Wheat, barley and rye contain a protein that can produce severe intestinal symptoms in people with celiac disease, and a team of scientists at Columbia University in New York has now identified distinct signatures of immune system cells that drive the disorder.
Celiac disease is marked by turncoat components of the immune system whose proliferation is triggered by dietary, a protein found in specific grains. Ingestion of gluten by those who are predisposed to the disease leads to a heightened inflammatory state, bloating, gas, constipation and even stunted growth among affected children. As serious as those symptoms are, they're just a few on a long and complex list.
To better understand the natural history of the disease, lead author of the new research, Dr. Adam Kornberg and colleagues, examined samples of the upper small intestine of 11 patients with active celiac disease who had not yet begun gluten-free diets. The research also included an additional 19 patients with celiac disease who were previously gluten-free and subsequently re-challenged with gluten, and 17 healthy participants.
Indeed, a full repertoire of T cells is involved in the assault on the small intestine, which underlies the seriousness of celiac disease. But gluten directly induces the reprogramming of natural memory αβ and γδ intraepithelial T cells, inducing a detrimental inflammatory state in the gut. For patients in the study who received a gluten challenge—that is, consuming gluten as part of the research—the team found that it triggered a reprogramming of the key T cell subsets.
Intestinal cells are not only remodeled, their crippled state paves the way to a cascade of medical problems. These conditions can range from anemia and telltale skin rashes on the elbows, knees, torso and scalp to chronic conditions that emerge as a direct consequence of a sustained inflammatory response and nutritional deficiencies.
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