Celiac disease historical perspective
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]
Overview
Since the advent of human life on the earth, human beings have met their nutritional demands through hunting. In times of scarce supply of food from animal sources humans used to turn to fruits, seeds, and nuts for their nutritional needs. About 8,000 years ago, Aretaeus, a Greek physician from Cappadocia, wrote a total of 8 books on medicine. In one of his books, he described a patient with celiac disease and called it 'koiliakos'. It came from Greek word of 'koelia' (abdomen), explaining diarrhea as the inability to retain food and the passage of undigested material through the gastrointestinal tract. This later formed the basis of explanation of various diseases presenting as chronic malabsorptive diarrhea, including celiac disease. In October 1887, Samuel Gee, an English pediatrician, comprehensively explained celiac disease in one of his lectures. Gee was of the opinion that if a patient affected by celiac disease can be cured at all, it must be by means of diet. He also added that the percentage of farinaceous food intake in celiac patients must be low. Gee also introduced the concept of gluten-free diet for the relief of symptoms.
Historical Perspective
Here is the historical perspective of celiac disease at a glance
| Beginning of the mankind | 2.5 million years ago | Hunting and eating meat, fruits, seeds, and nuts | |||||||||||||||||||||||||||||||||
| 10,000 years ago | Neolithic period | Discovery of agriculture. New antigens have been introduced to human diet (protein from cow, goat, and donkey milk, bird eggs, and various cereals). First cases of celiac disease. | |||||||||||||||||||||||||||||||||
| Discovery | 2,000 years ago | Aretaeus A Cappadocian physician | Described celiac disease, calling it koiliakos. It came from Greek word 'koelia (abdomen), representing a "suffering abdomen" | ||||||||||||||||||||||||||||||||
| 1812 | Mathew Baillie A Scottish physician | Described some adult patients experiencing malnutrition and bloating along with chronic diarrhea | |||||||||||||||||||||||||||||||||
| 1887 | Samuel Gee A famous English pediatrician | Gave a detailed explanation of celiac disease, presenting a lecture on "Celiac affection" | |||||||||||||||||||||||||||||||||
| 1924 | Sidney Haas A New York city pediatrician | Used a new dietetic therapeutic option for 10 children with celiac disease, the banana diet | |||||||||||||||||||||||||||||||||
| 1949 | Wood An Australian gastroenterologist | Invented a simple flexible biopsy tube which could be used for GI biopsies without requiring X-ray or gastroscope assistance | |||||||||||||||||||||||||||||||||
| 1950 | Wim Dicke A Dutch pediatrician | Suggested in his doctoral thesis that elimination of wheat, rye, and oats from diet would result in cure of celiac disease | |||||||||||||||||||||||||||||||||
| 1950 | Wim Dicke's colleagues, Weijers and Van de Kamer | Presented stool fat measurement as a method to diagnose celiac disease | |||||||||||||||||||||||||||||||||
| 1954 | John Paulley An English pathologist from Ipswich | Discovered the pathophysiology of celiac disease, that is histological abnormalities in small intestine lining | |||||||||||||||||||||||||||||||||
| Diagnosis | 1955 | Marcelo Royer An Argentinian gastroenterologist from Buenos Aires | Developed a technique for duodenal biopsy under fluoroscopic vision | ||||||||||||||||||||||||||||||||
| 1956 | Margot Shiner A German-British gastroenterologist | Developed another technique for duodenal biopsy under fluoroscopic vision | |||||||||||||||||||||||||||||||||
| 1964 | Berger A Switzerland immunologist | Detected and reported anti gliadin antibodies in children with celiac disease | |||||||||||||||||||||||||||||||||
| 1969 | European Society of Pediatric Gastroenterology (now ESPGHAN) | Gave the diagnostic tool of “Interlaken criteria”, which was used for about 20 years | |||||||||||||||||||||||||||||||||
| 1971 | Seah A British physician | Discovered an auto-antibody, the anti-reticulin; showing that antibody is not necessarily an anti-food protein | |||||||||||||||||||||||||||||||||
| 1983 | Chorzelski A Polish dermatologist from Warsaw | Discovered anti-endomysium antibodies and dermatitis herpetiformis in celiac disease patients | |||||||||||||||||||||||||||||||||
| Treatment | Recently | Main guidelines | • Agency for Healthcare Research and Quality (AHRQ, 2004)[1] • American Gastroenterological Association (AGA, 2006)[2] • North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NSPGHAN, 2005)[3] • European Society of Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN, 2012)[4] • National Institute for Health and Clinical Excellence (NICE, 2015)[5] | ||||||||||||||||||||||||||||||||
Discovery
- At the beginning of human life on the earth, nutritional demands were met through hunting. In severe circumstances, inability to hunt for a while, encouraged the utilization of fruits, seeds, and nuts.[6]
- 10,000 years ago the mankind learnt to cultivate and grow agriculture. Humans have utilized foods that were not been known for 2.5 million years.[7]
- During Neolithic period, some new foods such as milk from cow, goat, and donkey, along with bird eggs, and various cereals were introduced for daily utilization of human beings.[6]
- Amongst agricultural products, wheat showed a higher rate of growth and resistance to environmental changes. It became the main food source of human beings related to agriculture.[8]
- There were no problems until some members of the tribe suffered from abdominal discomfort, after eating wheat based products.
- About 2,000 years ago, Aretaeus, a physician from Cappadocia, wrote a total of 8 books on medicine. In one of his books, he described a patient with celiac disease and named it 'koiliakos', derived from a Greek word 'koelia' (abdomen). This was represented as “if the stomach be irretentive of the food and if it pass through undigested and crude, and nothing ascends into the body, we call such persons coeliacs”.[6]
- 17 centuries later, in 1812, Mathew Baillie, a Scottish physician, probably unaware of Aretaeus, presented his point of view about some adult patients experiencing malnutrition and bloated abdomen along with chronic diarrhea due to specific diet, “some patients have appeared to derive considerable advantage from living almost entirely upon rice." Unfortunately, his work was not considered much.[6]
- In October 1887, Samuel Gee, an English leading authority in pediatrics, gained the full credit of explanation of celiac disease, presenting a lecture named "celiac affection" to medical students; which was published next year. Gee mentioned that "If the patient can be cured at all, it must be by means of diet".[9] He also added that "the allowance of farinaceous food must be small".[10] He also found gluten-free diet relieved symptoms, which relapsed when gluten was introduced again.[6]
- In 1920s, Sidney Haas, a New York city pediatrician, used a new dietetic therapeutic option for 10 children with celiac disease, the banana diet; owing to his success in treating a child with anorexia nervosa by the diet. 8 of those children were "clinically cured" and the remaining 2 died.[11]
- In 1949, Wood, an Australian gastroenterologist, invented a simple flexible biopsy tube which could be used for GI biopsies without requiring X-ray or gastroscope.[12]
- In 1950, Wim Dicke, a Dutch pediatrician, suggested in his doctoral thesis that elimination of wheat, rye, and oats from diet would result in reasonable cure of celiac disease. He found the pathological factor to be gluten.[13]
- At the same time, Wim Dicke's colleagues, Weijers and Van de Kamer, presented a way to diagnose celiac disease by using stool fat measurement.[14]
- In 1954, John Paulley, a pathologist from Ipswich in England, discovered the histological abnormalities in small intestinal lining as the main pathophysiology of celiac disease.[15]
Diagnosis
- In 1955, Marcelo Royer, a gastroenterologist from Buenos Aires, developed a technique for duodenal biopsy under fluoroscopic vision. He was inspired by Wood's instrument.[16]
- In 1956, Margot Shiner, a German-British gastroenterologist, also developed a technique for duodenal biopsy under fluoroscopic vision. He was also inspired by Wood's instrument.[17]
- In the mid to late 60’s, it was understood that a jejunal biopsy, showing villus atrophy was the best way to diagnose celiac disease. Since atrophy of villi may also have some other causes, the diagnosis could not be approved until gluten was proven to be the cause of atrophy.
- In 1964, Berger, a Switzerland immunologist, detected and reported anti-gliadin antibodies in children with celiac disease.[18]
- In 1969, European Society of Pediatric Gastroenterology (now ESPGHAN), presented “Interlaken criteria” as a diagnostic tool, which was used for about 20 years. The criteria consisted of full remission of the symptoms on using gluten-free diet, along with curing the atrophic lesions in GI lumen, and finally recurrence of the disease, once gluten was reintroduced in diet.[6]
- In 1971, Seah, a British doctor, found that the antibody is not necessarily an anti-food protein, but it is actually an auto-antibody, the anti-reticulin.[19]
- In 1983, Chorzelski, a dermatologist from Warsaw, discovered anti-endomysium antibodies and dermatitis herpetiformis in celiac disease.[20]
- In 1986, the Coeliac society on United Kingdom was founded. Similar societies were also founded around the world.
Treatment
- The main management guidelines are issued by Agency for Healthcare Research and Quality (AHRQ, 2004)[1], the American Gastroenterological Association (AGA, 2006)[2], the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NSPGHAN, 2005)[3], the European Society of Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN, 2012)[4], and National Institute for Health and Clinical Excellence (NICE, 2015)[5].
Outbreaks
- There has just been one outbreak of celiac disease in Sweden. The details of this outbreak are summarized below:[21]
- It was established that since celiac disease has genetic, immune-mediated, and chronic features, it rarely contributes to an outbreak.
- This outbreak was quite unique for celiac disease, suggesting evolution of causal factors or environmental influences on Swedish children.
- It is assumed that an outbreak can be caused by introducing large amounts of gluten containing foods to the diet of children, immediately after withholding breast milk.
- At the beginning of outbreak more girls were affected with celiac disease than boys.
- Children that were born in summer had higher rate of celiac disease, due to high gluten containing foods during winter, when the infections are more common.
Landmark Events in the Development of Treatment Strategies
- In October 1887, Samuel Gee, an English leading authority in pediatrics, completely explained celiac disease, presenting a lecture named "celiac affection" to medical students; which was published the year later. Gee mentioned that "If the patient can be cured at all, it must be by means of diet".[9] He also added that "the allowance of farinaceous food must be small".[10] He also found that the gluten-free diet relieved symptoms, which relapsed when gluten was reintroduced.[6]
Famous Cases
- The following are a few famous cases of celiac disease:
- Drew Brees: Star quarterback for the Saints
- Justin Morneau: Twins first baseman Justin Morneau
- Chelsea Clinton: Bill Clinton’s daughter
- Zooey Deschanel: Star of the show “New Girl”
- Novak Djokovic: World renowned tennis player
- Victoria Beckham: Wife of soccer star, David Beckham
- Jessica Simpson: Actress
- Amy Yoder Begley: Olympic runner
- Ryan Phillippe: MacGruber star
- Susie Essman: Mostly known for her role on the show “Curb Your Enthusiasm”
- Rachel Weisz: Appeared in films such as “Constantine” and “The Mummy”
- Heidi Collins: A news anchor for CNN
- Robin McGraw: Dr. Phil’s wife
- Keith Olbermann: A broadcaster for Fox and ESPN
- Cedric Benson: Cincinnati Bengals running back
- Josh Turner: Famed country singer
- Elisabeth Hasselbeck: Member of “The View”
- Emmy Rossum: Known for her glamorous acting
- Dana Vollmer: U.S. swimmer
- James Starks: Green Bay Packers running back
References
- ↑ 1.0 1.1 "Celiac Disease: Summary - AHRQ Evidence Report Summaries - NCBI Bookshelf".
- ↑ 2.0 2.1 Rostom A, Murray JA, Kagnoff MF (2006). "American Gastroenterological Association (AGA) Institute technical review on the diagnosis and management of celiac disease". Gastroenterology. 131 (6): 1981–2002. doi:10.1053/j.gastro.2006.10.004. PMID 17087937.
- ↑ 3.0 3.1 Hill ID, Dirks MH, Liptak GS, Colletti RB, Fasano A, Guandalini S, Hoffenberg EJ, Horvath K, Murray JA, Pivor M, Seidman EG (2005). "Guideline for the diagnosis and treatment of celiac disease in children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition". J. Pediatr. Gastroenterol. Nutr. 40 (1): 1–19. PMID 15625418.
- ↑ 4.0 4.1 Husby S, Koletzko S, Korponay-Szabó IR, Mearin ML, Phillips A, Shamir R, Troncone R, Giersiepen K, Branski D, Catassi C, Lelgeman M, Mäki M, Ribes-Koninckx C, Ventura A, Zimmer KP (2012). "European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease". J. Pediatr. Gastroenterol. Nutr. 54 (1): 136–60. doi:10.1097/MPG.0b013e31821a23d0. PMID 22197856.
- ↑ 5.0 5.1 "Coeliac disease: recognition, assessment and management | Guidance and guidelines | NICE".
- ↑ 6.0 6.1 6.2 6.3 6.4 6.5 6.6 "www.cureceliacdisease.org" (PDF).
- ↑ Guandalini, Stefano (2008). "Historical Perspective of Celiac Disease": 1–11. doi:10.1159/000128267.
- ↑ Guandalini, Stefano (2008). "Historical Perspective of Celiac Disease": 1–11. doi:10.1159/000128267.
- ↑ 9.0 9.1 Dowd B, Walker-Smith J (1974). "Samuel Gee, Aretaeus, and the coeliac affection". Br Med J. 2 (5909): 45–7. PMC 1610148. PMID 4595183.
- ↑ 10.0 10.1 Losowsky MS (2008). "A history of coeliac disease". Dig Dis. 26 (2): 112–20. doi:10.1159/000116768. PMID 18431060.
- ↑ Haas, Sidney V. (1932). "CELIAC DISEASE". Journal of the American Medical Association. 99 (6): 448. doi:10.1001/jama.1932.02740580016004. ISSN 0002-9955.
- ↑ Wood, I (1949). "GASTRIC BIOPSY REPORT ON FIFTY-FIVE BIOPSIES USING A NEW FLEXIBLE GASTRIC BIOPSY TUBE". The Lancet. 253 (6540): 18–21. doi:10.1016/S0140-6736(49)90344-X. ISSN 0140-6736.
- ↑ Dicke, W. K.; Weijers, H. A.; KAMER, J. H. v. D. (1953). "Coeliac Disease The Presence in Wheat of a Factor Having a Deleterious Effect in Cases of Coeliac Disease". Acta Paediatrica. 42 (1): 34–42. doi:10.1111/j.1651-2227.1953.tb05563.x. ISSN 0803-5253.
- ↑ Kamer, J. H. Van De; Weijers, H. A.; Dicke, W. K. (1953). "Coeliac Disease: An Investigation into the Injurious Constituents of Wheat in Connection with their Action on Patients with Coeliac Disease". Acta Paediatrica. 42 (3): 223–231. doi:10.1111/j.1651-2227.1953.tb05586.x. ISSN 0803-5253.
- ↑ Paulley, J. W. (1954). "Observations on the Aetiology of Idiopathic Steatorrhoea". BMJ. 2 (4900): 1318–1321. doi:10.1136/bmj.2.4900.1318. ISSN 0959-8138.
- ↑ ROYER M, CROXATTO O, BIEMPICA L, BALCAZAR MORRISON AJ (1955). "[Duodenal biopsy by aspiration under radioscopic control]". Prensa Med Argent (in Spanish; Castilian). 42 (33): 2515–9. PMID 13289533.
- ↑ Shiner, Margot (1956). "DUODENAL BIOPSY". The Lancet. 267 (6906): 17–19. doi:10.1016/S0140-6736(56)91854-2. ISSN 0140-6736.
- ↑ "Diagnostische Bewertung des Nachweises von Gliadin-Antikörpern bei Cöliakie | SpringerLink".
- ↑ Seah PP, Fry L, Hoffbrand AV, Holborow EJ (1971). "Tissue antibodies in dermatitis herpetiformis and adult coeliac disease". Lancet. 1 (7704): 834–6. PMID 4102529.
- ↑ Chorzelski, T.P.; Beutner, E.H.; Sulej, J.; Tchorzewska, H.; Jablonska, S.; Kumar, V.; Kapuscinska, A. (1984). "IgA anti-endomysium antibody. A new immunological marker of dermatitis herpetiformis and coeliac disease". British Journal of Dermatology. 111 (4): 395–402. doi:10.1111/j.1365-2133.1984.tb06601.x. ISSN 0007-0963.
- ↑ Ivarsson A (2005). "The Swedish epidemic of coeliac disease explored using an epidemiological approach--some lessons to be learnt". Best Pract Res Clin Gastroenterol. 19 (3): 425–40. doi:10.1016/j.bpg.2005.02.005. PMID 15925847.