International Journal of Celiac Disease
ISSN (Print): 2334-3427 ISSN (Online): 2334-3486 Website: Editor-in-chief: Samasca Gabriel
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International Journal of Celiac Disease. 2013, 1(1), 19-22
DOI: 10.12691/ijcd-1-1-8
Open AccessEditorial

The Neolithic Revolution and Subsequent Emergence of the Celiac Affection

Hugh James Freeman1,

1Department of Medicine (Gastroenterology), University of British Columbia, Vancouver, Canada

Pub. Date: December 18, 2013

Cite this paper:
Hugh James Freeman. The Neolithic Revolution and Subsequent Emergence of the Celiac Affection. International Journal of Celiac Disease. 2013; 1(1):19-22. doi: 10.12691/ijcd-1-1-8


Evidence suggests that celiac disease initially emerged as a distinct intestinal disorder sometime after organization of hunter-gatherers into human workforces capable of agriculture, especially wheat cultivation. This Neolithic revolution possibly developed to permit competitive survival over other hunter-gatherer groups. Recent archeological data suggests that wheat cultivation may have occurred in eastern , near the Gobleki Tepe, a recently discovered archeological site in the , about 10,000 to 12,000 years ago. DNA fingerprinting data suggests that diploid Einkorn wheat from this region was domesticated through hybridization into other more modern hexaploid grains with a higher more immunogenic gliadin content. Clinical features suggestive of celiac disease and recommendations for treatment are believed to have been first described by Aretaeus from Cappadocia about 250 AD, and later, by other clinicians from Europe and . In recent decades, celiac disease has become further defined as a clinical and pathological disorder developing in genetically predisposed individuals as a result of an immune-mediated reaction to specific peptides in wheat and other grains. Data largely from screening studies also suggests that the disorder is not uncommon, occurring in up to 2% of most populations studied. Detection is also increasing, possibly due to better clinical recognition, wider use of screening methods and, possibly, a true increase in celiac disease occurrence.

celiac disease Areteaus the Cappadocian Samuel Gee gluten-free diet Neolithic revolution agriculture wheat cultivation

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[1]  Freeman HJ, Chopra A, , Recent advances in celiac disease. World J Gastroenterol 2011; 17: 2259-2272.
[2]  Gujral N, Freeman HJ, Thomson AB. Celiac disease: prevalence, diagnosis, pathogenesis and treatment. World J Gastroenterol 2012; 18: 6036-6059.
[3]  Dube C, Rostom A, Sy R, Cranney A, Saloojee N, Garritty C, Sampson M, Zhang L, Yazdi F, Mamaladze V, Pan I, Macneil J, Mack D, Patel D, Moher D. The prevalence of celiac disease in average-risk and at-risk Western European populations: a systematic review. Gastroenterology 2005; 128 (4 Suppl 1): S57-S67.
[4]  Rubio-Tapia A, Ludvigsson JF, Brantner TL, Murray JA, Everhart JE. The prevalence of celiac disease in the United States. Am J Gastroenterol 2012; 107: 1538-1544.
[5]  Rubio-Tapia A, Kyle RA, Kaplan EL, Johnson DR, Page W, Erdtmann F, Brantner TL, Kim WR, Phelps TK, Lahr BD, Zinsmeister AR, Melton LJ 3rd, Murray JA. Increased prevalence and mortality in undiagnosed celiac disease. Gastroenterology 2009; 137: 88-93.
[6]  Freeman HJ. Detection of adult celiac disease using duodenal screening biopsies over a 30-year period. Can J Gastroenterol 2013; 27: 405-408.
[7]  Freeman HJ. Sulindac-associated small bowel lesion. J Clin Gastroenterol 1986; 8: 569-571.
[8]  Rubio-Tapia A, Herman ML, Ludvigsson JF, et al. Severe spruelike enteropathy associated with olmesartan. Mayo Clin Proc 2012; 87: 732-738.
[9]  Heun M, Schafer-Pregl R, Klawan D, Castagna R, Accerbi M, Borghi B, Salamini F. Site of Einkorn wheat domestication identified by DNA fingerprinting. Science 1997; 278: 1312-1314 .
[10]  Pizzuti D, Buda A, D’Odorico A, D’Inca R, Chiarelli S, Curioni A, Martines D. Lack of intestinal mucosal toxicity of Triticum monococcum in celiac disease patients. Scand J Gastroenterol 2006; 41: 1305-1311.
[11]  Batuman E. The sanctuary. The world’s oldest temple and the dawn of civilization. The New Yorker, December 19 and 26, 2011; 72-83.
[12]  Adams F (translator). On the Coeliac Affection. The Extant Works of Aretaeus, the Cappadocian. London, Sydenham Society. 1856; 350-351.
[13]  Losowsky MS. A history of coeliac disease. Dig Dis 2008; 26: 112-120.
[14]  Selcuk ZT, Coplu L, Emri S, Kalyoncu AF, Sahin AA, Baris YI. Malignant pleural mesothelioma due to environmental mineral fiber exposure in Turkey. Analysis of 135 cases. Chest 1992; 102: 790-796.
[15]  Emri S, Demir A, Dogan M, Akay H, Bozkurt B, Carbone M, Baris I. Lung diseases due to environmental exposures to erionite and asbestos in Turkey. Toxicol Lett 2002; 127: 251-257.
[16]  Dogan AU, Baris YI, Dogan M, Emri S, Steele I, Elmishad AG, Carbone M. Genetic predisposition to fiber carcinogenesis causes a mesothelioma epidemic in Turkey. Cancer Res 2006; 66: 5063-5068.
[17]  Dikensoy O. Mesothelioma due to environmental exposure to erionite in Turkey. Curr Opin Pulm Med 2008; 14: 322-325 .
[18]  Gasbarrini G, Miele L, Corazza GR, Gasbarrini A. When was celiac disease born?: the Italian case from the archeologic site of Cosa. J Clin Gastroenterol 2010; 44: 502-503
[19]  Dowd B, Walker-Smith J. Samuel Gee, Aretaeus, and the Coeliac Affection. Br Med J 1974; 2: 45-47.
[20]  Paveley WF. From Aretaeus to Crosby: a history of coeliac disease. Br Med J 1988; 297: 1646-1649.
[21]  Losowsky MS. A history of coeliac disease. Dig Dis 2008; 26: 112-120.
[22]  Lewkonia RM. Letter. Samuel Gee, Aretaeus and the Coeliac Affection. Br Med J 1974; 2: 442.
[23]  Gee SJ. On the coeliac affection. St. Bartholomew’s Hospital Report 1888; 24: 17-20.
[24]  Snell AM. Clinical observations on nontropical sprue. Arch Intern Med 1936; 57: 837-856.
[25]  Paulley JW. Observations on the aetiology of idiopathic steatorrhoea; jejunal and lymph node biopsies. Br Med J 1954; ii: 1318-1321.
[26]  Haas S. Value of banana treatment in celiac disease. Am J Dis Child 1924; 28: 421-437.
[27]  van Berge-Henegouwen GP, Mulder CJ. Pioneer in the gluten free diet: Willem-Karel Dicke 1905-1962, over 50 years of gluten free diet. Gut 1993; 34: 1473-1475.
[28]  Freeman HJ. Non-dietary forms of treatment for adult celiac disease. World J Gastrointest Pharmacol Ther 2013; 4: 108-11.
[29]  Freeman HJ. Celiac disease associated with primary biliary cirrhosis in a Coast Salish native. Can J Gastroenterol 1994; 8: 105-107.
[30]  Suttles W. Coping with abundance: subsistence on the northwest coast. In: Suttles W, Ed. Coast Salish Essays. University of Washington Press, Seattle. 1987; 45-63.
[31]  Suttles W. The early diffusion of the potato among the Coast Salish. In: Suttles W, Ed. Coast Salish Essays. University of Washington Press, Seattle. 1987; 137-151.
[32]  Harris C. The lower mainland, 1820-1881. In: Wynn G, Oke T, Eds. Vancouver and its region. University of British Columbia Press, Vancouver. 1992; 38-68.