Alessio Fasano, MD, has published an article in the August 2009 issue of the journal Scientific American entitled "Surprises from Celiac Disease."
The article is the story of the evolution of celiac disease, the history of diagnosis and research on the disease, and how the condition may hold important implications for other autoimmune disorders, from diabetes to multiple sclerosis.
Celiac disease, a condition characterized by sensitivity to gluten, a protein found in wheat, has won the attention of the medical community only in recent years. The genetic disorder affects as many as one out of 133 Americans, according to a groundbreaking 2003 study by Fasano, professor of pediatrics and director of the University of Maryland Center for Celiac Research at the University of Maryland School of Medicine.
The National Institutes of Health estimates that about 2 million people in the U.S. have celiac disease, and that more than 95 percent of people with the condition go undiagnosed.
Fasano's article in Scientific American chronicles the evolution of celiac disease, beginning 10,000 years ago in the Middle East at the birth of agriculture. When ancient people learned to plant seeds, they developed grains such as wheat, rye and barley.
The consumption of these grains marked the emergence of celiac disease. In patients with the disorder, gluten triggers an autoimmune reaction, producing antibodies that destroy the small intestine. There are no drugs to treat the disease; patients usually control their symptoms with a gluten-free diet.
Wheat - Fasano writes in Scientific American - is the third element necessary in order for celiac disease to manifest itself. Celiac patients must also have a genetic predisposition to the disorder, as well as an unusual permeable intestinal wall.
The article details how celiac disease flew under the medical community's radar for so long. In fact, Fasano's own 2003 study was most extensive search for Americans with celiac disease that had ever been done. It found that the disease was more than 100 times more prevalent than previously believed.
The article describes how gluten induces the celiac patient's immune system to attack the intestine and cause chronic indigestion and diarrhea. Symptoms less obviously tied to celiac disease include anemia, osteoporosis, chronic fatigue and even schizophrenia.
Fasano also discusses how current research is exploring treatments for celiac disease, including studies sponsored by Alba Therapeutics, which is based in the University of Maryland BioPark. And he writes of how his own research and that of others is examining the connections between celiac disease and other autoimmune disorders.
"We can begin to hope that this disease, which has followed humanity from the dawn of civilization, is facing its last century on earth," Fasano writes
To view a video of Fasano explaining his research, click here. Real Player is required.