Title Komplikacije celijakije Title (english) Complications of celiac disease Author Karla Petrovčić Mentor Zrinjka Mišak (mentor)Committee member Irena Senečić-Čala (predsjednik povjerenstva)Committee member Marija Jelušić (član povjerenstva)Committee member Zrinjka Mišak (član povjerenstva)Granter University of Zagreb Defense date and country 2024-07-12, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Celijakija je kronična autoimunosna enteropatija koja zahvaća oko 1% populacije globalno i može se pojaviti u bilo kojoj životnoj dobi. Nastaje u genetski predisponiranih pojedinaca nakon izlaganja glutenu u hrani. Gluten, smjesa pšeničnih proteina, sveprisutni je sastojak današnje prehrane pa se tako može naći u kruhu i pekarskim proizvodima, tjestenini, keksima i kolačima. Slični proteini glutenu, nalaze se i u raži i ječmu, dok se za zob smatra da je sigurna i u većine neće izazvati simptome celijakije. Peptidi glutena, koji nastaju nakon djelomičnog probavljivanja, ulaze u laminu propriju tankoga crijeva te tako aktiviraju i urođeni i stečeni imunosni odgovor ukoliko postoji genetska predispozicija koja obuhvaća prisutnost HLA -DQ 2 i DQ 8 haplotipa na antigen prezentirajućim stanicama. Naime HLA-DQ2 i DQ8 vežu deamidirane ostatke glutena te tako aktiviraju CD4+ T stanice. Osim CD4+ T stanica, u patogenezi celijakije sudjeluju i CD8+ T stanice, interferoni, interleukini IL-7, IL-15, IL-21 i B stanice koje proizvode protutijela na tkivnu transglutaminazu i deamidirani glijadinski peptid. Simptomi celijakije posljedica su upale, deficijencije mikronutrijenta i autoimunosnog odgovora na tkivnu transglutaminazu, a mogu se prezentirati crijevnim i izvancrijevnim simptomima. Upravo zbog mogućnosti zahvaćanja gotovo bilo kojeg organskog sustava, danas je otežano i često, zakašnjelo dijagnosticiranje celijakije. Dijagnoza celijakije uključuje serologiju i potvrdu anti-tTG protutijela te biopsiju sluznice tankoga crijeva. Celijakija se uspješno liječi strogom doživotnom bezglutenskom prehranom. Kasno prepoznata ili neliječena celijakija može dovesti do razvoja brojnih komplikacija, malignih i nemalignih, dok pravilno provođenje bezglutenske prehrane sprječava njihov razvoj. Cilj ovog rada je prikazati moguće komplikacije celijakije te ukazati na važnost ranog prepoznavanja i pravilnog liječenja.
Abstract (english) Celiac disease is a chronic autoimmune enteropathy that affects about 1% of the global population, and can occur at any age. It develops in genetically predisposed individuals after exposure to dietery gluten. Gluten, a mixure of wheat proteins, is a ubiquitous component of today’s diet and can be found in bread and other baked goods, pasta, cookies and cakes.
Similar proteins to gluten can also be found in rye and barley, while oats are considered safe and do not cause symptoms of celiac disease in most people. Gluten peptides, which result from incomplete digestion, enter the lamina propria of the small intestine and thus activate both innate and adaptive immune response in genetically predisposed individuals. Genetic
predisposition includes the presence of HLA-DQ2 and DQ8 haplotypes present on antigenpresenting cells. HLA-DQ2 and DQ8 bind deaminated gluten residues and thus activate CD4+ T cells. In addition to CD4+ T cells, CD8+ T cells, interferons, interleukins IL-7, IL-15, IL-21 and B cells which produce antibodies to tissue transglutaminase and deaminated gliadin peptide, are involved in the pathogenesis of celiac disease. The symptoms of celiac disease are a consequence of inflammation, micronutrient defficiency and an autoimmune response to tissue transglutaminase and can present with both intestinal and extraintestinal symptoms. Due to the possibility of affecting almost every organ system, diagnosis of celiac disease is often difficult and delayed. The diagnosis includes serology and confirmation of anti-tTG antibodies, as well as biopsy of the small intestine mucosa. Celiac disease can successfully be managed with a strict, lifelong gluten-free diet. Late diagnosis or untreated celiac disease can lead to the development of numerous complications, both non-malignant and malignant, while proper adherence to a gluten-free diet prevents their development. The aim of this paper is to present the possible complications of celiac disease and highlight the importance of early diagnosis and treatment.
Keywords
celijakija
gluten
autoimunost
komplikacije celijakije
refraktorna celijakija
Keywords (english)
Celiac disease
gluten
autoimmunity
complications of celiac disase
refractory celiac disease
Language croatian URN:NBN urn:nbn:hr:105:156488 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2024-06-16 19:16:52
