With increasing research on the interplay between genetics and environmental risk factors in the early stages of coeliac disease, the need to harmonise scientific terms and concepts in this field has increased. In an effort led by researchers at Karolinska Institutet and the Mayo Clinics, 22 scientists from 7 countries have published a review on the stages of early coeliac disease. The paper is published in Gut.
Coeliac disease (CeD) is an immune-mediated disease characterised by small intestinal enteropathy. It has a rising incidence worldwide and currently affects about 1% of the global population.
The International Society for the Study of Coeliac Disease (ISSCD) therefore set up a task force, the so called Before Coeliac Disease (B4CeD) task force, to define crucial concepts about the early development of CeD. As part of this work, some 2,623 scientific publications were reviewed, out of which 438 were read in full.
Important to identify patients at an early stage
"The aim of this effort was to harmonise concepts to advance better research and clinical practice targeting individuals who are at the early development stage of CeD," says first author Jonas F. Ludvigsson , professor at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, and paediatrician at Örebro University Hospital.
"We hope that consistent use of terms and concepts will facilitate comparison of research findings, increase translatability into clinical practice and improve clinical guidelines", Ludvigsson continues. "Coeliac disease is a quickly evolving field."
Publication
B4CeD: harmonising scientific terms and concepts in early coeliac disease.
Ludvigsson JF, Auricchio R, Yao J, Agardh D, Ciacci C, Green PHR, Jansson-Knodell CL, Jonkers I, Lebwohl B, Leffler DA, Leonard MM, Liu E, Marild K, Pinto-Sanchez MI, Rubio-Tapia A, Sanders DS, Stahl MG, Tye-Din J, Verdu EF, Verma R, Zingone F, Murray JA. Gut 2026 doi: 10.1136/gutjnl-2026-338154 [published Online First: Oct 23, 2026]. DOI: 10.1136/gutjnl-2026-338154.
Competing interests
Ludvigsson has coordinated an unrelated study for the Swedish IBD quality register (SWIBREG), which has received funding from the Janssen Corporation. JFL has also received funding from MSD/Merck for a study on Chinese Healthcare Registers and a collaboration on inflammatory bowel disease. He also has an ongoing collaboration with Takeda Pharmaceuticals on coeliac disease and on chronic liver disease. For all other authors, we refer to the publication.
