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    Could Hookworm Infections Help Cure Celiac Disease?


    Jefferson Adams

    Celiac.com 11/16/2009 - Could unknown benefits from one of the oldest parasites of the human digestive tract hold the key to cure for celiac disease?


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    Australian scientists think so. Encouraged by successful treatments of Crohn's and ulcerative colitis by American researchers using a pig whipworm (Trichuris sues), a team of Australian researchers is recruiting volunteers with celiac disease for trials using human hookworm (Necator americanus).

    The researchers have undertaken a similar preliminary study using a human hookworm in Crohn's patients.

    Researchers hypothesize that the disappearance of intestinal parasites from humans in developed countries may be responsible for the upsurge in many diseases including Celiac Disease, Crohn's, ulcerative colitis, asthma and hay fever.

    Using a small group of healthy people with celiac disease, the investigators will look to see if human hookworm interferes with the human immune reaction to gluten.

    Parasites survive partly by interfering with the host's immune response. The mechanisms they use to accomplish this are similar to those required by a person to regulate against the so-called autoimmune disorders, wherein the body begins to fight against itself.

    The investigators suspect that when parasites are excluded from the environment, some individuals become sufficiently self-reactive to develop an autoimmune disease.

    Using a small group of healthy people with celiac disease, the investigators will test if a human hookworm, Necator americanus, inhibits immune responsiveness to gluten.

    Specifically, they will examine whether hookworm infection will change the immune processes and suppress gluten sensitivity in people with celiac disease.

    Celiac disease is a good model for studying Crohn's disease because both involve similar immune changes. However, celiac patients are usually healthier overall, and, importantly, are not taking powerful immune suppressive drugs, and the provocative antigens (molecules that engage the immune system and provoke the disease) are well known and can be administered or cut out at will.

    In addition to directly benefitting celiac disease sufferers, this study may provide potential guidance in the use of hookworms to control inflammatory bowel disease.

    The study is open to people with proven celiac disease who reside in Brisbane, Australia. Those who enroll will be required to avoid gluten for six months.

    The blinded study will compare disease activity and immunity after a controlled break from the gluten-free diet in celiac patients, before and after hookworm infection.
    The team will use conventional and experimental methods to examine the disease severity and the immune system of celiac subjects before and after being inoculated with N. americanus.

    They will then compare immunity levels of the study subjects
    against those of matched, celiac control subjects (not infected with hookworm), before and after eating four pieces of standard white bread each day for three to five days.

    The initial study group will be small. The researchers will recruit ten subjects for each arm of the study, for a total of twenty.

    Initially, ten larvae will be placed on the skin under a light dressing for thirty minutes, followed by five more after twelve weeks.

    The researchers intend to asses whether the hookworm infection will change the immune processes and suppress gluten sensitivity in people with celiac disease. Outcomes to be measured will be those that reflect the activity of celiac disease.

    Stay tuned to see if hookworm therapy will be coming to a gastroenterologist near you! Tell us what you think. Would you sign up? Comment below.

    Source:
    ClinicalTrials.gov

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    Guest Cecilia

    Posted

    OMG... This would be a dream come true. Please please God make it work!

    Cecilia from Argentina

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    Hookworms is a thought, but until scientists can tell for sure that it's beneficial I don't think I would do it. Have you heard of breeding with a Histocompatible person? A man on a science site told me that could reduce the immune system attacking itself--I wish science would look into that as an option so my future kids may not have to be wheat intolerant.

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    Guest CGally81

    Posted

    I for one would gladly sign up! Anything to not have to be super vigilant about my diet. If intentional hookworm infection comes to a gastroenterologist in my area, I'll go right for it. Whatever it takes.

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    Guest Jeff Kelly

    Posted

    Well it sounds sufficiently yucky for me to sign up and really, these initial trial folks are true guinea pigs in the sense that the risk that this hypothesis isn't taking into account that the risks from hookworm infection will outweight any potential benefits from blunting or muting the autoimmune reaction to gluten.

    I'll pin my hopes on the enzyme combo or larazetide acetate, thank you.

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    I myself live in the US and have had Crohn's for 10 years and am gluten sensitive (i.e. wheat/gluten triggers Crohn's flareups). I was inoculated with 25 hookworm (Necantor Americanus) this past June. Since that time, my Crohn's symptoms have been getting consistently better and now are a fraction as bad as they once were. Generalized inflammation is much less. However, as far as gluten sensitivity goes, it will get worse before it gets better with this therapy.

     

    This is because the hookworm actually cause the body change anatomically and flatten its villi out (in an attempt to flush the worm out). Even people that historically have no problem with gluten will oftentimes become gluten sensitive at this time due to this for a period of months. After this change completes, the hope with me is that the gluten sensitivity symptoms largely reside, since the worms also promote the creation of peripheral T suppressor cells.

     

    The therapy does not have a linear path of improvement and is long term (the brunt of benefits begin after 4-6 MONTHS, and it will take 1 to 1.5 YEARS to see the full effect) but I have been amazed with my progress so far due to a little worm. Fingers crossed.

     

    BTW, there is a wealth of published literature out there about hookworm and autoimmune diseases. I reviewed all of that, talked to my GI doctor and family, and took the plunge.

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    Would love to know more about this study but definitely would consider participation. Interesting theory from an RN point of view.

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    I have been living with Celiac for 20 years and look forward to the day they come up with a supplement for us. But, oh my, I could not think of allowing worms into my body. I'm sure I would have nightmares of them crawling around inside. I wish good luck to those that are brave enough to do this.

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    Guest Gloria Brown

    Posted

    The researchers expectations for a control group to eat four pieces of white bread for three to five days is dangerous for those individuals. I hope hookworm therapy will not prove so as well.

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    I have had Celiac disease for 30 years, since my mid twenties, and follow a strict gluten free diet. If an unknown sneaks in the reactions are severe and have become more severe as time has gone by. If I ate four pieces of bread a day for 3-5 days I would not be able to tolerate it. One bite of bread would cause 6 hours of pure pain and two more days to be able to be able to absorb nutrients without pain. I would not sign up for this as the damage done to my gut by ingesting that much white bread would not outweigh a cure. After reading rbd's remark, it doesn't sound like it's healthy due to the body's worm elimination process. No thanks!

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    Guest Amanda McClain

    Posted

    I do not doubt that something that has occurred in my body, could also be cured by something from nature. For those who brave the frontier and participate in the study, my prayers are with you. If there is a cure, YEAH! If not, I am still happy to be here and in good quality of health. Would I be willing to participate, absolutely.

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    Guest Karen McGravey-Gajera

    Posted

    Wonderful hope!!!

    My daughter could do this...we live in the northeast USA. Please keep us updated!

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    I have had problems from gluten intolerance for15 years but have only been gluten free for 6 months. I feel no better but the few symptoms I had are better. But I miss eating my favorite foods so much that if this works and the side effects aren't worse than the cure, I would definitely do this.

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    Guest Barbara

    Posted

    Very interesting. I am all for finding a cure. However, as a mother of a 9 year old daughter who has been gluten free for almost 2 years now, I could never put her through the process as it was described in this article. Heck, I don't think I would do it - never mind her. That being said, I am very glad that others are willing to give it a try in hopes of finding a cure for everyone.

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    It will be most interesting to see the final results of this 'worm trial'. I guess most of us are not happy at the thought of some parasite wriggling around inside of us. But who knows - if it means that we can eat some REAL bread again - HOORAY!

    I was diagnosed as Coeliac in late 2006 and have been very careful to avoid gluten containing foods. I also believe that the longer a person is on a gluten-free diet the more sensitive they become if gluten is accidentally introduced into the diet. I have several other autoimmune diseases which specialists think are definitely connected to Coeliac Disease. Maybe they would improve or disappear with the 'worm treatment'

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    Guest Christine

    Posted

    I myself live in the US and have had Crohn's for 10 years and am gluten sensitive (i.e. wheat/gluten triggers Crohn's flareups). I was inoculated with 25 hookworm (Necantor Americanus) this past June. Since that time, my Crohn's symptoms have been getting consistently better and now are a fraction as bad as they once were. Generalized inflammation is much less. However, as far as gluten sensitivity goes, it will get worse before it gets better with this therapy.

     

    This is because the hookworm actually cause the body change anatomically and flatten its villi out (in an attempt to flush the worm out). Even people that historically have no problem with gluten will oftentimes become gluten sensitive at this time due to this for a period of months. After this change completes, the hope with me is that the gluten sensitivity symptoms largely reside, since the worms also promote the creation of peripheral T suppressor cells.

     

    The therapy does not have a linear path of improvement and is long term (the brunt of benefits begin after 4-6 MONTHS, and it will take 1 to 1.5 YEARS to see the full effect) but I have been amazed with my progress so far due to a little worm. Fingers crossed.

     

    BTW, there is a wealth of published literature out there about hookworm and autoimmune diseases. I reviewed all of that, talked to my GI doctor and family, and took the plunge.

    I am amazed at what "rbd" had to say about voluntarily being infected with hookworms. A brave person, although I'm considering it myself. I'd love to hear more about his/her progress. Wonder if it's possible to easily kill those little blood suckers if things went south?

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    I would definitely do this! I actually thought about asking my doc, but then realized since it isn't even through the study phase yet, it would probably be difficult for her to get a hold of some hookworms....I would love to be cured of this!!!

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    I searched this topic after reading about other beneficial effects of hookworm in auto-immune conditions and was very excited to see that it's already being researched! I wouldn't hesitate to participate in clinical trials if any are available in my area, (Northern California).

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    Guest Laurie

    Posted

    I'm very skeptical about this working. I was recently diagnosed with Hashimoto's Thyroiditis, celiac disease AND a hookworm infestation. I've already got hookworms and they didn't stop me from getting an autoimmune illness or from having autoimmune responses to gluten, casein and soy.

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    Guest worm buddy

    Posted

    well, well, well.....how interesting to read all the above comments. I am one of those participants residing in Brisbane Australia and was fortunate enough to be one of the 'guinea pigs' mentioned. I have been inoculated for over a year now and at the end of the trial, I chose to keep my new buddies (to answer one blog - a single dose of worming tablets will see an end to our friendship!).

     

    I chose to keep my new found friends as they are a naturally occurring parasite and I have felt no side effects - in fact I feel that the effects of incidental 'poisoning' from eating out has been reduced (based on pre-inoculation experiences). I agree with some comments that I had to give it a go with a hope to find assistance in dealing with and hopefully recovering from this condition.

     

    The first stage is over and my understanding is that the consenting control group are also being inoculated after which time, the initial inoculated group will be offered to rejoin the longitudinal study. It is reported that the initial findings are favorable, hence the continuance of the study. To answer Laurie, it may depend on the type of hookworm you have and I guess you can't measure the difference you may feel if you didn't haven't any hookworm - can't have it both ways. Keep on eye on this one!

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    Guest veronica

    Posted

    Thank you worm buddy for being our guinea pig and giving us hope.

     

    We are praying for you. I would be a guinea pig here in Ohio.

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    I find this interesting. After 11 years of many unrelated symptoms, 2 naturopaths suspected gluten but blood work was always negative. My own research led me to the possibility of parasites. (puppies, kitties, gardening etc.) After a 3 month parasite cleanse/ diet changes with some positive results it then seemed like a Violent shove into gluten and dairy intolerance. Fasting was the only thing that brought relief. (gastro, muscles, extreme fatigue and many more) Then gluten and dairy free continued the relief of many non classic gluten sensitivity symptoms. I had always thought the parasite cleanse was the link. As with many gluten sensitive people, doctors have been of little help. Even the celiac specialist that sent me my genetic test showing DQ 2.5 with the letter stating I have NO celiac risk, since my endoscopy was normal. Thank You to everyone in this study, blessed health to you all.

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    I think it's important to note hookworms most commonly found in humans are not native to North America but are believed to have arrived during slavery. Hookworm disease is known to cause anemia and iron deficiencies depending on the bodies current state of health. Sufferers symptoms include protein deficiency, mental dullness, heart failure among others, but intestinal absorption is not a feature of this disease. For all that are considering the infection, I would ask if further stressing the body's ability to fight off symptoms of foreign agents is worth simply avoiding an gluten? I don't and I would choose health and listening to my body's natural indicators.

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    I know this is an old thread, but there's an interesting recent discussion about this on the NPR Radiolab episode "Parasites", Season 6, Episode 3.

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    Is the study still going on? What are the results so far?

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    I myself live in the US and have had Crohn's for 10 years and am gluten sensitive (i.e. wheat/gluten triggers Crohn's flareups). I was inoculated with 25 hookworm (Necantor Americanus) this past June. Since that time, my Crohn's symptoms have been getting consistently better and now are a fraction as bad as they once were. Generalized inflammation is much less. However, as far as gluten sensitivity goes, it will get worse before it gets better with this therapy.

     

    This is because the hookworm actually cause the body change anatomically and flatten its villi out (in an attempt to flush the worm out). Even people that historically have no problem with gluten will oftentimes become gluten sensitive at this time due to this for a period of months. After this change completes, the hope with me is that the gluten sensitivity symptoms largely reside, since the worms also promote the creation of peripheral T suppressor cells.

     

    The therapy does not have a linear path of improvement and is long term (the brunt of benefits begin after 4-6 MONTHS, and it will take 1 to 1.5 YEARS to see the full effect) but I have been amazed with my progress so far due to a little worm. Fingers crossed.

     

    BTW, there is a wealth of published literature out there about hookworm and autoimmune diseases. I reviewed all of that, talked to my GI doctor and family, and took the plunge.

    Hi RDB,

     

    You posted this in 2009. Now 5 years later, did the hookworms help with the celiac?

     

    Would be great to get an update, Mark.

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    Jefferson Adams is a freelance writer living in San Francisco. He has covered Health News for Examiner.com, and provided health and medical content for Sharecare.com. His work has appeared in Antioch Review, Blue Mesa Review, CALIBAN, Hayden's Ferry Review, Huffington Post, the Mississippi Review, and Slate, among others.

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    The research team included Antti Saari, MD; Samuli Harju, BM; Outi Mäkitie, MD, PhD; Marja-Terttu Saha, MD, PhD; Leo Dunkel, MD, PhD; and Ulla Sankilampi, MD, PhD. They are variously affiliated with the Department of Pediatrics, School of Medicine, University of Eastern Finland, Kuopio, the Children’s Hospital at the University of Helsinki and Helsinki University Hospital in Helsinki, Finland, the Folkhälsan Research Centre in Helsinki, Finland, the Department of Molecular Medicine and Surgery at the Karolinska Institute in Stockholm, Sweden, the Department of Pediatrics at Tampere University Hospital in Tampere, Finland, the Centre for Endocrinology at the William Harvey Research Institute of Barts and the London School of Medicine and Dentistry at Queen Mary University of London in London, England and the Department of Pediatrics at Kuopio University Hospital, Kuopio, Finland.
    Their longitudinal retrospective study included growth data of healthy children from primary health care providers, and children with celiac disease from primary health care, and three university hospital outpatient clinics in Finland, Kuopio University Hospital, Tampere University Hospital, and Helsinki University Hospital, from January 1, 1994, to April 9, 2009.
    Children of the reference population were under 20 years of age, while children in the celiac disease group were between 1 and 16 years of age. In the reference population of 51,332 healthy children, the team screened according to five age- and sex-specific growth parameters: height standard deviation score and body mass index standard deviation score, distance from the population mean, distance from target height, change in height standard deviation score, and change in body mass index standard deviation score.
    They evaluated these parameters and their combination in 177 children with celiac disease by analyzing longitudinal growth data from birth until diagnosis of celiac disease.
    They measured the screening accuracy for detecting abnormal growth in children with celiac disease by using receiver operating characteristics analysis expressed as the area under the curve. When the team screened using the combination of all 5 growth-screening parameters, they detected celiac disease with good accuracy ([95% CI] = 0.88 [0.84–0.93] for girls and 0.84 [0.77–0.91] for boys).
    When they set the screening specificity at 90%, they saw abnormal growth in 57% of the girls with celiac disease, and in 48% of the boys with celiac disease for two years prior to diagnosis. This study shows that most kids with celiac disease experience faltering growth prior to diagnosis. An effective growth-monitoring program could have detected celiac disease in these kids several years earlier.
    By using several growth-monitoring parameters in combination, preferably using computerized screening algorithms that are integrated into an electronic health record system, researchers can improve sreening accuracy.
    Source:
     JAMA Pediatr. 2015;169(3):e1525. doi:10.1001/jamapediatrics.2015.25.

  • Recent Articles

    Jefferson Adams
    Celiac.com 06/21/2018 - Would you buy a house advertised as ‘gluten-free’? Yes, there really is such a house for sale. 
    It seems a Phoenix realtor Mike D’Elena is hoping that his trendy claim will catch the eye of a buyer hungry to avoid gluten, or, at least one with a sense of humor. D’Elena said he crafted the ads as a way to “be funny and to draw attention.” The idea, D’Elena said, is to “make it memorable.” 
    Though D’Elena’s marketing seeks to capitalizes on the gluten-free trend, he knows Celiac disease is a serious health issue for some people. “[W]e’re not here to offend anybody….this is just something we're just trying to do to draw attention and do what's best for our clients," he said. 
    Still, the signs seem to be working. D'elena had fielded six offers within a few days of listing the west Phoenix home.
    "Buying can sometimes be the most stressful thing you do in your entire life so why not have some fun with it," he said. 
    What do you think? Clever? Funny?
    Read more at Arizonafamily.com.

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    Bakery On Main started in the small bakery of a natural foods market on Main Street in Glastonbury, Connecticut. Founder Michael Smulders listened when his customers with Celiac Disease would mention the lack of good tasting, gluten-free options available to them. Upon learning this, he believed that nobody should have to suffer due to any kind of food allergy or dietary need. From then on, his mission became creating delicious and fearlessly unique gluten-free products that were clean and great tasting, while still being safe for his Celiac customers!
    Premium ingredients, bakeshop delicious recipes, and happy customers were our inspiration from the beginning— and are still the cornerstones of Bakery On Main today. We are a fiercely ethical company that believes in integrity and feels that happiness and wholesome, great tasting food should be harmonious. We strive for that in everything we bake in our dedicated gluten-free facility that is GFCO Certified and SQF Level 3 Certified. We use only natural, NON-GMO Project Verified ingredients and all of our products are certified Kosher Parve, dairy and casein free, and we have recently introduced certified Organic items as well! 
    Our passion is to bake the very best products while bringing happiness to our customers, each other, and all those we meet!
    We are available during normal business hours at: 1-888-533-8118 EST.
    To learn more about us at: visit our site.

    Jefferson Adams
    Celiac.com 06/20/2018 - Currently, the only way to manage celiac disease is to eliminate gluten from the diet. That could be set to change as clinical trials begin in Australia for a new vaccine that aims to switch off the immune response to gluten. 
    The trials are set to begin at Australia’s University of the Sunshine Coast Clinical Trials Centre. The vaccine is designed to allow people with celiac disease to consume gluten with no adverse effects. A successful vaccine could be the beginning of the end for the gluten-free diet as the only currently viable treatment for celiac disease. That could be a massive breakthrough for people with celiac disease.
    USC’s Clinical Trials Centre Director Lucas Litewka said trial participants would receive an injection of the vaccine twice a week for seven weeks. The trials will be conducted alongside gastroenterologist Dr. James Daveson, who called the vaccine “a very exciting potential new therapy that has been undergoing clinical trials for several years now.”
    Dr. Daveson said the investigational vaccine might potentially restore gluten tolerance to people with celiac disease.The trial is open to adults between the ages of 18 and 70 who have clinically diagnosed celiac disease, and have followed a strict gluten-free diet for at least 12 months. Anyone interested in participating can go to www.joinourtrials.com.
    Read more at the website for Australia’s University of the Sunshine Coast Clinical Trials Centre.

    Source:
    FoodProcessing.com.au

    Jefferson Adams
    Celiac.com 06/19/2018 - Could baking soda help reduce the inflammation and damage caused by autoimmune diseases like rheumatoid arthritis, and celiac disease? Scientists at the Medical College of Georgia at Augusta University say that a daily dose of baking soda may in fact help reduce inflammation and damage caused by autoimmune diseases like rheumatoid arthritis, and celiac disease.
    Those scientists recently gathered some of the first evidence to show that cheap, over-the-counter antacids can prompt the spleen to promote an anti-inflammatory environment that could be helpful in combating inflammatory disease.
    A type of cell called mesothelial cells line our body cavities, like the digestive tract. They have little fingers, called microvilli, that sense the environment, and warn the organs they cover that there is an invader and an immune response is needed.
    The team’s data shows that when rats or healthy people drink a solution of baking soda, the stomach makes more acid, which causes mesothelial cells on the outside of the spleen to tell the spleen to go easy on the immune response.  "It's most likely a hamburger not a bacterial infection," is basically the message, says Dr. Paul O'Connor, renal physiologist in the MCG Department of Physiology at Augusta University and the study's corresponding author.
    That message, which is transmitted with help from a chemical messenger called acetylcholine, seems to encourage the gut to shift against inflammation, say the scientists.
    In patients who drank water with baking soda for two weeks, immune cells called macrophages, shifted from primarily those that promote inflammation, called M1, to those that reduce it, called M2. "The shift from inflammatory to an anti-inflammatory profile is happening everywhere," O'Connor says. "We saw it in the kidneys, we saw it in the spleen, now we see it in the peripheral blood."
    O'Connor hopes drinking baking soda can one day produce similar results for people with autoimmune disease. "You are not really turning anything off or on, you are just pushing it toward one side by giving an anti-inflammatory stimulus," he says, in this case, away from harmful inflammation. "It's potentially a really safe way to treat inflammatory disease."
    The research was funded by the National Institutes of Health.
    Read more at: Sciencedaily.com

    Jefferson Adams
    Celiac.com 06/18/2018 - Celiac disease has been mainly associated with Caucasian populations in Northern Europe, and their descendants in other countries, but new scientific evidence is beginning to challenge that view. Still, the exact global prevalence of celiac disease remains unknown.  To get better data on that issue, a team of researchers recently conducted a comprehensive review and meta-analysis to get a reasonably accurate estimate the global prevalence of celiac disease. 
    The research team included P Singh, A Arora, TA Strand, DA Leffler, C Catassi, PH Green, CP Kelly, V Ahuja, and GK Makharia. They are variously affiliated with the Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Lady Hardinge Medical College, New Delhi, India; Innlandet Hospital Trust, Lillehammer, Norway; Centre for International Health, University of Bergen, Bergen, Norway; Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Gastroenterology Research and Development, Takeda Pharmaceuticals Inc, Cambridge, MA; Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy; Department of Medicine, Columbia University Medical Center, New York, New York; USA Celiac Disease Center, Columbia University Medical Center, New York, New York; and the Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India.
    For their review, the team searched Medline, PubMed, and EMBASE for the keywords ‘celiac disease,’ ‘celiac,’ ‘tissue transglutaminase antibody,’ ‘anti-endomysium antibody,’ ‘endomysial antibody,’ and ‘prevalence’ for studies published from January 1991 through March 2016. 
    The team cross-referenced each article with the words ‘Asia,’ ‘Europe,’ ‘Africa,’ ‘South America,’ ‘North America,’ and ‘Australia.’ They defined celiac diagnosis based on European Society of Pediatric Gastroenterology, Hepatology, and Nutrition guidelines. The team used 96 articles of 3,843 articles in their final analysis.
    Overall global prevalence of celiac disease was 1.4% in 275,818 individuals, based on positive blood tests for anti-tissue transglutaminase and/or anti-endomysial antibodies. The pooled global prevalence of biopsy-confirmed celiac disease was 0.7% in 138,792 individuals. That means that numerous people with celiac disease potentially remain undiagnosed.
    Rates of celiac disease were 0.4% in South America, 0.5% in Africa and North America, 0.6% in Asia, and 0.8% in Europe and Oceania; the prevalence was 0.6% in female vs 0.4% males. Celiac disease was significantly more common in children than adults.
    This systematic review and meta-analysis showed celiac disease to be reported worldwide. Blood test data shows celiac disease rate of 1.4%, while biopsy data shows 0.7%. The prevalence of celiac disease varies with sex, age, and location. 
    This review demonstrates a need for more comprehensive population-based studies of celiac disease in numerous countries.  The 1.4% rate indicates that there are 91.2 million people worldwide with celiac disease, and 3.9 million are in the U.S.A.
    Source:
    Clin Gastroenterol Hepatol. 2018 Jun;16(6):823-836.e2. doi: 10.1016/j.cgh.2017.06.037.