The whole of the bacteria hosted in our intestine, or the microbiome, forms a vital critical mass that interacts with our body – “for better or worse” – starting from birth. As recent studies have shown, the intestinal microbiome appears to have significant connections to gluten-related disorders.
The articles published in this issue of the DSI Forum explore different perspectives on the relationships between the microbial flora populating our intestine – known as the intestinal microbiome – and gluten-related disorders, first among them coeliac disease: two apparently distant “worlds” that are actually surprisingly linked.
A glance at PubMed, the most complete medical-scientific database worldwide, shows that there has been an exponential growth in the number of publications on the intestinal microbiome since the early 2000s, jumping from 35 articles in 2004 to 1,656 in 2014! In 2014 alone, no fewer than 21 articles dealt with the relationships between the “bacterial world” of the intestine and coeliac disease. Such an increase is primarily due to the development of new technologies in molecular genetics that enable us to analyse the intestinal bacterial flora quickly, easily and accurately. Regarding coeliac disease, one of the most relevant topics today is the impressive increase in the frequency of this illness over recent decades, a phenomenon that cannot be ascribed to changes in genes, which require much more time to take place, but only to environmental changes. These include changes in diet, lifestyle, the spread of infections, and the bacterial population that has settled in our intestine.
As a paediatrician, I am particularly interested in the potential relationship between certain factors in early life, such as type of birth (natural or Caesarean), infant feeding, intestinal infections and the use of antibiotics, the intestinal microbiome and the risk of developing coeliac disease. The analysis of these aspects could help us to better understand the “recipe” for the genetic and environmental cocktail that leads to the development of gluten-dependent disorders – not just coeliac disease, but also non-coeliac gluten sensitivity. In terms of treatment, an understanding of persistent changes in the microbiome, known as dysbiosis, could foster the implementation of new treatments aimed at improving quality of life in people suffering from gluten-related disorders.
Author
PROFESSOR CARLO CATASSI
- Professor for pediatrician at the Marche Poltechnic University (Italy)
- President of the Italian Society for Pediatric Gastroenterology, Hepatology and Nutrition, years 2013-2016
- Coordinator of the Dr. Schär Advisory Board