grow people who suffer from celiac disease in Italy, but grew up in the same way those who want to share this issue and "making community." In our country's intolerance to gluten, food protein contained in wheat and other cereals such as barley and rye are about 100 thousand . Incidentally, the diagnosed cases represent only a "minority" of all Italian celiac, as the total number estimated is around 600 thousand (one per hundred inhabitants), with a ratio of cases diagnosed and cases escaped diagnosis by more than 1 through 5. What are the expectations of all these people, accustomed to living with a healing diet, gluten-free diet, but affect, and not a little psycho-relational aspects of everyday life? On a clinical level a deeply felt need is to avoid finding now considered more important for diagnostic purposes, ie, intestinal biopsy, carried out using gastroduodenoscopia . That investigation, as safe, it is considered invasive, especially in younger children. There may be important news on this soon, because in recent years have developed several simple blood test, such as finding anti-transglutaminase and anti-deamidated gliadin, with a reliability equal to, if not better, than the intestinal biopsy.
The endoscopy will remain crucial in cases of doubt , but may soon be avoided if the lab results "speak clearly". The treatment plan calls for the celiac, first, a quality product always better than diet-therapy, which must be not only gluten-free, but also valid in other nutritional and organoleptic properties, eg. not too high in fat, simple sugars and additives. In reality, this requirement is increasingly met by the continuous evolution of products offered available from industry specialist. But the dream of celiac disease is undoubtedly that of "the pill" in which healing can take a free diet! The recent explosion of knowledge has allowed us to glimpse new pathophysiological potential solutions to this problem, with enzymes that digest the gluten ingested before contact with the intestinal surface, or with a pill that "close the gates" of intestinal permeability, or finally by a vaccination.
Several clinical trials are underway to evaluate the efficacy and safety of these new compounds, so it is not science fiction to say that the gluten could return in the future, at least in part, on the table of celiac disease. Nevertheless, it should avoid the facile optimism: not only a need for further clinical data on efficacy and safety of these products, but there is also the risk that excessive confidence in the drug solution would result in a "lowering of the guard" against the gluten-free diet attitude that could be harmful, especially for risks that can be achieved in a poor control of celiac disease.
