Researchers Review the Pivotal Role of Inflammation as a Trigger of Celiac Disease

Celiac.com 02/20/2023 - Celiac disease is a condition that is caused by the immune system's response to gluten, a protein found in wheat, rye and barely. In celiac patients, an immune response triggers a pro-inflammatory environment in the small intestine, causing damage to the tissue. A major role in the pathogenesis of celiac disease is played by the HLA-restricted gliadin-specific intestinal T-cell response generated in a pro-inflammatory environment. 

A recent review article highlights the growing body of research that supports the central role of inflammation in the development of celiac disease, and how it is influenced by factors such as sensitivity to gluten and other pro-inflammatory agents. 

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The review is authored by researchers Maria Vittoria Barone, Renata Auricchio, Merlin Nanayakkara, Luigi Greco, Riccardo Troncone, and Salvatore Auricchio. The are variously affiliated with the Department of Translational Medical Science, University Federico II in Naples, Italy; and the European Laboratory for the Investigation of Food Induced Disease (ELFID), University Federico II in Naples, Italy.

Live studies on a population at risk have explored the mechanisms behind this inflammation. These studies show cellular and metabolic alterations in the absence of a T cell-mediated response, before the onset of the disease and before the introduction of gluten in the diet. Gluten exacerbates these constitutive alterations, both live and in the lab. 

The role of inflammation in celiac disease has led researchers to consider it as a chronic inflammatory disease, similar to other autoimmune disorders. 

The review also explores the crucial role played by the intestine in controlling inflammation both locally and systemically, and the impact of nutrients and gut bacteria on inflammation. 

Reduction of Early Inflammation Could Delay Onset of Celiac Disease

Celiac disease is characterized by inflammation, which plays a critical role in the onset of the disease. It begins with a pre-clinical phase where the body is set up for inflammation, making it susceptible to various pro-inflammatory agents, including gluten. Historically, research has focused on the T-cell response in celiac disease, but there is growing recognition of the importance of the pre-inflammatory state. Modulating this state with a Mediterranean-type diet or preventing intestinal viral infections could have a significant impact on the onset of celiac disease, and could be easier to manage than the more complex autoimmune response. The implications of this research extend to additional chronic inflammatory diseases including inflammatory bowel diseases and diabetes, where early intervention with the state of inflammation in at-risk subjects could have a lasting impact on their health.

Read more in mdpi.com