Message from Norman Rosenblum, INMD Scientific Director
May 2022

May marks Celiac Disease (CD) Awareness Month in Canada. The theme for this year is “Could it be Celiac?”. CD is one of the most common autoimmune disorders and is estimated to affect 1% of Canadians, however about 90% of CD cases remain undiagnosed^{Footnote 1}. Because of CD’s multifaceted clinical presentation (e.g., patients may have severe gastrointestinal symptoms and malabsorption, extraintestinal symptoms or no symptoms at all), diagnosis remains a challenge. A Canadian study in 2013 showed that the mean age at diagnosis is 45 years, which amounts to an average diagnostic delay of 12 years^{Footnote 2}. This year, the Canadian Celiac Association (CCA) and others concerned about CD are continuing to raise awareness about the disease.

CD is a chronic autoimmune disorder where the ingestion of gluten in predisposed individuals results in the development of a mucosal immune response that subsequently leads to damage in the small intestine characterized by villous atrophy and crypt hyperplasia^{Footnote 3}. People with CD are twice as likely to develop coronary artery disease and four times as likely to develop small bowel cancers^{Footnote 4}. CD has also been shown to be associated with many autoimmune and idiopathic diseases including type 1 diabetes (about 3-12% of people with type 1 diabetes present with celiac disease)^{Footnote 3}. Currently, the only treatment for CD is a life-long, strict gluten-free diet which is challenging because gluten is present in so many different foods.  The diet is also expensive, may be of limited nutritional value, and is not readily accommodated in many countries. 

CD prevalence is increasing worldwide and the reason for this increase is unclear, but may relate to changes in dietary and hygiene habits that affect the gut microbiota^{Footnote 5}. CIHR has funded important research that may inform the development of a treatment for CD. For example, Dr. Elena Verdu’s team is currently investigating the interplay between diet and gut microbiota in CD pathogenesis. Specifically, Dr. Verdu’s team is looking at identifying groups of bacteria in the gut that may be able to digest wheat proteins better and could potentially prevent or treat CD.

In the past few decades, there have been many research developments in the field of CD, specifically about understanding the interactions between the disease, diet and the environment. Although a gluten-free diet remains the only effective treatment for CD, the CD community continues to investigate potential alternative treatments and raise awareness about the disease.

Norman Rosenblum, MD, FRCPC, FCAHS
Scientific Director
CIHR Institute of Nutrition, Metabolism and Diabetes

Date modified:

2022-05-26