Perspectives to take into account when Studying Celiac Disease in China and Central America

Amavilia Pérez Villavicencio, Carlos Beirute Lucke, Amado Salvador Peña

Resumen


Until quite recently, it was thought that celiac disease existed neither in China nor in Central America. The cultivation of rice in China and the cultivation of maize from the Mexican highlands have respectively been the basis of nourishment in China and Central America. Environmental, social and cultural changes in these regions allow foreseeing an increase of patients with celiac disease in both regions of the world. By way of example, we can point to the deworming of rural populations which contributes to a change in the TH2 to TH1 predominant intestinal immune response, changes in the intestinal microbiota, mainly in urban areas due to access to antibiotics, change in dietary habits due to the influence of “fast foods” and changes in traditional diets based on rice or maize due to the diffusion of diets with a higher gluten content. However, it is necessary to analyze difficulties in these countries regarding the identification of the disease as well as the techniques involved in its diagnosis. The main limitation of these studies lies in the absence of duodenal biopsy specimens. In fact, every population where celiac disease is thought to be emerging needs to adjust its array of detection procedures. Although it is true that sensitive and specific serologic tests for celiac disease have allowed greater confidence in establishing the prevalence of this disease in European and North American studies, the information in China and Central America is still scarce. The creations of interdisciplinary study groups are necessary to design specific protocols for each region.


Palabras clave


celiac disease, china, central america

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