Immunogenetic Pathogenesis of Celiac Disease and Non-celiac Gluten Sensitivity.

Authors:
Celia Escudero-Hernández, Amado Salvador Peña, David Bernardo
Year of publication:
2016
Volume:
18
Issue:
7
Issn:
1522-8037
Journal title abbreviated:
Curr Gastroenterol Rep
Journal title long:
Current gastroenterology reports
Abstract:
Celiac disease is the most common oral intolerance in Western countries. It results from an immune response towards gluten proteins from certain cereals in genetically predisposed individuals (HLA-DQ2 and/or HLA-DQ8). Its pathogenesis involves the adaptive (HLA molecules, transglutaminase 2, dendritic cells, and CD4(+) T-cells) and the innate immunity with an IL-15-mediated response elicited in the intraepithelial compartment. At present, the only treatment is a permanent strict gluten-free diet (GFD). Multidisciplinary studies have provided a deeper insight of the genetic and immunological factors and their interaction with the microbiota in the pathogenesis of the disease. Similarly, a better understanding of the composition of the toxic gluten peptides has improved the ways to detect them in food and drinks and how to monitor GFD compliance via non-invasive approaches. This review, therefore, addresses the major findings obtained in the last few years including the re-discovery of non-celiac gluten sensitivity.