Pigment Epithelium-Derived Factor Affects Angiogenesis in Celiac Disease

Celiac Disease, Gluten-Free Diet and Metabolic Dysfunction-Associated Steatotic Liver Disease

Celiac disease (CD) is a chronic autoimmune disorder triggered by the ingestion of gluten-containing food by genetically predisposed individuals. Hence, treatment of CD consists of permanent avoidance of wheat, rye, barley, and other gluten-containing foods. Lifelong adherence to a gluten-free diet (GFD) improves the symptoms of CD, but recent evidence suggests it is also associated with a higher risk for hepatic steatosis and the coexistence or emergence of other cardiometabolic risk factors. Moreover, a higher risk for liver steatosis is also reported by some authors as a potential extraintestinal complication of the CD itself. Recent nomenclature changes designate the association between hepatic steatosis and at least one of five cardiometabolic risk factors as metabolic dysfunction-associated steatotic liver disease (MASLD). An extended network of potentially causative factors underlying the association between MAFLD and CD, before and after dietary therapy is implemented, was recently described. The individualized treatment of these patients is less supported by evidence, with most of the current recommendations relying on empiric clinical judgment. This review focuses on the causative associations between CD and hepatic injury, either as an extraintestinal manifestation of CD or a side effect of GFD, also referring to potential therapeutic strategies for these individuals.

Optical coherence tomography angiography findings of retinal vascular structures in children with celiac disease

PURPOSE

To investigate the vasculature of the retina and choroid in children with celiac disease using optical coherence tomography angiography (OCTA).

METHODS

A total of 60 children with celiac disease and 71 healthy controls were included in this study. All participants underwent comprehensive ophthalmologic examination and OCTA imaging. The vascular structures and the vascular density (VD) in the superficial and deep retinal vascular zones, the foveal avascular zone (FAZ) and foveal density were automatically determined using the software 3 × 3 OCTA and AngioAnalytics. Choroid thickness was calculated manually by retinal specialists.

RESULTS

No statistically significant difference in VD was found between subjects and controls. The FAZ was larger in the celiac group than in controls (0.306 ± 0.12 mm² vs 0.287 ± 0.11 mm²), but the difference was not statistically significant (P = 0.383). Subfoveal choroid thickness was thinner in the celiac group (309.9 ± 76.97 μm) than in the control group (328 ± 68.51 μm), but the difference was not statistically significant (P = 0.157) CONCLUSIONS: No statistically significant differences in VD, mean FAZ or mean subfoveal choroidal thickness were found in children with CD compared to controls.