On Medscape you can find Dr. Alessio Fasano's article "News on Celiac Disease: Where Are We? Where Are We Going?". This report summarizes developments in celiac disease research as discussed at Digestive Disease Week 2008.
PLEASE NOTE Dr. Fasano has a significant stake in Alba Therapeutics, which is seeking a medical treatment for celiac disease.
"Celiac disease is now considered an autoimmune disorder triggered by the ingestion of gluten and similar proteins of barley and rye in genetically susceptible subjects." Three studies suggested that intestinal permeability is also part of the celiac formula, helping to explain why only some people with the genetic disposition test positive for celiac disease. "A group from Italy showed that the duodenal microbiota of children with celiac disease who were exposed to gluten was radically different from the microbiota of children with celiac disease who were on a gluten-free diet." Gluten sensitivity (as opposed to celiac disease) "may be related to activation of the innate immune system without the involvement of the adaptive immune response." An Italian study "showed preliminary data suggesting a protective role for delayed gluten introduction on the onset of celiac disease in genetically at-risk infants." In at least some diagnostic cases, it might be time to question whether certain blood tests might make a biopsy diagnosis unnecessary. Work continues on medical therapies for celiac disease.