Wiki page
INDEX
How to read this page
Start with the article narrative. Use the right sidebar to jump from prose into concept context, nearby graph relationships, and source provenance.
Wiki articles: 64
Extraction files: 22 TTL files in extractions/
Current focus: post-diagnosis management, follow-up, complications, and therapy landscape
Last compiled: 2026-05-06
Articles
| Article | Summary | Key Concepts |
|---|---|---|
| overview | Definition, quick-reference card, key facts | autoimmune, gluten, small intestine, GFD |
| terminology | Classification subtypes; spelling; related disorders | asymptomatic, NRCD, RCD, NCGS |
| symptoms | GI and extraintestinal manifestations; deficiencies | diarrhea, malabsorption, neuropathy, anemia |
| causes | Gluten proteins, HLA-DQ genetics, environmental triggers | gliadin, HLA-DQ2, HLA-DQ8, prolamins |
| mechanism | Immune pathway from gluten ingestion to villous atrophy | tTG, deamidation, T cells, Marsh classification |
| diagnosis | Blood tests, endoscopy, Marsh grading, differential dx | TTG IgA, biopsy, ESPGHAN guidelines |
| management | GFD, monitoring, NRCD/RCD, cancer risk | gluten-free, dietitian, DEXA, EATL |
| epidemiology | Prevalence, demographics, risk groups | 1 in 200, underdiagnosis, HLA geography |
| history | Discovery timeline from ancient Greece to 1960s | Gee, Dicke, villous atrophy, wheat-famine link |
| research | Emerging diagnostics and treatments | glutenases, larazotide, immunomodulation |
| society | Psychosocial burden, religion, GF food economics | anxiety, Eucharist, Passover, cross-contamination |
| research_plan | Structured plan to fill research gaps — 8 priority areas, search queries, sources to acquire | glutenases, immunotherapy, IL-15, HLA blocking, RCD, microbiome |
| glossary | Plain-English definitions for key terms, biology concepts, and full acronym table | HLA, IEL, tTG, EATL, SIBO, FODMAP, villi, cytokines, serology |
| skos-lexicon | Human-readable summary of the concept scheme extracted from the current corpus | SKOS, lexicon, ontology, concept clusters |
| celiac-serology | Consolidated view of the antibody-testing layer in diagnosis and monitoring | serology, TTG IgA, EMA, DGP, IgA deficiency |
| antigen-presentation | Bridge page for APC / MHC II / HLA-DQ / CD4 T-cell logic | antigen presentation, HLA-DQ2/DQ8, epitopes, T cells |
| gluten-related-disorders | Boundary map of celiac disease versus adjacent gluten-related entities and mimics | NCGS, wheat allergy, dermatitis herpetiformis, gluten ataxia, SIBO |
| oats | Dedicated synthesis page for the oats question in celiac disease | avenin, contamination, tolerance, GFD |
| wheat-allergy | Differential page distinguishing allergic wheat reactions from celiac disease | IgE, allergy, differential diagnosis |
| follow-up-after-diagnosis | Practical synthesis page for what to monitor, who should follow, and how recovery is assessed after diagnosis | follow-up, serology, dietitian, quality of life, DEXA |
| gluten-exposure-and-cross-contamination | Practical synthesis page for calibrating contamination risk without drifting into hypervigilance | contamination, thresholds, restaurants, oats, GFD |
| gluten-thresholds | Practical synthesis page for translating ppm labels and trace exposure into biologically meaningful dose thinking | thresholds, ppm, contamination, dose, GFD |
Concept Pages
Gut Anatomy & Pathology
| Page | Core Idea |
|---|---|
| small-intestine | Anatomy of the three segments; why duodenum/jejunum are hit hardest |
| villi | Finger-like projections; the absorptive surface destroyed in celiac |
| enterocytes | The absorptive cells; brush border; rapid turnover; role in gliadin processing |
| villous-atrophy | The central structural damage; graded by Marsh; drives malabsorption |
| crypt-hyperplasia | The gut's failed repair attempt; elongated crypts |
| malabsorption | Nutrient absorption failure; downstream cascade of deficiencies |
| tight-junctions | Molecular seals between gut cells; loosened by zonulin; drug target |
| intestinal-permeability | How open/closed the barrier is; the leaky gut mechanism |
Key Proteins & Molecules
| Page | Core Idea |
|---|---|
| prolamins | The disease-causing grain storage proteins; resistant to digestion |
| gliadin | The primary wheat prolamin; the 33-mer peptide; most immunogenic |
| tissue-transglutaminase | Repair enzyme that modifies gluten AND becomes autoimmune target |
| deamidation | tTG's chemical conversion of gliadin → 100× stronger HLA binding |
| zonulin | Gliadin-triggered protein that opens tight junctions |
Immune System & Genetics
| Page | Core Idea |
|---|---|
| hla-dq2-dq8 | The genetic lock; necessary but not sufficient; 40% of population carries these |
| cd4-t-cells | The commanders of the immune attack; activated by HLA-gluten complex |
| il-15 | Innate immune alarm; drives IEL proliferation; central to RCD type 2 |
| cytokines-celiac | IFN-γ, IL-15, IL-21 etc.; the chemical signals coordinating damage |
| intraepithelial-lymphocytes | Immune sentinels in the epithelium; earliest histological marker |
| autoantibodies-celiac | Anti-tTG antibodies; both disease driver and diagnostic marker |
| iga-and-iga-deficiency | Why celiac tests use IgA; why IgA deficiency causes false negatives |
| antigen-presentation | The adaptive bridge from deamidated gluten peptide to CD4+ T-cell activation |
Diagnosis
| Page | Core Idea |
|---|---|
| ttg-iga-test | First-line blood test; 92.8% sensitivity; correlates with disease activity |
| celiac-serology | The overall antibody-testing logic tying TTG IgA, EMA, DGP, and IgA deficiency together |
| marsh-classification | 0–3c histological grading scale for biopsy damage |
| endoscopy-biopsy | Procedure; why multiple samples; endoscopic features; capsule alternative |
| gluten-challenge | Re-introducing gluten before testing; when it's needed; protocol |
Treatment & Management
| Page | Core Idea |
|---|---|
| gluten-free-diet | The only proven treatment; what to eliminate; cross-contamination; recovery timeline |
| gluten-thresholds | The practical question of how ppm labels relate to real daily dose and mucosal risk |
| follow-up-after-diagnosis | The practical bridge from diagnosis to monitoring, recovery, and escalation if symptoms persist |
| oats | The special-case grain: often tolerated if pure, but biologically and practically ambiguous |
| non-responsive-celiac | Symptoms persist on GFD; usually SIBO/FODMAP/inadvertent gluten, not RCD |
| refractory-celiac | True treatment failure; type 1 vs type 2; aberrant IELs; EATL risk |
Complications
| Page | Core Idea |
|---|---|
| eatl | The most feared cancer complication; pre-malignant continuum from RCD type 2 |
| dermatitis-herpetiformis | Skin form of gluten sensitivity; IgA deposits; pathognomonic |
| osteoporosis-celiac | Multiple mechanisms of bone loss; often silent; DEXA monitoring |
| celiac-hepatitis | Mildly elevated liver enzymes; resolves on GFD |
| peripheral-neuropathy-celiac | Nerve damage from deficiency + autoimmunity |
| gluten-ataxia | Cerebellar autoimmune damage from anti-TG6 antibodies |
| iron-deficiency anemia | Most common extraintestinal presentation; frequently the only clue |
Related Conditions
| Page | Core Idea |
|---|---|
| gluten-related-disorders | Hub page for celiac-adjacent gluten entities and important mimics |
| ncgs | Gluten symptoms without celiac markers; faster onset/offset; mechanism unclear |
| wheat-allergy | Allergic wheat reaction distinct from autoimmune celiac disease |
| sibo | Bacterial overgrowth mimicking celiac; most common cause of NRCD after unintentional ingestion |
Emerging Treatments
| Page | Core Idea |
|---|---|
| glutenases | Enzyme therapy to digest gluten before immune system sees it; most advanced pipeline |
| larazotide-acetate | Tight junction drug; blocks zonulin; Phase 3 missed primary endpoint |
| il-15-inhibitors | AMG 714 and others; targets innate immune arm; most relevant for RCD |
| tolerance-induction | Re-training T cells to ignore gluten; Nexvax2 failed; KAN-101 in Phase 2 |
Source Documents
| File | Type | Coverage |
|---|---|---|
raw/Celiac_disease.pdf | Wikipedia article (PDF) | Comprehensive overview: all major topics |
Concept Map (Key Relationships)
GLUTEN (wheat/barley/rye)
↓ ingested by
GENETICALLY PREDISPOSED INDIVIDUAL (HLA-DQ2/DQ8)
↓ triggers
AUTOIMMUNE RESPONSE (tTG, T cells, cytokines)
↓ causes
VILLOUS ATROPHY → MALABSORPTION
↓ manifests as
SYMPTOMS (GI + extraintestinal)
↓ diagnosed by
TTG IgA + BIOPSY (Marsh classification)
↓ treated by
LIFELONG GFD
↓ if ineffective →
NRCD → RCD (Type 1 / Type 2)
Open Questions / Remaining Gaps
- How much does food-environment cross-contamination contribute outside the home in practice?
- How should users interpret the gap between acute immune activation thresholds and longer-term mucosal injury thresholds?
- What is the best educational synthesis for young adult bone health after diagnosis?
- Which therapy candidates are most likely to matter first in ordinary practice, rather than only in specialist/refractory settings?
- How does gut microbiome composition modulate disease onset and severity?
Roadmap Snapshot
Completed thematic blocks:
- Sprint A — management / oats / follow-up
- Sprint B — contamination / practical management update
- Sprint C — nutrient recovery / bone / follow-up quality
- Sprint D — therapy landscape refresh
Most likely next thematic block:
- Sprint E — thresholds / exposure / real-world contamination