New Frontiers in Celiac Disease: Genetics, Environment, Microbiome, and Precision Medicine

Celiac disease (CD) is a complex immune-mediated enteropathy triggered by gluten in genetically predisposed individuals. While the central role of HLA-DQ2/DQ8 and gluten exposure is well established, these factors alone are insufficient to explain disease onset, heterogeneity of presentation, global epidemiological trends, and variable clinical outcomes. Over the past decade, major advances have increased our understanding of CD pathogenesis.In addition to classical genetic susceptibility, new evidence highlights the contribution of different areas such as: Non-HLA genetic variants, epigenetic regulation, early-life environmental exposures, infections and antibiotic use, gut microbiome composition and function, intestinal barrier dysfunction and immune regulatory pathway. Simultaneously, new technologies such as multi-omics approaches, systems biology, advanced immunophenotyping and machine learning are providing deeper insights into disease prediction, stratification, and potential prevention strategies.This Research Topic aims to gather high-quality original research, reviews, and translational studies addressing emerging determinants and mechanisms of celiac disease, with a particular emphasis on gene–environment–microbiome interactions and their clinical implications. We welcome contributions covering, but not limited to:- Pathogenesis and Mechanisms: Novel genetic susceptibility loci beyond HLA, epigenetic and transcriptomic regulation, immune pathways driving loss of tolerance to gluten, intestinal barrier integrity and mucosal immunity and systems biology approaches to CD- Environmental and Early-Life Determinants: Infant feeding patterns and timing of gluten introduction, infections, antibiotic exposure, and microbiota modulation, environmental toxins or dietary components, epidemiological trends and population-based studies- Microbiome and Host–Microbe Interactions: Gut microbiota composition and function in CD, microbial metabolites and immune modulation, microbiome-based risk prediction, and microbiota-targeted therapeutic strategies- Biomarkers and Risk Stratification: Predictive biomarkers in at-risk populations, multi-omics integration for disease prediction, non-invasive diagnostic tools, precision medicine approaches in CD- Translational and Clinical Perspectives: Risk modeling and prevention strategies, disease heterogeneity and clinical phenotypes, refractory CD and complications, emerging therapeutic targetsTherefore, by integrating genetic, environmental, microbial, and immunological perspectives, this Research Topic should provide advances on our understanding of the complex pathogenesis of CD, the identification of novel risk determinants and modifiable factors, to promote precision risk stratification and personalized management and foster translational research bridging mechanistic discoveries and clinical application. We encourage interdisciplinary studies that combine clinical cohorts with advanced molecular and computational approaches. Topic editors: Irena Senecic-Cala, STEFANO MARTELOSSI Source: https://www.frontiersin.org/research-topics/73255/new-frontiers-in-celiac-disease-genetics-environment-microbiome-and-precision-medicine