More and more patients with celiac disease are asking us “Should I be vaccinated against COVID-19, or not? What to do?” These are unknown things, we live in new times. What we can do is gather information and present it to you in the following. My colleagues, Professor Hugh James Freeman and Professor Aaron Lerner will give you answers in 2 articles of high academic level “COVID-19 AND CELIAC DISEASE” and “COV-2 IN CELIAC DISEASE: A PATHOGEN OR JUST ALONG FOR THE RIDE?”, which I invite you to read. We have also a nice article “IS THERE IS A LINK BETWEEN COVID-19 AND CELIAC DISEASE?” from USA. As Editor-in-chief, I will present you official information from official websites.
- MeSH
- celiakie * komplikace prevence a kontrola MeSH
- COVID-19 MeSH
- kongresy jako téma MeSH
- lidé MeSH
- rizikové faktory MeSH
- vakcíny proti COVID-19 normy škodlivé účinky terapeutické užití MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- zprávy MeSH
COVID-19 is a novel coronavirus that appears to cause a systemic disorder largely marked by fever and respiratory symptoms as well as diarrhea. The agent gains access to respiratory and gastrointestinal cells through a complex molecular mechanism associated with increased ACE2 receptor expression on brush border membranes of epithelial cells. Because some autoimmune-based disorders, including celiac disease, appear to be at increased risk for viral and community-acquired bacterial infections, a number of preliminary survey studies from different countries, largely web-based or telephone-based, have suggested that COVID-19 infection risk is not increased in celiac disease. However, specific sub-groups of patients with celiac disease have not been thoroughly evaluated. For example, selective immunoglobulin A deficiency or other immune deficiency states with celiac disease may represent a special risk group for COVID-19 and other viral infectious agents.
- MeSH
- celiakie * komplikace prevence a kontrola MeSH
- COVID-19 MeSH
- kongresy jako téma MeSH
- lidé MeSH
- rizikové faktory MeSH
- vakcíny proti COVID-19 normy škodlivé účinky terapeutické užití MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- zprávy MeSH
