Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Endosc. Aug 16, 2026; 18(8): 118718
Published online Aug 16, 2026. doi: 10.4253/wjge.118718
Published online Aug 16, 2026. doi: 10.4253/wjge.118718
Celiac disease onset and inflammatory milieu
Edward J Ciaccio, Peter H Green, Department of Medicine, Celiac Disease Center, Columbia University College of Physicians and Surgeons, New York, NY 10032, United States
Randi L Wolf, Department of Health Studies and Applied Educational Psychology, Columbia University, Teachers College, New York, NY 10027, United States
Carolina Ciacci, Department of Medicine, Surgery, Dentistry, Scuola Medica Salernitana, University of Salerno, Salerno 84081, Italy
U Rajendra Acharya, Department of Mathematics, Physics, and Computing, University of Southern Queensland, Toowoomba QLD 4300, Australia
Author contributions: Ciaccio EJ conceived the review framework, developed the scientific reasoning, and drafted the manuscript; Wolf RL contributed to epidemiologic and environmental interpretation; Ciacci C and Green PH provided clinical and translational expertise; Acharya UR contributed to systems modeling and analytical structure. All authors reviewed, edited, and approved the final manuscript.
AI contribution statement: The authors acknowledge the assistance of OpenAI’s ChatGPT (GPT-5) and Google AI in editorial review and icon generation.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Edward J Ciaccio, PhD, Senior Scientist, Department of Medicine, Celiac Disease Center, Columbia University College of Physicians and Surgeons, HP 9-943, 180 Fort Washington Avenue, New York, NY 10032, United States. ciaccio@columbia.edu
Received: January 12, 2026
Revised: February 3, 2026
Accepted: July 29, 2026
Published online: August 16, 2026
Processing time: 213 Days and 11 Hours
Revised: February 3, 2026
Accepted: July 29, 2026
Published online: August 16, 2026
Processing time: 213 Days and 11 Hours
Core Tip
Core Tip: In this article, the relationship between celiac disease and the inflammatory milieu is discussed and contrasted. The effects of inflammation on disease onset and recovery on a gluten-free diet are described in detail. After thoroughly covering the published literature, we suggest a hypothesis-generating paradigm that may possibly reduce the odds of a susceptible person developing the disease, and reduce the time needed for recovery after diagnosis. The paradigm reflects biologic plausibility and emerging mechanistic evidence, rather than clinical endorsement. The growing relevance of these concepts to modern gastrointestinal endoscopic technique is then highlighted.