Hugh James Freeman
International Journal of Celiac Disease. 2013, 1(1), 19-22DOI:
Abstract: 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.