Controversial issues of prophylaxis of celiac disease

From the moment the modern concepts of the pathogenesis of celiac disease were shaped, the role of environmental factors in its development has been widely discussed. The interest of a majority of researchers was attracted to the potential influence of the nature of infant feeding on the risk of the disease. The authors analyzed studies published over the last 15 years demonstrating the changing perceptions of the role of breastfeeding and timing of introducing gluten-containing products in the pathogenesis of celiac disease. Results of the largest recently published controlled trials provided reliable data that it is impossible to develop oral tolerance to gluten in genetically determined celiac disease, while the risk and timing of the disease onset are primarily conditioned by the specific genotype of the patient.