The external world of gluten and autoimmunity

• Published in: Gut 2001-10, Vol.49 (4), p.463-464
• Main Author: LONDEI, M
• Format: Article
• Language: English
• Subjects: Age; Analysis; Animals; Autoimmune diseases; Autoimmune Diseases - genetics; Autoimmune Diseases - immunology; Celiac disease; Celiac Disease - genetics; Celiac Disease - immunology; Comorbidity; Complications and side effects; Development and progression; Diabetes; Disease; Diseases in Twins; Environmental Exposure; Genetic disorders; Gluten; Glutens - immunology; Health aspects; Humans; Mice; Mice, Inbred NOD; Patients; Twins, Monozygotic
• ISSN: 0017-5749; 1468-3288; 1458-3288
• DOI: 10.1136/gut.49.4.463

In a simplistic way, antigens encountered on a mucosal surface trigger a Th2 (sometimes and depending on the authors Th3 or T regulatory) type of response instead of a proinflammatory Th1 response, dominant in autoimmune diseases. 4 This mucosal characteristic has been exploited to protect or even treat autoimmune diseases via induction of mucosal tolerance. 5 Some gastrointestinal diseases are associated with autoimmunity but coeliac disease (CD) has two important characteristics that make it a cut above the rest: the strongest HLA association and a single well defined trigger-gluten. 6 CD itself is a "spurious" autoimmune disease as it induces a reaction against self (antibodies against tissue transglutaminase) but this self aggression resolves on gluten withdrawal and hence strictly speaking does not qualify as an autoimmune disease. Because we can control the encounter with the environmental factor (gluten) in CD, this is an ideal condition to study the relevance of the environment in induction of autoimmunity. [...]we have to clarify why these late diagnosed patients are more prone to develop autoimmunity and how they differ compared with early diagnosed patients if we want to "make sense" of this finding. [...]functional, epidemiological, as well as genetic studies are required to unravel this puzzling question to shed light on the nature of the link between CD and autoimmune diseases and possibly to autoimmunity itself.